Teen regains mobility thanks to innovative treatment at Sidra medicine

Doha, Qatar: Diagnosed at birth with Arteriovenous Malformation (AVM) of his foot, life for then fourteen-year-old Simon Saade was a constant struggle.

An AVM is when blood vessels become abnormally tangled, directly connecting arteries and veins and causing them to bleed or steal blood from normal tissues. This can prevent the surrounding tissues from getting enough oxygen. People with AVM face the risk of rupturing and bleeding, leading to potentially serious health complications.

AVMs are frequently found in the head, neck, and on limbs. Simon’s case was rare as it was on the plantar surface of his foot, which interfered with his ability to walk properly. 

In his early childhood, Simon underwent several corrective procedures abroad. However, the procedures did not produce the desired results causing one of his legs to become longer than the other; forcing him to rely on crutches to balance his movement. Simon also continued to face health risks, and his family constantly had to carry a backpack filled with medical supplies to handle any unexpected bleeding episodes.

The Saade family, originally from Lebanon but residing in Qatar, were advised to seek treatment at Sidra Medicine, a specialist women’s and children’s hospital.

Simon Saade and the Sidra Medicine IR team

Innovative treatment

Understanding the complexity of Simon's case, Sidra Medicine’s Interventional Radiology Department (IR) formulated a personalized treatment plan that included several sessions of embolization. The IR team’s treatment of Simon’s AVM focused on managing the symptoms and reducing his risk of bleeding, which in turn helped improve his quality of life.

Endovascular Embolization is a minimally invasive procedure that uses a catheter navigated through a small incision in the groin. This procedure was implemented to close the abnormal blood vessels in Simon’s ankle, with the goal of shrinking the AVM by blocking blood flow to the area.

Dr. Walid Mubarak, Interventional Radiology Attending Physician and Clinical Lead at Sidra Medicine, said, "What makes this intervention stand out is its minimally invasive nature and selectivity, allowing us to access the third-degree branches of the foot. This cutting-edge approach is not available in many children's hospitals, as it requires going deep into the vascular system.

The impact of the procedure is almost immediate, eliminating the need for long hospital stays. Simon was able to go home the next day, with only a small band-aid on his thigh.”

This was the first phase of Simon’s treatment program, promising a quick and effective recovery without the usual side effects of traditional surgeries.

"The doctors at Sidra Medicine explained everything clearly, ensuring I was involved every step of the way. The Interventional Radiology team prioritized my wellbeing, and their goal was to get me walking again. The procedures they performed led to a faster recovery with less pain and without any complications, unlike anything I'd experienced before," said Simon.

Following his embolization at Sidra Medicine, Simon also needed vascular corrective surgery – a procedure that could only be performed abroad.

The IR team at Sidra Medicine facilitated this process by creating a 3D printed model of Simon’s foot. This effectively illustrated the malformation and the issues from the procedure he had in his early childhood.

The detailed model was then sent to a specialist surgeon in France, enabling them to meticulously plan for the corrective surgery.

Follow up care and plastic surgery

After the corrective surgery in France, Simon also needed plastic surgery to aid in his recovery process. His parents chose to come back to Sidra Medicine for the procedure.

Dr. Mitch Stotland, Vice Chair of the Department of Surgery and Division Chief of Plastic, Craniofacial and Hand Surgery at Sidra Medicine, explained: "The initial corrective procedure left a skin defect that required a skin graft, which the surgeon in France dressed and kept open so that we could manage the graft at our end, here in Qatar.

We performed a wound debridement and split thickness skin graft on Simon's right foot. By coordinating efforts, we were able to achieve the most optimal results.  The procedure was a success; Simon's wound healed well enough for him to finally be free of any further invasive procedures.”

Big strides

Despite undergoing numerous procedures over several years, Simon’s recovery after each embolization was remarkably swift and nearly painless. He regained his ability to walk without crutches and could do all the activities of a normal teenager. The backpack full of medical supplies, which had been a constant companion, was finally retired to the back of the closet.

Bernard, Simon’s father, said: "When your child is battling a serious medical condition, you'll do everything in your power to find the best care. We were initially devastated by Simon's AVM and the lack of effective treatment options. Our search led us to Sidra Medicine, where the team became like family. We're eternally grateful for the care our son received at Sidra Medicine and are hopeful for his future."

Five years on, Simon is now a university student and is no longer hindered by pain while walking.

“By championing minimally invasive procedures through interventional radiology, Sidra Medicine is lessening the physical burden on patients and enabling quicker recovery times. This innovative approach highlights Sidra Medicine’s unwavering commitment to improving patient outcomes. It was an absolute pleasure working with the Saade family as they were considered part of our team and involved in every step, advocating for Simon and helping us formulate his personalized treatment plan. Thank you for your trust in us,” concluded Dr. Mubarak.