Huntington Hospital Performs New Limb-Saving Procedure To Help Avoid Amputation

HUNTINGTON, NY — Huntington Hospital has performed its first transverse tibial transport procedure, an advanced technique designed to stimulate new blood flow in patients with severe peripheral vascular disease who may otherwise face amputation.

Dr. Jacqueline Prevete, a surgical podiatrist at Northwell's Huntington Hospital, recently performed the procedure on a male patient. The patient was also under the care of vascular surgeon Dr. Sarrina Shraga.

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Known as TTT, the procedure is generally reserved for high-risk patients with critically poor blood flow to their lower extremities who have exhausted other treatment options, hospital officials said.

Patients considered for TTT often have diabetes or renal disease or a history of smoking and may have already undergone angiograms, angioplasty, stent placement or other vascular procedures without sufficient improvement.

"This is truly a limb salvage procedure for patients who may otherwise have no remaining options," Prevete said. "Many of these individuals have already been through multiple vascular procedures and are still at risk for amputation. TTT gives us another tool to help restore blood flow and potentially preserve the limb."

During the procedure, a controlled cut is made in the tibia and a portion of the outer layer of bone is carefully elevated. The surgery is performed using fluoroscopic imaging to guide placement and alignment.

A metal transport device is then secured to the bone with pins. Following surgery, the patient turns a dial on the external device twice a day, gradually moving the bone segment by about 0.5 to 1 millimeter per day.

The gradual movement, which takes place over roughly two months, is intended to stimulate the body's healing response and encourage improved blood flow to the affected limb, according to the hospital.

The surgery itself generally takes between one and 1½ hours.

Huntington Hospital used the TL-Elevate device, part of a newer generation of technology that hospital officials said has helped expand the use of TTT.

"Patients who are considered for this procedure are often among the most complex we treat," Shraga said. "They frequently have advanced peripheral vascular disease and have already exhausted standard endovascular or surgical options. Being able to offer another limb preservation strategy is significant, particularly for patients who may otherwise be facing major amputation."

Hospital officials said TTT has received increased attention in recent years amid technological advances and growing efforts to preserve limbs in patients with severe circulatory disease.

Results can vary depending on a patient's overall health, the severity of the disease and their ability to follow recovery instructions.

"This milestone reflects Huntington Hospital's commitment to bringing innovative, advanced care to our community," Huntington Hospital President Dr. Nick Fitterman said. "Performing our first TTT procedure demonstrates the strength of our multidisciplinary team and our ongoing focus on providing patients with leading-edge treatments that can improve outcomes and quality of life."