Vascular Care
Peripheral vascular disease (PAD)
PAD is a life threatening condition that causes the narrowing or blockage of the vessels that carry blood from your heart to your legs. PAD often goes undetected, so it is important to understand the risks and why you should get screened and diagnosed. If left untreated PAD can cause amputations of the toes, feet, and, even legs.
In the early stages of PAD you may not have any symptoms.
Understanding your risk factors:
- Age over 60
- High blood Pressure
- Diabetes
- Smoking
- High Cholesterol
Symptoms of PAD
- Weakness, heaviness, pain, cramping, numbness or tingling in the leg slash calf muscles especially during walking and other activities
- Foot or leg pain that disturbs sleep
- coldness in the lower leg or foot
- Discoloration in the toes or feet
- sores or wounds on toes, feet, legs that heal slowly or won’t heal
Ultrasound of Carotid/Neck
Ultrasound of the Abdomen
Ultrasound of the KidneyThe Endovascular Approach to Lower Extremity Arterial Disease Treatment
Peripheral artery disease (PAD) is treated most effectively by eliminating blockages in the arteries and restoring blood flow to tissues in the leg that aren’t receiving enough oxygen-rich blood.
If medication, exercise, lifestyle changes, and risk factor modification are not sufficient to reduce PAD symptoms or progression, patients are usually good candidates for minimally invasive revascularization.
Minimally invasive revascularization involves going directly into the blood vessel with catheter-based devices such as balloon angioplasty, stenting, and atherectomy. Selection is based on factors such as symptom severity, anatomy and location of the blocked artery, extent of blockage, and the patient’s other pre-existing medical conditions. It may take place over multiple staged procedures with a multitude of techniques to ensure patient safety and optimal clinical outcomes.
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Balloon angioplasty involves threading a wire through the narrowed or blocked artery along the length of the blood vessel. A deflated balloon is placed over the wire and then inflated, opening the blockage and allowing blood to flow more freely.
A stent is a wire mesh, tubular device that is inserted into the blood vessel containing the blockage. The stent is able to expand, so it is often used to prop open the blocked artery and hold the vessel open after balloon angioplasty. Stents stay in the body and are made of a special metal or polymer material.
Atherectomy is a procedure that involves destroying plaque in the artery using a laser device that emits high energy UV light to unblock the artery, or a mechanical device that spins and cuts or shaves away plaque.
Endovascular surgery is a form of minimally invasive surgery that was designed to access many regions of the body via major blood vessels. Endovascular techniques were originally designed for diagnostic purposes. Basic techniques involve the introduction of a catheter percutaneously or through the skin, into a large blood vessel. Typically the blood vessel chosen is the femoral artery or artery found near the groin. Access to the femoral artery for example, is required for peripheral, carotid, and aortic angiographic procedures. Alternative routes for entering the arterial circulation include the radial or brachial artery in the arm or the pedal artery in the foot. The catheter is injected with a radio-opaque dye that can be seen on live X-ray or fluoroscopy. As the dye courses through the blood vessels, characteristic images are seen by the endovascular surgeon and can assist in the diagnosis of diseases such as atherosclerosis, peripheral vascular disease, carotid artery disease, or aneurysms such as abdominal aortic aneurysms (AAA). This is a new technique developed to treat aortic aneurysms and dissections by use of stentgrafts which are inserted into the vasculature via the femoral arteries in the groin.Arterial Wound Treatment
Arterial wound treatment generally has three components
- manage PAD risk factors to improve overall vascular health
- keep the wound clean and free of infection to allow healing
- restore blood flow to the wounded tissue.
Chronic venous insufficiency CVI
Is a form of venous disease that occurs When veins in the legs have trouble moving the blood back to the heart. This can be caused by damage to the veins which can lead to blood pooling in the leg veins. Your leg veins contain valves that help your blood flow in the correct direction, when they don’t operate correctly, gravity takes over and flow does not move upward. Chronic venous insufficiency can include your deep veins, superficial veins and/or perforating veins.
How do we diagnosis: Venous Ultrasound
A vein ultrasound is a non-invasive imaging technique that is used to visualize vessel structure and blood flow in the veins, usually the legs. A transducer or wand is placed directly on the skin over the area being investigated, with the help of ultrasound gel and high frequency sound waves from the transducer sound waves are used to create an image. A venous ultrasound is used to help diagnose varicose veins comma venous insufficiency and other vein related conditions.
- 30-45 minutes, painless
- Wear comfortable, loose fitting clothing (shorts are preferrable)
- Avoid caffeine the morning of and hydrate
Symptoms of chronic vein insufficiency:
- achy or tired legs
- burning tingling or pins and needles in the legs cramping in your legs at night
- edema or swelling in your lower legs and ankles
- flaking or itching skin on your legs or feet
- leathery looking skin on your legs
- ulcers are open sores
- varicose veins
Treatments
Venogram Or Venography
A procedure that shows blood flow in your veins. Its main purpose is to help diagnose and manage conditions that affect your veins, including blood clots and May Turner Syndrome
In many cases, providers use vascular ultrasound to diagnose blood clots in your veins. However, venography is an alternative when ultrasound isn’t possible or doesn’t provide enough information. Providers also use venography to plan or guide venous disease treatments.