Surgeon Adopts Unique Laser Treatment To Avoid Amputation

Danbury Hospital is one of the first hospitals in the country to offer a new laser procedure that can help save people’s legs. Alan M. Dietzek, MD, the hospital’s chief of vascular surgery, is using a new excimer, or “cool” laser procedure called CLiRpath (Cool Laser Revascularization for Peripheral Artery Therapy), to help clear total obstructions of leg arteries, common in some people with diabetes and severe peripheral arterial disease.

“The CLiRpath procedure offers a highly suitable alternative to surgery for carefully selected patients; however, it does not replace surgery as the standard treatment for this condition.,” Dr Dietzek said. “In some patients, the results have been dramatic. For those without other options, CLiRpath gives them a chance to save their legs.

“Used in coronary arteries, this procedure has now been FDA-cleared for use in leg arteries and it provides vascular surgeons another minimally invasive tool for the treatment of peripheral vascular disease,” he said.

The procedure usually takes one to two hours followed by one to two days of recovery for most patients.  In most cases, hospitalization is not required and patients resume their normal activities within several days.  It is significantly less expensive compared to other treatments for blocked leg arteries and reimbursable by most insurance companies, including Medicare.

“I just wanted to be able to walk,” said Ridgefield resident Frances Hamilton. “So, I went to my internist and said ‘I’ve had it.’ He referred me to Dr Dietzek, who did the laser surgery. When I woke up, there was only a Band-Aid on my leg and now I can do whatever I want to do! It’s been a godsend for me. I anticipated feeling better and having a big zipper up my leg. I don’t even have a scar, so I can climb the stairs at the opera with my daughter in New York wearing high heels and no one would ever know that I had surgery.” 

Critical limb ischemia (CLI), the most severe form of peripheral arterial disease, is the progressive accumulation of plaque and thrombus in the arteries of the leg, resulting in obstruction of blood flow. If untreated, CLI can lead to rest pain, the development of foot ulcers, and the onset of limb loss. CLI affects approximately one million people in the United States and one million in Europe. Each year, nearly 100,000 of them on each continent have toe, foot, or leg amputations.

Developed by the Spectranetics Corp and recently cleared by the Food and Drug Administration, CLiRpath vaporizes arterial blockages that cannot be crossed by standard guidewires (small, flexible wires used to position catheters) in leg arteries, restoring straightline blood flow. With restored blood flow, there may be a greater chance that wounds can heal, limbs can be saved, and patients’ psychological and physical well-being can be improved.

The CLiRpath procedure involves two components: the CVX-300 laser unit and small CLiRpath fiberoptic catheters. The laser unit produces an intense light beam that is delivered through the catheters to a small area of tissue with great precision. The CLiRpath catheter, which is made of tiny, flexible, silica fibers — each about the width of a human hair — delivers short bursts of “cool” ultraviolet energy directly to the obstruction in the artery, vaporizing the blockage.

Physicians say the CLiRpath system will provide thousands of CLI sufferers with a new alternative in the fight against amputation.

“For severe peripheral vascular disease, this tool can, for the first time, provide an effective interventional treatment option for patients,” said Dr J. Daniel Garnic, interventional radiologist at Glendale Heart Center in Glendale, Calif. Dr Garnic participated in clinical trials using the CLiRpath system. “This is particularly important for patients facing amputation.”

To learn more about CLiRpath, talk to your doctor or call Dr Dietzek’s office at 798-6986.