News Feature | June 9, 2016

Innovative Technology Helps Allegheny Health Network Doctors Treat PAD

Christine Kern

By Christine Kern, contributing writer

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Highmark Health’s VITAL Innovation Program and AHN bring capability to the Pittsburgh market.

Peripheral  Artery Disease, or PAD, is a disease in which plaque builds up in the arteries that carry blood to the head, organs, and limbs. While it is most common in the legs, it can also attack the arteries that take blood from the heart to the head, arms, kidneys, and stomach, making it a serious and often life-threatening condition. The condition affects nearly 20 million adults annually in the United States.

Now, a team of cardiovascular surgeons at Allegheny General Hospital (AGH), part of Allegheny Health Network (AHN), has become the first in the region to use new technology to provide relief for people suffering from peripheral artery disease (PAD). Together, Highmark Health’s VITAL Innovation Program and AHN have introduced the technology to the Pittsburgh market.

Until recently, treatment of PAD relied on the use of X-ray and a touch-and-feel approach by physicians to guide their way through the arteries to the area of obstruction. The approach developed by Highmark Health’s VITAL Innovation Program and AHN uses an advanced imaging tool called optical coherence tomography (OCT), developed by California-based Avinger, allowing physicians to navigate through arteries more effectively and safely to remove blockages and achieve the best possible outcome for the patient.

“Previously, the way we treated PAD with catheters was a bit like driving down your street in the dark,” said Satish C. Muluk, MD, Director of the Division of Vascular Surgery and Vice Chair of the Department of Thoracic and Cardiovascular Surgery at AHN. “You might know where you’re going, but you can’t see everything along the way. Using Ocelot and Pantheris, however, is like turning on the headlights.

“We now have the ability to clearly see our way through the artery. This means there is less risk of damaging the artery walls, which can lead to an aggressive healing-and-scarring process that increases the risk of restenosis, or a re-narrowing of the artery after treatment.”

Physicians use recently FDA-approved Pantheris to see and remove plaque simultaneously during an atherectomy, a minimally invasive procedure that involves cutting plaque away from the artery and clearing it to restore blood flow. To clear a complete blockage of the artery, known as a chronic total occlusion (CTO often common in older patients, AGH vascular surgeons can now use the Ocelot catheter.

“We’ve successfully treated CTOs with the Ocelot catheter that we otherwise would not have been able to manage interventionally,” said Bart Chess, MD, an AGH vascular surgeon. “With some patients, we will use the Ocelot catheter in conjunction with Pantheris. If there is not a total blockage, then we may only need to use Pantheris.”

A 130-patient clinical trial of the Pantheris device demonstrated a vessel restenosis rate of only 8 percent and no vessel perforation, clinically significant dissection or late aneurysm.