Let There Be Lightbox!

A new imaging system means much better treatment for some people with peripheral artery disease. Saint Peter's 'Lightbox' offers physicians a clearer picture, allowing for safer and more effective operations.



Doctors at Saint Peter’s University Hospital have a promising new weapon in the fight against peripheral artery disease, or PAD .

PAD is a common circulatory problem marked by impeded blood flow to the extremities, usually the feet and lower legs. The classic symptom of PAD is claudication (pain while walking), which can adversely affect quality of life. And one complication is skin ulcers, which if left untreated can lead to gangrene and the risk of amputation. PAD is also associated with an increased risk of heart attack, stroke and transient ischemic attack (“mini-stroke”).

Like stroke itself, PAD is a complication that can result from atherosclerosis, in which deposits of fats, cholesterol and other substances (also known as plaque) build up inside the arteries.

+DO YOU KNOW THE SYMPTOMS OF PAD?


Many people who have peripheral artery disease (PAD) don't have any symptoms. But those who do may experience:

>>Pain, numbness, achiness or heaviness in the leg muscles when walking or climbing stairs.
>>Weak or absent pulses in the legs or feet.
>>Sores or wounds on the toes, feet, or legs that heal slowly, poorly, or not at all.
>>A pale or bluish color to the skin.
>>A lower temperature in one leg than the other leg.
>>Poor nail growth on the toes and decreased hair growth on the legs.
>>Erectile dysfunction, especially among men who have diabetes.

Initial management of patients with PAD who suffer from claudication is often medications and exercise therapy. In patients who continue to have claudication or have wounds that are not healing, a procedure to open the blocked arteries is recommended. In approximately 40 percent of patients who suffer from PAD , the artery that supplies blood flow to the foot is totally occluded, which makes it difficult to achieve a successful, durable result. Navigating through these long occlusions without damaging the arteries themselves has been challenging. But a new imaging system called Lightbox, which in central New Jersey is exclusive to Saint Peter’s University Hospital, offers physicians a clearer picture of the blocked arteries and allows them to operate more safely and effectively.

“It uses light waves coming from the tip of a catheter to help us see as it goes into the lesion,” says Stephan Haspel, R.N., manager of cardiac catheterization. “This allows us to stay within the lesion and away from good tissue.”

The system is manufactured by a company called Avinger. Bart Beasley, the company’s vice president of marketing, and Kevin Meehan, lumivascular program manager, say that Avinger forms close partnerships with the physicians and labs that purchase Lightbox. “Our goal is to collaborate with training the surgeons—and in getting the word out,” says Beasley. The company trained Ramzan Zakir, M.D., an interventional cardiologist who directs the peripheral vascular program at Saint Peter’s, as it has more than 100 physicians at about 60 hospitals around the country.

“Based on clinical trials, we believe Lightbox offers patients the best treatment modality in crossing through difficult blockages,” says Meehan. Dr. Zakir agrees. He has already performed several procedures using Lightbox since the hospital acquired the technology in December 2013. “Our success rate has been excellent,” says Dr. Zakir. “This tool is a real game changer.” —D.L.

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