Perpheral Artery Disease Patient Regains Use of Right Leg
David Ganz had experienced cramp-like pain in his right leg for two or three years. A stoical, 76-year-old ex-Marine, he disregarded the discomfort until it became so severe one cold February day that he couldn't stand up.
A cardiologist friend referred Mr. Ganz to the CardioVascular Institute (CVI) at Beth Israel Deaconess Medical Center (BIDMC) for a non-invasive ultrasound that identified significant circulation blockages in his right leg. He also suggested that Mr. Ganz contact Allen Hamdan, MD, a CVI vascular surgeon.
After the ultrasound, on the way home, Mr. Ganz called Dr. Hamdan's office from his car. "I said 'I'd appreciate it if Dr. Hamdan would give me a call,' thinking I'd be lucky if I heard from him in two weeks," he recalled. Before Mr. Ganz turned into his Belmont driveway, his cell phone rang: It was Dr. Hamdan, who had already evaluated the ultrasound. "He said, 'Turn around and come back. I want to see you.' "
Three Causes of Leg Pain
When legs are painful, the problem can be arthritis, neurologic issues related to the back, vascular issues or some combination of the three. Dr. Hamdan performed an angiogram, an X-ray image that shows blood flow within arteries. The angiogram confirmed that the origin of Mr. Ganz' pain was peripheral artery disease (PAD), a vascular issue. It also indicated that in his case, stenting -- a nonsurgical procedure in which an artificial tube is installed to prop open a clogged artery -- was not the solution.
Within a week, Dr. Hamdan performed an endarterectomy on Mr. Ganz' leg. "I opened the artery and physically removed the plaque and then repaired the artery wall," he said. "Mr. Ganz had the most severe form of peripheral artery disease."
Dr. Hamdan continued, "A lot of people with PAD have no symptoms. Then there are those who have problems walking, which is called claudication, and that is what we commonly see. However, Mr. Ganz had rest pain, which means the circulation is so poor that you get pain even when the leg is at rest. It predates a situation where you can get ulcers or gangrene and lose your toes or leg."
A Happy Ending
By summer, the retired businessman could walk a mile and was back on the golf course.
"Dr. Hamdan did amazingly good work and now I've got the use of my right leg," said Mr. Ganz. "Overall, it's been a wonderful experience. This doctor is not only an extraordinarily good surgeon, but also he did something very unusual to see a problem in a report on a guy he never knew and react immediately."
Dr. Hamdan advises people not to ignore leg pain, especially as they get older. "If you're having trouble walking and it's progressive and no one is giving you answers, you should see a doctor because that is not normal -- especially if you were active before," he said. "Even if the artery blockages are very severe, we can fix the vast majority of patients with endovascular (minimally invasive) measures or surgery."