Walk of Life

Leading-edge treatment relieves chronic leg pain.

After ten years of suffering, Howard Starr found relief for his painful legs at Vascular Interventional & Vein Associates.

Howard and Betty Starr

Even if they did have nine lives, cats would still have nothing on Howard Starr. This 71-year-old retired engine mechanic has survived nine heart attacks and three open heart surgeries, including triple and quintuple bypass procedures.

A US Navy veteran who served aboard the destroyer USS Porterfield, Howard also survived a near four-year-long tour of duty in Southeast Asia during the Vietnam War, which is where the root of his health issues can be found.

“I was a mechanic on the Porterfield and was regularly loaned out to PT boats,” Howard reveals. “It’s hard to know how often it happened, but I was exposed to Agent Orange during the war, and that’s what caused all my heart problems.”

It’s not just Howard’s heart that has been negatively impacted by Agent Orange, a defoliant used during the war to reduce the enemy’s natural food supply. The exposure has also left him with diabetes and severe circulatory problems in his legs.

Because of his vast array of health issues, Howard is 100 percent disabled. Still, he was getting around rather well until a couple of years ago, when the circulation problems in his legs began to take a toll.

“His leg problems started after he had the five-way heart procedure in March 2007,” says Howard’s wife, Betty. “His legs would just get very tired very fast, and he had a lot of pain in his calf muscles.

He tolerated it for almost ten years, but when he had to take a break after just walking out to the mailbox to get the mail, his cardiologist finally said, You need to get this fixed.

Howard’s cardiologist knew just where to go for help, advising him to see board-certified and
fellowship-trained vascular surgeon Pranay T. Ramdev, MD, the founder and president of Vascular Interventional & Vein Associates.

Like Playing PAC-MAN

“When Howard first came in, he was having difficulty walking even short distances primarily because of pain in his left calf,” Dr. Ramdev explains. “As part of our initial examination of him, we did an ultrasound of that leg.”

The ultrasound revealed that Howard was suffering from peripheral artery disease, or PAD, a common
circulatory problem in which the narrowing of an artery due to plaque build-up inside the artery limits blood flow to the legs and feet.

As was the case with Howard, symptoms usually begin to present themselves in middle age and worsen over time. For years, surgery was required to remove the plaque, but there are now some outpatient plaque-
clearing options that Dr. Ramdev specializes in.

“The most effective procedure for treating peripheral arterial disease used to be a surgical bypass in which stents were placed, and it had to be done in a hospital and required a hospital stay afterward,” Dr. Ramdev explains.

“But the technology is so advanced now that we can perform minimally invasive procedures in a surgical suite right in our office using a local anesthetic and a sedative. That keeps the patient from having to go to the hospital. I recommended this procedure for Howard, and he agreed.”

The minimally invasive procedure takes about an hour to complete and begins with the doctor entering the inverted-Y-shaped iliac artery through a half-centimeter incision in the groin. The doctor then runs a device that cuts, collects and removes the plaque down through the artery.

“There are different devices that can be used for this procedure, including one that spins at about twenty thousand rotations a minute that is very good for calcified plaque,” Dr. Ramdev notes. “For Howard, I used a device called the Medtronic HawkOne that works like the little characters in the old PAC-MAN games.

“It has a very sharp blade on the lower jaw portion that cuts and compacts the plaque, and you can make several passes with it. Once the plaque is cleaned out, a balloon is placed inside the artery that helps to create proper blood flow through the artery.”

Pain-Free Experience

After ten years of suffering, Howard Starr found relief for his painful legs at Vascular Interventional & Vein Associates.

Medtronic HawkOne

“I had no problems with the procedure whatsoever,” says Howard, who had one leg procedure done two years ago and another this past January. “They do a great job of making you feel relaxed, and I was able to watch the whole procedure on TV and even talked to the doctor. He would say, Can you see where I am now? And I’d say, Yep, I can see it all. It was amazing, and it didn’t hurt a bit.”

That pain-free experience extended beyond the completion of the procedure. Howard had dealt with an increase in pain and a decrease in mobility and function for nearly a decade, but within minutes of Dr. Ramdev completing the plaque-clearing treatment, he was back on his feet and walking without issue.

“That’s one of the great things about this procedure,” Dr. Ramdev explains. “Not only can you avoid a hospital visit and all that’s involved with that, but you get almost immediate relief from your symptoms, which was the case with Howard. By the time he left our office that day, he was walking virtually symptom free.”

“I was,” Howard confirms. “They didn’t let me walk out of the doctor’s office because they take you out in a wheelchair just to be safe. But I walked into the house when I got home, walked around without any problems that night, and I haven’t had any problem since.

“Now, I’m back going to the gym at least three times a week. I’m still quite active, and it’s because of Dr. Ramdev, who is just fantastic. He really is. He took great care of me, and I’d recommend him to anyone.

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