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Thread: Blockage in Arteries legs in SCI Treatments? Stroke risk

  1. #1

    Blockage in Arteries legs in SCI Treatments? Stroke risk

    I have small (pencil eraser size) wound on Big toe not healed after 4 months on advice of wound doc got Bilateral ultrasound on legs checking for blockage. Have some blockage and excessive plaque. Is this normal after 34 years complete T-8? Will see cardio vascular doc and wound doc this week to see what the plan is. I don't want to get to worked up yet but if the S word "surgery" is brought up I think stents
    I will definitely be looking at risk / reward scenarios here by anyone who has had it done. Also any input from nurses much appreciated . I have lab results but don't know what the numbers mean. Wound doc recognizes that SCI patients may have different treatment plan ... Anyway i see cardio vascular Tuesday and will add any info and ask maybe some more direct questions

    feeling a little uneasy...

  2. #2
    Hi pete4sake

    Yes - Your blockage with a plaque in your legs is causing the blood supply in your foot/toe to be compromised/blocked. That toe wound will not heal if the circulation is not restored in your leg.

    You will be seeing a vascular surgeon who will open up the circulation. It would be the same if you had a clogged artery in your heart or neck, both are compromising your cardiac circulation for your body. It would be a worthwhile procedure.

    pbr
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  3. #3
    Had cardio vascular consult today no apparent area of blockage in either leg however slow or monophasic blood flow to lower extremities . Doc ordered CT scan of area above groing to see if there is blockage there
    I guess that's my update for now see wound care again Thursday scan and follow-up with CV doc within 2 weeks

  4. #4
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    Quote Originally Posted by pete4sake View Post
    Doc ordered CT scan of area above groing to see if there is blockage there
    I guess that's my update for now see wound care again Thursday scan and follow-up with CV doc within 2 weeks
    FRAK! That's a long time. Nothing like making it more stressful, huh? Good luck, and keep us posted.
    Rollin' since '89. Complete C8

  5. #5
    I have no blockages in either leg as confirmed by ultrasound a few years back, but recently had a dermatologist cut a half inch diameter spot out of my shin for a suspected basal cell carcinoma and now I am left with a hole in my shin. Now, after four months, it is closed but I definitely have a depressed area in the middle. I was told it is going to take "a long time" to heal, but I am not buying it.

    Turns out it was nothing more than psoriasis and there is no way it needed to be done so rashly. 10 days of some trial cream would've been more prudent. He was very rash about it and I never should've let him do it. 10 days would not have killed me, even if it was basal cell, which I never had. I thoroughly expected him to give me some type of cream.

    I pressed him on this afterwards and he conceded that "in retrospect" he should not have done it.

    Do not let this happen to you without getting a 2nd opinion, even for supposedly minor surgical procedures.

  6. #6
    Do you remember the term mono phasic? or something like that to describe the blood flow to your legs as opposed to triphasic ? in an able bodied person


    Quote Originally Posted by crags View Post
    I have no blockages in either leg as confirmed by ultrasound a few years back, but recently had a dermatologist cut a half inch diameter spot out of my shin for a suspected basal cell carcinoma and now I am left with a hole in my shin. Now, after four months, it is closed but I definitely have a depressed area in the middle. I was told it is going to take "a long time" to heal, but I am not buying it.

    Turns out it was nothing more than psoriasis and there is no way it needed to be done so rashly. 10 days of some trial cream would've been more prudent. He was very rash about it and I never should've let him do it. 10 days would not have killed me, even if it was basal cell, which I never had. I thoroughly expected him to give me some type of cream.

    I pressed him on this afterwards and he conceded that "in retrospect" he should not have done it.

    Do not let this happen to you without getting a 2nd opinion, even for supposedly minor surgical procedures.

  7. #7
    Hi pbr/Sci nurse
    i had a scan with die to check for blockage higher up. I have complete blockage to my right leg and significant blockage to my left (sore is on my left big toe) Surgeon wants to be minimum invasive. Procedure he recommends is go in through groin with wire clean out left side so sore can heal He is not sure if he should even put in stent he wants to play it cautious maybe not even do right which would need stent. I am very infection prone so want to be cautious too but thinking leaving legs with minimum circulation is eventually going to lead to wounds that won't heal and possible amputation . I am going to talk it over with my SCI doc in September ,do wound care in the mean time and consult with Surgeon at the end of September. My wound on toe stays basically the same for last 5 months size of pencil erasure and not very deep but I guess the fact it hasn't healed in 5 months means it probably isn't going to. are there other questions I should be asking?

    Quote Originally Posted by SCI-Nurse View Post
    Hi pete4sake

    Yes - Your blockage with a plaque in your legs is causing the blood supply in your foot/toe to be compromised/blocked. That toe wound will not heal if the circulation is not restored in your leg.

    You will be seeing a vascular surgeon who will open up the circulation. It would be the same if you had a clogged artery in your heart or neck, both are compromising your cardiac circulation for your body. It would be a worthwhile procedure.

    pbr

  8. #8
    He did an angiogram/arteriogram? You are correct in assuming with decreased circulation- and it will most likely just get worse- you could have worse pressure e injuries and amputation would most likely be recommended. G specifics on surgery" just cleaning out/" or a bypass from one artery that has better blood flow?
    CWO
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  9. #9
    This was the test i was given
    EXAM: CTA ABDOMINAL AORTA AND BILATERAL RUNOFF WITH CONTRAST WITH 3D BILATERA

    As far as surgery i think his plan is to clean out and possibly iinsert stent in left with partial blockage but possibly leave right with full blockage alone. He is definitely wanted to be conservative , which I guess is good however
    with full blockage in right leg maybe procedure is worth the risk? vs possible complications another sore ,infection etc. I met with wound doctor today and even though surgeon said there was no hurry wound doc said toes can "go bad" in a hurry and so his opinion was to keep the wound dry and possibly schedule left leg clean-out procedure sooner rather than later. So they want me to treat with betadyne and gauze or mepilex silver pad for now.

    I am going to see if i can get my SCI doc (physiatrist) to weigh in next and am leaning to have a t least the lleft leg (with the toe sore) done ...

    Also the sore is .5 cm x .6 cm with almost no depth and has been rather constant for a little over 4 months




    Quote Originally Posted by SCI-Nurse View Post
    He did an angiogram/arteriogram? You are correct in assuming with decreased circulation- and it will most likely just get worse- you could have worse pressure e injuries and amputation would most likely be recommended. G specifics on surgery" just cleaning out/" or a bypass from one artery that has better blood flow?
    CWO

  10. #10
    CTA-A stands for angiogram or arteriogram. I would consider it because blockage will probably continue and then become a complete block. wWthout enough blood you will get wounds very easily and they will not heal. Once totally blocked it is a lot harder to clean out and put stent.

    This is imiliar to what is done for heart blockage etc... Short procedure, not much downtime.
    CWO
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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