Vera Ward with her daughters, Patricia Butterworth and Rhonda Beaver. Photo: Supplied
Vera Ward had seven brothers and sisters, but there were only 13 full legs among them.
A brother had both legs amputated and a sister had part of a leg removed in order to prevent critical limb ischemia from claiming their lives.
And when gangrene was discovered on Mrs Ward’s foot, it looked like the leg tally among the siblings would be reduced to 12.
“It was like someone had thrown a piece of black wax on the back of her foot and I knew it wasn’t good because it had a sweet, sickly smell to it,” said her daughter, Rhonda Beaver, who first noticed the gangrene.
“I accepted she was going to lost part of her foot or her leg. But they saved it.”
Like her siblings before her, Mrs Ward, 87, was suffering from critical limb ischemia, which is caused by a hardening of the arteries that prevents blood from flowing to the legs.
Its incidence is increasing, driven by an ageing population and higher prevalence of obesity and diabetes, and quite often results in leg amputation.
But vascular surgeons at Prince of Wales Hospital, using a technique known as endovascular revascularisation, have reduced the rate of amputations by 62 per cent.
Endovascular revascularisation involves drawing a wire into the arteries of patients and inflating them with a balloon, before inserting a stent that acts like scaffolding to keep them open.
Prince of Wales Hospital surgeons previously treated the condition with open surgery but shifted to an endovascular-first approach about eight years ago because it was less invasive for patients and cheaper on the health system.
Critics warned it would result in more legs being amputated.
But in a study published in the Journal of Endovascular Therapy in September, the hospital’s vascular surgery team has demonstrated that its new approach has the potential to save 100 limbs a year if it was rolled out across NSW.
During the eight-year study, the vascular surgery team salvaged 92 per cent of the legs they treated with endovascular techniques, compared with 80 per cent of those they treated with open surgery.
In real terms, about 42 legs are kicking that would otherwise have been removed.
“Everyone knew it was safer, everyone knew it was less invasive, everyone knew it would use less resources but, for years, people used to say bypass surgery is better in terms of saving legs,” endovascular surgeon Ramon Varcoe said.
“In our landmark trial, it was shown for the first time that this less-invasive surgery also saves legs.”
Each amputation costs the government $500,000 in surgery, rehabilitation and prosthetics.
But Dr Varcoe said the greatest burden was on the individual.
“It’s quite a big operation and it takes a huge toll on them. But it’s also the loss of independence that comes with it.
“Quite often, the loss of a limb is the beginning of a downward spiral, which ultimately sees the patient succumb to other, related health effects.”