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A New Treatment for Peripheral Arterial disease (PAD)

There is a new minimally invasive treatment called SilverHawk® that is very effective at removing fatty deposits, also known as plaque, which can build up on the inner linings of artery walls in a person’s legs.  This buildup of plaque in the arteries is called peripheral arterial disease, or PAD, which can increase the risk of heart attack, stroke, amputation, or death if left untreated.

The Plaque Excision Procedure

Plaque excision is a minimally invasive procedure performed through a small puncture site in the leg or arm. The SilverHawk® technology uses a tiny rotating blade to shave away plaque from inside the artery. As it is shaved off, the plaque collects in the tip of the device and then is removed from the patient.

Plaque excision has helped alleviate severe leg pain for thousands of patients, and in many cases it has successfully saved the legs of patients who were scheduled for limb amputation after other treatments failed.

How Plaque Excision Works

1. The SilverHawk catheter is inserted into the body through a small puncture site. The doctor pushes it along inside the artery until it reaches the site of the blockage.

2. Once the SilverHawk catheter is at the site of the blockage, a tiny rotating blade is activated. As the physician advances the catheter through the blockage, it shaves plaque off of the artery walls.



3. The plaque collects in the nosecone (tip) of the catheter and then is completely removed from the body. The physician may need to repeat these steps until enough plaque is removed to restore normal blood flow to the legs.

The SilverHawk® Plaque Excision System catheter

Precise and Predictable

Through a unique hinge design, the carbide blade is exposed at a fixed height during the procedure. This fixed height ensures that the plaque shaved off the artery’s walls are thin enough to be easily stored in the end of the device. The catheter is made of materials that allow surgeons a clear view of the blade and collection chamber during the procedure.

Massive Tissue Capture

		The SilverHawk is the first technology of its kind to remove significant amounts of atherosclerotic tissue (plaque) from long, diffusely diseased lesions. When the nosecone is full, the device can be removed, cleaned, and re-inserted to treat additional areas within the same lesion or additional lesions. The device consistently removes hundreds of milligrams of tissue to restore blood flow.
Atherosclerotic tissue (plaque) removed from an artery by the SilverHawk catheter.

Safety

Due to its unique design, the catheter removes significant amounts of plaque without overstretching and injuring the blood vessel. Vessel overstretch, known as barotrauma, can lead to a dangerous tear in the artery.
		A physician empties the SilverHawk catheter.

Risk Factors

Researchers have identified several risk factors that can be attributed to the development of PAD:

Diabetes

• There are 20.8 million children and adults in the United States who have diabetes.
• Diabetes mellitus increases the risk of lower extremity PAD by two- to four-fold.

Age

• The incidence of PAD increases with age, and affects approximately 20% of the U.S. population over age seventy.
• Due to an aging population, the estimated number of people with PAD is expected to grow to more than 17 million in 2010 and more than 22 million in 2020.

Smoking

• Smokers have three times the rate of intermittent claudication as non-smokers and are diagnosed on average ten years earlier.

Coronary artery disease (CAD)

• Clinical evidence of coronary artery disease almost triples the risk of intermittent claudication.

Additional risk factors include hypertension, high cholesterol, obesity, family history, and African American or Hispanic ethnicity.

Critical Limb Ischemia

If left untreated, PAD can progress to critical limb ischemia (CLI), which occurs when there is not enough oxygenated blood being delivered to the leg to keep the tissue alive. An estimated 1.5 to 2 million people in the United States and Europe suffer from CLI, which occurs when symptoms of PAD—including pain, non-healing wounds, tissue loss, or gangrene—become more severe.

When CLI develops, it can lead to constant pain and even amputation of toes, feet, and/or part of the leg. Within one year of the onset of CLI, 25% of patients will die and another 25% will require major amputation. Last year, over 150,000 amputations were performed in the U.S. and Europe, with a 40% mortality rate at two years post-amputation.

Other PAD Treatment Options

In the past, treatment options for PAD have included exercise therapy and medication. Other options have included bypass surgery and minimally invasive procedures such as angioplasty, which clears a channel in the artery for blood flow by pushing plaque up against the artery walls with a balloon.

To Obtain a Referral

If you are interested in the SilverHawk procedure ask your doctor if he or she believes it would be an appropriate treatment. Endovascular surgeon William Su, MD, performs the procedure at  Washington County Hospital. To schedule a consultation, call Dr. Su’s office at: 301-714-4335.

Free Screenings for PAD

The clinicians at Washington County Hospital regularly perform screenings for PAD.  For more information or to schedule an appointment, please call 301-790-8627.

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