Medicine: Arterial Plumbing

Hardening of the arteries can lead to gangrene—if the vessels become so clogged that too little blood gets through. From a plumber’s-eye view, the solution looks obvious: scrape out whatever is blocking the vessels.

Doctors have hesitated to use the plumber’s method because they feared that peeling off the inner lining (endothelium), along with the dead tissue, calcium and fatlike substances, might lead to dangerous clotting. A team of five French doctors, headed by Dr. Louis Bazy, chief surgeon of Paris’ St. Louis Hospital, has now apparently learned the trick. Dr. Bazy’s team splits open the artery (in extreme cases for as much as two feet), scrapes out the stoppage, sews it up again. In a few minutes nature deposits white corpuscles along the wall of the scraped-out artery; the corpuscles take the place, temporarily, of the endothelium.

Up to last July, Dr. Bazy & associates had operated on 47 patients; nine had gangrene and ten had arteries so clogged that gangrene would probably have developed. Eight died, all of them advanced cases of gangrene. Since July, Dr. Bazy and his team have performed about two operations a week—unplugging the main abdominal artery as well as arteries in the arms & legs. Up to last week there had been no new deaths; out of 100 cases, 65 have improved. In operations on arteries of the arms & legs improvement has been almost 100%, says Dr. Bazy.