NewDiamondback Procedure Provides State-of-the-Art Hope for Clogged Arteries

SHELBY - A vascular procedure offered at Cleveland Regional Medical Center may save patients, particularly those with diabetes, from undergoing extensive surgery and, in extreme cases, possible amputation due to poor blood circulation.

For more than six months, Andrew Taylor, MD, and Doug Hobson, MD, vascular surgeons in Shelby, have been using the Diamondback 360? - a tiny diamond-tipped blade that rotates within a clogged blood vessel breaking up hardened plaque. “This is one of the newest devices on the market,” Dr. Taylor said. “This procedure, called an incisional atherectomy, restores blood flow to the leg and in many cases saves the lower limb from amputation.”

More than 12 million people in the U.S. suffer from peripheral artery disease (PAD), a hardening or narrowing of the arteries that supply blood to the legs. If the arteries in the legs are clogged, it could mean similar problems in the arteries supplying the heart and brain. In fact, persons with PAD are six times more likely than others to die of a heart attack or stroke at some time within the next 10 years.

“PAD is a very common disease, particularly in people who smoke and those with diabetes,” said Dr. Hobson. “The most common symptom of PAD is pain, similar to cramping in the calves, hips or thighs during exertion. The pain, caused by ischemia or inadequate blood flow, can occur anywhere in the lower limbs.”

When muscles are being used, they need more blood flow. If there’s a blockage due to plaque buildup, the muscles won’t get enough blood during exercise to meet their needs and that’s what causes the pain, which is called “intermittent claudication.”

The other symptoms, including thickened nails and loss of hair on the feet and lower legs, are also a result of poor blood circulation.

Without good circulation, infections, ulceration, and even gangrene can develop in the limbs. This is the most common condition leading to leg amputation. But the Diamondback has proven to be a successful treatment for persons with PAD.

The Diamondback procedure, performed in CRMC’s Vascular Surgical Suite, doesn’t require an incision. “It’s just a needle stick,” Dr. Taylor said. “A catheter is inserted into the artery and it’s guided to the blockage.”

The blade, covered in very fine diamond dust, spins rapidly inside the leg artery, grinding away at the plaque. Diseased tissue provides resistance, allowing the blade to “sand” the plaque. With healthy tissue being more elastic, it gives way to the blade, cutting the risk of artery perforations and dissections.

“The resulting particles are smaller than blood cells, making clots unlikely,” Dr. Hobson said. “These particles eventually get filtered out of the body.”

This outpatient procedure means most patients are back to normal activity by the next day.

Drs. Taylor and Hobson perform many other “minimally invasive” vascular procedures including angioplasty and stenting of the blood vessels to treat PAD, but “Cleveland Regional is the first hospital in Western North Carolina to offer this particular procedure,” Dr. Taylor said.

The traditional treatment for PAD included open surgical bypass, which meant a multiple-day stay in intensive care for patients, significant blood loss and increased risk of heart damage.

Since 2007, the Diamondback 360° has helped treat more than 9,000 patients nationwide and is quickly becoming a first-line therapy for saving limbs and lives in the battle against PAD.

If you think you have PAD, talk to your personal physician for a referral to a vascular surgeon. For more information on vascular services please call Johnny Stamey at 980-487-3654.

Symptoms of PAD include:

- Pain, cramping, numbness or fatigue in the leg that comes on with physical activity and is relieved with rest.

- Pain may eventually persist even at rest. When it occurs in bed, it can sometimes be relieved by dangling the leg down the side of the bed.

- Cold feet year round

- The skin on your feet and legs has lost its normal healthy hue, and you often develop sores that are slow to heal

- thickened nails and loss of hair on the feet and lower legs

PAD also can present without symptoms and then it’s diagnosed through the ankle-brachial index. This is a simple test measuring blood pressure at the ankle compared to that of the arm. Lower systolic blood pressure in the ankle is an indication of peripheral vascular disease.

Lifestyle changes to lower risk:

- Stop smoking and remove yourself from the presence of second-hand smoke
- Moderate exercise such as brisk walking
- Lose weight
- Controlling diabetes

“Providing care in a personalized, compassionate manner.” For more than 85 years, Cleveland Regional Medical Center (CRMC) has served the healthcare needs of Cleveland County and the surrounding region. The 241-bed Joint Commission accredited medical center consistently places an emphasis on quality, state-of the-art medical technology and an abiding concern for providing care in a personalized, compassionate fashion. Backed by Carolinas HealthCare System, Cleveland County HealthCare System also consists of the 102-bed Kings Mountain Hospital, the 120-bed Cleveland Pines Nursing Center and the 60-bed Crawley Memorial Hospital in Boiling Springs.