Vascular Surgery: A Leg Up

John McGeehan was sitting on a chair in his garden in the seaside community of Point Pleasant, New Jersey, on a lovely summer day. Picking dead flowers out of a potted plant—his golden retriever, Jack, at his side—he felt his left leg fall asleep.

Just two weeks before, John had minimally invasive surgery to repair an abdominal aortic aneurysm (AAA). The procedure went smoothly. He’d gone home the day after surgery with an endograft (a stent-graft) at the site of his aneurysm and two adhesive bandages covering his incisions on each side of his groin. Two days later, he was back at work and feeling fine.

It was a drastically different situation from what happened to his father in 1975. His father also had an AAA, which may occur as part of an inherited syndrome, but he didn’t know it until he collapsed one day when he was in his 50s. He unfortunately passed away during surgery.

His father’s experience scared him so much that, at age 32, John consulted with his doctor. An ultrasound found a tiny aneurysm on his aorta, but it was not serious enough for surgery. Every few years, John had an ultrasound to track the aneurysm’s growth. In 2018, his doctor told him it had grown to a dangerous stage and recommended surgery.

In June of that year, he had the surgery, and his recovery seemed to be moving along smoothly. So on the Friday in his garden when his leg fell asleep, he thought it was weird but wasn’t worried. He got up to walk it off. Then the pain rapidly worsened.

A Fortunate Twist of Events

His wife was shopping in Atlantic City, New Jersey, with her sister, so John was home alone. He called one of his daughters, who had just left his house, but she couldn’t get back quick enough. With the pain escalating, he called 911. The Point Boro First Aid Squad is located around the corner from his house, so before he even hung up the phone, emergency services personnel were at his door. They loaded him into their emergency vehicle and took off for Ocean Medical Center, just three miles away.

As his pain worsened on the ride to the hospital, John remembers he told the squad members, “Please just open the back doors and push me out. I can’t take it.” He’d never felt pain so intense. He blacked out before getting to the hospital.

Once at the Hirair and Anna Hovnanian Emergency Care Center at Ocean, the emergency team faced a challenge. John hadn’t been a patient there before, so they didn’t have any of his records—and he was unconscious, so he couldn’t tell them about his medical history.

They were able to learn that he’d had recent surgery for an AAA at another hospital, but were unable to reach John’s surgeon because he was on vacation. That surgeon’s back-up couldn’t be reached, and the on-call surgeon was a general surgeon who didn’t have the knowledge to help them.

Luckily, the Jersey Coast Vascular Institute (JCVI), a group practice of board-certified, fellowship-trained vascular specialists affiliated with Hackensack Meridian Health, is on Ocean’s campus. Because JCVI has seven vascular surgeons on staff, vascular specialists are available at Ocean 24 hours a day, year-round—which is incredibly rare for hospitals in general, let alone a community hospital. Two of JCVI’s vascular surgeons, Frank Sharp, M.D., and Scott Cluley, M.D., were immediately available to help John.

When Time Is Critical

“The clock was ticking because the legs can’t be without blood flow for more than a certain amount of time before there’s permanent damage and the inability to move the legs forever,” Dr. Sharp says.

Unable to learn more about John’s surgery, Drs. Sharp and Cluley evaluated the situation and jumped into action, performing an axillobifemoral bypass, which reroutes blood flow from the right arm down into both sides of the groin. Each surgeon worked on one side of John’s body to accomplish the treatment as quickly, efficiently and safely as possible.

The surgeons discovered that John had a rare complication of AAA surgery: His endograft had become blocked, cutting off the blood flow to his legs. With the doctors’ combined expertise and fast action, John’s legs were saved.

After spending a week and a half recovering in the hospital, John elected to get his inpatient rehab at Shore Rehabilitation Institute, a 40-bed acute rehabilitation facility located at Ocean. “[They] wheeled me over to Shore Rehab for about 10 days,” John says. “I couldn’t walk when I got there, but I walked out without any assistance. The staff at the hospital and at rehab were fantastic.”

Today, John has some neuropathy (nerve damage that results in numbness, tingling, muscle weakness and pain in the affected area) and lymphedema (swelling) in his left leg, which makes walking long distances difficult. But otherwise, he is able to do what he wants to do.

“I’m thankful I can do what I can, even though it’s reduced,” John says. “They saved my legs. I don’t even want to think about what my life would be like if I didn’t have my legs.”

Next Steps & Resources:

Learn about lifesaving vascular care available across the Hackensack Meridian Health network.

Dr. Sharp practices in Brick. To make an appointment, call 732-202-1500.

Dr. Cluley practices in Brick and Toms River. To make an appointment, call 732-202-1500.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.