Mom needs a vascular surgeon for rare issue

[Austinvines 318]

Found out in March that my mom was born with a persistent sciatic artery and instead of the femoral artery supplying her leg from the top, her arteries loop around from back to front. This caused an aneurysm/clotting and she almost lost her foot.

 

The surgeon who wants to repair it has never done this particular surgery and no one in his practice has either. The condition affects .05% of the population that’s not surprising. He does bypasses daily on hearts but this will be a much longer run. Any idea on how to find a surgeon in Texas who may have done one and would it make sense to go with that doctor, even if she’d have to travel back home after 3-4 days recovering in whatever hospital out of town it gets performed in?

[tx 3 putt 78,519]

100% find an experienced surgeon. Your Dr / the current surgeon should have a recommendation ?

I’ll take a guess that you’ll be heeded to the Houston med center soon. Good luck 

[royiv 9,718]

Don't know if he's done this particular procedure, but Gustavo Oderich at UT Physicians in Houston is a pretty well known vascular surgeon. He's the chief of vascular surgery at UTHealth. Might be a good spot to start to see if anyone in that group is experienced with what your mom needs.

https://www.utphysicians.com/provider/gustavo-oderich/

[royiv 9,718]

By the way, username checks out.

[Bevo 13,832]

4 hours ago, royiv said:

Don't know if he's done this particular procedure, but Gustavo Oderich at UT Physicians in Houston is a pretty well known vascular surgeon. He's the chief of vascular surgery at UTHealth. Might be a good spot to start to see if anyone in that group is experienced with what your mom needs.

https://www.utphysicians.com/provider/gustavo-oderich/

It is an exceedingly rare malformation. We might have some general experts on the subject here. I'm not one of them.

Here is a pretty good overview: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472080, https://www.sciencedirect.com/science/article/pii/S1078588409000513

There are multiple approaches to treatment such as stenting and there are some hybrid approaches as well. Caitlin W. Hicks at Johns Hopkins may give you some insight. Money is always an issue and I don't know anything about your finances. I can tell you though that finding an expert will be difficult but is a good place to start. Ask her current doctor for help in finding a second opinion.

[Bevo 13,832]

@Fat Bastard may have some leads.

[deadshank 24,654]

Get three bids.  
 

Seriously, hopes she gets good help n

[Mullet Free 39]

On 5/13/2023 at 10:30 AM, Austinvines said:

 

Found out in March that my mom was born with a persistent sciatic artery and instead of the femoral artery supplying her leg from the top, her arteries loop around from back to front. This caused an aneurysm/clotting and she almost lost her foot.

 

The surgeon who wants to repair it has never done this particular surgery and no one in his practice has either. The condition affects .05% of the population that’s not surprising. He does bypasses daily on hearts but this will be a much longer run. Any idea on how to find a surgeon in Texas who may have done one and would it make sense to go with that doctor, even if she’d have to travel back home after 3-4 days recovering in whatever hospital out of town it gets performed in?

He said she would be on bypass? What do you mean by this?

 

I’ll say vascular surgeons’ basic job is connecting arteries via various approaches and methods likes different grafts. As a not vascular surgeon, some aberrant vascular anatomy in a leg doesn’t seem that exciting that it would require some super specialist. It’s not an ascending thoracic aortic aneurysm. That said, if you’re not comfortable with the doc then look around. I would say the most experienced vascular surgeon in your area is a good start. 

[Fat Bastard 652]

Didn’t log on yesterday and just saw this. Exceedingly rare. Biggest risks are aneurysm formation and thrombosis that can lead to acute limb ischemia which can ultimately threaten the limb if not treated in time. 
 

The sciatic artery should normally regress by the end of the first trimester in utero. The superficial femoral artery is the dominant artery of the thigh giving off the popliteal and then the 3 tibial arteries after that. In the persistent sciatic artery there typically isn’t a femoral artery anymore. 
 

Best ways to diagnose and help with planning are with CT angiography or invasive angiography. But beware, what I do for a living (stenting diseased arteries) should not be discussed as an option for treatment. The treatment is through interposition grafts or femoral-popliteal bypass (assuming the proximal anastamosis at the common femoral and distal anastamosis at the popliteal are good targets for bypass). 
 

She absolutely needs a vascular surgeon. Oderich mentioned upstream is very good, as is Miguel Montero-Baker at Houston Methodist.

 

good luck to your mother and please keep us informed how she does. Crazy rare case.