Rerouting blood from blocked arteries to veins may prevent leg amputation, UH study finds

Doctors at University Hospitals (UH) believe a procedure they have developed has the potential to offer thousands of patients hope to retain their limbs.

In a study of 105 people just published in the New England Journal of MedicineUH doctors said an experimental new therapy called transcatheter materialization has helped about two-thirds of their patients most at risk for amputation keep their leg.

An estimated two million Americans have a vascular disease so severe they could lose a limb, according to UH.

For some patients with advanced poor circulation in their limbs, current medical therapies to restore oxygen flow do not work, and an above-ankle amputation is required to save their lives.

Dr. Mehdi Shishehbor, president of the Harrington Heart and Vascular Institute at UH, said those who cannot be helped by bypass surgery or endovascular revascularization procedures make up 20 to 30 percent of his patients. But he said a newly discovered procedure can bypass blocked arteries in the leg and circulate blood through the veins to the foot.

“We will treat the veins that are not diseased and make the veins become an artery and supply blood, oxygenated blood to the foot to heal the wounds,” Shishehbor said.

The procedure has improved outcomes for the majority of his patients, who would otherwise have had to resort to amputation, he said.

“It’s amazing because hope has arrived,” Shishehbor said. “Seventy-six percent of the time by using this technology, we can save their limbs and allow them to regain their quality of life, to be able to enjoy their life, to wear a regular shoe, to be able to go to work.”

Not only does the procedure save his patients from the psychosocial implications of amputation, it saves lives, he said. Nearly half of all patients with vascular disease will die within five years of amputation, Shishehbor said.

He said the study included a diverse group of patients. Almost half were black, Hispanic or Latino because, according to Shishehbor, non-white people are at disproportionate risk of amputation compared to white patients.

He hopes this will lead to FDA approval, but said the UH Heart and Vascular Institute will continue to use the therapy in a new trial now underway.

The study was funded by LimFlow, which developed the procedure.