U-M's minimally invasive revascularization procedure can treat peripheral arterial disease

Henry Gibbs, 58, is a ballroom dance instructor, but he was forced to hang up his dancing shoes when a circulation condition, common among older adults, caused severe leg pain and cramping.

"My legs were so bad I couldn't do anything," says Gibbs, of Saginaw, Mich. "I couldn't walk. I couldn't cut the grass. I was a dance instructor who couldn't dance."

Gibbs came to the University of Michigan Cardiovascular Center where he was diagnosed with peripheral arterial disease, a common condition affecting about 20 million Americans.

"Peripheral arterial disease is similar in many ways to heart disease where atherosclerotic plaque builds up in the arteries of the legs," says Paul Michael Grossman, M.D., an interventional cardiologist at the U-M Cardiovascular Center.

"This can be caused by a build-up of cholesterol, can be related to risk factors such as smoking, diabetes, hypertension and having elevated cholesterol and there are genetic factors that also probably play a role in development and progression of PAD," he says.

The difference between peripheral arterial disease, or PAD, and heart disease is the blockages are outside the heart, usually in the legs. While PAD itself is not life threatening, it does greatly affect quality of life, and without proper medical management can lead to heart attack or stroke.

To answer the needs of the increasing number of people affected by PAD, the University of Michigan has started one of the country's first multidisciplinary programs devoted to managing PAD.

"We've brought together experts from multiple fields, all who are focused on the treatment and management of patients with severe peripheral arterial disease. These include experts from vascular surgery, vascular medicine, cardiology, interventional radiology and allied health care professionals who are all working together to take care of our patients," the U-M cardiologist explains.

For some patients, eliminating risk factors for PAD can help reduce symptoms. For others, medications may be added.

If those fail to improve symptoms, patients can undergo a minimally invasive revascularization procedure, such as stents or angioplasty, to clear the blockage and improve blood flow. Better blood flow can reduce or eliminate symptoms and reduce the risk for heart attack and stroke.

A recent study by the Michigan Cardiovascular Consortium showed elderly patients, even those over age 80, were no more likely than younger patients to suffer major complications or deaths after procedures to treat PAD. The elderly may no longer need to be excluded because of their age.

The U-M is the coordinating center for the cardiovascular consortium and its registry of patients who have had vascular interventions. The consortium works to improve patient outcomes with a special focus on reducing complications, and improving safety, efficacy and appropriateness of procedures.

"I'm glad I had the procedure done. My life is so much better," Gibbs says." My legs are better, I feel better, my wife feels better because I can go and do things that I couldn't do before. I feel like a new man with new legs," he says.

"I said I wanted to dance again and I'm dancing."