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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