Peripheral Vascular Disease Won’t Stop Her

Interventional vein procedures restore blood flow to legs, prevent amputations.

When 87-year-old Julia Nieves was younger, she worked on the assembly line at two factories in her native Connecticut. Both built weapons for the military. In 1989, Julia retired and relocated to Florida, where most of her children had already moved. Shortly after arriving, she met her future husband, Francisco.

Having had both legs treated, Julia  is again able to walk with her husband, Francisco.

“She settled in Port Richey in a house across the street from where I lived,” Francisco remembers. “As we got to know each other, we learned we both love to travel, so we decided to hitch up and travel together all over the United States. We’ve been married for 29 years.”

Several years ago, while the couple resided in Hernando County, Julia began to experience serious health problems related to poor circulation. Her primary care provider referred her to Thomas Mathews, MD, FACC, a fellowship-trained interventional cardiologist at St. Luke Heart Institute, which provides all aspects of cardiovascular care and also treats venous disease, erectile dysfunction and stroke.

“Dr. Mathews has been Julia’s cardiologist for 15 years,” Francisco shares. “A few years back, Julia suffered a stroke, and Dr. Mathews took care of her. The reason she had the stroke was because there was no blood circulating to her brain.

With Dr. Mathews help, Julia recovered pretty quickly and pretty much completely.”

Over time, however, Julia’s poor circulation affected her legs as well.

“There were several small blood vessels in Julia’s legs that were clogged up, so the blood wasn’t flowing properly,” Francisco elaborates. “She felt a stinging pain, numbness and cramping. The pain in her legs became pretty bad.

“She rated her pain as a 10 on a scale of one to 10, and it caused a lot of problems for her. When Julia and I first met, she walked faster than me, but her leg pain slowed her down quite a bit. It also woke her up and kept her awake at night.”

Julia put up with the pain in her legs for months before finally discussing the issue with Dr. Mathews. As part of a thorough evaluation, Dr. Mathews performed an ultrasound exam of Julia’s legs.

“We discovered that she had significant blockages from plaque in several blood vessels in her legs, a condition called peripheral vascular disease (PVD),” Dr. Mathews reports. “It wasn’t good for her health or overall heart condition because she couldn’t exercise and be active, which ultimately makes the PVD worse.”

Dangerous Situation

The plaque blocking the arteries in Julia’s legs consisted of cholesterol and calcium deposits.

“It was like concrete in there, a very hard, solid block,” Dr. Thomas observes.

Untreated, poor circulation and blockages in the legs can lead to severe consequences.

“Eventually, patients develop ulcers on their skin, which can become infected,” Dr. Mathews describes. “If toes don’t get enough blood flow, they can be lost. If a leg fails to receive sufficient oxygen from blood due to blockages, a condition called critical limb ischemia may develop and the patient can lose an entire leg to amputation.

“Amputation is a more serious matter than simply having a leg removed; it impacts the patient’s entire life. Fifty percent of people who undergo an amputation die within the following two to five years. It’s a very dangerous situation.”

Fortunately, Dr. Mathews offers advanced technologies and interventional procedures to eliminate blockages in the arteries, restore healthy blood flow and prevent amputation. Among them is angioplasty.

“During angioplasty, we insert a small catheter through an IV in the groin and thread it through the circulatory system to the area in question,” Dr. Mathews explains. “We then use a laser to vaporize the blockage in the blood vessel.

“When we perform an angioplasty, we sometimes insert a balloon, which we inflate to further open up the narrowed artery. In some cases, we place a stent to hold the blood vessel open after the procedure.”

“With two simple procedures, we repaired (Julia’s) circulation issue and allowed her to avoid major surgery.” – Dr. Mathews

At St. Luke Heart Institute, Dr. Mathews offers other interventional procedures to open blocked arteries in the legs, restore circulation and prevent amputation. One is rotoablation, which works like a Roto-Rooter® to carve through the blockage.

“Rotoablation is also called rotational atherectomy, and it’s performed using a small, rotating blade inserted through a catheter,” Dr. Mathews edifies. “The blade gently pulverizes the blockage into tiny pieces that can safely pass through the bloodstream and ultimately be eliminated from the body.”

Angioplasty and rotoablation are same-day, outpatient procedures performed in the cardiac catheterization lab inside St. Luke Heart Institute. They are 95 percent effective at restoring circulation in the legs. In about 5 percent of cases, interventional cardiologists must place a stent following the procedure to minimize narrowing in the artery.

“We used rotoablation and balloon angioplasty on Ms. Nieves, and they were very successful,” Dr. Mathews reports.

“With two simple procedures, we repaired her circulation issue and allowed her to avoid major surgery. In the old days, the only option was to open up the leg and perform a bypass. That’s a four- to six-hour surgery with multiple risks and potential complications.”

“A Definite Success”

According to Francisco, Julia is doing very well since undergoing the interventional procedures at St. Luke Heart Institute.

“A lot of the pain, stinging and numbness were alleviated,” he reveals. “It isn’t totally gone yet, but it’s much better. She says the pain is about a two or three on a scale of one to 10, which isn’t bad. She’s feeling quite a bit of relief.”

Julia’s lifestyle has improved as well.

“She’s able to sleep better. She doesn’t wake up with the pain like she used to,” Francisco explains. “And she walks pretty well. She doesn’t walk as fast as before, but we walk together.

“The treatment was a definite success. She had it done on both legs and it has improved her condition significantly. I definitely recommend it to others with the same condition.”

Francisco has kind words for Dr. Mathews and his staff.

“Dr. Mathews is wonderful. He’s a very good person and a good doctor,” Francisco raves. “He’s very knowledgeable.

That’s why we stick with him. His staff is very polite. They’re really nice people, and they treat us well.

“When we lived in Hernando, we had a short drive to Dr. Mathews’ office. Now that we’re living in Port Richey, we have a 40-minute commute, but it’s worth it. We’re happy with St. Luke Heart Institute, and we would never change.”

© FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. mkb
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      Dr. Mathews now can perform peripheral procedures in their clinic setting, including peripheral angiograms and peripheral stents. Treat leg pain, intermittent claudication, and chronic limb ischemia in the clinic. This is only for certain ... Read More

    • Thomas Mathews, MD, FACC

      Thomas Mathews, MD, FACC, is board-certified in cardiology, internal medicine, interventional cardiovascular and cardiac catheterization. He is a fellow of the American College of Cardiology. Dr. Mathews earned his medical degree from the Medi... Read More