Emory Johns Creek doctor offers hope to amputee candidates

Laser technology can save legs otherwise lost to arterial disease

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JOHNS CREEK, Ga. – Emory Johns Creek Hospital’s Dr. Greg Robertson says many of the 150,000 limb amputations annually could be prevented if more people were aware of a new surgical procedure he helped pioneer.

The cause of these amputations is what is known as peripheral arterial disease (PAD) where the arteries become clogged with plaque – the build-up of fatty deposits and other cells that can build up in the walls of arteries over time.

The old technology of detecting plaque build-up with X-rays does not provide the degree of visual competency to go in and scrape the walls of the arteries. In advanced cases, the treatment becomes amputation.

“It’s a problem. There is so much awareness of cancer and heart disease, but PAD flies under the radar,” Robertson said.

Robertson says what is especially tragic is there is a new procedure to allow a tiny laser camera mounted in the device that allows the surgeon to see to score the arterial walls. The way Robertson describes the device (called an Ocelot and manufactured by Avinger Co.) is it is like an auger with a laser camera.

“So what we need to do is a better job of educating doctors and nurses to screen for PAD – not only to diagnose it, but to treat it with the latest technology,” he said. “It’s a 15-minute test similar to an EKG.

“What is needed is the understanding, the training and the passion to treat PAD patients.”

Patients most at risk of PAD are diabetics and smokers.

Robertson has been working with Dr. John Simpson at Stanford University. Simpson is perhaps the leader in less invasive cardiovascular surgical procedures and invented the Ocelot.

Robertson conducted the trials for the Ocelot in Germany and South America that got the Ocelot medically approved for use in the United States.

“It is really life-changing for these patients,” Robertson said. “It allows the surgeon to see inside the artery as he performs the [removal of plaque]. You put a laser camera on the device; it allows the surgeon to stay on target without poking a hole in the artery.”

He recently had a 38-year-old patient who was a farmer in Tennessee. Diagnosed with PAD, he was referred to Robertson as his last and best chance to prevent amputation. Robertson was successful in saving the leg with this minimally invasive procedure.

“He had already lost his other leg at the knee in an accident. As a farmer, had he lost his other leg he would not have been able to earn a living,” Robertson said. “Not only that, blocked arteries are the leading cause of death in America.”

BUS 04-30-14