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Americans, especially Baby Boomers (born between 1946 and 1964), should be aware of the increased incidence of peripheral vascular disease—the narrowing of blood vessels outside of the brain and the heart—which result in circulation blockage and if untreated can lead to severe pain or the need for amputation.  Peripheral vascular disease most prevalent in older adults and is a common worldwide problem; currently 10 million Americans are affected.

Symptoms can include pain and aching in the lower extremities with walking or any exercise; pain in the feet
or lower extremities at rest; or on occasion, development of sores or gangrene of the feet. One of the most common sites of this disease is the femoral popliteal segment (the arteries extending from the groin to
the knee).

A mid-term study presented at the 60th Annual Meeting of the Society for Vascular Surgery indicates that minimally invasive surgery for peripheral vascular disease in blocked thigh arteries may be a feasible alternative to surgical bypass. “We found the newer technique resulted in reduced pain, a shorter hospital stay, faster recovery and a quicker return to daily activities,” said lead author John C. Kedora, MD, a surgical resident at Baylor University Medical Center in Dallas. “There also was less cost overall, which saves an unprecedented amount of money in medical care both for the individual and for the medical community.”

“Previously surgeons used the more invasive surgical bypass to treat diseased thigh arteries. Typically two incisions were required, one at the groin and one at the knee. The procedure also usually required general anesthesia and multiple days in the hospital,” said Dr. Kedora. “The recovery period was from four to six weeks. For the last few years newer endovascular approaches have been utilized, where angioplasty (using an inflated balloon to open the passage) or a stent (reinforcement device) is placed within the area of blockage.”

Dr. Kedora noted however that long-term results with the previous type of therapy has been disappointing, with many patients having recurrent disease and symptoms within six months to one year of treatment. In addition, the length of artery to be treated was generally confined to a segment of less than three centimeters in order to hopefully provide the best results.

“In the last two years, longer arterial segments have been treated through a needle hole, without general anesthesia and with no overnight stay in the hospital,” said Dr. Kedora. Our study looked at one of the newest devices, which includes a stent with a covering of material called polytetrafluoroethylene. “A balloon was used to dilate the blocked segment and the stent was inserted. This allowed the return of blood through the new "tube" placed within the artery.

“These devices have been effective and thought to be equal to the previous surgical bypass, but until now were never directly compared to patients that had actually undergone bypass,” he said. “We studied 86 patients (100 limbs) in two groups, who either received a surgical bypass or the endovascular percutaneous stent treatment. After 12 months we found no statistical difference between either group or functions. The success rate was 75 percent for patients obtaining the minimally invasive treatment and 83 percent for those who had a bypass. Thirteen patients in each group had a secondary procedure to maintain continued arterial flow; the overall success rate after these procedures was 86 percent for the less invasive treatment and 90 percent for the surgical treatment."