business

"Hold still, sweetie!" Dr. Daniel Dulas cheerfully commanded.

Flat on her back and sedated in the cardiac catheter lab at Mercy Hospital in Coon Rapids, Jerene Olson, 60, mumbled and stared blankly at the ceiling. Her left leg jerked involuntarily.

Cloaked head-to-toe in surgical blues, Dulas held a spaghetti-thin wire between his fingers and delicately snaked it into Olson's femoral artery near her groin. He peered at a computer screen image overhead to gauge its progress.

The guide wire was inched ever so deliberately through the artery in Olson's left leg until it met its expected foe: a pocket of calcified plaque the consistency of uncooked pasta. Dulas pumped a foot pedal, causing the wire to rotate erratically like a jump rope in furious motion.

The device is part of a clinical trial financed by New Brighton-based Cardiovascular Systems Inc. (CSI). The wire's diamond-encrusted crown sanded and pulverized the plaque, clearing the artery and restoring blood flow to Olson's leg and foot.

Bzzzzzzz.

Twenty seconds. Twenty-three. Twenty-nine. Thirty.

"Almost home, honey!" Dulas called.

Unbearable pain

Olson, of St. Francis, was found to have peripheral arterial disease last year after her lunchtime walks became unbearably painful. "My legs would cramp up so bad I could hardly walk," she said. "Sometimes I could get a block, sometimes two blocks, and then it was like, 'How am I going to get back?' "

The disease, caused by blockages in the arteries that supply the legs with blood, affects eight to 12 million people in the United States, according to the American Heart Association. Smokers, diabetics and those with high blood pressure and cholesterol are most at risk.

Their most common symptom: A crampy kind of leg pain called claudication.

"In the main artery in her thigh, which feeds all the arteries below her knee, she has at least three severe blockages," explained Brian Wise, an imaging technologist who assisted Dulas in last November's procedure. "So it's the same thing as a heart attack in the leg."

While the concept of a heart attack is easy for most patients to understand, peripheral arterial disease is not exactly a well-thumbed page in most Merck Manuals. As a result, the disease often goes undiagnosed. Or misdiagnosed as "muscle pain" or "arthritis."

Most patients suffering from the disease see their worlds gradually grow smaller and smaller as their capacity to exercise declines and perhaps disappears.

"Maybe they can't golf the back nine anymore, maybe they can't make it out to the mailbox anymore, but they really don't think to tell their doctor about the pain," said Paul Tyska, CSI's vice president of business development.

And even if a patient is vocal about the pain, there's no guarantee peripheral arterial disease will be diagnosed.

John Borrell, CSI's vice president of sales and marketing, said he recently visited his family doctor for a lingering cold. The two chatted and Borrell asked the doctor how many claudication cases he'd seen in his career.