At the University of Miami Health System, our vascular surgeons are dedicated to improving the quality of life for all patients. We perform advanced and complex limb salvage procedures to treat peripheral artery disease and critical limb ischemia, reducing the need for amputation.

Candidates

You may qualify for a limb salvage procedure if you have severe peripheral artery disease or critical limb ischemia. These conditions restrict blood flow to the limbs, putting them at risk for wounds, infection and, ultimately, amputation.

What to Expect

Before scheduling your limb salvage procedure, your doctor may perform a physical exam and run some blood tests to ensure you are healthy enough for the procedure. You may also need an angiogram imaging procedure to identify areas where blood flow is blocked.

Your limb salvage procedure may involve a combination of techniques to restore blood flow to your limb. Typically, it involves a minimally invasive procedure called angioplasty. Angioplasty uses specialized tools, including a tiny balloon (during balloon angioplasty) and a stent (mesh tube) to open up narrowed blood vessels and keep them open. Limb salvage procedures use the latest tools to access even small blood vessels.

During your procedure, you will be asleep under anesthesia. Because of the anesthesia, you will need to avoid eating for eight hours before your procedure. 

Once you are under anesthesia, your doctor will make a small incision in your groin or wrist, depending on the location of the narrowed vessels. They will use X-ray guidance to place a catheter (thin tube) into the blocked area. They will then inflate a small balloon at the end of the catheter to open up the blood vessel. They may then guide a stent through the catheter and place it in the previously blocked area. The stent will keep the blood vessel open. 

Your doctor may repeat this process in multiple blood vessels, depending on your needs. Once they are finished, they will remove the catheter and bandage up the incision.

In addition to or instead of angioplasty, you may also need a peripheral artery bypass. Like during angioplasty, you will be asleep under general anesthesia for this procedure. Once you are asleep, your doctor will make an incision above the blocked blood vessel. They will then clamp off blood flow temporarily above and below the blockage.

They will then attach a vein taken from another area of your body or a plastic tube (called a graft) both above and below the blockage. This will provide a way for blood to flow around the blockage. Once the graft is in place, they will remove the clamps, restore blood flow, and sew up the incision.

Another technique commonly used for limb salvage procedures is endarterectomy. This is a minimally invasive procedure, similar to angioplasty, that allows your surgeon to use X-ray guidance to place a specialized catheter into the blocked area. They can then use tiny razors to scrap away the buildup inside the artery. This helps restore blood flow. 

No matter which procedure or combination of procedures you have, you will be taken to a recovery area to lie flat for a few hours (if you had a groin incision). You may be able to go home the same day or the day after your limb salvage procedure.

With restored blood flow, you should have improved wound healing. However, you may also need additional wound care therapies such as hyperbaric oxygen treatment or additional debridement (removal of infected tissue). New stem cell therapies also use stem cells from your own bone marrow to improve healing.

For stem cell therapy, your physician will use a needle to remove bone marrow from your leg bone. Stem cells will then be extracted from the bone marrow in a lab. Your physician can then inject stem cells into your limb. The stem cells may help your body create new blood vessels, improving blood flow. Stem cell therapy may be an option if endovascular or surgical treatments aren’t right for you.

Why Choose UHealth?

Leading-edge imaging care in South Florida. Our doctors are also researchers discovering new ways to improve diagnosis and treatment. That means you can get some of today’s most promising advancements through clinical trials. You benefit from the latest developments that are fast-tracked from the lab to the bedside.

Advanced, hard-to-find procedures. Our doctors are committed to caring for every patient. That’s why they offer the latest treatments, including limb salvage, endovascular grafting and thoracic outlet decompression, to improve your blood flow. 

All the care you need, from one physician. Our vascular surgeons perform a wide range of procedures so you can have the same physician for any vascular care you need as your condition changes. Whether you need a stent replaced or a vein grafted, you can always turn to the doctor you trust.

Experienced doctors, reliable results. UHealth vascular surgeons perform hundreds of stent placements, angiograms and more every year. You can rely on their experience to help you avoid complications and have a positive outcome.