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Tiny Razor Cleans Out Leg Arteries

Doctors Using a Razor the Size of a Grain of Rice Are Cleaning Out Clogged Leg Arteries

By LAURAN NEERGAARD AP Medical Writer

The Associated Press

WASHINGTON Oct 31, 2005 — Doctors using a razor the size of a grain of rice are shearing ribbons of yellowish sludge from inside clogged leg arteries.

It's the latest therapy for a hard-to-treat disease that slowly chokes off blood flow in millions of people's legs. And the shavings it extracts are more than icky evidence of illness: A drug giant is buying this plaque for research on how to keep arteries from clogging in the first place.

Peripheral artery disease, or PAD, afflicts at least 12 million Americans as their leg arteries stiffen and narrow. Eventually, the lack of blood flow to muscles causes an aching pain while walking, called claudication. In severe cases, patients can hobble no more than a block or two.

Worse, PAD leads to about 150,000 amputations a year as arteries become completely blocked.

More than mobility is at stake: Having PAD increases the risk of a heart attack or stroke sevenfold if leg arteries are clogged, other blood vessels almost certainly are, too.

Yet trouble walking often is wrongly considered a sign of aging instead of disease, meaning too few patients seek help early.

Clogged legs can be harder to alleviate than clogged heart arteries. Balloons threaded inside arteries, called angioplasty, to push aside the plaque and the use of scaffolding-like metal stents to hold arteries open don't work as well in the legs, where "restenosis" or reblockage with scar tissue or new plaque can occur quickly. The final option is a leg bypass, open surgery to reroute blood flow around the blockages.

Two new technologies offer the hope of better alternatives:

The tiny razor, called the SilverHawk, is threaded in a catheter through patients' arteries to the blockages. Then the blade emerges and begins shaving; plaque collects in the device's tip for extraction.

In a registry tracking 335 patients for a year so far, 79 percent have needed no further treatment of the shaved-out areas, lead researcher Dr. Roger Gammon of Austin, Texas, announced at a major heart meeting last month. The razor even is credited with saving some particularly severe patients from imminent amputation.

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