{"id":24879,"date":"2019-06-12T13:27:22","date_gmt":"2019-06-12T19:27:22","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=24879"},"modified":"2022-11-16T11:13:34","modified_gmt":"2022-11-16T18:13:34","slug":"interventional-cardiology-saves-a-leg","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/interventional-cardiology-saves-a-leg\/","title":{"rendered":"Interventional cardiology saves a leg"},"content":{"rendered":"
<\/div>

Laurie Sharp’s health care story is a saga of three kidney transplants and a slew of serious complications spanning three decades. If you’re in a hurry, through, here’s the gist, and it’s well worth remembering: Interventional cardiology saves more than hearts.<\/p>\n

Sharp, 52, was born with bad valves at the base of the tubes connecting her kidneys to her bladder. These faulty ureterovesical valves allowed urine to reflux back into the kidneys. She was 17 before it was diagnosed; by then, the damage had been done. When she was 29, she received one of her mother\u2019s kidneys.<\/p>\n

\"A
Laurie Sharp still has two feet thanks to her own persistence and the work of CU School of Medicine interventional cardiologists at UCHealth.<\/figcaption><\/figure>\n

The 1995 transplant at what\u2019s now UCHealth University of Colorado Hospital<\/a> at the Anschutz Medical Campus<\/a> (UCH) was a success, but it came with a strange complication: About a year after the transplant, her left calf cramped severely if she walked more than a few dozen yards. Soon, her whole foot hurt. Physicians diagnosed a blood clot in the left common femoral artery \u2013 the side opposite of where her mother\u2019s kidney had been transplanted. The clot choked blood flow to her lower leg, which caused the cramping.<\/p>\n

The prescribed treatment suited the active Sharp well: She should exercise a lot, they told her, because doing so would spur the growth of collateral blood vessels (natural bypasses) that would ultimately reroute flow to her left leg. So she walked, she did elliptical machines and she did exercise classes. It took about three years, all told, but it worked. Her leg was fine again.<\/p>\n

Sharp\u2019s first child, Kayla, was born before the transplant; her second, Sophia, came five years after that, in 1998; and her third, Spencer, came in 2003. Sharp knew that pregnancy was hard on kidneys (it\u2019s hard on the whole body, after all), but her UCH doctors monitored her closely and the babies were all healthy. Unfortunately, Sharp didn\u2019t fare as well. The kidney failed.<\/p>\n

Kidneys two and three<\/strong><\/h3>\n

She went on dialysis \u2013 not easy to balance with three young children \u2013 for 20 months, until November 2006, when a friend donated a kidney for a second transplant at UCH.<\/p>\n

Sharp\u2019s leg was fine this time, but her 5\u20191\u201d frame began shedding weight. She dropped from about 120 pounds on down to a skeletal 70 over the course of a several of years \u2013 a reaction to antirejection medications. When her doctors cut back the dose, her kidney function worsened. By 2015, not only did the second kidney start to fail, but her leg also started hurting again. She was back on dialysis and ended up with an infection she picked up on an airplane. It became life-threatening and kept her in the hospital for two-and-half weeks at UCH. While Sharp was there, a CU School of Medicine medical fellow noted skin peeling from Sharp\u2019s toes and told her she was at risk of losing the foot.<\/p>\n

\"A
Dr. Ehrin Armstrong<\/figcaption><\/figure>\n

While still on dialysis, she underwent a femoral artery bypass in November 2016. The vascular-surgery procedure involved sewing in a synthetic tube to replace the blocked section of the artery. As can happen, the bypass itself soon clotted and became blocked.<\/p>\n

She was on dialysis for 18 months until her husband Mark\u2019s participation in a kidney transplant chain brought Sharp a third kidney in October 2017 \u2013 the wait a result of Mark\u2019s rare blood type. This time, she maintained her weight and was healthy, renally speaking. But her leg and foot really hurt. As months passed, the leg\u2019s circulation dropped to the point where she had to sleep with her left leg hanging down from the bed to keep blood flowing to it with the help of gravity.<\/p>\n

