Dodging Disaster

Advanced techniques for unblocking arteries save leg.

Early last year, Ines ripped a nail on the big toe of his right foot. With his diabetes not well controlled, that minor injury degraded, and as his daughter explains, caused a chain reaction that nearly cost Ines his leg.Dr. Pradip Baiju of Heart and Vascular Care in Orlando and Longwood closed the open wound on Ines’ right foot by unblocking the arterial blood flow in his leg.

“My father never told me about his toenail, and because we live in St. Croix in the US Virgin Islands, we keep socks on his feet to protect him from mosquitoes,” shares Georgeanna.

“So I didn’t know anything was wrong until he told me his ankle was hurting him. When I checked his ankle, I saw his toe and it was a mess. I said, What’s going on here? Why is this smelling? His toe was very swollen and ugly.”

Georgeanna immediately took her father to the island’s hospital. The doctors there were forced to remove Ines’
gangrenous toe.

“The procedure was unsuccessful, and my father was left with a large wound on his foot that wouldn’t heal,” Georgeanna discloses. “The wound was pretty serious. There was even bone exposure.

“St. Croix had recently endured a category five hurricane that compromised the hospital, so staff there weren’t able to give my father the care he required. He needed more intense treatment for his wound. We decided to leave the island and go to Florida. We arrived in Clermont on Mother’s Day 2018.”

Once in Florida, Georgeanna’s cousin took her and her father to a prestigious hospital in Orlando. Staff there called in a podiatrist who was also a wound care specialist. The podiatrist took one look at Ines’ foot and immediately referred him to Pradip Baiju, MD.

Dr. Baiju is an endovascular specialist and interventional cardiologist at Heart and Vascular Care in Orlando and Longwood. He specializes in the prevention, diagnosis and management of peripheral vascular and cardiac disease.

“The wound care specialist called me in for an emergency,” Dr. Baiju recalls. “He told me he had a patient who might lose his leg due to a severe wound on his right foot. I saw him that same afternoon.

“The wound left by the amputation of Ines’ toe was very deep. I could place three fingers into it, and if I looked through it, I could see his bones. The doctors at the hospital were planning to perform a below-the-knee amputation on Ines. That’s when they sent him to me for a second opinion.”

As part of his evaluation, Dr. Baiju wanted to know how efficiently oxygen-bearing blood, which promotes healing, was flowing to Ines’ right foot. The doctor performed an x-ray examination of Ines’ arteries called an angiography. Results of that exam showed multiple severe blockages in the arteries in Ines’ lower legs, especially in his right leg.

“I determined that Ines didn’t have any blood flow going down into his right leg,” Dr. Baiju confirms. “He had a condition called peripheral arterial disease, or PAD. That’s a common circulatory problem caused by a blockage or a narrowing of the arteries that carry blood to the legs and feet.

“In Ines’ case, all the arteries below his knee were blocked – one hundred percent in some cases. He also had an eighty percent blockage at his knee joint. I had to open up those blockages and restore blood flow to his foot.”

“Dr. Baiju told us that the arteries going down Dad’s leg were blocked, and blood couldn’t get to his foot to heal the wound,” Georgeanna echoes. “He said, Bring Ines to my center; I will take care of the problem.

Finest Technology 

During the angiography, the doctor identified two different types of blockages in Ines’ leg arteries.

“Some of them were filled with cholesterol,” Dr. Baiju observes. “Others were made of cholesterol, but also contained calcium. Like cholesterol, calcium can accumulate in the arteries over time. In these cases, I use the Diamondback 360® Peripheral Orbital Atherectomy System to clear the arteries.

“This system uses a rotor blade with a diamond-tipped burr that spins at high speeds inside the artery. Using this system, we literally sand the calcified blockage and create an opening for the blood to flow through.”

Dr. Baiju used this system while performing the first two of three separate procedures. Within a week of performing the second procedure, blood was once again flowing to the wound, Dr. Baiju reports.

During the third procedure, Dr. Baiju concentrated on the cholesterol-filled blockage near Ines’ knee and used a different atherectomy device called the TurboHawk™ excision system to clear it.

“With this device, we shaved the blockage and removed it from the body,” Dr. Baiju explains. “Removing the blockage opens up the artery’s blood flow. In treating Ines, we used the best technology available because different types of blockages require different devices to get the best results.”

Return Trip

Dr. Baiju’s treatments worked well for Ines. After finishing the treatment, Ines and Georgeanna returned to St. Croix, but they returned to Florida yet again to show Dr. Baiju the final outcome of his efforts.

“They told me the reason they came back was to see me and show me Ines’ foot,” Dr. Baiju says. “The wound had completely healed. There was nothing there. It looked like a brand-new foot.

“It really made me happy that the family came back to tell us they’re doing well. Ines wanted me to see what his foot looked like because when I first saw him, they were ready to amputate his leg. Cases like these are very heartwarming.”   

Georgeanna notes that Dr. Baiju’s treatments started working quickly for Ines. She and her father started seeing a difference in the size of Ines’ wound shortly after treatment began. And she agrees with Dr. Baiju’s assessment of her father’s results.

“Within three days of the procedures, we started seeing dramatic improvement in my father’s foot,” Georgeanna enthuses. “The wound started healing. More flesh was growing from the inside out, which is the right way to heal.

“The end result of Dr. Baiju’s treatment is that the wound on my father’s right foot is completely gone, and his foot looks healthy and normal again.”

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