'Inside Look' at Blood Vessels Aids PAD Treatment

Daniel Spillane loved to hike and scale steep trails alongside waterfalls in the Poconos. Over time, though, it became too painful to even walk down the block.

“It started out every now and then, I’d get pain in one leg. It kept escalating and escalating to the point where I couldn’t walk four houses down the block without a cane. I’d have to sit down and rest for half an hour,” he said.

A supermarket butcher, the 54-year-old also had trouble standing for long periods of time.

“I’d have to drag my leg to keep up with an eight-hour day,” he said. “It was to the point where it was do or die.”

Daniel visited his primary care physician, who referred him to Virtua vascular specialist Luai Tabaza, MD, FACC, FSCAI, RPVI. Dr. Tabaza diagnosed Daniel with peripheral artery disease (PAD), a condition where plaque buildup in the arteries restricts blood flow to your arms or legs. This can lead to muscle pain and cramping when walking, a condition called claudication.

But thanks to an innovative procedure called lumivascular atherectomy performed in October 2021 at Virtua Our Lady of Lourdes Hospital, Daniel is back working and enjoying walks pain-free.

Targeting Plaque

Lumivascular atherectomy incorporates an imaging fiber attached to the end of a catheter that allows the vascular specialist to better differentiate between healthy and diseased tissue as they remove plaque from the inside of a blood vessel.

“This technology allows me to remove as much plaque as possible while minimizing damage to artery walls and healthy tissue,” said Dr. Tabaza. “I can see in real time where I am in the vessel and how much plaque I am taking out. This is the next level of targeted treatment.”

Traditional atherectomy utilizes fluoroscopy, a type of medical imaging that shows a continuous X-ray image on a monitor, like a movie. Lumivascular atherectomy still requires fluoroscopy, but it’s not needed as often during the procedure, reducing the amount of radiation exposure to patients and the medical team.

A balloon integrated into the catheter helps to maneuver a high-speed blade that shaves off the plaque. The plaque is stored within the catheter and then removed from the body.

“We can rotate and engage the plaque at different angles. We are able to target specific areas of with plaque while avoiding dissecting the artery walls and reducing the chances of the blood vessel becoming blocked again,” said Dr. Tabaza.

If needed, a separate catheter is used to implant a stent or deliver a medication to keep the artery open.

‘Amazing Procedure’

Daniel was conscious during the procedure and watched as Dr. Tabaza removed clots from his blood vessels and inflated a special, drug-coated balloon to treat the area.

“I was totally amazed. I could see what came out of me, what he extracted from my arteries. I was in bad shape. I had no blood flow. The way they inflated the artery and got the plaque out— that’s amazing,” he said.

Moving Forward

Daniel resumed working a few days after the procedure, and now walks pain-free near his Haddon Township home. He hopes to someday hike the Pyrenees and Himalayas mountains.

“Since the procedure, I’ve been walking four times a day around the lake. Walking and jogging. I’ve been able to work out at home, too. I wasn’t able to do that,” he said. “I’ve had no pain, and haven’t needed the cane. I’m fixed. I’m thrilled.”

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Updated May 4, 2022