Saving Grace

Minimally invasive procedure clears blocked arteries, preserves former sprinter’s foot.

Keeping pace with Julian Steinberg was quite a chore back in the 1960s. A high-school sprinter at the time, Julian once finished third in the state of Ohio in the 100-meter dash and later went on to run track at Ashland University.

Photo courtesy of Julian and Vicky Steinberg.

Vicky and Julian Steinberg

Hampered by hamstring injuries, Julian’s sprinting career came to an end after a couple of years of running on the college circuit, but it wasn’t until after he suffered a stroke in January of 2016 that Julian really slowed down.

“The stroke forced me into retirement,” Julian says. “Before that, I was very active, both socially and professionally, running to and from trade shows selling lighting fixtures, ceiling fans and other accessories. I covered the whole state of Florida.”

Julian, who was diagnosed with diabetes shortly after he moved to Florida in 1972, suffered the stroke not long after he began to experience some vascular blockages in his legs that resulted in the development of a bothersome sore just below his left ankle.

“Once this sore developed it just wouldn’t go away,” says Julian’s wife, Vicky. “In fact, it only got worse. It eventually developed into a pseudomonas sore and it was really terrible. I mean, his foot was swollen, his leg was swollen; it was just awful.

“For a while we were going to a wound care center and they would dress it and put salve on it. They even sent a visiting nurse out twice a week to change the bandage, but it didn’t get any better. None of the doctors we went to had an answer for it.

“Almost every doctor we saw came to the same conclusion – that they would have to amputate the foot. We were very close to losing the foot, which was just devastating to Julian, when we went to see this one podiatrist who advised us to see Dr. Baiju.”

Specialized Procedure

Dr. Baiju is Pradip Baiju, MD. An endovascular specialist and interventional cardiologist, Dr. Baiju is the owner of Heart and Vascular Care, where he specializes in the prevention, diagnosis and management of peripheral vascular and cardiac disease.

“I specialize in helping people who are diabetic or have poor circulation and end up with ischemia [lack of blood supply], gangrene, ulcers or have black or purple toes and cold feet and legs and are facing a life-changing amputation,” Dr. Baiju informs.

“My goal is to avoid amputation at all costs, and we do that through a highly specialized procedure that opens the blood vessels that supply the legs and feet. This procedure improves circulation, which promotes healing and allows us to avoid amputation.”

The procedure Dr. Baiju specializes in is called an atherectomy. It is a minimally invasive technique that shaves and removes the atherosclerotic plaque blocking the blood flow in the arteries that carry blood from the heart to the rest of the body, including the legs and feet.

“We call this technique a percutaneous peripheral intervention, where you can either work your way down a large artery through small punctures in the artery of the groin or work your way up a smaller artery through a little pinhole in the foot,” Dr. Baiju educates.

Julian first visited Dr. Baiju in November 2016. During that initial visit, Dr. Baiju learned that failed attempts by other doctors to clear blockages in the arteries in Julian’s legs were the root cause of the ulcer that had developed just above his left ankle.

“Prior to seeing me, several attempts were made to clear the arteries in Julian’s legs,” Dr. Baiju explains. “During the first attempt, stents were placed in the left leg, but those stents became clogged with scar tissue and his arteries plugged up again below the stents.

“Another attempt was made by a surgeon who tried to clear the arteries by going up through his left foot, but that attempt failed, too. That was the cause of the ulcer developing at the point where he made the pinhole to enter the artery.”

“It would have been devastating had Julian lost his foot or his leg. That’s what we were facing when were told to go see. Dr. Baiju, but he took care of everything. – Vicky

Through his initial examination, Dr. Baiju further discovered that the flow of blood through the arteries in Julian’s legs was blocked from the mid-thigh all the way down to his foot, the result of which was a great deal of pain, swelling and discoloration.

Because of the ulcer, the option of attempting to clear the blocked arteries by going upward through the foot had been eliminated. That forced Dr. Baiju to try to clear the blockages by entering through the groin, which he succeeded in doing.

Stunning Success

“It took me more than two hours, but I got it done,” says Dr. Baiju, whose attempts were further complicated by the fact Julian has a kidney disease that prevented him from using iodine to visualize the blockage while performing the procedure.

“Using the iodine contrast would have worsened his kidney disease, so I had to use a carbon dioxide contrast to visualize the blockage and shave it down,” Dr. Baiju explains. “That required a little more time to complete the process, but we got the artery open.”

Julian returned a week later and had the same procedure done on another artery in his right leg. That allowed for a normal flow of blood through both legs and within three months of undergoing those procedures, Julian’s ulcer healed.

That, though, was not the end of Julian’s ordeal. Four months later another blockage developed in the stent that had been placed previously. Dr. Baiju repaired that blockage by using a specially coated balloon to coat the inside of the artery.

“It’s a new technology that uses a new type of balloon in which a medication is coated on the outside of the balloon,”Dr. Baiju explains. “Once the balloon is in the artery, we blow it up and the medicine on the outside lines the artery.

“We performed that procedure in March 2017. We have been monitoring Julian constantly ever since, and he’s doing great. He’s two and a half years out from that last procedure and his legs are fine. I have not had to touch him since.”

 

 

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