Innovative procedure saves Midlands woman's foot from amputation

COLUMBIA, SC (WIS) - It's being called "the most dramatic advance" in preventing limb removal, according to one Midlands surgeon.

That surgeon is Dr. Daniel Clair, Chair of the Department of Surgery for the University of South Carolina and the Palmetto HEALTH-USC Medical Group. He's a vascular surgeon who was integral in bringing "LimFlow" to Palmetto Health Richland Hospital.

The procedure is in the clinical trial stages and is only being performed at three hospitals in the country. One of those hospitals is Palmetto Health Richland.

"It's usually performed in people who have such severe vascular disease in their arteries that they don't have an option for getting blood flow back through the arteries into the foot itself," said Dr. Clair. "In the past, the only thing we had to offer these patients was segmental amputation of parts of their foot and in most people that wound up in losing the foot completely."

The procedure essentially manipulates the arterial and venous systems in the body. Arteries carry oxygenated blood away from the heart, while veins carry de-oxygenated blood back to the heart. For a patient suffering from severe vascular disease or ischemia (an inadequate blood supply to a part of the body) the arterial system may not be delivering blood to a limb due to a blockage.

That's where the LimFlow procedure comes in. Using small punctures around the ankle, the surgeon can guide a catheter through a patient's artery and, using a needle, across to meet another catheter in a vein. Through that needle, a wire is passed into the venous system.

Then, the surgeon passes stents with covered fabric to direct the blood flow from the artery into the vein. Over the wire that's in place, a device cuts the valves, allowing the blood flow to go in the opposite direction.

Dr. Clair explained that the artery has a lot of pressure in it, while the vein doesn't. The flow pressure is driving from the artery, into the vein, and then to the affected foot itself.

"This is the biggest advance I've seen in people with the risk of amputation for people who are going to lose their foot in 25 years of practice," Dr. Clair said.

The proof is in the scans and, if you look at Willhemina Reed's pre and post-op CT scans (Dr. Clair's first patient using the LimFlow procedure), her ischemia was completely cured after undergoing the surgery.

"Me being the first one it was kind of worrisome," Reed said. "I didn't know what to think but I had faith that it was going to work.

He assured me that – I knew he was going to do everything he could."

Reed began suffering pain in May of 2017. She then went back to the doctor with an infected toe. After several tests and doctors visits, they found the source of her pain was the lack of blood flow to her foot. She was facing the potential of amputation until she met Dr. Clair.

Now, she walks on both feet with no pain. Meanwhile, the LimFlow procedure is currently in its clinical trial infancy, with several years of patients and studies ahead.

"It's truly a blessing," Reed said. "I'm just thankful, I really am."

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