“Losing a leg brings great physical, emotional and psychological consequences,” said Rosales. “Our study proved this innovative technique can be effective in preventing amputations.”
In laser-assisted angioplasty, the cardiologist makes a small incision in the groin opposite the affected leg and runs a narrow catheter, or tube, across to the blocked artery.
A small laser device is placed on the end of a guide wire and threaded through the tube to the point where the obstruction begins. Energy directed from the laser vaporizes the plaque clogging the artery. The cardiologist gradually extends the laser and repeats the process until the artery is opened and blood flow restored.
After a path is cleared by the laser, Rosales and his team perform balloon angioplasty and place stents as needed to keep the vessel open.
Laser-assisted revascularization can prevent the need for surgery in many cases, but as Rosales explained, open surgery may still be necessary in severe instances of peripheral artery disease. “Sometimes, you can’t even see where the old vessel was. You don’t have a path to follow.”
Such was the case with Rosa of Houston, a 68-year-old mother of 10 who experienced blockages in both legs. “I couldn’t walk that much. I had to sit down and rest,” Rosa recalls. “My legs were just constantly in pain.”
While the laser technique was able to restore adequate blood flow to her left leg, her right leg required surgery. Now that she’s back on her feet, she sometimes experiences pain in the right leg but has no complaints about the left one.
Rosa is diabetic, a condition that often causes problems with legs and feet, and many of the patients in Rosales’ study experienced even more advanced complications.
People with diabetes, chronic high blood pressure or coronary artery disease often develop sores on their legs and feet. Blocked arteries can prevent these ulcers from healing properly, which can lead to amputations.
The trial Rosales conducted at Memorial Hermann-TMC involved 25 patients for whom traditional techniques had failed. Many of them had non-healing ulcers on their legs and feet. Of those studied, 22 avoided amputation, 18 of them without additional surgery.
Follow-up treatment in the Memorial Hermann Wound Care Center plays a vital role in recovery for many patients. “Wound care is essential,” Rosales stressed. “Sometimes, we prescribe hyperbaric oxygen therapy to speed the healing of ulcers.”
Fortunately, neither Rosa nor Robert developed ulcers, but they could have faced serious consequences if the blocked arteries in their legs had not been properly treated.
The minimally invasive laser technique used by Rosales gets patients back on their feet within a day or two, and both Rosa and Robert can attest to the long-term effectiveness of the procedure.
“I’ve had no recurrence of problems in my legs at all,” said Robert, who underwent the laser procedure three years ago. “I was playing tennis within a week without any discomfort.”
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