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Balloon angioplasty gets man on his feet

ALBUQUERQUE, N.M. — Donald Hoeschen loves to ski. But about four years ago, arterial disease made it increasingly painful for him even to walk.

By last year, Hoeschen found himself holding a walker rather than ski poles. A condition called peripheral arterial disease, or PED, was restricting blood flow in the arteries of his legs.

“When muscles don’t get the blood, they cramp up,” said Hoeschen, 71. “Once they cramp up, you’re toast. It stops you in your tracks.”

In December, the retired salesman became one of the first New Mexicans to receive a new treatment that uses balloon angioplasty both to clear a blocked artery and deliver a drug intended to keep it open.

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The U.S. Food and Drug Administration in October approved the first drug-coated balloon used to re-open arteries in the thigh that are narrowed or blocked by fatty deposits called plaque.

Donald Hoeschen walks dogs for a friend 20 minutes each day and spends 45 minutes a day on a treadmill. Arterial disease in his legs forced him to use a walker before treatments in December and January. (Jim Thompson/Albuquerque Journal)

Donald Hoeschen walks dogs for a friend 20 minutes each day and spends 45 minutes a day on a treadmill. Arterial disease in his legs forced him to use a walker before treatments in December and January. (Jim Thompson/Albuquerque Journal)

The Lutonix drug coated balloon is manufactured by Lutonix Inc. of New Hope, Minn.

FDA approval now allows doctors to treat PAD by using a balloon catheter to deliver a drug inside a blocked artery in the leg, said Dr. Guilherme Marin, an interventional cardiologist for Presbyterian Medical Group, who treated Hoeschen.

“It is a fantastic tool that now is part of our routine arsenal for treating peripheral arterial disease to help improve patient’s symptoms in the long run,” Marin said of the treatment.

Hoeschen, who received two such treatments Dec. 15 and Jan. 3, is among five New Mexico patients treated with the drug-coated balloon catheter at Presbyterian, the first Albuquerque hospital to offer the procedure.

Balloon angioplasty long has been used to re-open blocked or narrowed blood vessels. A collapsed balloon is placed inside the blood vessel using a wire, then inflated to re-open the blockage.

A study in the U.S. and Europe showed that the drug coated balloon was more effective than conventional balloon angioplasty in preventing arteries from forming scar tissue and re-closing, the FDA said in a written statement.

Some 8 million people in the U.S. have PAD, including at least 12 percent of people ages 60 and older, according to the U.S. Centers for Disease Control and Prevention.

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Hoeschen experienced the classic symptoms of PAD – pain and cramping while walking. In severe cases, PAD can lead to muscle atrophy, non-healing sores and even loss of limbs.

Treatments range from measures to limit risk factors, such as quitting smoking and controlling high blood pressure and diabetes, to surgical interventions, including stents and bypass surgery.

A stent is a wire-mesh tube used to hold open a blood vessel. Bypass surgery redirects blood flow to avoid a blocked artery.

Hoeschen said he received two stents – one in each leg – and by-pass surgery several years ago, but symptoms quickly returned.

The U.S. Food and Drug Administration this past fall approved the Lutonix 035 drug-coated balloon catheter to treat, among other things, arterial problems in the leg.

The U.S. Food and Drug Administration this past fall approved the Lutonix 035 drug-coated balloon catheter to treat, among other things, arterial problems in the leg.

The new therapy offers advantages over existing treatments, Marin said.

“A conventional balloon opens up the blockage and the artery and improves blood flow that way,” he said. But scar tissue commonly causes blockages to reoccur.

The new technique delivers a drug called paclitaxel, which has been shown to reduce the formation of scar tissue.

“That’s the beauty of the paclitaxel delivery. Not only are you able to relieve the obstruction at first, but you also medically increase the likelihood that area is going to stay open in the long run,” Marin said.

The balloon also eliminates the use of stents, which leave hardware inside the body that sometimes need to be surgically removed, he said.

For now, the FDA has approved the technique only for use above the knee. Marin said he expects future research to develop balloons that can be used in the smaller blood vessels below the knee.

Hoeschen said he is pleased with the results so far.

“I don’t need to use a walker at all anymore,” he said. Today, he walks 45 minutes a day on a treadmill. He also walks a friend’s dogs 20 minutes a day. “I walk with a vengeance.”

Best of all, Hoeschen has a ski trip planned in early March.

“I live for skiing,” he said.


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