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Diseases & Prevention - Vascular Disease


Abdominal Aortic Aneurysm (AAA)

An abdominal aortic aneurysm occurs when part of the aortic artery in the abdomen weakens and bulges out. Aneurysms are often discovered during a routine physician visit or during tests for another condition as they develop slowly over many years and often have no symptoms unless they rupture. A ruptured aneurysm is a life-threatening situation that requires immediate medical attention. Many aneurysms start off very small and stay small although some grow quickly. That’s why if you are diagnosed with an aneurysm, you should work closely with your physician to monitor its growth. When an aneurysm gets too large or is growing quickly, your physician may recommend an interventional procedure or surgery to reinforce the weakened area to prevent it from rupturing

Symptoms
Often times, there are no symptoms of an aneurysm.
• Sometimes, as an aneurysm enlarges, people notice a pulsating feeling near the naval, back pain or a constant pain in the abdomen or side of the abdomen
• If an aneurysm ruptures, symptoms may develop very quickly and include: pain (in the side, back or abdomen), clammy skin, dizziness, nausea, vomiting, rapid heart rate, shock and low blood pressure.

Treatment

The goal of treatment is to prevent the aneurysm from rupturing. Generally, the treatment options include medical monitoring or if the aneurysm is large or fast growing, surgery may be the best option.
• Medical monitoring – if the aneurysm is small and there are no symptoms, often treatment involves regular ultrasound exams to see how fast it is growing.
• Surgery – if the aneurysm is large or growing quickly, surgery may be ordered. The most common approach is an interventional procedure in which a graft is inserted through catheter in the leg and threaded into the aorta to reinforce the weakened area. Open abdominal surgery involves replacing the damaged section of the aorta with a small tube or graft which is sewn into place. Whether a patient has open or endovascular surgery depends on a variety of factors including the size and location of the aneurism, the patient’s age and other risk factors the patient may have.

Carotid Artery Disease (Carotid Artery Stenosis, Carotid Artery Occlusion)

Carotid artery disease is a narrowing of the carotid artery due to a buildup of plaque. Left unmanaged, carotid artery disease can lead to a stroke.

Symptoms
• Carotid artery disease often has no symptoms and the first signs are often a stroke. If you have a family history of carotid artery disease, it is important to see a physician and further evaluate your risk factors, monitor your condition and determine the best course of action.

Treatment
Treatment for carotid artery disease focuses on lifestyle changes, medication and procedures when needed.
• Medications – medications may be given to reduce the possibly of stroke by lowering blood pressure, reducing cholesterol or thinning the blood.
• Lifestyle changes -- avoid tobacco, exercise regularly, eat a healthy diet and manage other conditions such as diabetes or high blood pressure.
• Stents or surgery -- more advanced disease may require surgery to remove the plaque (carotid endarterectomy) and possibly a stent to keep the artery open.


Deep Vein Thrombosis (DVT)

DVT is a blood clot in a deep vein, usually in a leg, but sometimes in an arm or other veins. Blood clots can be triggered by surgery, cancers, extending periods of sitting or bedrest, pregnancy, injuries to blood vessels, birth control pills or hormone replacement therapy.

Symptoms
• Swelling (usually in one leg or arm)
• Pain or tenderness often described as a cramp
• Redness or warmth in the sore area

Treatment
Treatment for DVT focuses on preventing the clot from getting bigger and breaking off and forming a pulmonary embolism in the lungs. Options include:
• Blood thinners – keep the clot from getting bigger and keep additional clots forming.
• Clot buster drugs – used in more severe cases or when other medications aren’t working, clot buster drugs (thrombolytics) are used to break up a clot quickly.
• Filter – for patients who can’t take blood thinning medications, a filter may be inserted into the abdomen to catch blood clots before they get to the lungs.
• Compression stockings -- reduce swelling and prevent blood from pooling and clotting.

