Just the sound brings Richard Wallace back to his childhood. "I grew up a few blocks from the Pennsylvania Railroads Mainline." He watched the trains every weekend while his mother cooked dinner. "She died of a heart attack when she was 47."
Richard's health veered off track at the same stop. "I had a heart attack on March 5 of my 47th year." In the last seven years, Richard's had 25 stents in his heart. They're typically inserted through a catheter that starts in the groin and travels through the heart. But getting the catheter out is painful. "They're straddling you. There's at least two people. It feels like they're reaching in and pulling your bones out through your skin."
Cardiologist Barry Weinstock is using a new procedure to ease Richard's pain. "It's a soft sponge that's absorbable." A sponge is threaded through the catheter. It plugs up the hole in the artery to stop the bleeding, which eliminates the need for doctors to apply extreme pressure to the groin. "This is entirely outside the artery and it's just a soft, absorbent sponge, so there's really no danger of damage to the artery."
Richard says it didn't hurt at all. "Didn't feel a thing." He needed just one day of rest. "The recovery time was so much faster. It was almost like, boom, it's over." So instead of spending hours in bed…"This is an actual town that I'm modeling."
He can get back to the important details in his life.
Doctor Weinstock says he does this procedure up to seven times a day. He says it costs more, but those costs are balanced out by a shorter hospital stay.
BACKGROUND: According to the American Heart Association, 16.8 million people are living with heart disease, and many of them have undergone angioplasty. During angioplasty, surgeons use a balloon to open a blockage in a heart artery in order to improve blood flow to the heart. In 70 percent of angioplasty procedures, surgeons leave behind a stent to keep that artery open. A stent is a wire metal mesh tube that is inserted using a catheter. The catheter is most often threaded through a small puncture in the femoral artery, which is located in the groin. Surgeons move the catheter up into the blocked heart artery, inflate the balloon and leave behind the stent. Over time, the lining of the artery grows over the stent.
Angioplasty is performed to treat atherosclerosis, a condition that occurs when a material called plaque builds up in the inner walls of the arteries. When plaque builds up in the coronary arteries -- those that carry blood to the heart -- a patient has coronary artery disease and may require angioplasty. According to the National Institutes of Health, more than 1 million angioplasty procedures are performed each year in the United States.
RISKS: Although complications caused by cardiac catheterization are rare, a few can occur. Patients may be allergic to the contrast dye that is injected before a stent is placed. The procedure also carries a slight chance of heart attack or stroke, but the most common complications occur around the groin puncture site (Source: Angioplasty.org). Risks at the puncture site include hematomas, or bleeding under the skin, and trauma or damage to the femoral nerve.
ELIMINATING THE PAIN: After angioplasty, the puncture site has to be closed. Surgeons sometimes do this with manual compression, which is often painful and requires the patient to lie still for many hours. The actual process of applying pressure lasts for about 30 minutes. Other times, surgeons use small closure devices. These devices include "plugs" made of bovine collagen and nitinol clips that work similar to a grommet punch. The application of these vascular closure devices (VCDs) are often described by patients as extremely painful.
A new closure device uses a soft, bio-absorbable polymer sealant material called polyethylene glycol. The same material has been used for over 10 years in other medical products like gel caps and eye drops. After the angioplasty procedure, the surgeon places the material gently over the puncture area. The sealant immediately expands three to four times its original size -- like a sponge -- and stops bleeding and seals the artery shut. The sealant stays behind but naturally dissolves within 30 days (Source: Vascular Disease Management).
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