©2004CONNECTICUT POST (Used with permission)
HealthScience Section
February 5,2004

Deep freeze therapy

Cryoplasty latest method to unclog arteries


With winter winds whipping around, and occasional snowfalls making life difficult for everyone, it's hard to believe that the cold can actually be good for you.

But it can—at least if you're suffering from congested arteries.

Yale-New Haven is the first hospital in the state and the second in New England to offer cryoplasty, a new procedure that uses cold air to treat peripheral vascular disease, or the hardening and clogging of arteries that supply the legs and feet.

The disease, most common in men older than 50, often causes severe leg pain and those suffering from it have a hard time walking or doing similar activities, said Dr. Bauer Sumpio, co-director of the Yale Endovascular Center at Yale-New Haven.

"When an artery is clogged, whatever the artery is supplying is affected," he said. "If the artery is supplying the brain, you get a stroke. If it's supplying the heart, you get a heart attack. [In peripheral vascular disease] you get pain in the legs and calves."

Previously, balloon angioplasty was the most popular treatment for unclogging arteries. In that procedure, doctors force open the artery using a small balloon, and dislodge the plaque. However, arteries treated below the hip have a high incidence of clogging up again.

This is because the tearing and stretching of the blood vessel can result in scar tissue that clogs the artery just as the plaque did. About 40 percent of those treated with angioplasty need to return for treatment.

Dr. John Aruny, the other co-director of the Endovascular Center, said that the new procedure can alleviate the congestion, but limit the possibility of scarring.

In cryoplasty, a similar balloon device is used, but is filled with pressurized nitrous oxide. The liquid expands, turning into a gas and cooling the balloon to 14 degrees.

The cold gas freezes the plaque, causing it to crack, allowing for better blood flow. It doesn't cause the scarring that angioplasty does, because the cold air prompts natural cell death of the cells in the artery.

"The body is turning over cells all the time," Aruny said. "When cells die off naturally, you don't get scarring. [Cryoplasty] tricks the body into thinking this is just natural cell turnover."

The cold air is in the artery for only a short amount of time—about 20 seconds—to prevent freezing anything but the plaque.

Sumpio and fellow co-director Dr. John Aruny began using the technology after the first of the year, and have already done several procedures.

"We're still early in the game," Aruny said. "But hopefully this will lessen the need to go back [and do another procedure]."

Indeed, early trials have indicated that nine months after cryoplasty, 85 percent of treated arteries remained open.

Doctors are investigating using cryoplasty in arteries in the heart, but Kyle Kramer, executive director of cardiac services at Yale-New Haven, said there might not be a need for the technology there.

Angioplasty can produce the same obstacles in treating clogged heart arteries as it does in treating peripheral vascular disease, he said, but other treatment methods have been developed to help solve that problem.

A method that is working well is the drug eluting stent, a stent that holds the vessel open after angioplasty, while releasing a drug that inhibits scarring.

Meanwhile, Aruny is optimistic that cryoplasty will be helpful to patients battling peripheral vascular disease.

"We're hoping that, with this, we can obtain a more durable result over time," he said.