Pediatric and Congenital Heart - Cedar
Black Amputation Rates Are High —Knowing Your Risk Can Lower It
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Peripheral artery disease (PAD) is a common cardiovascular disease that leads to some 400 amputations performed each day in the United States. It is a serious medical condition, prevalent in the Black community, that can also lead to stroke, heart attacks and, in some cases, death.
Yet a recent survey has found that while millions of Americans have cardiovascular disease or diabetes, very few are aware of peripheral artery disease, and even fewer have ever had a discussion about it with a medical professional.
PAD causes blockage in the vessels that carry blood from the heart to the legs and affects more than 12 million Americans. Leading risk factors for PAD are the common chronic health conditions that disproportionately impact underserved communities.
"These new insights are particularly concerning among those most at risk and come at a time when a staggering 1 in 20 Americans over 50 years of age experience PAD," said Dr. George D. Dangas, president of the Society for Cardiovascular Angiography & Interventions, and a professor at the Mount Sinai School of Medicine in New York City.
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The PAD Pulse Alliance Survey, which came out in February, polled 2,000 Americans to learn about their level of awareness of disease symptoms, risk factors, and overall doctor-patient communications around PAD. The survey included responses from 1,000 Black and Latino people, which is important given that both populations are at a higher risk of developing PAD and related complications.
The facts tell the story.
The survey "confirms what we feared: millions don't have the tools they need to help start a conversation with their healthcare providers because patients are unaware of their risks and the common signs and symptoms," Dangas added.
The top three risk factors for PAD are diabetes, high blood pressure, and use of tobacco products — health risks that occur in the Black community at disproportionately high rates
compared to their white counterparts. Current or former smokers make up 80% of PAD patients.
People with diabetes are three to four times more likely to suffer from the disease than the general population and 35% to 55% of people with PAD also have high blood pressure.
Other studies show that higher concentrations of PAD occur in communities that also suffer from high stress and deprivation, which is also common in many underserved Black communities. Exacerbating the issue: little or no access to nutritious food options and areas to exercise also play an important role.
"We believe that exposure to more distressed circumstances and more access-to-care barriers increases your risk of getting the disease and also getting detected later for the disease," says Dr. Kim G. Smolderen, an associate professor of medicine and psychiatry at Yale University School of Medicine. "There is a lot of unawareness that is still happening not only in the general public, but also in the medical community that needs to be addressed."
"The disturbing variations in PAD prevalence, treatments and outcomes underscore another perilous consequence of the health equity gap in managing chronic conditions," said Foluso Fakorede, MD, CEO of Cardiovascular Solutions of Central Mississippi, co-chair of the Association of Black Cardiologists PAD Initiative. "It's critical to increase awareness among racial and ethnically marginalized communities and the providers who serve to close the gap."
This story was originally published online with Word In Black, a collaboration of the nation's leading Black news publishers (of which The Washington Informer is a member).
R3 Vascular Secures Funding To Support Bioresorbable Scaffold Trial
Medical device company R3 Vascular has successfully closed an $87m Series B financing round led by affiliates of Deerfield Management, to support a trial of its bioresorbable scaffold, MAGNITUDE.
The financing round saw participation from existing shareholders, including 415 Capital and a strategic investor.
R3 Vascular's ELITE FDA IDE pivotal trial will assess MAGNITUDE to treat below-the-knee (BTK) peripheral arterial disease (PAD).
The company also plans to use the funding to support additional research and development, regulatory submissions worldwide, advance manufacturing processes and initial commercialisation.
MAGNITUDE is a next-generation bioresorbable scaffold intended to meet the needs of patients suffering from chronic limb-threatening ischemia due to BTK PAD.
The company's bioresorbable scaffolds, crafted from an ultra-high molecular weight polylactic acid polymer, are designed to be thinner, stronger, and more flexible.
Concurrently, R3 Vascular has named Christopher Owens as the new president and CEO.
With an extensive background in the medical device industry, Owens takes over leadership from founder Kamal Ramzipoor, who transitions to the role of chief technology officer (CTO).
Owens' experience includes leadership roles at Gynesonics, IDEV Technologies, MicroVention, and Bausch & Lomb's Surgical Division.
Owens said: "R3 Vascular's novel bioresorbable scaffolds encompass a world-class polymer and scaffold design that drives significant next-generation advantages with our technology.
"This, accompanied by our unparalleled scalable and flexible manufacturing processes and capabilities, contribute to the company's mission to further improve the treatment and outcomes for patients suffering from PAD.
"This significant financing is also a testament to the belief in our evolutionary bioresorbable scaffold technology to provide treatment for this significant and growing problem of below-the-knee PAD."
Furthermore, David Neustaedter and Michael Hurley from Deerfield Management will be joining R3 Vascular's board of directors as part of the financing agreement.
