Loma Linda University Health is internationally renowned for expertise, leadership and dedication to bringing the most innovative care to patients with different medical problem including peripheral vascular disease.
Our physicians are world leaders in the areas of peripheral vascular disease and limb care, and they work collaboratively to provide extraordinary care and improved outcomes for some of the most complicated cases. We are dedicated to delivering expert care with a personal touch, providing individualized attention to each patient.
Vascular clinic offers comprehensive care for diseases of the vascular system (blood vessels), including peripheral artery disease, diffuse and premature atherosclerosis, venous disease and varicose vein. Our specialists diagnose and manage patients with arterial, and venous disease, as well as acute and long- term care of patients with hypercoagulable state. We have several specialty services and resources to ensure patient gets the best treatment.
What our program offers
- Screening for peripheral arterial disease of the legs, including measurement of ABIs and arterial ultrasound.
- Screening for abdominal aortic aneurysm (AAA), a potentially fatal condition if not caught early
- Evaluation and management of signs and symptoms of peripheral arterial disease in the legs, such as claudication (leg pain), and vascular ulcers.
- Multidisciplinary approach to wound care, involving vascular medicine specialists, vascular surgeons, podiatrists, endovascular (minimally invasive) treatment of blockages in the arteries of the legs, and hyperbaric oxygen treatment.
- Utilizing the latest technology and techniques in endovascular (minimally invasive) interventions of the legs to ensure excellent long term results, such as atherectomy, drug-coated ballooning, and use of the flexible Supera stent.
- Diagnosis and treatment of peripheral venous disease and venous insufficiency (varicose veins, venous ulcers, and swelling of the legs). Offering sclerotherapy and radiofrequency ablation of varicose veins.
- Optimizing and managing your whole cardiovascular health, since atherosclerosis in the arteries of the legs often also affects the arteries of the heart (coronary artery disease) or the brain (cerebrovascular disease).
Conditions Treated
Venous Disease
The direct cause of varicose veins and spider veins is unhealthy valves in your veins that allow blood to flow in the wrong direction, which leads to strained and bulging veins. Pregnancy, weight gain, and the simple effects of aging can aggravate vein disease. Other factors–such as employment that requires long periods of standing or sitting, can also worsen varicose veins symptoms over time.
Varicose veins and spider veins are the two vein conditions caused by vein disease that affect the largest number of people in the US. They bring visible signs and symptoms that can cause discomfort, pain, embarrassment, and fatigue. This not only makes sufferers feel self-conscious, but prevents them from living the healthy, active lives they want to live.
Vein conditions that are seemingly cosmetic are often caused by a progressive underlying vein disease that could lead to more serious conditions if left untreated. The more quickly people seek treatment, the lesser the chance of developing more symptoms and of needing even more extensive treatment. So once you understand the root cause of your vein condition, the next step is finding the right treatment.
Arterial Disease
Peripheral arterial disease (PAD) is a disease that occurs in the arteries of the arms and legs. Arteries are the blood vessels that carry oxygen and nutrient-rich blood from the heart to all areas of the body. Healthy arteries have a smooth lining that prevents blood from clotting and promotes steady blood flow.
In PAD, the arteries become narrowed or blocked when plaque gradually forms inside the artery walls. Plaque is made of excessive fat, cholesterol and other substances floating through the bloodstream, such as inflammatory cells and calcium. If the arteries become narrowed or blocked, blood cannot get through to feed organs and other tissues, causing damage to the tissues and eventually tissue death.
Risk factors for developing PAD are: smoking, diabetes, age (above 50 years old), race (black people have 2 fold higher risk), coronary artery disease, hypertension and hyperlipidemia as well as a positive family history.
PAD is the "tip of the iceberg" and often is just one manifestation of systemic atherosclerosis, which needs to be aggressive managed to prevent not just limb loss, but also heart attack and stroke.
Procedures Performed
When patients suffer from hardening of the arteries, or atherosclerosis, their arteries are partially blocked by a substance called plaque. The muscles and other tissues of the arms and legs need oxygen and nutrients to work. If the arteries that feed the arm or leg are blocked by plaque (a mixture of cholesterol, fat, calcium and other substances), the leg will not work well and may experience pain or numbness. In extreme circumstances, they may require amputation. When these blockages occur in the legs or arms, they are called peripheral artery disease.
Peripheral artery endovascular interventions remove the plaque and restore the flow of blood through the artery. With these interventions we treat peripheral artery diseases without surgically opening the leg or arm. Instead, the doctors use tools including catheters. By using a catheter, doctors avoid making large surgical cuts when they remove the blockage. As a result, procedures that rely on a catheter generally decrease pain, pose less risk of infection, avoid large scars and shorten recovery times.
Peripheral Artery Interventions
Angioplasty and Stenting
A catheter is a thin tube that is inserted into a blood vessel through a small cut, usually in the leg or arm, and threaded to the site of disease. Once in place, it acts as a tunnel, enabling the doctor to efficiently guide the tools to where they are needed. During angioplasty, the doctor uses a catheter to guide a small, unfilled balloon to the site of the blockage. The balloon is inflated, pressing the plaque tight against the wall of the artery. After angioplasty, the catheter may be used to place a small mesh tube, called a stent, into the site of the blockage. The stent works to keep the plaque packed against the wall of the blood vessel and the artery propped open. As a result the opening in the artery is wider, and blood can flow more freely to the target organ muscles.
Atherectomy
In this procedure, the doctor removes the plaque from the artery. Using a catheter, the doctor directs a very small device with tiny blades that can precisely shave the plaque from the artery wall while safely collecting it. In some cases, the doctor may use a tiny laser that blasts the plaque into small pieces that dissolve in the blood. One advantage of these approaches is that no medical device is left in the body after the completion of the procedure.
What to Expect
During a peripheral vascular intervention, you will have anesthesia, so the discomfort and pain will be minor. It may be a local anesthetic, so you won’t feel much discomfort where the doctor will insert the catheter into your groin or arm. You’ll remain awake and be able to follow the doctor’s instructions. In other cases, you may get a general anesthetic, so you will not be awake during the procedure. These procedures generally can take between 30 minutes to several hours. You’ll remain on your back throughout the procedure.
After the procedure, you may stay in the hospital for one to two days to allow you to safely recover. If your procedure is performed early in the day and you are recovering well, you may be allowed to go home the same day. Possible side effects include allergic reactions to some of the medicines and dyes used during the procedure. You may experience irregular heartbeats. As with all operations, bleeding and infection are risks. Other risks include brain damage, heart attack, strokes and more blockage of the artery over time.
The signs and symptoms of peripheral vascular disease can sometimes be subtle. If you are experiencing pain or cramping in your legs or thighs, swelling, discoloration or non-healing wounds, you will need to be worked up for peripheral vascular disease. If you have any of the above mentioned symptoms talk to your primary care doctor about referring you to one of our vascular specialist.
