UNMC researchers get $3.5 mil grant to fix failing stents
August 11th, 2015
Peripheral Arterial Disease, or P.A.D., affects millions of Americans. But the treatment of the disease is far from perfect, or for that matter, effective. KVNO’s Brandon McDermott reports on new research from the University of Nebraska Medical Center, and what it could mean for people living with P.A.D.
“It just progressively got worse and worse to the point of tears and waking up in the night unable to control the pain anymore. “
Donna Woodworth has Peripheral Arterial Disease, a condition where plaque builds up in the arteries of your arms and legs, causing blockages. It can lead to amputation and even death in rare cases. One in twenty Americans have P.A.D. Most of those people are over 50.
There are several treatments for P.A.D., the most common of which is inserting a stent, a tiny tube like device doctors use to keep an artery open after the blockage is removed.
However many stents end up failing. Unsatisfied with the current treatment options, the National Institutes of Health awarded the University of Nebraska Medical Center a $3.5 million grant, to find out why stents keep failing.
Dr. Jason MacTaggart is one of the researchers named in the grant. He says physicians try to help P.A.D. patients in numerous ways before thinking about surgery; from thinning the blood with aspirin to controlling blood pressure. Exercise and quitting smoking are also good orders to follow to prevent P.A.D.
“The fact that there is so many different types of treatments to manage this particularly issues, speaks to the fact that there isn’t one that is dominant and good for everyone,” Dr. MacTaggart said.
For years, doctors had to rely on bypass surgery to treat P.A.D., which included large incisions on the leg, cutting the artery open and rerouting the blood through plastic or a patient’s vein- a serious surgery which led to many patients dying on the operating table.
Now, physicians typically use what’s called balloon angioplasty, Dr. MacTaggart explains:
“Threading a little wire and tube, through a blocked artery getting out through the other end where it’s usually still open a little bit. Then you blow up a balloon and stretching the artery out and compressing the plaque on the other side. When you take the balloon out it allows flow back through to where the blockage once was.”
Woodworth has had both balloon angioplasty work done and stents put in since being diagnosed with P.A.D. a year ago. But her symptoms went undiagnosed for nearly three years. When she got her first stent in her leg, she says the difference was immediate.
“I had no problem walking over here. I had no problem from the office to down the hall here. Last year in January, before this all started, there was no way I could have done that.”
She says even though she hasn’t had a problem with the stents, she is concerned.
“Yeah, I’m fearful of it blocking or something going wrong,” Woodworth said. “But hopefully the advancements that continue to be made with medicine will handle that.”
Advancements like the ones being made by Alexey Kamenskiy, a biomedical-engineer and Dr. MacTaggert’s research partner. He’s using donated tissue and cadavers to study to find clues about why most stents end up failing.
‘So essentially what we are trying to do, is to combine engineer approaches to see how the artery is bending , twisting and longitudinally contracting during limb flexion,” Kamenskiy said.
Kamenskiy says much like a set of headphone wires that tangle and short out, stents are susceptible to getting tangled too, so to speak.
“One of the experiments we are doing is we are trying to understand how exactly the artery is bending and twisting. What kind of motions the artery goes through when we bend the limb during walking.”
From a structural engineering standpoint, meaning how stents are put together, Kamenskiy says researchers need to start with the basics.
“Because in order to design a better device you need to understand the environment in which this design needs to function.”
This collaborative effort between medicine and engineering will, according to Dr. MacTaggart, help researchers develop a more effective and lasting treatment for people suffering with P.A.D.
“This is going to open the door for additional patients to be helped and the ones we are already able to help I think it’s going to hopefully make their surgeries go a lot further than they do now. You can open an artery up and suddenly the next day, they can walk. I just had a patient who was able to go visit his daughter in Asia and walk around and see the sights. If we hadn’t opened his arteries up with stents, he would’ve been waiting for the rest of his family on the bus.”
Along with helping people stay active, Dr. MacTaggart says if stents could work better and last longer, doctors could give patients, like Donna Woodworth, more peace of mind.
Some risk factors for P.A.D. include diabetes, smoking, high blood pressure, high cholesterol, obesity, and aging. For the grant, UNMC has received organ and tissue donations from Nebraska Organ Recovery System.
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