Dr Guy Mayeda speaks about Peripheral Vascular Disease and the Silverhawk Excision System
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Female Speaker: Welcome to GoodSam TV, Good Samaritan Hospitals medical podcasting channel. In this episode Dr. Guy Mayeda will talk about an alternative treatment to Peripheral Vascular disease called as the SilverHawk Plaque Excision System. Dr. Guy Mayeda: Peripheral Vascular disease of the legs basically is due to loss of circulation due to blockage of the arteries in the legs and due to plaque mostly cholesterol plaque, which accumulates in the arteries over the time and then it inhibits blood flow to the lower extremities. Probably only about a quarter of the people with Peripheral Vascular Disease are actually diagnosed with the disorder, so it's still a largely diagnosed disease in the United States and last year approximately 150,000 people in the United States underwent amputations of lower extremity of the legs due to Peripheral Vascular Disease. Most of the procedures to open up blocked arteries in the cath lab up today has been using balloons, we call angioplasty similar to what we used in the heart and also stents which are metal tubes which expand inside the artery to hold it open, similar to what we use to treat coronary artery disease in the heart. The SilverHawk device is a newer type of device which actually goes in and removes the plaque from the arteries. So rather than compressing the plaque open to create a large-lumen or channel for blood to flow, we go in with this particular device, it's called an atherectomy, where we shave the plaque out and the plaque is collected inside the device and then removed. The procedure in the cath lab will vary anywhere from half an hour to we have had procedures as long as 6 hours in the cath lab, it depends on how much disease or blockage there's and how complex the disease is in the arteries. We've been able to more recently open up blocked arteries with this device that were 100% blocked where there was no flow at all and in that type of situation the procedure obviously so much longer. This device is a completely different approach in terms of opening up the arteries. One of the benefits of this particular procedure is the plaque that we take out of the artery, now can be used as a research tool or something to be studied and we're using this data to look at from a pharmacological standpoint to see target to help us develop medications to regress or decrease the atherosclerosis in patients with atherosclerosis and also to hopefully prevent atherosclerosis from forming in patients who are at risk. It's been very a useful tool in the catheterization laboratory. I think a lot of patients in the past who would have undergone amputations for untreatable disease are oftentimes now candidates to have the artery opened up. We have been able to avert or abort amputation in several patients. Right now as a co-director of the Transfusion Free Medicine Program in conjunction with Dr. Leo Orr and we're treating patients in this, or refer to Good Samaritan Hospital for Transfusion Free Medicine and Surgery Center. It's kind of a team effort. So this program originally was developed in conjunction for patients with cardiac disease or coronary artery disease, whom we referred for bypass surgery and originally it was almost unheard of patients to undergo open-heart surgery without a need for blood transfusion. Over the last 10 years now the treatment for coronary artery disease has evolved such that most patients do not require bypass surgery and as an interventional cardiologist my role for patients who are referred here for coronary artery disease is to evaluate to see them to see if they can be treated with less invasive types of procedures such as be an balloon angioplasty, stent, atherectomy of coronary arteries, and avoid bypass surgery or sometimes even in patients who do need to have bypass surgery we will treat them with less invasive procedures like angioplasty or stents to stabilize them enough so that they can be treated by Dr. Orr to get their blood counts up to highe
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