Taking the Right Path
Advanced Vascular Procedure Saves Patient’s Limb, Lifestyle
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| Jess Carneal can enjoy an active life with his granddaughters, Christina and Caroline, after undergoing a procedure to save his leg. The distal vein pass is designed for patients who are not candidates for regular bypass surgery. |
Vascular disease is a common, yet serious, problem that affects the body’s circulatory system. It occurs when cholesterol and other fats circulating in the blood build up inside major arteries, reducing blood flow to the brain, heart and limbs. Left untreated, vascular disease can lead to a higher risk of stroke, kidney failure and loss of limbs. That’s why the vascular program at Inova Mount Vernon Hospital, a core component of Inova’s Heart and Vascular Institute, provides the latest in advanced surgical techniques to treat patients with vascular disease, from the simplest to the most complex cases.
“Our goal is to offer world-class services to Mount Vernon Hospital patients in terms of saving their limbs from the ravages of atherosclerosis, and provide the best dialysis access and stroke prevention available,” says Richard F. Neville, MD, FACS, Director of Vascular Services at Inova Mount Vernon Hospital.
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Finding His Way
For 80-year-old Alexandria
resident J. Lee Carneal, the battle
with vascular disease was
a struggle that he was able to
overcome with the help of Dr.
Neville and another dedicated
physician. His journey began
when he was first diagnosed with
coronary artery disease two years
ago. Carneal had cardiac bypass
surgery, followed by a pacemaker
implant to maintain a steady
heartbeat. But Carneal’s struggle
didn’t end there. Soon after
completing surgery, he developed renal failure, necessitating dialysis three times per week.
A subsequent diagnosis of peripheral artery disease caused him to experience delayed wound healing in both legs. It wasn’t long before he was diagnosed with critical limb ischemia, a condition in which lack of circulation caused by blocked arteries led to the surgical loss of his lower right leg.
By the time Carneal sought care at Inova Mount Vernon Hospital, his remaining leg was starting to show signs of poor circulation. Suffering from serious infection, Carneal felt constant pain and was no longer able to garden or go on outings with his granddaughters. “It got so I couldn’t do anything with the foot because of the swelling and infection,” he recalls.
The Right Treatment
Carneal visited with Rodeen Rahbar, MD, an assistant professor of surgery at The George Washington University School of Medicine & Health Sciences and vascular surgeon at Inova Mount Vernon Hospital. Recognizing that Carneal’s leg could be saved with an advanced procedure, Dr. Rahbar collaborated with Dr. Neville, who is known nationally and internationally for his limb salvage techniques. Drs. Rahbar and Neville performed an innovative
procedure that Dr. Neville developed called a distal vein patch.
The procedure allows a bypass to be performed on patients who are not good bypass candidates.
“Using the distal vein patch, we can take someone from a 20 percent chance of saving the limb to a 70 or 80 percent chance of saving the limb,” says Dr. Neville.
For Carneal, the innovative technique meant his leg would be saved, allowing him to enjoy an independent lifestyle.
“Some surgeons may not have considered limb salvage in a case like Mr. Carneal’s,” says Dr. Rahbar. “With due diligence, we take an aggressive approach to limb salvage.”
As for Carneal, he’s back to doing the activities he loves.
“My quality of life is better than it was before,” he says. “I can
go outside and mess around in the yard,” he says. “I go places
with my granddaughters."
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| Unrestricted (left) and Restricted (right) Blood Flow In peripheral artery disease, the arteries that supply blood to the legs are narrowed, typically because of atherosclerosis. |
It’s a common circulatory problem. In fact, one in every 20 Americans over the age of 50 has peripheral artery disease (PAD). Many people, however, mistake their symptoms as a natural sign of aging and don’t report warning signs to their doctors. Early detection and treatment of PAD can improve your quality of life, help you maintain your independence and mobility, and lower your risk for heart attack and stroke. Here are signs to watch for:
Most people with PAD do not have symptoms, so ask your doctor about being screened if you are over age 70; over age 50 and you smoke or have diabetes; or are under age 50 but you have diabetes and risk factors for vascular disease such as high blood pressure, high cholesterol or obesity. |
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