Amputation Avoided After Severe Peripheral Artery Disease Diagnosis

BIDMC Contributor

APRIL 19, 2023

man walking

Jim Bartimo spent his career in journalism, crisscrossing the United States. He reported on technology in Silicon Valley, the economy and business for the Wall Street Journal and became a founding editor of Bloomberg News. After a full professional life, Jim happily retired to New Hampshire, where his family vacationed during his childhood.

Jim was enjoying this chapter of life, when he suffered an increasing ache in his left leg. “It felt awful, like a really bad charley horse. It was difficult for me to walk.” The pain became too much to bear. Jim called an ambulance that took him to the nearest hospital where doctors ordered an angiogram, a scan that shows how blood flows through arteries.

Jim learned he had significant peripheral artery disease (PAD), a development of blockages or atherosclerosis in the arteries that supply blood to the legs. Jim’s blockage extended from his femoral artery in the groin all the way down to the level of the calf. Without this key blood flow, the foot became gradually more painful and put him at risk for gangrene.

Is Amputation Avoidable? 

Jim was devastated when doctors explained his left leg needed to be amputated to save his life. As an older adult living alone, he imagined being unable to care for himself, and having to give up his large 2-story home and active lifestyle. Jim decided against the amputation, and sought a second opinion. However, the new specialist he saw weeks later read the hospital angiogram report and agreed amputation was Jim’s best option.

A chance encounter at a San Francisco airport offered Jim hope. His dear friend, David Needle, was there waiting for his plane when he saw a man wearing a BIDMC logo on his jacket. He approached this man—a physician—they struck up a conversation. When David contacted him a week later after he learned of Jim's situation, the physician, Arriyan S. Dowlatshahi, MD knew just what to do. He helped facilitate an appointment between Jim and Mark Wyers, MD, a vascular and endovascular surgeon, and Co-Director of BIDMC’s Limb Preservation Center.

Leg Saved by Vascular Surgeon 

“We frequently treat patients like Jim at the Limb Preservation Center with Chronic Limb Threatening Ischemia (CLTI),” explained Dr. Wyers. “They risk losing their limbs due to diabetes, peripheral vascular disease, infection, trauma or other reasons.” The Limb Preservation Center is the only program in New England—and one of few in the country—to bring together the specialties of podiatry, vascular and plastic surgeries to offer patients like Jim more treatment options. “It is this coordinated, multidisciplinary effort that allows us to take on the most challenging cases.”

Dr. Wyers met with Jim and performed a new, minimally invasive angiogram that showed Jim’s condition was treatable and that the leg could be saved. He would need femoral tibial bypass surgery, a procedure to redirect blood around blocked vessels in a patient’s lower leg or foot using a vein from the same leg to perform the reconstruction. “Dr. Wyers came into the room after the test and said, ‘Oh, yes. We can do this.’ It was an incredible relief,” Jim recalled.

“Restoring good blood flow can take several different forms and there are several factors to consider in order to choose the best and safest option for each patient. We have many minimally invasive approaches, including angioplasty to open up narrowed or blocked blood vessels. Sometimes angioplasty is combined with placement of a stent, a wire mesh "scaffold" to keep the artery open. For more advanced cases, like Jim’s, we have the option of various forms of bypass surgery,” explained Dr. Wyers. “For patients with severe PAD, combined with ulcer or infection of the foot, blood flow needs to be restored immediately to have the best chance of saving the limb.”

During femoral tibial bypass surgery, doctors use a graft—a vein taken from another place in a patient’s leg or an artificial blood vessel. The graft begins at the femoral artery in the groin and connects to one of the tibial arteries in the lower leg. Bypass to one of the arteries in the foot itself is also possible to restore blood flow. After Dr. Wyers performed the successful surgery, Jim spent less than 4 days in the hospital healing before returning home.

Limb Preservation Expertise

Dr. Wyers and his colleagues Barry Rosenblum, DPM, Associate Chief, Podiatry and Podiatric Foot Surgery, and Dr. Dowlatshahi, Plastic Surgery; Surgery of the Hand, are Co-Directors of BIDMC’s Limb Preservation Center. They represent a team of aligned specialties that give patients expanded treatment options and leading-edge care. The limb preservation center team comprises 7 vascular surgeons, 6 podiatrists and two plastic surgeons as well as many PAs, NPs and nurses.

“Our physicians contribute to, and lead, research that advances the science of limb preservation. We participate in clinical trials for new devices and even non-surgical therapies designed to improve blood flow. We work closely with the Rongxiang Xu, MD, Center for Regenerative Therapeutics to pioneer and educate our peers on treatment options that directly affect the lives of patients like Jim,” Dr. Wyers said.

Life After a Femoral Tibial Bypass

Nearly one and a half years after his surgery, Jim is back to retirement, avidly gardening and fishing, and remains in his two-story home. He wants others to understand how important it is to pay attention to leg pain and advocate for one’s health. He is grateful to have found Dr. Wyers and the skills of his medical team. Jim adds that during his health crisis, “I’ve learned that it is really important to have family or friends with you for support and help. It’s an amazing story when you tell it to someone.”

Jim returns to the Limb Preservation Center every 6 months to monitor his health and says that each time, “I walk out 100%.”

Treatment at BIDMC

With our expertise and support, patients can return to an active lifestyle. Contact us today to be a part of our program. Call 617-632-8424 to schedule an appointment. Learn more about the Limb Preservation Center.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
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