Kolkata docs give new lease of life to man with severe heart and leg blockages 

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Doctors in Kolkata have given a new lease of life to a 42-year-old man from Kolkata who was dealing with shortness of breath on exertion and severe calf muscles pain while walking. He was found to have significant blockages not only in the arteries of his heart but also in both lower limbs. 

Dr Prof. Partha Sarathi Banerjee, senior interventional consultant Cardiology at Manipal Hospital in Salt Lake, successfully performed complex angioplasty using a stent and drug-eluting balloon, restoring normal blood flow within the arteries. The operation lasted for more than three hours.

Diagnosis and treatment 

The man had multiple cardiovascular risk factors, including high blood pressure, smoking and excess weight. His hearts pumping function was around 40 per cent, while his ECG did not show any critical changes. However, clinical examination revealed very weak pulses in both lower limbs, raising suspicion of serious peripheral arterial disease. Considering his symptoms and examination findings, it was decided to perform angiography to evaluate both the coronary arteries supplying the heart and the arteries supplying the legs.

His angiography revealed extensive vascular disease. The left anterior descending (LAD) coronary artery had a long-segment blockage of approximately 90 per cent, while the right coronary artery was completely blocked. Further evaluation showed that the renal arteries were normal. However, the right superficial femoral artery was completely blocked, while the corresponding artery in the left leg was also critically narrowed.

Dr Banerjee said, “The patient came with leg muscles pain on walking and chest discomfort with history smoking and Hypertension. His angiography revealed one major coronary artery (LAD) 90 per cent block and right coronary artery 100 per cent block (CTO), lower limb arteries (SFA)on both sides were total and 95 per cent blocked on right and left sides respectively. We successfully performed balloon dilatation and stent deployment and DEB dilatation in LAD artery and Right SFA in the same sitting. He is doing well and is recovering steadily. The patient with severe coronary artery disease and bilateral peripheral arterial disease was managed through a carefully same sitting interventional procedures, particularly because raised serum creatinine required doctors to balance vascular treatment with protection of kidney function, added Dr Banerjee.

Since the patient had elevated creatinine, the medical team decided against treating both legs during the same sitting to minimise the amount of contrast dye used and reduce the potential risk to kidney function. Following the coronary intervention, doctors treated the completely blocked artery in the right leg. A guidewire was carefully passed across the blockage, followed by balloon dilatation. A drug-coated, self-expanding stent (ELUVIA) was then deployed across the long blocked segment, successfully restoring blood flow to the right lower limb.

The man remained stable and comfortable following the procedure.