Avoiding Leg Amputations Due to Peripheral Arterial Disease | Q&A

Johns Hopkins Medicine Vascular Surgeon Dr. Thomas Reifsnyder discusses symptoms, diagnosis and treatment of severe peripheral arterial disease (PAD). He also shares insight on how to avoid limb amputations, including leg and foot removal.

Questions answered:
1. Describe what you do. (0:11)
2. Why see a vascular surgeon for PAD? (0:18)
3. What advice would you give to a patient who is in danger of losing a limb to PAD? (0:39)
4. What is PAD and how does it present? (1:54)
5. What are the risk factors for PAD? (3:28)
6. How is PAD diagnosed? (3:50)
7. Which patients are the most challenging to treat? (5:03)
8. Describe when an open surgery or minimally invasive procedure might be recommended. (7:25)
9. Describe the surgery. (8:43)
10. What can patients expect after surgery? (9:24)
11. Why should someone seek treatment at Johns Hopkins? (10:29)

[martiriggs]

Thank you Dr Reifsnyder, you are the Superman that saved my mother’s leg in Pittsburgh in 1993. Along with your sidekicks, Mike and Ike. You are awesome!

[dytzydays]

Just had my femoral to femoral bypass. Instant results. Forget my feet could be pink and warm. I can walk again 🤩

[danskroko]

Diagnoses led to 4 Stents(No Episode)...Drinking and Smoking for 30 yrs...QUIT COLD TURKEY ...Changed diet 180 and Exercising again! Walking 2 miles a day and Working out again.

[wendysteinkoenig]

I had blood clots in my foot 2 different times and had angioplasty 5 or 6 times and a stent put in. I had lost part of my big toe. I started having severe pain in my thigh so I went to the ER and found out the stent had failed. The Dr came in and told me I was going to lose my leg at the knee and they were going to do it the next day. Hearing that news was devastating but what choice did I have. Anyway the next day the Dr came to see me before the surgery and gave me the best news ever. He couldn't explain it but I wasn't going to lose my leg. They did bypass surgery and I ended up losing the tip of my second toe. Way better than my leg. I'm 15 months post op and still have discomfort in my thigh but everyday I thank God for saving my leg. The Drs too.

[maykerr]

As a non-smoker non-drinker non-diabetic active 83 yr old man had tingling toes told arthritis of the toes....Pain got worse in the Calves went to family physician told to ice-pack and take Advil for pain....Finally calve pain got worse went to ER was admitted fast had angioplasty, the artery burst clots escaped so same day another operation stent...waited 2 weeks for blood flow back to toes but told not enough pulse going to the toes so 2 weeks later had to have my 5 toes and part of right foot amputated....So I would say some doctors just are not qualified enough to diagnose this disease as I had complained to my Doctor for over nearly 3 yrs but he never once examined me for a pulse on my foot till it was too late. Wish I seen your video a few years ago, then I would not have waited so we believed our family doctor just arthritis of the never once questioned him so we just took it as old age like most of us Seniors get from most

[annegomez]

Going through this right now, hence the youtube search. Dr. Reifsnyder has such a calming voice and manner, he has put me instantly more at Thank you Dr. R. : )

[loriryan]

Thank you Dr. Reifsnyder, for the very informative video on this condition. My husband suffers from P.A.D., as well as diabetes and has already had several procedures to help the P.A.D., but your clear and concise video has helped us better understand his condition, along with his options, so thank you so much.

[siddickcadersa]

God bless you Dr for helping patients.Really appreciate.thanks.

[xelakram]

This is an excellent and very informative video. Thank you so much, Dr. Reifsnyder.

[grandlux]

Wow. Thank you for this video. My son ask me to take a look because of his diagnosis. This is eye opening and now we can ask better questions.

[kurtslavain]

I'd avoid leg amputation by death if need be. Honestly, death is preferable to amputation for me. That might not apply to everyone, but for my character/personality it applies 100%

Wow ... what a story to live with! Happy for you!

