Saving Grace

Minimally invasive procedure clears blocked artery, preserves leg.

It took him until he was 70 years old, but William Humble finally married his high-school sweetheart, Carol, eight years ago.

Photo by Fred Bellet.

William and Carol are once again enjoying a happy, active retirement.

“One thing led to another, and we both wound up marrying other people after high school,” Carol explains. “But then his wife died, and my husband died, and one day after all that happened, I called William and asked if I could come by and visit. We were married five weeks later.”
William and Carol spent their first six years as a married couple reacquainting themselves and traveling across the country, bouncing from the Smokey Mountains to the Pacific coast, before taking a week-long cruise to the Caribbean.
The past two years have been a little more of a grind for the Ocoee couple. They have spent most of that time visiting doctors, mostly because of an agonizingly painful health issue that nearly cost William his right leg and foot.
When this problem first cropped up, William says he thought it was athlete’s foot. As time passed, however, the issue grew progressively worse. In time, William started getting ulcers on his feet, and his toes turned purple and black.
Frustrated by the condition’s persistence and the horrific pain it caused, William eventually visited a doctor whose diagnostic tests revealed that William was suffering from severe peripheral artery disease, or PAD.
PAD is a common circulatory problem caused by a blockage or a narrowing of the arteries that carry blood to the legs and feet. In William’s case, it was his right femoral artery that was blocked. As a result, he soon saw a surgeon who performed a relatively major surgery called femoral popliteal bypass surgery.
That surgery was complicated by a post-operative infection of the leg. Then, the bypass graft collapsed, which once again left William in excruciating pain. The only thing more painful was the message he then received from the surgeon.
“He told us, I can’t do anything more for you, and sent us to Shands Hospital,” Carol remembers. “After a while, the people at Shands told us pretty much the same thing, then put William on a clinical trial for a substance that’s supposed to make your blood vessels grow.”
William participated in the trial for four months, receiving eight injections every other week. The trial concluded before William realized any relief, however, which left William in the same desperate situation he was in prior to beginning the trial.
“They told us at Shands that they’d continue treating William but that they were probably going to have to take his right leg from just below the knee,” Carol says. “This was in October 2014. At the time, we were still seeing a doctor who was trying to do some skin grafts on William’s foot. After he heard what happened at Shands, he said,
I know a doctor who once told me, if you ever have any really bad patients, send them to me. We were willing to try anything at that point, so we went to see him.”

Practice Emphasis

The doctor William and Carol were referred to 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.
“My practice motto is Strong Heart and Walk Free and the emphasis of my practice is to help the heart and save the legs,”
Dr. Baiju informs. “We do that for 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.
“My focus is to avoid amputation at all costs, and we do that through a highly specialized but minimally invasive procedure designed to open even the tiny blood vessels that supply the legs and feet. Improving the circulation will provide the leg and feet with better blood flow, resolve the ischemia, promote ulcer healing and save the legs from 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, which are blood vessels that carry blood from the heart to the rest of the body, including the feet.
“We call this minimally invasive 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.
“With William, we did both and were tested to the limits of our experience and technology. The first time, we went down an artery through a hole in the groin. Then, a few months later, we went back in through the foot. In both cases, to scrape the blockage out, I used a diamond-tipped burr that spins at sixty thousand to one hundred twenty thousand revolutions per minute. It was like sanding off heavy, hardened arteries.
“After that was done, we did a drug-coated balloon angioplasty in which these leading-edge balloons, which are actually drug-coated balloons, were used to keep the circulation open as long as possible. Stents were then put in the arteries to keep the sites of angioplasty from collapsing. It was through this technique that I was able to open up the blockages in William’s leg and get the blood flowing back to his foot.”

Looking, Feeling Better

Because William required two procedures, the healing process took several months. It wasn’t long after the first procedure was completed that William began to notice a difference in the way his right foot looked and felt.
“All of a sudden, the disease on the toes and the foot stopped progressing,” Carol reports. “And then, after a while, the pain began subsiding. He was no longer waking up in the middle of the night screaming because his foot hurt so badly.
“Then, after Dr. Baiju performed the second atherectomy and angioplasty, the blood really got flowing. Since then, William’s ulcer has healed completely and he’s been pain free for almost a year. We’ve even taken another cruise to the Caribbean.”
Dr. Baiju’s care of William didn’t end with the procedures he performed to save his foot. He recently performed a percutaneous coronary intervention where he placed a stent in an artery that was 95 percent blocked in William’s heart.
“I have no idea where William and I would be right now had we not been referred to Dr. Baiju,” Carol says. “He has truly been a lifesaver. They were talking about taking William’s right leg and foot, and he saved them both.
“And now that Dr. Baiju has done the heart procedure, William has a lot more energy. It’s been a tough couple of years, but we have a chance now to get back to enjoying our lives together again, and we’re looking forward to that.”

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