Monday, March 19, 2012

New surgery method saving more diabetics from amputation

SINGAPORE: A minimally invasive surgery method is helping more diabetic patients save their legs from being amputated.

Known as a Drug Eluting Balloon, it is coated with a drug similar to those used in chemotherapy but in very low doses.

The process involves the insertion of a drug coated balloon into the blood vessels of their legs to widen the narrowed blood vessels while the drugs help delay scarring and the re-narrowing of blood vessels.

The arteries of 75 per cent of the patients remained open for more than three months.

Changi General Hospital vascular surgeon Dr Steven Kum explained: "We have a high proportion of Singaporeans between the age of 18 and 69 who are diabetic. In my opinion, this is a great burden for our health care system and this is only expected to increase. We are amongst the highest incidence and prevalence of diabetes in this region and we know if you have diabetes, with time, you'll get narrowed arteries in the leg and coupled with infection and there's a high chance of you getting an ulcer in the leg. Once you have an ulcer in the leg which doesn't heal, with insufficient blood supply, it's extremely high risk for having an amputation.

"An amputation has got a significant impact not only to the patient, in the sense that the patient will be wheel chair bound. Only half of all our amputees end up walking. The cost and burden to society are enormous."

Fifty patients at Changi General Hospital have undergone the procedure since it was introduced in August 2010.

Upon follow up with 30 of the 50 patients who underwent the surgery, the hospital found that 90 per cent were able to save their legs.

This is up from the 70 to 80 per cent previously achieved without the use of the drug eluting balloon.

Sixty-three-year-old Tan Lian Ann is one patient who has benefited from such a procedure.

He underwent surgery three months ago on his left leg and is now doing the same surgery on his right.

Mr Tan said: "There was no choice. If I didn't do it, it would get infected and that would've been bad. I was scared so I had to come in to do the surgery."

Doctors also said this minimally invasive procedure is also more favourable for elderly patients as it does not require the patient to undergo general anaesthesia.

Dr Andrej Schmidt of the Department of Angiology at Park Hospital in Leipzig said: "We often treat patients that aren't in very good condition. They're often very old and have concomitant diseases, heart disease and diabetes. Therefore, their surgery requires general anaesthesia, which can also be some kind of risk for these kinds of patients. We can do these treatments with local anaesthesia without the use of general anaesthesia. Therefore, endovascular is really less of a problem for these older patients."

Traditional surgery involved an open bypass procedure which is a relatively invasive procedure.

Doctors also said such procedures see a faster recovery rate and are less painful for patients.

- CNA/fa

View the original article here

Source From Channel News Asia

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