Walk On

Minimally invasive vein treatment relieves chronic leg fatigue.

Retired school teacher Marlene Burke and her husband, Tom, love to travel. They’ve toured most of Europe and the Caribbean together and once combined a trip through the Canadian Rockies with their other favorite pastime – camping.

Photo by Jordan Pysz.

Vein treatment allowed Marlene to enjoy every stop on her Rhone River cruise.

This past Christmas, Tom surprised Marlene and a friend of hers with a mid-July trip to the south of France, where they would spend eight days sailing down the Rhône River on a cruise that included walking tours of six towns between Avignon and Lyon.
There was just one problem: For years, Marlene, 74, found it difficult to walk more than a couple hundred yards before chronic cramping, tightening and fatigue forced her to stop and rest. It’s a problem that can put a bit of a damper on a dream vacation.
“It’s one thing to be with your husband and kind of go at your own pace, but when you’re with a tour group, you don’t want to hold everyone up and slow the group down,” Marlene states. “I was determined to go on the trip, though.
“I decided that I was just going to have to be extra careful this time around and be as smart as I could about it. I figured I would just have to stop and rest and catch my breath and then go on, but I was willing to do that to make the trip.”
Marlene has long associated her leg problems with a back injury she suffered as a teenager during a bad fall. Just weeks before leaving for her trip, she learned that the true cause of her leg discomfort was something much different.
“I had gone to see my doctor for my six-month check-up, and a nurse practitioner who I don’t always see there put a stethoscope on my carotid artery,” Marlene remembers. “She then told me she wanted me to get an ultrasound done.
“Once I got the ultrasound done, I went back to the doctor, and she told me she wanted me to see this one particular doctor because there was a procedure she wanted him to do for me. I assumed this was all related to my back, but I was wrong.”

Surprising Diagnosis

The doctor Marlene was advised to see is not a back specialist. He is board certified and fellowship trained vascular surgeon Pranay T. Ramdev, MD, the founder and president of Vascular Interventional & Vein Associates.
“Marlene first came to me with a question of a possible carotid artery blockage in her neck,” Dr. Ramdev reports. “While she was here, however, she complained of significant discomfort in her calves when walking even short distances.
“We then evaluated her in our office and found that she had pulses in her groin but no pulses in her feet. After that, we performed a formal ultrasound on her that showed she had fairly significant disease in both her lower extremities.”
The disease Marlene was diagnosed with is peripheral artery disease, or PAD. It is 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 Marlene, 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 technology is so far advanced now that we can perform some of these minimally invasive procedures in a surgical suite right in our office using local anesthetic and a sedative, so the patient doesn’t have to go to the hospital,” Dr. Ramdev educates. “I recommended this procedure for Marlene and she 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 down through the artery that cuts, collects and removes the plaque.

Like Playing PAC-MAN

“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 Marlene, I used a device that works like the little guy in the old PAC-MAN games.
“It’s called a Medtronic HawkOne, and it has a very sharp blade on the lower jaw portion of it that cuts and compacts the plaque so you can make several passes with it.
“After the plaque is sufficiently cleaned out of the artery, a balloon is placed inside the artery to open up the blood flow. With Marlene, we found that she had a complete blockage at the right groin, so we cleaned that out and reestablished blood flow down her right leg.”
Marlene was scheduled to have her procedure done just 12 days before she was planning to leave for France, which left her concerned that she might need to cancel her trip to allow for time to recover.
Dr. Ramdev assured her that was not necessary.
“As far as recovery goes, all you need to do once the procedure is over is lie flat on your back for about six hours in this special room they have,” Marlene relates “After that, you’re good to go, and let me tell you, they take great care of you while you’re there.
“They have TVs, and a nurse is right there with you the whole time. They even have assistants checking on you all the time to make sure everything is okay. I give them all an A-plus grade for their care and the same for Dr. Ramdev because he did a great job.

“That procedure was like a miracle. For me, it was nothing short of life-changing.” – Marlene

“I went home that night, and my legs were still a little sore the next morning, but it was nothing I couldn’t handle. And the best thing is that the cramping and pain were gone. Those were eliminated immediately, and boy, what a difference that made on the trip.
“My husband had signed me up for just about every tour on that trip, and I went on all of them and I kept up with everybody. And let me tell you, we walked miles and miles and miles on cobblestones through villages and towns everywhere.
“It was just a great trip, and I know that I would not have had as great a time as I did had I not had that procedure done by Dr. Ramdev. That procedure was like a miracle. For me, it was nothing short of life-changing.”

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