Times of India
18 July 2009
By Dipti Barve

Angioplasty procedure also helps prevent blockages in legs of diabetic patients, can prevent amputations, experts say
Angioplasty is no longer solely a matter of the heart. It can also prove to be a life–saver for diabetics. Take the case of Suhas Patil, a middle–aged civil engineer and diabetic. Patil was experiencing pain while walking. He could not cover a distance of even 100 metres properly due to cramps and numbness in his legs. After undergoing various medical tests, he was shocked to know that the arteries of both his legs had blockages of more than 90 per cent.

Dr Shirish Hiremath, cardiologist and director of Ruby Hall Clinic, and Dr C N Makhale performed the angioplasty procedure on both his legs. It turned out that Patil was suffering from Peripheral Vascular Disease (PVD) which resulted from the blocked arteries of the legs.

Patil said, “I was initially shocked and felt like I had lost both my legs. But the leg angoplasty gave me a new lease of life. Diabetic patients like me should not ignore even small problems related to legs because they are more prone to this disease.”

What is PVD?
PVD occurs when the arteries (blood vessels) supplying blood to various parts of the body become narrow because of the build–up of fatty deposits (atherosclerosis), sometimes called plaque or lesions, on the inside walls (linings) of the blood vessels. When the arteries carrying blood to the legs become too narrow because of these deposits, blood flow is reduced and the leg muscles do not get enough oxygen to support physical activity.

Diagnosis Difficult
Hiremath said, “It is estimated that only about 30 per cent of PVD patients are diagnosed, mainly due to the asymptomatic nature of the disease. Even leg pain is present only in about 10 per cent of the patients, reducing the diagnosis rate further. However, ABI (Arterial Brachial Index) is a test that helps detect the disease and aids in correct diagnosis.”

He added, “Though timely treatment may help reduce diabetesrelated amputations of legs and feet, diabetic patients should be careful of PVD, a progressive atherosclerotic disease carrying a high risk of limb loss, stroke and premature death.”

In fact, experts warn that people with co–existing diabetes and PVD, which is widely prevalent, are more likely to undergo amputation of limbs. “Given the fact that PVD in diabetes is largely asymptomatic, educating patients plays a key role in preventing major complications later on. While 82,000 people have diabetesrelated amputations of leg and feet each year in India, timely treatment can significantly reduce this number,” said Hiremath.

How to Avoid Amputations?
“However, foot care programmes that include regular examinations and patient education may prevent up to 85 per cent of these amputations. Newer technology such as long ballooning has an 80 per cent success rate and helps in salvaging the limbs of a patient,” said Hiremath.