For those with severe vascular disease, treatments are limited. But a pioneer procedure is serving as a new “last resort” for those with the disease. WAMC’s Samantha Simmons spoke with some of the surgeons performing the operation that essentially turns veins into arteries as well as a recipient of the treatment.
“It's been, been a long time. You know, so many surgeries, you're doped up, and you get done with the surgery, you're on medications. I don't even know what medications I'm on right now. There's so many more. It's like having a bowl of cereal. There's just pills and pills,” Berkery said.
Joseph Berkery underwent the LimFlow System surgery last summer. The former chief of the Maplewood Fire Department was suffering from gangrene in his left foot, which has now been amputated. The retired firefighter then began experiencing gangrene in the big toe on his right foot.
Berkery was experiencing, for the second time, chronic limb-threatening ischemia. The most advanced stage of peripheral arterial disease, those with ischemia experience persistent pain, ulcers, and gangrene. Those with the highest risk of developing the advanced disease are people with diabetes, heart disease, obesity, and other chronic conditions with amputation being the only remaining treatment, until now.
Berkery, who has a prosthetic for his lower left leg, faces challenges despite having that tool.
“Today, it's swollen around knee up,” Berkery said. “I tried to get it on. It didn't work. And that's the second time. They made one for me the first time, and it was something wrong. They had to redo, make a whole other one, and they gave me old one back. So, if you know anybody looking for a used leg…”
He knew losing his right foot would be a worst-case scenario. So, he turned to surgeons at St. Peter's Health Partners in Albany for the new procedure in an effort to safe his right foot.
Yaron Sternbach, a vascular surgeon, says maintaining a patient’s quality of life is most important when heading into the operating room.
The operation is a last resort for cases where bypass surgery, regular arterial stents or angioplasties don’t work.
He says during the roughly 1.5-hour, minimally invasive procedure that uses stents and devices to bypass blocked arteries in the leg and foot, blood is rerouted through veins, revascularizing tissue.
“Quality of life can't be overstated. I think, you know, data focuses on lifespan, but we're really, actually focused on health span more than that. And independent mobility, as I said, is one of the biggest factors,” Sternbach said. “When you look at that, it's also a big factor in terms of the cost of care. It's much more expensive to care for someone who is not independently mobile, they require much more help on an ongoing basis. So, for all those reasons, you know we need to do whatever we can in order to keep folks functional.”
Sternbach says people often wait for things to get better, especially in cases like this, but timing is of the essence.
“Once patients are too far along with their gangrene or ulcers, is not healing, if there's extensive bony involvement with infection, even though we can restore blood flow, that leg from a soft tissue standpoint and a functional standpoint, may no longer be salvageable,” Sternbach said.
Since the hospital’s first successful LimFlow operation in August 2024, Sternbach and William Raible, a fellow vascular surgeon, have performed three of these operations.
Raible says the operation isn’t so different from work they already do, though.
“It's putting together a bunch of different techniques we're already, you know, trained and skilled at, with some new tools to create a new outcome, again, routing blood from the artery to the vein using some of LibFlow technology that's been developed over the years,” Raible said.
Berkery, however, isn’t new to the world of recovery. He lost his eye in a crash while working with the fire department, and, has had five back surgeries where he came close to dying.
But he didn’t let these operations stop him from living a playful life. His wife, Bonnie, says he likes to prank those whose care he is under.
“When he lost his eye, he had a toy that was actually a Halloween prop,” Berkery’s wife said. “It was a little ball of the eye that was bloodshot that always looked up. And we would go down to our local establishment bar, and Joe, being funny. Would roll it down the bar and scare people with that.”
“But when I went into surgery that day to have the eye taken out, I stuck it in the shirt pocket here, and the nurse, it fell out,” Berkery said. “It was on the floor, and she went to pick it up, and she was, ‘Oh, my God.’”
Berkery is now in his own apartment, able to be independent and excited to be out of a rehabilitation center.
