Surgeon uses new technology to see and clear blocked arteries

Frances Heying

My legs hurt so badly for so many years,” said Frances Heying of Marshall, Missouri. “I could hardly walk a block at the most. I don’t really know how I was walking before. My legs would cramp up. They just wouldn’t move. They would just lock up.”

To alleviate the pain and improve her overall health, Todd Vogel, MD, chief of vascular surgery for University of Missouri Health Care, recommended a minimally invasive procedure using new technology.

Todd Vogel
Todd Vogel, MD

“When he suggested the surgery for my legs, I was all for it,” said Heying, who had trusted Vogel with a carotid artery procedure five months before. Vogel describes the new technology as a way to see inside a dark tunnel.

“This new technology, optical coherence tomography, allows us to visualize arteries from the inside and treat patients who would have required bypass surgery in the past,” Vogel said. “Traditionally, there has been a very poor success rate crossing totally blocked arteries. This is the first time we’ve been able to look inside an artery and use internal imaging to guide the catheter precisely to the best site of the blockage. The patients who benefit most are those who would otherwise require an open bypass or even amputation.”

During the minimally invasive procedure, Vogel uses the new technology to capture 3-D images in real time from within an artery. Guided by this imaging system, he can precisely maneuver a catheter to the site of a total blockage. He uses a drill-like device at the tip of the catheter to tunnel through the blockage, enabling a guide wire to pass across the blocked or closed part of the artery. A balloon or stent is then 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.”

According to the Centers for Disease Control and Prevention, approximately 8.5 million Americans have peripheral artery disease, or PAD. The term refers to a common circulatory problem in which plaque builds up inside arteries within the legs, blocking blood flow. It causes leg heaviness, pain and cramping. In severe cases, tissues in the legs or feet die because they do not get enough oxygen. When this happens, doctors may recommend an amputation, in which part of the leg or foot is removed, to save the person’s life.

Frances Heying and dog

An open bypass procedure would have been the next step for Heying, when Vogel recommended the new minimally invasive procedure.

In October 2014, Vogel performed the procedure on Heying’s right leg at University Hospital. The procedure took approximately two hours, and Heying returned home the next day. She soon noticed that color was returning to her leg and it had warmed considerably. In February 2015, Vogel performed the procedure on Heying’s left leg and she again noticed results quickly.

“The more I walk, the better my legs feel now,” Heying said. “I can walk without pain. They feel like new legs. I would recommend the surgery to anyone, if Dr. Vogel does it.”

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