[Trumpsterasskiker]

THANKYOU! for posting. this helped me with my search for a doctor who does venious rest wanted to amputate my Dads leg. Dr Izzo and AlKiere in Tampa are the Greatest!!! and did a bypass in my dads leg at Tampa general. goes to show you there are some shoemakers out there mascarading as doctors and others that are Medical geniouses. Im forever graetful to Dr Izzo and the team he put together to take care of my 79 year old father..

[FloridaDumpling]

I’m 64, had claudication in both my legs and also in the arches of my feet. Had testing, then the “roto-drill” procedure in each leg, weeks apart. Additionally, the artery to my left kidney was blocked. The pulse of my left foot wasn’t strong, & was still having pain in the left foot. So I then had a balloon angioplasty in the left leg the same day a stent was put in near my kidney. I’m not diabetic, though somewhat sedentary (Ok, I’m a potato…). Intend to start a walking program soon though in order to be a better potato…maybe a French fry!

[wandaqueen]

I just had femoral endarterectomy and iliac bilateral stents done 2 weeks ago. I couldn't walk far at all before the pain in my hip and thigh would cause me to limp and stop walking.

[jackgalmitz]

Admittedly my father was already 86 y.o. when he had the leg bypass. It didn't take and as a result he started to develop gangrene. They gave us a few days to decide what we wanted to do. As for myself, I suggested to my father to let his life go in a hospital so they could make it as painless as possible. Besides being diabetic for about 25 years, he was already showing signs of dementia (not alzheimer's). My mother voted against me and later explained she couldn't have it on her conscience. Well my father had to have his leg above the knee amputated. I thought doing this to such an old man was immoral. He lived 3 more years, barely able to get around, watching daytime television with my mother. Consider well before having a bypass.

[worksbykaye]

Help. My father is suffering from pain in the calves. He kept screaming saying that he could not take the pain any longer. I feel helpless because here in the Philippines, the cost of laboratories and checkup are expensive and we could not afford it. :(

[Sacdizzle]

Is there a possibility for revasculazation if the blockage or microvascular disease is in the foot? I'm trying very hard to avoid amputation but they seem to think there's absolutely no other way to fix this issue

[Leoviliti]

Sometimes I cannot get warmth to my feet all my legs receive ..is surging pain and icey coldness ..and my toes are so stiff they feel ready to snap off.
Other times ...especially if walking for half an hour and I have socks and trainers on..
I will struggle to breathe due to my usual COPD ... Then my limbs follow suit by cramping up with shooting pain in the feet, the shins and reaching the thighs ..
They begin to burn with heat and swell at the ankles ..
I stop walking ...and continue after just a few yards each time ..consistently.
And once home again the pain, no matter if I'm resting stays with me. More so in bed and hang my legs down over the bed .
It takes approx three days for the pain to subside a little.
Sleep is a no no, I don't grow hair on my legs any more and they are extremely shiny ..and cracked dry skin.
I'm going to see a vascular consultant very soon.. as my own doctor suggested it was P.A.D
This has been with me for over several years ..I'm 58 ..but it's only when it got so bad even in rest that I decided to visit my doctor..
I do get scared than my limbs might go gangrene .
Already I've got sores that don't heal ..and if they do .they leave behind sensitive red scarring..

Dealing with breathing problems and this .. helped me to give up smoking 🚭 once and for all..but so far it hasn't helped .

[anthonyguada]

I live in Quebec CANADA
I have the best and top notch Vascular Surgeon in all CANADA
Why would I get a second option when I have the Best of THE BEST
I had a stent and a by-pass in one leg
I had a triple heart by-pass
I have a (shockbox) defibrillator installed in my chest
I am a diabetic
just had the bottom of my heel removed I am on a VAC-therapy
I cannot use my right leg at all cannot place my foot on the floor at all ( such fun )
I have a fracture on the same foot that cannot be fixed - I have to wait for the VAC to be removed
and only then they can screw my fracture together.
The pain is just bloody amazing
And on top of this all
I am unemployed
I am a single father raising a young special needs child *alone*
I need Gods help so much