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Dr.Amita
Dr.Amita, Doctor
Category: Medical
Satisfied Customers: 2103
Experience:  MD.Extensive knowledge of medicine.Faculty at a leading tertiary care teaching hospital.
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I was wondering if you could help me? I really need to know

Customer Question

Hello I was wondering if you could help me? I really need to know the answer to this question but its a specialised one? In a nutshell my partner had vascular surgery to improve blood supply to his foot to enable immobilisation surgery to his big toe. How long would he have to be shown to be maintaining a good pulse/blood supply before they would operate or now this supply is good should it be done asap? Many thanks Andrea
Submitted: 1 month ago.
Category: Medical
Expert:  Dr.Amita replied 1 month ago.

Thanks for your question.

What type of surgery he has had/

Is it vascular bypass or an angioplasty or stenting?

What is his age?

Thanks

Customer: replied 1 month ago.
Hi he had angioplasty 8th September and had a scan on Thursday showing good pulse and blood supply to groin, back of knee and foot. He is 60. Thanks
Expert:  Dr.Amita replied 1 month ago.

Can you telll me which vessel had the angioplasty?

Customer: replied 1 month ago.
Hi they went in his groin and down the leg past the back of his knee.
Expert:  Dr.Amita replied 1 month ago.

Thanks for the information.

Long term patency of these vessels after angioplasty is around 50% and as the time passes the risk for re stenosis increases.

The decision to operate at his toe would depend on other factors as well.These would include the status of the arteries distal to the area of angioplasty and the restoration of the Ankle brachial index.

If everything is in order the surgery can be done within 3-4 weeks post the angioplasty.

Customer: replied 1 month ago.
The foot consultant he saw just before his vascular scans this week said he would need to see a constant blood supply for 4 months before an operation. This contradicts what he said last year which was get in straight away after the vascular op to give a fighting chance. The foot man also checked his pulse in the leg (by hand) and said not enough pulse for an op really yet 2 days later had an ultrasound to say it was perfectly good by the vascular team. we are now between a rock and a hard place vascular says ok to go now (as you do) what do we do now?
Expert:  Dr.Amita replied 1 month ago.

I feel there is a difference in assessment between foot surgeon and the vascular surgeon.

I feel the way forward may be to have the vascular surgeon discuss the issue with the foot surgeon and reach a consensus regarding the adequacy of blood supply and the attendant risk at the time of surgery.

Customer: replied 1 month ago.
This would be my dream and surely the obvious answer. I've tried this tact before mentioning this in both departments and this appears to fall on deaf ears. In hospitals is there someone in authority I could go to who could help me achieve this goal? (In this case St Georges) like asking the boss in charge to get his departments to communicate and quickly?
Expert:  Dr.Amita replied 1 month ago.

I understand that you are in a difficult situation.

You may get in touch with a directors of particular departments to explain your problem and seek their help in the matter.

Customer: replied 1 month ago.
in theory there should be a Director of Vascular and a Director of Orthopeadic I can write/email to both simultaneously?. In desperation I may try and raise funds for him to go private - i googled some places. I will try and get a quote but I guess they even charge for the consultation? Thank you for giving straight answers - so strange to have to ask the internet to get straight direct answers that you feel the consultant in front of you is squirming out of.
Expert:  Dr.Amita replied 1 month ago.

I am not fully aware of UK system but in US there is a director for each department.

There must be some analogous hierarchy in UK.

Do take a moment to honor my answer by clicking on 4-5 stars at the top of the page.You can come back to the thread if you forgot something.

Expert:  Dr.Amita replied 1 month ago.

Do you have any more questions?

If done do rate my answer to honor my time and my work by clicking on 4-5 stars at the top of the page.

You can come back to the thread for any additional information on the topic.

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