New stent surgery can help to avoid leg amputations

PUBLISHED : Tuesday, 10 August, 2010, 12:00am
UPDATED : Tuesday, 10 August, 2010, 12:00am

A Chinese University professor yesterday called for greater public awareness of blood vessel blockages in the leg, saying a new type of surgery could save many patients from losing limbs.

More than 30 million people worldwide have blockages that could lead to amputation, but less than half know it.

The condition, peripheral arterial disease, is similar to heart disease - when blood cannot flow through narrowed vessels to the limbs and body, tissues die.

As most patients are the elderly, they might mistake early symptoms, such as mild to serious leg cramp while walking, for normal arthritis. In more serious cases, patients develop leg ulcers. Half of the patients died in five years, and half of them needed an amputation within a year, Professor Yu Cheuk-man, head of Chinese University's cardiology division, said.

Bypass surgery is the traditional way to treat the condition, but Yu said not everyone was suitable for such large-scale surgery, particularly older people in poorer health.

He said a new type of minimally invasive procedure could save these patients. The process involves inserting a flexible and fracture-resistant metal stent into the patient's leg artery using partial anaesthesia, allowing quicker recovery. The stent expands constricted vessels to allow better blood flow and the mortality rate was 0.5 per cent or lower, Yu said. The procedure costs HK$20,000 to HK$40,000 per leg in public hospitals.

Among 35 patients who underwent the procedure from February 2009 to July this year, 27 recovered. Some of the patients' constricted vessels were as long as 30cm. The average age of the group was 73. Six died and two needed amputations, but Yu said that was because they had other chronic conditions or were referred to the hospital too late.

'Some vessels are entirely blocked, like a blocked tunnel that nothing can pass through. Earlier detection could have saved more patients,' he said.

Chinese herbalist Au-yeung, 74, was one of Yu's patients. The tissue in his left big toe was dead and orthopaedic doctors advised amputation below the knee. Instead, he had the stent procedure and has since recovered. Although his big toe still needed to be amputated, Au-yeung said he was grateful he could keep the leg.

Yu said the condition would become more common as the population aged, and that 40 to 50 per cent of people aged 80 or above could have the condition. People with hypertension, heart disease and diabetes are more likely to have the disease.