LI Doctors Using Balloons to Clear Blockages from Legs

Dr. Mitchell Weinberg, director of peripheral vascular intervention for NSLIJ

November 8, 2014
LI Doctors Using Balloons to Clear Blockages from Legs

Plaque can block vessels in the legs just as it obstructs arteries feeding the heart, but doctors on Long Island have begun treating extremity blockages by way of a device coated with a well-known cancer drug.
Dr. Mitchell Weinberg, director of peripheral vascular intervention for the North Shore-Long Island Jewish Health System, described the medical problem as PAD -- peripheral artery disease. The new treatment is a form of angioplasty, which means threading a balloon-tipped catheter from the groin to the site of blockage anywhere in the leg.

The balloon is coated with paclitaxel, a drug long used to treat breast cancer and other malignancies.

"I think this is probably the most exciting time in the treatment of PAD in a decade," Weinberg said Friday. The new system, called Lutonix DCB, is made by an Arizona-based medical device company. The treatment system was approved last month by the U.S. Food and Drug Administration.
"We are taking a chemotherapeutic and putting it in the vessel wall," Weinberg said. "This is a local application of the drug without flooding the vessel and it slows the regrowth of [obstructive] cells," he said.

More precisely, Weinberg added, expanding the balloon presses the plaque to the side of the vessel wall, permitting blood to flow freely. Paclitaxel, which is on the balloon, is absorbed into the vessel in an infinitesimal amount, he said, but possesses the powerful capacity to prevent plaque regrowth.
For years, doctors have successfully used paclitaxel-coated stents to retard reblockage of coronary arteries.

PAD is a growing public health concern, according to the National Heart Lung and Blood Institute. Symptoms include leg pain while walking or climbing stairs. The condition increases the risk of heart attack, and stroke. The people most at risk are smokers and former smokers, as well as those with high blood pressure, elevated cholesterol and diabetes, institute scientists say.

Dr. Richard Matano, director of vascular surgery at St. Francis Hospital in Flower Hill, said the Lutonix system isn't the only one to address PAD with paclitaxel. Another device made by Medtronic in Minnesota and tested at St. Francis is awaiting FDA approval. That one also involves threading a drug-tipped balloon catheter to the site of blockage.

Matano said treatment with either system is not a cure-all because they do not effectively address all types of plaque, particularly long segments of the obstructions.


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