Peripheral Therapeutic Catheter

Arterial occlusion treatment - peripheral therapeutic catheter - Dr. Hossam El Mahdy

Peripheral therapeutic catheters are used in cases of leg vein occlusion caused by atherosclerosis and reduced blood flow to the limbs. This may lead to difficult healing of wounds and ulcers, as well as tissue loss and death, as occurs in the advanced stages of gangrene.

What is peripheral arterial occlusion and what are its causes?
Peripheral arterial occlusion is a common result of atherosclerosis, which leads to poor circulation in the lower limbs. The global population with peripheral arterial disease is estimated to be more than 200 million, and this number has increased by more than 20% over the past decade.

If the blocked arteries that are supposed to supply the body with blood and oxygen are left untreated, the accumulation of excess fat and cholesterol will lead to serious health problems. Many factors contribute to fat accumulation, including:
• Unhealthy diet.
• Lack of exercise.
• Smoking.
• Diabetes.
• Aging: infection rates rise from about 5% in individuals between the ages of 40-50 years to nearly 20% in people at the age of eighty years.
• Having a family history of hypercholesterolemia, hypertension or peripheral vascular disease.

What are the complications of peripheral vascular disease?
Complications of occlusion of blood vessels are often caused by low or absent blood flow. These complications may include:
• Severe pain in the affected limbs.
• Restriction of daily movement due to the patient's feeling of pain or discomfort.
• Poor wound healing and thus ulcer formation.
• Amputation of a limb.
• Stroke, which is 3 times more likely in people with peripheral arterial occlusion.
Therefore, patients with blocked blood vessels need to follow a strong treatment plan to prevent these complications, and this is what the skilled doctor aspires to protect his patients as Dr. Hossam El-Mahdy, Professor of Vascular Surgery at Cairo University.

Who are the patients who need a peripheral therapeutic catheter?
- Patients with intermittent claudication, which is the occurrence of contractions in the leg muscles during movement. Claudication is the most common symptom of peripheral arterial disease and causes a decrease in physical functioning and quality of life.
During rest, the muscles need less blood flow, so the pain goes away with rest. The pain may occur in one or both legs, depending on where the blocked or narrowed artery is.
- Patients with severe peripheral arterial disease, and therefore experience pain at rest, and loss of foot tissue in the form of non-healing wounds and ulcers or gangrene that may require amputation of a limb, due to chronic ischemia that threatens the affected limb.

What is a peripheral therapeutic catheter?
Peripheral therapeutic catheterization is a procedure used to treat peripheral arterial occlusive disease or atherosclerosis. Peripheral therapeutic catheters are intended to restore blood flow to the lower limbs. This procedure eliminates pain, numbness and the need for amputation of the limbs. Because catheter procedures are minimally invasive, patients who receive treatment often have faster recovery times and lower risks compared to open surgery.

How is peripheral arterial disease diagnosed?
Before performing a therapeutic peripheral catheter procedure, a proper diagnosis of peripheral arterial disease is required. This can be done using one or more of the following screening methods:
• Ankle-brachial index (ABI): The Ankle-brachial index is a non-invasive test to measure blood flow in the arteries of the leg and arm. The ABI is calculated by dividing the blood pressure in the ankle by the blood pressure in the arm. If the resultant ratio is less than 0.9, this may indicate the presence of PAD in the patient's legs.
• Ultrasound (Doppler): Ultrasound is a non-invasive procedure where high-frequency sound waves are used to evaluate the functions and structures of blood vessels without using any injections or radiation.
• Magnetic resonance angiography: MRI angiography is a type of magnetic resonance imaging that specifically shows the blood vessels in the body.

How is peripheral therapeutic catheterization done?
1- Peripheral therapeutic catheterization is done under local anesthesia, usually involving a small puncture in an artery in the thigh.

2- The catheter tube is inserted into the hole to the place where the disease is, this is based on x-rays. The catheter is attached to a camera to view the arteries. The catheter is nothing but a narrow plastic tube that holds the balloon at the tip, and the artery is widened by the balloon to keep the artery open.

3- Sometimes a metal stent, which is cylindrical, reticular and expandable, is placed using a catheter to keep the affected artery open to its normal size, so that blood can continue to flow to the limbs.
Prof. Dr. Hossam El-Mahdy makes the decision to place a stent when the catheter alone cannot dilate the artery sufficiently or in certain places.

4- After completing the procedure, which does not take more than 30 minutes, the tube is withdrawn and the patient does not feel any pain, and the doctor presses on the entry site in the thigh for 10 minutes, in order to avoid bleeding in the artery.
5- The patient is then advised to wear compression bands and to reduce movement relative to prevent the occurrence of blood accumulation.

With this advanced technology, many patients with Peripheral Arterial Diseases can now be treated with a procedure that is less invasive and less risky than previous surgical procedures with similar results and shorter recovery times.

What are the advantages of peripheral therapeutic catheter?
- Done without general anesthesia; This makes it the perfect solution for all groups that have difficulty undergoing general anesthesia, such as those with hypertension and those who are allergic to the materials used in the general anesthetic procedure.
- It does not cause pain as there is no surgical incision.
- There is no risk of blood loss that may occur in open surgeries; Which protects the patient from the need for a blood transfusion or exposure to infection in one way or another.
- There are no reasons that prevent the patient from using the catheter, even if there is a weakness in the kidneys or excessive sensitivity to the dye of the arteries, as Prof. Dr. Hossam El-Mahdy relies on the use of carbon dioxide gas instead of dye.
- Catheterization can be performed safely on all patients, even those with diseases of the heart, lungs and liver.

Can peripheral vascular disease be prevented?
Peripheral vascular disease can be prevented, by preventing atherosclerosis and controlling risk factors. The prevention program may include:
• Quitting smoking and avoiding passive smoking and tobacco products in general.
• Making changes in your diet by reducing fats, cholesterol and carbohydrates and increasing your intake of fruits, vegetables, low-fat dairy products and lean meats.
• Treatment of hypercholesterolemia with medicines prescribed by the attending physician.
• Losing excess weight.
• Taking medications to reduce the risk of blood clots, as prescribed by your doctor.
• Exercising for 30 minutes or more daily.
• Controlling of diabetes.
• Controlling of hypertension.

Where can the peripheral catheterization be performed?
Dr. Hossam El-Mahdy, Professor of Vascular Surgery, is considered the best in performing peripheral therapeutic catheters and treating peripheral arterial occlusions in Egypt, due to his constant pursuit and interest in the knowledge and application of the latest available treatment methods globally.