\u201cSo where people usually jumpstart their lives again, I couldn\u2019t walk,\u201d Sharp said. \u201cI was debilitated in a different way.\u201d<\/p>\n

Vascular surgeons told her what no one wants to hear: the blocked graft in her leg was irreparable. The only option was to amputate below the knee.<\/p>\n

\u201cI had already gone through so much,\u201d Sharp said. \u201cI was like, \u2018Are we going to start taking limbs now? I just had a really hard time digesting it. I was born with the kidney problems. This was borne of something else.\u201d<\/p>\n

Help would arrive from an unexpected place: interventional cardiology.<\/p>\n

\"A
Dr. Kevin Rogers<\/figcaption><\/figure>\n

Not just the heart<\/strong><\/h3>\n

Interventional cardiology traditionally involves minimally invasive heart procedures that use catheters to open up arteries or replace faulty heart valves. But interventional cardiologists also apply their expertise to arteries and veins far from the heart. Sharp, determined to exhaust all options before resorting to amputation, pressed her providers and reached out to family and friends.<\/p>\n

CU School of Medicine and UCHealth interventional cardiologists Dr. Ehrin Armstrong and Dr. Kevin Rogers<\/a> were alerted to Sharp\u2019s case in late July 2018. Her pinkie toe had gone black, and Sharp was by then \u201con track to lose her leg,\u201d as Rogers put it. Armstrong and Rogers believed they could restore blood flow by opening up the clotted tube graft from the prior vascular surgery. The challenge would be to ensure that it didn\u2019t clot again, the key to which would be ensuring good blood flow above and below the graft. Rogers went over the plan with Sharp at the UCHealth Heart and Vascular Center<\/a>. There were risks, but if it worked, she could keep her leg. Either way, it had to happen quickly.<\/p>\n

The procedure Rogers and Armstrong performed in early August 2018 was to have taken about an hour and a half. It proved more challenging than they had expected, involving a tricky catheter transit across the main clot, zapping the clot with a laser, and using balloons to widen arteries and stents to keep them open. Sharp lost a lot of blood in the process, but four hours later, the interventional cardiology team had restored blood flow to her left leg.<\/p>\n

On two feet<\/strong><\/h3>\n

Eight months later, Sharp wore open-toed shoes on a sunny April morning outside UCH\u2019s Courtyard Cafe. She had just been in for a routine kidney check whose numbers would turn out good. She sees Rogers every three months. He says that, having made it several months without clotting, the interventional cardiology fix stands a good chance of holding. The toes of her left leg looked no different than those of her right. They and the rest of Sharp\u2019s feet had recently carried her about, pain-free, during a family trip to Mexico, and she had the suntan to prove it.<\/p>\n

\u201cThis isn\u2019t a cure-all. They\u2019ve talked about cleaning it out again down the road,\u201d Sharp said. \u201cBut how would I describe it? Spectacular.\u201d<\/p>\n

As Sharp walked back inside and down the hall toward the Anschutz Outpatient Pavilion parking valets, she said she usually makes a point of avoiding talk about her health. But she wants to get the word out, she says. If amputation comes up, \u201cget a second, third, or fourth opinion\u201d \u2013 and don\u2019t forget about interventional cardiology.<\/p>\n

\u201cThat\u2019s why I have my leg today,\u201d she said. \u201cThat\u2019s why I can walk through this hall.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Laurie Sharp’s health care story is a saga of three kidney transplants and a slew of serious complications spanning three decades. If you’re in a hurry, through, here’s the gist, and it’s well worth remembering: Interventional cardiology saves more than hearts. Sharp, 52, was born with bad valves at the base of the tubes connecting […]<\/p>\n","protected":false},"author":23,"featured_media":24876,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[84,3512,82,3300,3414,3415,9167,37,39],"class_list":["post-24879","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-cardiology","tag-heart-and-vascular-care-cardiovascular","tag-heart-and-vascular-care-cardiology","tag-heart-surgery-treatments","tag-kidney-transplants","tag-living-kidney-donation","tag-specialized-services","tag-transplant-resources","tag-transplant-services"],"acf":[],"yoast_head":"\nInterventional cardiology saves a leg - 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