Deborah Offers Surgical and Nonsurgical Interventional Treatments for Vascular Disease

Vascular specialists and surgeons at Deborah Heart and Lung Center are currently offering surgical and nonsurgical interventional procedures, allowing for treatment of vascular disease from its most mild to most critical stages. Including balloon, stent, and Rotablator interventions and the latest in surgical treatment approaches, these procedures afford physicians the opportunity to treat patients at any stage of the disease.

Rodolfo Pascual, MD, William Rough, MD, and Jeffrey Hager, DO, Vascular Surgery Program Director, perform vascular surgery at Deborah Heart and Lung Center, surgically treating patients in one of the Center's five operating suites. Nearly 400 procedures are performed annually, the most common of which are carotid endarterectomies, abdominal aortic aneurysm resections and lower extremity revascularizations.

Patients in Deborah's new Comprehensive Vascular Program are referred for surgery when disease has progressed beyond nonsurgical treatment methods, when the patient is at risk for stroke or when severe disease in lower extremities is causing constant pain or posing a threat to limb viability. All patients are evaluated by Deborah's cardiologists prior to surgery to determine the risk of coexisting coronary artery disease. If atherosclerosis is found in coronary arteries, the patient's surgeries can be performed either simultaneously or staged, according to the severity of the blockages.

"Because of the strong relationship between vascular disease and coronary artery disease, each vascular surgery patient at Deborah is first screened for coexistent coronary artery disease," said Dr. Hager. "If it is determined that a patient has atherosclerosis in the coronary arteries as well as the peripheral vessels, we can often offer them the option to have both conditions corrected at once, ultimately reducing hospital stay and recovery time."

According to Dr. Hager, atherosclerosis in the legs is treated differently than in the arteries of the neck. Symptoms of carotid atherosclerosis or aortic atherosclerosis can result in stroke or aneurysm, while the main symptom in the leg is pain, which can often be treated nonsurgically and is not typically life-threatening. Vascular surgeons will treat patients with iliac or femoral blockages first with medications and/or walking programs to increase a patient's level of pain-free activity. Then, if patients are determined to be candidates and are willing, nonsurgical intervention may be attempted. Only after the disease has progressed beyond these methods, or when a patient is suffering from limb-threatening ischemia, will the vascular team recommend a surgical bypass procedure. According to Dr. Hager, surgery is deferred because many patients can be successfully treated for years without surgery, and also because patency rates of femoral bypass surgeries can be inconsistent, and further interventions may eventually be needed.