Peripheral Artery Disease

Background

Clinical KeyPeripheral artery disease is an occlusive disease where the blood flow in a region (typically the legs) is inadequate for the demand in the region, resulting in symptoms that may be not present at rest, but occurs with activity, such as walking or climbing stairs. Atherosclerosis may be a cause of peripheral artery disease, as the gradual narrowing of the arteries can restrict blood flow. Other causes can be high blood pressure, diabetes, obesity and smoking.

Current Treatment

Diagnosis can be made with a good history and one of several tests, including an ankle-brachial index, ultrasound or angiogram. Treatment involves cessation of the symptoms and correcting any underlying causes of the condition. Symptom correction can include medical therapy to control blood pressure, but may include angioplasty or surgery to bypass the obstructed areas of blood flow. Underlying conditions can include better management of blood sugar in folks with diabetes, exercise regiments, smoking cessation and weight loss.

Focused Ultrasound

It is thought that focused ultrasound can disrupt the clot formation and promote the flow of blood. Much of the work on this remains pre-clinical, but if success is found in the treatment of peripheral arterial disease, focused ultrasound may help in treatment of atherosclerosis in human hearts as well.

Clinical Trials

There are several mechanisms by which focused ultrasound can be involved in expanding the blood flow in compromised arterial regions. One area of interest is that stem cells appear to be attracted to and are more adherent in regions that have been treated with focused ultrasound compared to regions that have not had focused ultrasound treatment. There is a current clinical trial that is looking at this situation at Arkansas Heart Hospital in Little Rock. Click here to learn more about the study, or contact Mary Catherine Faulkner (501-690-2339 or ).

Notable Papers

Papadopoulos N, Yiallouras C, Damianou C. The Enhancing Effect of Focused Ultrasound on TNK-Tissue Plasminogen Activator-Induced Thrombolysis Using an In Vitro Circulating Flow Model. J Stroke Cerebrovasc Dis. 2016 Dec;25(12):2891-2899. doi: 10.1016/j.jstrokecerebrovasdis.2016.07.052.

Devanagondi R, Zhang X, Xu Z, Ives K, Levin A, Gurm H, Owens GE. Hemodynamic and Hematologic Effects of Histotripsy of Free-Flowing Blood: Implications for Ultrasound-Mediated Thrombolysis. J Vasc Interv Radiol. 2015 Oct;26(10):1559-65. doi: 10.1016/j.jvir.2015.03.022. Epub 2015 May 4.

Almekkaway MK, Shehata IA, Ebbini ES. Anatomical-based model for simulation of HIFU-induced lesions in atherosclerotic plaques. Int J Hyperthermia. 2015 Jun;31(4):433-42. doi: 10.3109/02656736.2015.1018966.

Zhang Y, Dong H, Xu Y, Shi R, Gu J, Lang H, Gao J, Zhang WW. External ultrasound for carotid atherosclerotic plaque treatment. J Ultrasound Med. 2015 Mar;34(3):451-9. doi: 10.7863/ultra.34.3.451.

Shehata IA, Ballard JR, Casper AJ, Liu D, Mitchell T, Ebbini ES. Feasibility of targeting atherosclerotic plaques by high-intensity-focused ultrasound: an in vivo study. J Vasc Interv Radiol. 2013 Dec;24(12):1880-1887.e2. doi: 10.1016/j.jvir.2013.08.013.

     

Share this page