Peripheral Arterial Disease (PAD), Peripheral Vascular Disease

Peripheral artery disease is a narrowing of the arteries to the legs, stomach, arms and head. PAD can result in coronary artery disease, heart attack and stroke. Left untreated, it can lead to gangrene and amputation. PAD may be caused by diabetes, blot clots, high cholesterol, high blood pressure, hardening of the arteries, inflammation, injury or trauma. PAD may lead to blood clots deep in the veins (DVT) or pulmonary embolisms (PE) if a blood clot breaks off and goes to the lungs.

Symptoms
• Cramping, pain or tiredness in the legs or hips while walking or climbing stairs which often goes away with rest.

Treatment
Treatment for PAD focuses on reducing symptoms and preventing the progression of the disease. In many cases, PAD can be managed by lifestyle changes, exercise and medication:
• Medications – medications may be given to reduce high blood pressure, reduce high cholesterol or to thin the blood.
• Lifestyle changes -- avoid tobacco, exercise regularly, eat a healthy diet, manage other conditions such as diabetes or high blood pressure and practice good foot and skin care.
• Stents or surgery -- more advanced PAD may require an interventional procedure such as angioplasty to widen blocked vessels or stent placement to keep a vessel open or peripheral artery bypass surgery may be formed to redirect blood flow around a blocked vessel.


Pulmonary Embolism (PE)

A pulmonary embolism is a blood clot that has traveled to the lungs and blocks some or all of the blood supply. Pulmonary embolisms can be very serious and often life-threatening.

Symptoms
Some PE have no symptoms and may result in sudden death. If there are symptoms, they may include:
•   Shortness of breath
•   Sharp stabbing chest pain when breathing deep
•   Fast breathing and heart rate
•   Blood when coughing
•   Sweating
•   Light headedness or fainting

Treatment
Treatment options for PE include:
•   Medication – to thin the blood or dissolve clots.
•   Interventional procedures -- to remove clots.


Risk Factors & Prevention of Vascular Disease 

Risk Factors
While some risk factors for heart and vascular disease cannot be changed, others are modifiable by changes in lifestyle:
• Having high blood pressure, high cholesterol or diabetes
• Having a family history of cardiovascular disease
• Smoking
• Eating an unhealthy diet (lots of saturated fat, transfat, cholesterol, sugar, salt)
• Not getting enough physical activity
• Being overweight
• Consuming too much alcohol
• Being over age 45 for men or over age 55 for women

Preventing Heart & Vascular Disease

Fortunately, there are many things you can do to reduce your risk for heart and vascular disease, including:
• Don’t use tobacco or breathe secondhand smoke – smoking raises blood pressure and puts you at significantly higher risk for heart disease and stroke.
• Eat healthy – Eat a mix of fruit, vegetables, lean meat or other proteins, whole grains and healthy fats (olive oil, nuts, seeds and fatty fish). Limit your intake of foods high in sodium (processed foods), saturated fats and cholesterol (red meats and egg yolks).
• Stay active – Exercise not only strengths your heart and improves circulation but it can also help maintain a healthy weight, lower cholesterol and blood pressure and reduce stress. Try to get 30 minutes of moderate to intense physical exercise on most days.
• Watch your weight – Being overweight strains your heart and can lead to diabetes and other conditions that can damage the heart.
• Limit alcohol consumption – Drinking too much alcohol can raise your blood pressure and lead to weight gain which increase the risk of heart disease. Men should have no more than two alcoholic drinks per day, and women should have no more than one drink per day.
• Manage diabetes diabetes doubles the risk of diabetic heart disease because high blood sugar from diabetes can damage blood vessels and the nerves that control the heart and blood vessels.
• Get enough sleep – If you don't get enough sleep, you raise your risk of high blood pressure, obesity and diabetes. Most adults need 7 to 9 hours of sleep per night.
• Manage stress – Stress can take a toll on your overall health and can lead to unhealthy coping strategies, such as drinking, smoking or overeating. Manage stress by getting plenty of sleep, avoiding negative self-talk, exercising, listening to music, meditating or focusing on something calm or peaceful.