Localized discrete abdominal aortic stenosis leading to bilateral lower limbs claudication is uncommon in Asians. We had a patient with complaints of pain in both lower limbs while walking for almost one year duration and now he had pain at rest and the foot toes also started showing early gangrenous changes because of blood deficiency which might had required amputation of both foot if not treated in time.
We examined the patient clinically and did color Doppler of lower limbs and abdominal aorta where we found that he had severe narrowing of abdominal aorta below the renal arteries which supplies the blood to both lower limbs. Hence, Angiography was done to confirm and decide the further management.
There are kind of patients with abdominal aorta narrowing which are very rare and mostly were treated with major surgery with variable results and prolonged morbidity and hospitalization. Subsequently like ballooning and stenting of arteries of the heart, these cases can also be treated by the same method but only by experts and experienced interventional cardiologists. Most of these ballooning and stenting has been done by groin approach which is more troublesome for the patient.
We had done probably the first case in world by treating this case by Transradial (From wrist) approach. The case was done successfully showing immediate improvement in circulation in both lower limbs and disappearance of pain instantly. Patient went home next day within 24 hours and was able to do his routine activities from next day only. His toes which were heading for amputation, recovered in next 2 weeks time. The present patient is fully normal doing all his activities.
This is to highlight the importance and utility of experienced interventional cardiologist who can treat the various parts of the body besides heart wherever blood circulation need to be improved by ballooning and stenting.
Not to the say the list we have been treating large number of such rare patients by improving circulation in various parts of the body, the brief details of such cases can be read in subsequent issues.
At last keeping the charitable nature of the hospital the charges for highly skilled procedures are probably the minimum in Delhi like this case was treated with total cost of approx one Lakhs Rupees wherever the same patient would have spent almost double the money and that also with more troublesome groin approach to the patient.