After seven failed surgeries over the course of a decade, Bruce Barton was at the end of a long road, one that he could barely walk.
His doctors at several Massachusetts hospitals were unable to alleviate the leg pain that plagued him. His last doctor’s final words shocked him. He was told they did their best, but it was unsuccessful. As a type 2 diabetic, he could expect to lose a toe, a foot, possibly a leg.
That shocking news rattled Barton’s memory. He recalled a golfing buddy, also his cardiologist, mentioning a colleague who was conducting remarkable research with successful results in patients with issues in the lower extremities. Barton learned that doctor was now in Rhode Island: Peter A. Soukas, MD, director, peripheral vascular interventional laboratory at The Miriam Hospital.
It was game on for Barton, a resident of Cape Cod, retired tool-die engineer and, per his daughter Nicki, a scratch golfer (a very good amateur). He was holding on to a part-time job at a golf course where he could get a few holes in, but the pain and cramps in his legs prevented him from walking further than 25 yards at a time.
During his first exam with Dr. Soukas, Barton recalled the doctor’s diagnosis. Barton was suffering from critical limb ischemia (CLI). The corrosion in his veins was blocking blood flow through his legs. He was on a very dangerous path and in the depths of despair. "Dr. Soukas said I had a very tough, complex case. But he was also very encouraging and told me he was 100 percent sure he would make me better."
How would Dr. Soukas deliver on such a promise? By shocking the plaque out of Barton’s arteries with the new game-changing technology called shockwave intravascular lithotripsy that was central to his clinical study. In principle, the technology is similar to lithotripsy that is used to breakdown – more like explode – kidney stones so they can pass. For Barton, the technology would send a shockwave through his blocked arteries.
Why hadn’t his previous medical teams thought of this procedure? They didn’t have the technology nor were they paying attention to the innovative research happening in Rhode Island. As an associate professor with The Warren Alpert Medical School of Brown University, Dr. Soukas was managing a clinical trial that elevated The Miriam to the first hospital in New England to use Shockwave IVL with positive results.
"We were the first hospital in the world to use shockwave treatment for a narrowed carotid stent in a calcified artery. Now we have the highest volume of patients in the nation being treated with this innovative technology," Dr. Soukas said. "As a research hospital, we’re able to attract many patients to our trials. Our research activity is one reason we’re able to get exciting, new technology."
The minimally invasive procedure allowed Dr. Soukas to send shockwaves through Barton’s artery, causing the calcium blockage to fracture much like a windshield does when hit by a rock, with spider-like lines intact. As a result of the fracturing, the blockage becomes softer, more malleable, allowing full expansion of the artery at low pressures. This reduced the risk of dissection, disruption of the inner lining or the artery by 77 percent and reduced the need for a bailout stent (mechanical scaffold) by 75 percent.
Barton’s daughter, an exercise physiologist, is glad to have her father back to the man he was, lighting up every room he enters. What’s next for the grandfather of her twin boys who recently turned 10 years old?
"The doctors in Massachusetts asked him what was his '10,'" she shared. "He said it was to walk with his grandkids at Disney."
Not only did Barton find lifesaving treatment in Rhode Island. When he’s ready to go to Disney, he’ll find it’s much easier to fly out of Rhode Island, too.
Dr. Peter A. Soukas is the director of the peripheral vascular interventional laboratory at The Miriam Hospital and specializes in carotid stenting and the treatment of lower extremity disease. He is also an associate professor of medicine in the department of medicine and director of the vascular and endovascular medicine fellowship program at The Warren Alpert Medical School of Brown University.
