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Innovative Approaches To Treating Peripheral Artery Diseaseand Other Vascular Conditions

 

Episode14

Description:  

During Peripheral Artery DiseaseAwareness (P.A.D.) Month, which brings to the forefront a debilitating circulatory disorder that impacts one in five people over age 60, hosts Kym
McNicholas and Dr. John Phillips, along with Nurse Practitioner Kay Smith, are talking to Dr. Jay Mathews. Dr. Mathews is an Interventional Cardiologist in Bradenton, Florida, whom several patients through nonprofit, The Way To My Heart's community call, "Dr. Miracle" for his limb-saving efforts with their care. He is fascinated by the innovation happening around P.A.D. and
other vascular diseases and shares some of the technology that's catching his eye.

In the introduction of Dr. Mathews, Kym shares a powerfulstory in which he exhausted all efforts to save an elderly woman’s leg. The woman had struggled with an occlusion for five years and because of it, was on deck for amputation on a Tuesday due to a non-healing wound on her toe. On the Friday prior, her daughter reached out to The Way To My Heart after 7pm eastern time to say a wound on her toe had taken a turn for the worse and was asking our
Nurse Practitioner Kay whether she should go to the emergency room. The problem was that the local emergency room had the vascular specialist on call who said amputation was her only option and the daughter wanted one last attempt for limb salvage. So, NP Kay contacted Dr. Mathews and found out he was on call that weekend. He is known for hisadvanced limb salvage skills and could attempt to save her leg. He told NP Kay he would be on standby Saturday morning for evaluation and possible angiogram.

The catch?

The emergency department (ED) in which he practiced was 90 minutes away. NP Kay was able to facilitate admittance to the out-of-area ED and arrange transportation. Dr. Mathews successfully revascularized her leg using minimally invasive tools and techniques, with only a few toes lost.

That story sparked a conversation about the importance ofgetting a second opinion prior to any amputation. The situation demonstrates different options available based on facility and physician. One of the concerns Dr. Phillips expressed was with the form patients are asked to sign prior to an angiogram, where blood flow restoration is attempted using minimally invasive tools and techniques. The form some patients are asked to sign gives physicians permission to perform an amputation at the physician’s discretion if they fail to restore blood flow during the angiogram. Patients don’t have a chance to get a second opinion and see if a second set of hands with a different skillset and set of tools might be more successful. During the discussion, Kym drives home the importance of patients reading any consent form carefully and having a candid discussion with the physician about their preference to get a second opinion prior to amputation so they don’t wake up surprised that their leg is gone.

The Heart of Innovation producer Mike Matthews' mom Christanever had that opportunity for a second opinion. She transitioned in February after a long battle with P.A.D., including the loss of one leg. We are dedicating this show in memory of Christa. In the third segment, Mike shares his mom’s struggles with P.A.D. and what he wished he knew upon her diagnosis
that he now knows based on listening to Dr. Phillips and Dr. Jay Mathews discuss advanced treatment options through the broadcast.

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Discussion on the innovative P.A.D. treatment centeredaround drug coated stents and balloons, advances in below-the-knee dissection repair, atherectomy, which involve devices that physically remove plaque, lithotripsy, which is sonic pressure waves that create a series of microfractures to break-up artery plaque, as well as deep vein arterialization (DVA), where a
physician can re-route blood flow through a vein using advanced techniques. Dr. Mathews also discussed advances in robotics, virtual reality, and Artificial Intelligence (AI) and treating vascular diseases.

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