Vascular surgeon teaches others to prevent amputation

An Oklahoma City vascular surgeon has perfected a minimally invasive procedure to restore blood flow to lower extremities – preventing amputation for many – and he’s sharing this knowledge with physicians who come from all over the U.S. and Canada to observe this technique.

Jim Melton, D.O., co-founder of the CardioVascular Health Clinic, said he hosts two or three training courses each quarter to show other doctors the benefits of this procedure.

“The procedure is percutaneous – minimally invasive – lower extremity intervention using a retro-pedal approach,” Melton said. “The objective of the procedure is to re-establish blood flow to the lower extremity, therefore improving quality of life, preventing amputation, healing wounds of the feet or legs, and alleviating claudication pain.” 

Claudication pain, commonly in the legs, is caused by lack of blood flow and often indicates peripheral artery disease (PAD), which typically is caused by a buildup of cholesterol in the arteries. Other risk factors for PAD include nicotine abuse, diabetes, high blood pressure, and genetics. 

Melton said many people mistake the symptoms of PAD for something else, and it often goes undiagnosed. Besides leg pain, symptoms can include leg weakness, numbness in the legs, or coolness of the feet. Open wounds or ulcers on the legs and feet that take a long time to heal are a strong indication of peripheral arterial disease. If left untreated, PAD can lead to gangrene and eventually amputation if the issue is not diagnosed and treated. 

The retro-pedal approach uses an ultrasound to guide a needle and small catheter into one of the arteries at the ankle.  Once the catheter has been placed, Melton is able to utilize the latest technology and products to treat the buildup of plaque in the artery.  This includes various devices that de-bulk or reduce the size of the plaque. After reducing the calcium inside the artery, balloons are used to further expand the artery.  If needed a stent can be placed after expansion of the artery. This procedure is done in an outpatient setting, with a success rate around 96%.

The retro-pedal approach results in a lower risk for bleeding complications, a higher success rate in the ability to cross a blockage in order to re-established blood flow.  It also significantly reduces radiation and decreases the amount of contrast to the patient.  

After the procedure, patients are sitting up, eating and drinking, visiting with family within 15 minutes. They recover in the facility for about two hours after the procedure.  The recovery at home is about two to three days with mild tenderness at the procedure site.

Susan Harrison, 61, has high praise for Melton and his team. She said she has had repeated problems stemming from hereditary small arteries. She was having pain in her calves and buttocks when she walked. Her doctor referred her to Melton.

“On my first visit, Dr. Melton said, ‘I understand you are nervous.’ He said, ‘I will take care of you,’ and from that point forward I knew I was in good hands,” Harrison said.

“When Dr Melton opened his state-of-the-art facility, he was in control,” Harrison added. “He has since started going in through my lower leg. Very small incision. Very easy healing time. I've had sores on my feet, and I pray I don't have to have surgery again, but if I do there is only one team that will touch me, and that's Dr Melton.”

Melton and the CardioVascular Health Clinic have hosted vascular surgeons, interventional cardiologist, and interventional radiologist who have come to learn the retro-pedal approach.

Melton said he wants to spread the word that amputation doesn’t have to be the answer for patients suffering from loss of blood flow in their lower extremities.   

 A native of Anadarko, Melton has been in practice for 25 years. He earned his Doctorate of Osteopathy at the Oklahoma State University College of Osteopathic Medicine. He performed his residency in general surgery and his fellowship in peripheral vascular surgery at Doctors Hospital in Columbus, Ohio. He is Board Certified in general and vascular surgery and has been instrumental in the advancement of vascular surgery in the state of Oklahoma throughout his career.  He is co-founder of CardioVascular Health Clinic, Advanced CardioVascular Solutions, and Advanced Surgical and Research Solutions.