"R3 Vascular secures funding to support bioresorbable scaffold trial" was originally created and published by Medical Device Network, a GlobalData owned brand.
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Can Exercise Therapy Ease Peripheral Artery Disease Symptoms?
Patricia Creque describes herself as "one of those people who has music in my head and am always ready to dance." Peripheral artery disease (PAD), however, had made it difficult for her to dance—or even walk. Could exercise therapy help?
"For years I had such issues with my legs," said Creque, 69, of Wyomissing. "I had no idea what was causing the pain, but it affected my quality of life."
Determined to find out what was going on, Creque researched possible causes of leg pain and read about PAD. When she learned it was caused by atherosclerosis, or hardening of the arteries, she began to connect the dots.
"I knew I had atherosclerosis, and I knew it had affected my heart, but I didn't know it could also be causing the pain in my legs," Creque said.
She consulted her primary care physician, who sent her to Penn State Health Vascular Surgery in Wyomissing. She learned that PAD is a common condition, affecting 5 to 6 million people in the United States. While some people with PAD are asymptomatic, others, including Creque, experience the classic symptom of leg cramping and pain with physical activity that gets better with rest.
Further Reading: Walking Toward Healthier Knees
"The pain from muscle cramping in the legs is always there when you walk, but as soon as you stop walking, it goes away," said Dr Ali Amin, a vascular surgeon at Penn State Health St. Joseph Medical Center. "That's the difference between PAD and other types of leg pain."
Cause and Symptoms of PADAmin explained that atherosclerosis causes blood vessels to narrow, restricting blood flow to a person's extremities—usually the legs. When blood supply is reduced, not enough oxygen and nutrients get to the muscles, especially during increased demand, such as walking, which results in pain.
Other symptoms may include pain in the foot while resting, discoloration of the feet or legs, numbness, and cold feet. More advanced symptoms include ulcers of the foot or gangrene of the foot or toes, which may result in amputation. PAD also can lead to coronary artery disease, which could cause a stroke or heart attack.
"PAD can be a serious condition," Amin said. "If you have leg pain only one day out of seven, that's not peripheral artery disease. But if you have pain every time you walk, you should take it seriously and get checked."
Benefits of Supervised Exercise TherapyOnce Creque had been diagnosed with PAD, she was treated with balloon angioplasty to open up her narrowed arteries. Despite this, her pain persisted. Eager for solutions, she resumed her research and discovered Penn State Health's supervised exercise therapy program. She contacted Spring Ridge Outpatient Center for more information.
Learning that she qualified for the program, Creque decided to enroll.
A clinical exercise physiologist with Penn State Health Spring Ridge Outpatient Center, Allison Canon leads the supervised exercise program for PAD patients. Participants who are able are instructed to walk on treadmills, Cannon said, while anyone who has trouble accessing a treadmill is encouraged to participate in walking exercises on the floor.
Exercise is prescribed for PAD patients because it increases blood flow and improves circulation, which can ease pain. Patients may experience discomfort while walking, but it's the best exercise for pain relief.
"We don't want patients working to severe pain, but some discomfort is good because it means the blood is working to get through blockages and to the muscles," Cannon said.
As they build up stamina and pain tolerance, patients are challenged to increase the distance they can walk on a treadmill. Creque, who said she could not tolerate much walking at all when she started the program, was able to accomplish three sets of 12 to 15 minutes on the treadmill by the end.
Program staff members observe patients, monitoring their vital signs, pain level, endurance, recovery time and the speed and elevation of the treadmill.
Cannon encouraged PAD patients who are interested in the program to consult with their provider about getting enrolled in a supervised exercise therapy program near them.
"It's really rewarding to work closely with patients and see how much they improve by their last day," Cannon said.
Any Exercise is Helpful for PADWhile supervised exercise therapy has been found to improve walking ability, overall function and health-related quality of life in patients with symptomatic PAD, patients who exercise on their own can also see improvements. Walking or using a stationary bike can increase blood flow to the legs, while swimming, yoga and stretching may improve overall circulation.
Amin advised patients to exercise as much as they are able, while also taking other steps to minimize their chances of developing PAD and lessening symptoms.
"Stop smoking, control your blood sugar, and watch your cholesterol and blood pressure," Amin advised. "Watch what you eat and exercise as much as you're able to. You don't have to go to the gym or have any special equipment. Just walk as much as you can."
Back to DancingCreque, who saw significant improvement in pain relief and movement after completing the supervised exercise therapy program, enrolled in a senior dance class at her gym. After several classes, she was asked, and agreed, to lead a Friday morning class.
"I never would have had the confidence to do that without the program," she said. "I came out of it feeling much stronger—mentally and physically."
Featured image: Patricia Creque, a graduate of the supervised exercise therapy program at Penn State Health Spring Ridge Outpatient Center, leads a dance class at Wyo West Fitness. Photo: Penn State Health
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