Housecall

Your legs, like your heart, need a healthy blood supply to thrive. If you have poor circulation, which is called peripheral artery disease (PAD), you may need specialized treatment to restore your mobility and quality of life or heal wounds.

Thanks to a collaboration between cardiologist Sabu George, MD, at Columbus Community Hospital, and David Vogel, MD, a vascular surgeon in private practice, people in our community can receive treatments for PAD. These treatments can restore blood flow, relieve pain and, in many cases, help prevent amputation.

Limb-saving care

PAD develops when blood vessels outside the heart narrow or become blocked by plaque and calcium. The condition is often silent at first, but may eventually cause leg pain that makes it hard to walk or sleep well. Some people develop nonhealing wounds, infections and even gangrene that can lead to amputation.

In the past, Columbus-area residents with PAD often had to travel out of town for specialized procedures to restore their circulation. Now Vogel, George and other providers who diagnose and manage patients with PAD can offer minimally invasive treatments right here in CCH's cardiac catheterization lab.

Those procedures include:

• Angiograms to diagnose blockages.
• Atherectomy, which cuts away plaque.
• Balloon angioplasty, which widens arteries.
• Stent placement, which involves placing a wire mesh into the artery to prop it open.
• Shock wave therapy, which breaks up calcium in arteries.

The doctors perform most of these procedures through a small hole in the groin under local anesthesia. They insert specialized catheters equipped with balloons or other tools into an artery and use it to treat the blockage. Patients typically go home the same day, with little to no downtime, Vogel noted.

For the most complex cases, some treatments may need to take place at specialized facilities with additional advanced resources. But in many instances they can be performed right here.

Teaming up for patients

Many patients who receive vascular disease treatments come to see George at the cardiology clinic. That's no coincidence. People who have coronary artery disease — blockages in the heart — often have blockages in the arteries of their legs, neck or other areas, George noted. It's important that people who are already being seen by a cardiologist also receive screening for vascular disease.

"We search for these blockages," George said. "And when we find them, if they need intervention, we intervene."
In other instances, patients first seek care in CCH's wound clinic for advanced foot wounds.

"The goal is to help people keep their legs so they can keep their functional status and quality of life," Vogel said.

Vogel brings his vascular expertise to Columbus twice a month, working with George's cardiology team and other providers. People who come to CCH for heart or wound issues can receive referrals for vascular disease testing and, if needed, treatment. Often, George completes the diagnostic imaging (angiogram) and Vogel performs the vascular interventions.

"When we collaborate this way, the patient benefits," George said.

For many patients, the ability to receive these treatments locally is life-changing. As George pointed out, what may seem like a short drive can be a significant burden for patients with limited mobility or transportation.

"I've had some patients tell me, if you can treat me here in Columbus, I'll agree to the procedure. If I need to go far away, I'm not doing it," George said.

CCH made the right decision in establishing the cath lab for the community's benefit, George said, noting that it has already served thousands of people.

The people of Columbus and the surrounding communities deserve to get that care here."
— Sabu George, MD

Signs of poor circulation

Talk with your doctor about getting tested for peripheral vascular disease if you have risk factors, such as diabetes or a history of smoking, or if you notice any of the following warning signs:

• Cramping, aching or tiredness in the legs while you’re walking that goes away when you rest and returns at a predictable distance.
• Cold, shiny or hairless skin on the legs or feet.
• Nonhealing ulcers on the legs or feet.
• Leg or foot pain at rest — especially at night.

Categories: Peripheral vascular disease