AboutLauri Ordway Expertise I can answer your questions related to peripheral vacular disorders. This includes all arteries and veins except those inside the head and inside the heart. IE: neck (carotid), arms (carotid subclavian bypases to Thoracic Outlet) belly (aortic aneurysm & occlusive disorders, renal artery stenosis), legs (iliac, femoral, popliteal, peroneal, dorasalis pedis, posterior and anterior tibial) arteries. Aneurysm & occlusive disease, atherosclerosis, leg pain, arterial wounds and gangrene, amputation prevention. Vein disorders: Blood Clots (DVT), post-phlebetic syndrome, varicose veins, venous stasis ulcers. I can help with vascular wound treatments. Also, Raynauds, Buerger`s disease, Thoracic Outlet and other miscellaneous vascular disorders.
I CANNOT answer questions about your heart disease, blood pressure, brain aneurysm, although I can help with questions about the arteries that go to and from those organs.
Experience I am a nurse, I have worked for 14 years with two terrific peripheral vascular surgeons, one of them is also the inventor of very innovative wound care products and surgical instruments to make vascular surgery procedures better and faster. I wrote and manage our clinic website and field questions from patients all over the world.
Expert: Lauri Ordway Date: 2/10/2006 Subject: Aortic-Femoral By-Pass
Question I am 59 and have suffered with PAD for 19 years, my mother also suffered from PAD, I have 3 stents in my chest for heart disease, 5'8 and 230lbs and losing. I carry my weight well as i am somewhat muscular but I am headed for a weight goal of 175lbs.
I have had an MRA and catherization for PAD and the resuilts were that I have a serious blockage where the Aorta and Illiac arteries junction.Both legs are affected.
My Cardiologists has referred me to a vascular surgeon which I have not yet been too for a possible by-pass. My concern is that my mother was never the same after this proceedure and would have been better off without it.
Is there any alternative to a serious blockage like mine? I can walk about 2 city blocks if they are not inclined, It seems like when a Dr treats a patient with insurance that the treatment and tests never end, I am concerned about surgery, I have done some research and do not like what I find. Your thoughts Please.
Harry
Answer Harry, well there are always hoices. Whether or not the resuts are what you might want is the problem.
You dont offermuch info, which is vital to offering any advice, for examole,if you are a smoker, the most important step you can take is to quit smoking. Chemicals in tobacco can damage your arteries. These chemicals can also greatly increase your chance of failure of any bypass for oclusive disease.
you are already working on acheivingand maintaining a healthy weight, by following a structured walking program at least 3 or 4 times a week, and daily (or more) massage to legs and feet, you can build up collateral circulation (new arteries) This also slows hardening of the arteries. When waliing, you will reach a spot, over and over, about the same distance, where you have calf pain, DONOT walk thru that pain, stop and allow the blood flow to relieve the pain, just stand still for a moment, until the paingoes away, then sart walking again. this is called intermittent claudication, by the way.
If you have high blood pressure, regular monitoring of your blood pressure and compliance in taking medication if prescribed is important. If you have diabetes, you need to control your blood sugar levels with diet and medication.
these measures will not fix a severe problem however, once the artery if occluded, narrowed to the point where your doc is talking surgery, you really will likly need surgery, once you have a bypass these conservaive measures can prevent additional sugeries.
If you have severe aortoiliac occlusive disease, whixh it sounds like you do, particularly if it does not improve with the measures described above, your physician may recommend a minimally invasive treatment called angioplasty to improve the circulation in your legs. For more extensive blockages or those that cannot be treated with angioplasty, surgery to bypass or clear your blocked arteries may be required.
During an angioplasty procedure, which is sometimes performed at the same time as an angiogram, a long, thin, flexible tube, called a catheter, is inserted into a small puncture over an artery in your leg and is guided through your arteries to the blocked area. Once there, a special balloon attached to the catheter is inflated and deflated several times. The balloon pushes the plaque in your artery against your artery walls, widening the vessel. In some circumstances, a tiny mesh-metal tube called a stent may then be placed into the narrowed area of your artery to keep it open. The stent remains permanently in your artery. After successful angioplasty, blood flows more freely through your artery.
thenice thing about abypass rather than angioplasy is the bypass sually lasts 10-20 years (unless you smoke or resume old, bad habits)
Bypass surgery, usually done through abdominal or leg incisions depending upon the location of the blockage, creates a detour around the narrowed or blocked sections of your artery. A Y-shaped tube made of synthetic fabric, called a graft, is attached to your aorta above the blockage. The two branches of the graft are then attached to either your left and right iliac arteries or other major arteries in each leg (called the femoral arteries). Although more invasive bypass surgery restores blood flow in about 85 percent of patients. Results are commonly maintained for 10 or more years.
As fas as you mom having had problems, every one is of course different and I suggest you find a peripheral vascular surgeon who has done hundreds of these cases. You need an experienced surgon, if you want to say where you are, nearest large or university towm, I may be able to offer a name.
