Education

PERIPHERAL VASCULAR DISEASE:

Peripheral arterialdisease (PAD) is a term usually used to describe conditions arising from blockages in the arteries supplying blood to the legs and feet. These blockages can be anywhere from the major arteries in the pelvis to the small arteries of the ankle and foot. The severity and location of the blockages is what determines the severity and type of symptoms that result. Many people have PAD without any symptoms. It is still important to identify PAD in asymptomatic people because it is often a warning of blockages in more serious locations like the heart and brain. As the PAD progresses, a symptom called "intermittent claudication" occurs. Claudication is a pain or burning or tiredness in the muscles of the leg (typically the calves and/or buttocks) that occurs while walking. As the PAD worsens, the distance a person can walk will decline. This reduced ability to walk not only adversely affects lifestyle, it also results in a sedentary lifestyle which adversely affects other risk factors like weight control, cholesteraol levels, and diabetes control. In more severe forms of PAD, a serious condition called "critical limb ischemia" (or CLI) results. This may present as resting pain in the foot or lower leg (typically worst at night), or non-healing ulcers of the toes and feet, or a blackening of the toes called gangrene. CLI is particularly common in diabetics. CLI is a serious disorder requiring medical attention in order to avoid complications requiring amputation. Circulatory Care of New Jersey offers broad experience in the evaluation and treatment of a wide range of problems in patients with either claudication or critical limb ischemia.
 
CAROTID ARTERY DISEASE:

Carotid artery disease typically describes the buildup of plaque in the neck arteries supplying the brain called the carotid arteries. Symptoms from these blockages can be a transient ischemic attack (TIA), fainting and/or dizziness, or stroke. As the blockage worsens, the risk of these symptoms grows. As blockages reach a severe level, it has been shown that surgical repair (carotid endarterectomy) reduces the risk of stroke. A new procedure called "Carotid Artery Stent Implantation" has gained enthusiastic support as a less invasive and less risky form of treatment. It is performed under local anesthesia in the groin and a balloon and metal stent are inserted into the carotid artery in the neck. The procedure typically takes about 45 minutes and requires an overnight stay in the hospital. Carotid artery stenting has recently been approved by the Food and Drug Administration. Dr. Cohen has had major experience with this procedure over the last several years.
 
RENAL ARTERY STENOSIS:

Renal artery stenosis is a condition that develops when plaque builds up in the artery supplying a kidney. The kidney is like the "thermostat" to the body in the way in controls the blood pressure. When renal artery stenosis develops, the kidney responds by driving the blood pressure up, leading to hypertension. As the blockage worsens further, the condition can lead to shrinkage of the kidney and ultimately to kidney failure. Opening the blockage with a stent often improves the blood pressure dramatically and can often prevent further kidney damage from developing. Dr. Cohen has had much experience in the implantation of renal artery stents.
 
ABDOMINAL AORTIC ANEURYSM:

An "Abdominal aortic aneurysm" (AAA) is a localized swelling of the abdominal aorta, which is the main artery in the abdomen that supplies the lower body. This is due to a weakening in the wall of the aorta. As a AAA enlarges, the risk of the aorta rupturing increases. Rupture of an AAA is serious event, often life-threatening. Therefore, surgical repair of AAA is indicated as the aneurysm reaches a certain size. Open surgical repair through an abdominal incision has been the mainstay of treatment for many years. More recently, a new approach called Aortic Stent-Graft Implantation offers patients a treatment which is much less risky, requires much less hospitalization, less post-operative recovery time, and can be done with two small incisions in the groins and regional (spinal) anesthesia. Dr. Cohen has been performing Abdominal Aortic Stent-Graft Implantation successfully for many years.
 
VASCULAR DIAGNOSTIC TESTS:

Almost all of these conditions can be evaluated very effectively in an office setting using non-invasive methods. These tests can measure blood pressure at different locations (ABI's, Segmental Pressures), blood volumes in the legs (Pulse Volume Recordings, PVR), blood velocity (Duplex), and vessel size and plaque (Ultrasound). Stress testing on a treadmill can also be done to assess the effects of exercise on leg circulation. All of these services are offered at Circulatory Care of New Jersey using state of the art equipment and highly trained technologists.
 

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