New Treatment For Peripheral Vascular Disease

Yale-New Haven Hospital was the first hospital in Connecticut and only the second hospital in New England to offer CryoPlasty, a new type of treatment for peripheral vascular disease (PVD) designed to unclog narrowed arteries using a method that simultaneously cools and dilates the affected blood vessels.

“We have many reasons to believe this new type of treatment is much more effective and promising in combating the debilitating problems of clogged arteries,” said John Aruny, MD, co-director of the Yale Endovascular Center at Yale-New Haven Hospital.

“Many patients who suffer from PVD do not suffer or experience any symptoms, with physicians believing that many patients attribute their pain to either arthritis or old age,” explained co-director Bauer Sumpio, MD. “For some people, however, even walking one city block can be extremely painful. The pain in the legs is often unbearable and can resume immediately following a period of rest with even minimal exercise.”

According to Dr Sumpio, these patients often are prescribed to increase their exercise program to improve their cardiac health. However, leg pain prevents them from being able to follow these orders, resulting in poorer cardiac health and therefore, not able to reach their cardiac fitness goal.

With CryoPlasty, an angioplasty balloon is filled with liquid nitrous oxide, which evaporates into a gas upon entering the balloon, causing it to expand, dilating the vessel and cooling it to 14 degrees F or 10 C. This causes several physiological reactions that open the artery while doing less damage than standard interventional therapies. The plaque clogging the artery cracks when it freezes, allowing for a more uniform dilation of the blood vessel than in regular angioplasty. The cooling also prompts programmed cell death, a natural occurrence that minimizes the growth of new scar tissue that occurs in response to injury caused by the stretching and tearing of the vessel wall that occurs with conventional therapies.

Dr Sumpio said early trials have shown that nine months after treatment with CryoPlasty, 85 percent of treated clogged leg arteries remain open. The procedure itself is virtually painless and often can be done with the patient returning home the same day. Relief of symptoms may be immediate.

Balloon angioplasty is often the first prescribed treatment for patients with clogged leg arteries because it is minimally invasive and cost-effective. In arteries below the hip, however, restenosis (reclogging) has a high recurrence rate.

“With nearly 40 percent of those patients treated with angioplasty or stenting needing treatment again, we believe that CryoPlasty and its potential for inactivating the cells that produce the scar of restenosis and reducing the number of patients needing revascularization to 15 percent is a significant improvement and huge benefit for patients,” said Dr Aruny. “With significantly less trauma to the blood vessels and potentially avoiding a return of the obstruction, we are confident this new treatment will be the method of choice for patients afflicted with PVD.”