By his own acknowledgement, you don't want to get to the point where you have to see Dr. Joseph Quintana. Quintana, an interventional cardiologist with Cardiology Care Consultants, deals with patients who have peripheral arterial disease, or PAD.
"I see them in all stages, but most of the time I get them at the end, close to when we have to amputate," Quintana said. "What we want to do is see these patients before they get to that stage so we can help them a lot sooner with lesser complications and be more successful."
Quintana is using the Crosser Catheter system in his effort to save limbs damaged by PAD.
PAD is a disease in which plaque -- made up of fat, cholesterol, calcium, fibrous tissue and other substances
in the blood -- builds up in the arteries that carry blood to the head, organs and limbs.
Developed by FlowCardia Inc., the Crosser system is revolutionizing treatment of chronic total occlusions, or blockages that have completely closed off circulation in arteries in the heart or legs.
"What we do is we open up the arteries," Quintana said. "If the artery is totally occluded, usually with angioplasty we are able to pass a wire and balloon or another device to fix the artery."
Unfortunately, when the artery is totally blocked and a wire can't be passed through it, many times the artery cannot be fixed.
That's when Quintana and the Crosser come in handy.
The Crosser Catheter uses high-frequency vibration to
navigate a thin 1.1-millimeter guide wire beyond chronic total occlusions. Once it is up against the blockage, the tip of the wire is made to vibrate 20,000 times a second.
"Once we are able to pass the guide wire through, we can do balloon angioplasty or place stents to open the blocked arteries up so the blood flow can keep going."
El Pasoan Shirley Best came within weeks of losing both legs below her knees.
"I've always been very active, but I got to the point where my legs were always heavy and I couldn't even walk," Best said. "I was having problems even when I would vacuum a room. My heart rate would just be pounding after a half a room."
Best, 67, had the procedure done in June 2012.
"I had been living in pain for probably seven years," Best said. "I had a blood clot in my toe at that time and I thought it was an in-grown toenail, so I let it go."
When it got to the point where she had gangrene in her toes, she knew it was time to seek help.
"I've always tried to be active, and this was really dragging me down," said Best, who retired in February to take care of her husband, who is in a nursing home. "I'm able to do more. I'm able to vacuum, I can cut my own grass and I can use my own Weed Eater. It's been wonderful."
An estimated 1.7 million people in the United States are living with limb loss -- 82 percent of them due to vascular disease -- according to the Amputee Coalition's website (amputee-coalition. org).
PAD affects more than 8 million Americans.
"Most individuals begin to have problems when they walk; they start to feel pain," Quintana said. "If you could walk a mile before, now you can only walk half a mile. The body is normally fed by nutrients, and blood flow is able to ambulate. Now, all of a sudden, because of the blockage, the areas involved need to have more blood flow. If it doesn't have it, the body responds with pain."
He said not having enough blood flow could lead to gangrene, the death of body tissue due to a lack of blood flow or a bacterial infection. Gangrene most commonly affects the extremities, including toes, fingers and limbs.
"The key is to help open up the circulation whether it be in the heart or legs to prevent amputations," he said. "By preventing an amputation, we are extending the life expectancy, and quality of life, of the patient."
He said 30 to 40 percent of the people who have amputations typically die within three to five years.
"That's what we want to prevent," he said. "If you can't walk, you can't exercise, if you can't exercise, you can't help your diabetes. It also makes it difficult to lower your cholesterol or your blood pressure."
The Crosser Catheter has a success rate of 83.5 percent.
"The risk and complications are low, it's very cost-effective, and most important to me, it saves the limb and returns the patient back into the normal productive lifestyle," Quintana said.
Other treatment options for PAD include medication or conventional angioplasty.
"Sometimes the risk factors with surgery could be higher and some of these patients may have already had by-passes and don't have enough veins to do another by-pass," he said. "By doing this procedure, our success rate is very high and the outcomes are very good."
Best said it changed her life.
"Before I go to sleep, I look at my legs," she said. "I exercise my legs and think how thankful I am that I still have them. It's God's decision when I go, but when I do go, I know this has made my life more livable."
Victor R. Martinez may be reached at vmartinez@ elpasotimes.com; 546-6128. ___