|
||||||||
 |
Send to a Colleague |
|
Doctor Profile |
John Ligush Jr., MD
CRL Surgical Associates
John Ligush has been a staff vascular surgeon at Martha Jefferson for over six years. Prior to moving to Charlottesville he was associate professor in the Vascular Surgery Section at Wake Forest University School of Medicine in Winston-Salem, North Carolina. He received his bachelor of science degree from Carnegie-Mellon University and his medical degree from the University of Pittsburgh, where he later completed his general surgery residency. He performed his fellowship in vascular surgery at University of North Carolina Hospitals in Chapel Hill. His wife, Donna, is also a former Pittsburgh native and a "retired" nurse anesthetist. When not cheering for his Pittsburgh sports teams, he is teaching his three children bass guitar chords or planting a new hybrid of grass seed in his yard.
MS. FAE WENT FROM A WHEELCHAIR AND AN UNCERTAIN FUTURE of chronic leg pain to walking without difficulty, thanks to a newtreatment that is re-establishing the standard of care for the treatment of deep-vein thrombosis (DVT). Only 26 years old, Ms. Fae was three weeks postpartum following the normal birth of her first child when she developed severe aching and edema in her right leg. She was diagnosed with an acute right femoral-popliteal DVT.
Deep-vein thrombosis is a common but serious medical condition that occurs when a blood clot forms in one of the larger veins, usually in the lower limbs. Acomplication of DVT, pulmonary embolism (PE), can occur when a clot dislodges and moves to the lungs, where it results in V/Q mismatch or PA outflow obstruction, creating a potentially lifethreatening condition. Up to 2 million Americans suffer from DVT each year, resulting in an estimated 300,000 deaths annually — more than breast cancer and AIDS combined. It has been stated that DVT related PE is themost common cause of preventable hospital death.
The presentation of DVT may range from an asymptomatic finding on an imaging study, to painless limb swelling, to phlegmasia cerulea dolens — massive venous congestion causing arterial and neurological compromise. Regardless of the presenting signs and symptoms, the long-term sequelae from DVT, particularly iliofemoral DVT, can be devastating secondary to unrelenting chronic venous hypertension (CVH). This CVH can result in chronic limb swelling, post-phlebitic syndrome and eventual venous ulceration. This condition is estimated to cost over $1 billion annually inmedical treatment and lost productivity. Traditionally, the treatment algorithm for DVT has been to follow a generic approach of instituting fast-acting anticoagulation (heparin: unfractionated or low molecular weight) followed by long-term oral anticoagulation (warfarin: three to six months). However, this treatment does nothing to alleviate the clot burden and reduce the risk for long-term CVH in a patient population with iliofemoral DVT, which occurs in up to 90 percent of patients. continued ...