Groundbreaking vein to artery op saves Chris' leg from amputation

A Middlesbrough surgeon has become the first in the region to perform a modern procedure that has saved patients like Christopher Dolan from major leg amputations.

Consultant vascular surgeon Ian Nichol, who works at The James Cook University Hospital, recently introduced reversed deep venous arterialisation for patients who would have no other treatment options available and would have undergone major amputation of their legs.

Reversed deep venous arterialisation is a bypass graft vascular surgery that essentially turns a vein into an artery. Normally a bypass graft would involve joining an artery to an artery to deliver blood to the foot, but this operation joins an artery to a vein – helping restore blood flow to the foot and preventing permanent limb loss.

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This revitalises circulation in the foot by creating a new blood flow connection between a healthy artery in the calf or ankle and a vein in the foot. The procedure is performed when there is no other option to improve the foot blood flow and the only option remaining is a major leg amputation. This is due to the fact there are no visible arteries left in the foot – a situation termed a “desert foot”.

One of the patients to benefit from this new surgery was civil servant Christopher Dolan, from Normanby. Chris, 50, was initially admitted to the hospital in July 2023 after suffering from a serious ulcer due to problems with footwear.

A debridement operation on his right foot ensued to remove dead and infected tissue to improve the healing of the remaining healthy tissue. Following the procedure, the medical team advised him to keep his wounds open to allow them to heal.

However, his wounds were still not healed after a few months which was attributed to his diabetic history. After seeing the podiatry team for ongoing medical support, Chris was referred to diabetic foot specialist and vascular surgeon Mr Nichol in November 2023.

Following a brief medical examination, the Middlesbrough consultant introduced the new procedure to Chris and made him aware of the potential benefits of the surgery.

As one of the first patients in the region to be offered this treatment which could save his life, Chris said: “I just really wanted to know what the potential downsides to the procedure were with it being a new technique.

“I have been diabetic for 36 years and have always been happy to help out medical staff with research anyway I can, and this was an opportunity to help myself and Mr Nichol refine his technique.”

The Middlesbrough resident successfully underwent the reversed deep venous arterialisation surgery in December 2023 – which has prevented his right leg from being amputated.

Mr Nichol said: “Introducing this new method of surgery has hugely benefited patients like Chris who have successfully avoided major amputations of their leg and are now able to walk without the need for a prosthetic leg.

“This has also helped the hospital in preventing future admissions from patients who would have had legs amputated and would require regular hospital interventions.”

Chris, who is back on his feet and slowly recovering from his surgery, added: “I am over the moon with the surgery as I still have a leg and it is a big change in your lifestyle which I was not ready for just yet.

“It got me mobile and walking again, what more can you ask for other than independence?

“I want to thank all of the staff involved, from Mr Nichol to the healthcare assistants who put up with my tantrums and bad moods whilst I was recovering.”

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