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Vascular Solutions

by Alessandro Nicolaci

We take a look at the latest trends in treating arterial and vascular diseases.

Vascular treatment highlights a field privileged with advancement and knowledge. Vascular disease may be a broad term that encompasses affliction to the circulatory system—with some common subcategories like venous, peripheral arterial and aneurismal disease—but the constant is that with today’s technology, treatment is more thorough and convenient than in days past thanks to noninvasive surgical options. A vascular condition is often serious, so if your physician does deem you a candidate for intervention or a surgical procedure, the following is proof you are at least in good hands with the latest and greatest at his or her disposal.

What’s ironic, though, is that with all these developments and advancements, physicians agree on one universal tool in treatment: prevention.

Cautionary signs
A person experiencing symptoms of a vascular disease can expect to incur a cardiac risk assessment performed by either a family practitioner or a cardiologist to evaluate the likelihood of having coronary disease. During the assessment, an in-depth history is evaluated determining tobacco usage, exercise and movement habits, and family history.

To highlight a few conditions found with vascular disease, doctors from Cooper University Hospital, Lourdes Health System and Virtua Surgical Group point to the most common cases. Peripheral arterial disease, or P.A.D., refers to the peripheral arteries (primarily the ones surrounding your heart) and the point where blockage of those arteries leads to body pain or cramps with activity, changes in skin color, sores or ulcers, and feeling tired. In an extreme case, total loss of circulation can lead to gangrene and the loss of a limb. Disease to your veins, or venous disease, develops as blood clots form as a result from damage to your veins, and aneurismal disease occurs when an artery throughout the body becomes enlarged and poses a life-threatening concern. This particular disease can sometimes go undetected.

Prevention
Specialists exist for specific conditions, but whoever your treating physician is, all would agree the first approach is prevention. “A penny of prevention is worth a pound of cure,” as cardiothoracic and vascular surgeon Dr. Steven Curiale of Our Lady of Lourdes Medical Center says. “And patients need to be more cognitive of a healthy lifestyle. Once you have a vascular disease, you will require close care and followup for life to ensure deterioration does not persist.”

It is at this point where the No. 1 treatment is recommended: modification of lifestyle. “Most patients do very well with risk factor modification, such as smoking cessation, exercise and improved dietary habits. When you look at this group in total, the common risk factor is tobacco use, and patients can do themselves a huge favor by getting themselves into a smoking cessation program to help prevent further damage to their blood vessels,” says Dr. Joseph V. Lombardi, a vascular and endovascular surgeon with Cooper University Hospital.

He goes on to clear the air: “A common misconception is that seeing a vascular surgeon means that you are going to be evaluated for surgery. While that is true, in part, most vascular surgeons try to adjust the patient’s lifestyle and risk factors first, as we know that these measures will greatly improve quality of life in the long run.” Surgery and advanced treatment are commonly used when the patient is too far from reversing their lifestyle, when their disease has developed due to other reasons, or at the discretion of the physician.

Advanced practices
If you are one of the millions dealing with a diagnosed vascular disease, or someone suffering from the symptoms, you have the opportunity to meet with a vascular surgeon or physician who has access to the latest resources.

According to Dr. Ashish Bedi, from the Virtua Surgical Group in Cherry Hill, one of the greatest benefits of technology is the ability to perform more endovascular interventions, such as opening up blocked arteries in the legs by accessing regions of the body through major blood vessels. Plus, there are other treatments becoming more common with the latest advancements that people may not be aware of, such as the ability to do cosmetic surgery for varicose veins.

For Lombardi, he sees aneurysms as one of the conditions benefiting the most. “I have a very busy aortic practice where I see a large number of patients who are treated for aneurysms,” he says. “We use minimally invasive techniques to treat more and more challenging aneurysms than in the past. Previously, these patients would have required a very long procedure with a significant incision in the abdomen. Nowadays, we are treating patients with devices called endografts that realign the aorta and are delivered through small incisions in the groin. Patients are basically up and out of bed the day of their surgery and they go home the next day with their aneurysm completely repaired.” That’s quite a milestone for vascular treatment, experts stress.

Curiale adds, “Surgery used to be the only option. Within the last 10 years, endovascular remedies have skyrocketed. Several new devices and stents are awaiting approval as we speak.” The United States has a careful approval process, which often results in longer research conducted than overseas. But with diligence comes a long-lasting, safe practice.

Future of the field
Medical advancements, hand-in-hand with technology, give hope to those in a state of prolonged pain or affliction. Undoubtedly, vascular disease still affects so many; so what can those people look forward to?

Bedi looks forward to a point in the next five years when stem cell research reaches a stage where arteries can be restored to a pre-disease state. Meanwhile, Lombardi praises, “I think I have been overwhelmed by the advances we have made for patients with significant diseases such as aortic dissection, aortic aneurysms and peripheral vascular disease. I am very confident that with further developments, we will be seeing unforeseen ways of treating the same problem with minimally invasive techniques that are effective and durable over the long term.”

Through all these advances, Bedi still has hopes for more change. “If there is one thing that I would love to be perfected, that would be the treatment of helping patients quit tobacco use. We could achieve so much with respect to the overall health of our country with patients smoking less frequently and, even better, not at all.

“If you look at the money spent on a health care basis alone for problems caused by smoking, you can tally a bill over $100 billion annually in financial costs to the economy—aside from the devastating impact it has on the quality of life of individuals and the burden it can put on family members. The bottom line is we need a better solution to help people quit.”

Resources

Cooper University Hospital
One Cooper Plaza, Camden
1 (800) 8-COOPER
CooperHealth.org

Lourdes Health System
1600 Haddon Ave. , Camden
(856) 757-3500
LourdesNet.org

Virtua Surgical Group
1935 Route 70 E., Cherry Hill
(856) 428-7700
VirtuaSurgical.org

Published (and copyrighted) in the Art of Living Well pull-out section of Suburban Family Magazine, Volume 3, Issue 12 (February, 2013).
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