KARACHI, June 23: Leg claudication, or difficulty in walking, a condition experienced by cardiac patients who may have been implanted with stints must neither be overlooked by concerned individuals nor by their surgeons as there could be every possibility of stint fractures and, or gangrene. Dr Syed A Mahmood, director for cardiac, Cath Lab and Interventional Cardiology, Sinai Grace Hospital, Wayne State University, USA, in a presentation “Cryoplasty for Leg Claudication” at the National Institute of Cardiovascular Diseases (NICVD) here on Thursday mentioned Cryoplasty to be extremely beneficial in preventing a wide range of complications, most importantly amputation of legs.

According to him the new emerging technique, approved only one and a half years back by the Food and Drug Administration (FDA), has been vigorously used in the United States and has efficiently addressed the problem with regard to rescindment of stint.

Closure of stint is registered to be 15pc to 30pc on an average and at times could be as high as 50pc in patients during first year of angioplasty, the cardiac surgeon said, adding that this could be avoided through application of cryoplasty.

It was observed with concern by cardiologists present on the occasion, including Prof Azhar Masood A. Farooqui, that the issue was largely ignored in Pakistan and patients reported only when doctors were generally left with no option but leg amputation.

Dr Syed A. Mahmood advised frequent questioning with patients regarding their comfort or discomfort level in context of mobility, particularly in terms of pace of walk, distance and duration following the procedure.

He mentioned that focus in the US was on preventing impairment besides containing wound cost and above all improved life quality, the guest speaker said.

At the very onset of his presentation, he said the polarcath tm Peripheral Dilatation system was indicated for femoral arteries, popliteal arteries, lilac arteries and even native fistulae.

He reminded that implantation of stint is witnessed in 25pc of the cases related to cardiovascular diseases and 50pc in context of interventions related to coronary arteries.

The expert mentioned that stinting of femoral pephilactic disease may achieve improved acute results, but late outcomes were still sub-optimal.

As for Cryoplasty, he said claudication input from baseline had been proven to 84pc while clinical potency was registered to be 82.6 per cent. Answering a question about application of cryoplasty

in the coronary artery, he said it was not being done and somebody was yet to pick it up.

Dr Azhar Farooqui later told APP that the speaker would be invited to conduct workshops on the very recent technique for local cardiac surgeons during the 17th Biennial Conference of Pakistan Society of Cardiologists scheduled for December. — APP