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Published on February 17, 2015

Mid-Missouri Woman Back on Her Feet After Bout With Arterial Disease

New minimally invasive PAD procedure offered at MU Health Care

An open bypass procedure would have been the next step for Frances Heying of Marshall, Missouri, because of arterial blockages in both her legs.

“My legs hurt so badly that I could hardly walk a block at the most,” Heying said. “For the short distances that I could walk, my legs felt like they were weighted down with concrete blocks.”

Heying, like more than eight million other Americans, has peripheral artery disease.

Peripheral artery disease, also known as PAD, is a common circulatory problem in which plaque builds up inside arteries of the legs, blocking blood flow. The initial symptoms include leg pain or cramping when walking. The disease can progress to include leg pain at night or while at rest. As the condition gets worse, patients are not able to walk for long periods of time, and often struggle to walk even short distances. Eventually, it can lead to gangrene of the foot or leg as the oxygen-starved tissue dies. Amputation of the limb is the only option once that level of damage occurs.

Todd Vogel, MD, associate professor and chief of the Division of Vascular Surgery at the University of Missouri School of Medicine and vascular surgeon at MU Health Care, is using new catheter-based imaging technology that allows physicians to see inside a leg artery while treating PAD.

“It’s the first time we’ve been able to look inside a vessel and use internal imaging to guide the catheter precisely to the best site of the blockage,” Vogel said. “Previously, we had to rely on a combination of X-ray imaging, as well as touch and feel, to locate and penetrate a complicated blockage or closure in an artery.

By visualizing the blockage from the perspective of the catheter rather than the top view that we get with traditional X-ray imaging, we have increased opportunities to cross through these difficult blockages.”

The new technology being used at MU Health Care is a minimally invasive approach that uses 3-D images from within an artery to precisely maneuver a catheter to the site of a total blockage. Spiral flutes at the tip of the catheter tunnel through the blockage, enabling a guide wire to pass across the blocked or closed part of the artery. A therapeutic device such as a balloon or stent can then be used to reopen the artery and restore blood flow to the patient’s limb.

“Because the procedure is minimally invasive, we are able to decrease operative risks for those with additional complex medical conditions, procedural times are shorter, and in most cases patients don’t need general anesthesia,” Vogel said. “Recovery times are also shorter, and radiation exposure is minimized as extensive X-ray imaging is often not needed.”

Ocelot Procedure for Peripheral Artery Disease

Todd Vogel, MD, leads a procedure to clear blocked leg arteries in a patient with peripheral artery disease. Vogel is using technology that allows surgeons to see inside arteries for the first time.

In October 2014, Heying underwent the procedure on her right leg at University Hospital. The procedure took approximately two hours, and Heying returned home the next day. She noticed immediately that color returned to her leg and it had warmed considerably.

“The more I walk, the better my leg feels now,” Heying said. “It hurt for so many years. I don’t really know how I was walking before. Now my left leg has trouble keeping up with my right leg. But Dr. Vogel is going to fix that soon. I’m just so pleased with the results.”

To learn more about peripheral arterial disease, its symptoms and treatments, please visit

Click here to download a high-resolution photo of Todd Vogel, MD.
Click here to download a high-resolution photo of Todd Vogel, MD, in surgery.