Advanced Treatments for Diseases of the Circulatory System

Vascular Institute Circulatory System

Diseases of the vascular, or circulatory, system are a common cause of disability, limb loss and even stroke and death. The Vascular Institute at Wellington Regional Medical Center offers enhanced diagnosis and treatment options for many vascular conditions, including a state-of-the-art vascular laboratory where virtually every aspect of the vascular system can be evaluated.

Meet Our Medical Director

Juan Gomez, MD

Dr. Gomez is the Medical Director for the Wellington Regional Medical Center Neurointerventional Radiology Program and the Director for the Vascular Institute. He is a board-certified radiologist with fellowship training in neurointerventional radiology, neurodiagnostic radiology and vascular/interventional radiology. Dr. Gomez performs acute stroke treatment, aneurysm coiling, intracranial and carotid stenting, arteriovenous malformation (AVM) embolization, intracranial and extracranial tumor embolization, and spinal angiography with intervention. He also has vast experience in endovascular treatment of complex lower extremity arterial disease, venous disease and aortic aneurysm treatment.

 

Our Team

Our multidisciplinary team includes board-certified specialists with years of experience and ongoing training in the diagnosis and treatment of vascular diseases. During your consultation, we will spend the necessary time to understand your unique concerns and issues. Testing, if needed, is performed using advanced diagnostics and interpreted by highly-trained physicians, and an individualized treatment plan will be prescribed.

We have physicians who provide the full spectrum of the latest interventions for the treatment of vascular disease, including the latest therapies and surgical procedures. Fortunately, many diseases of the circulatory system can be managed without surgery.

Conditions We Treat

The most common diseases and clinical symptoms we evaluate and treat include:

  • Peripheral Arterial Disease: Leg pain on exertion (claudication), nonhealing leg wounds, leg pain at rest
  • Aortic Disease: aortic aneurysms
  • Venous Disease: Leg swelling and cramping, leg skin changes and pigmentation, chronic nonhealing or recurrent ulcers (particularly at the ankle level), varicose and spider veins
  • Cerebrovascular Disease: Stroke, brain aneurysms, carotid stenosis/narrowing, arteriovenous malformations

For more information about the Vascular Institute at Wellington Regional Medical Center, please call 561-798-8543.

Peripheral Arterial Disease

Peripheral arterial disease (PAD) is the narrowing of blood vessels outside of the heart. PAD develops most commonly as a result of a hardening of the arteries called atherosclerosis. This occurs when cholesterol and scar tissue build up to form a substance called plaque, which narrows and clogs the arteries. The clogged arteries cause decreased blood flow to the legs, which can result in pain when walking and eventually gangrene and amputation.

People with PAD are at increased risk for heart disease and stroke. PAD is also a marker for diabetes, high blood pressure (hypertension) and other conditions.

Risk Factors 

General risk factors for PAD include:

  • Smoking
  • High blood pressure
  • Atherosclerosis
  • Diabetes
  • High cholesterol
  • Age (older than 60)

Symptoms

People with PAD may experience a range of symptoms, including:

  • Leg pain when walking or exercising that stops when resting
  • Foot or toe wounds that won't heal or heal slowly
  • Coldness in the lower legs and feet
  • Poor nail growth on the toes or hair growth on the legs
  • Erectile dysfunction, especially in men with diabetes

Detection and Diagnosis

Several diagnostic tests can be used to detect PAD, including:

  • Ankle-Brachial Index — This is a painless exam that compares the blood pressure in your feet to the blood pressure in your arms to determine how well your blood is flowing. An abnormal difference may indicate PAD.
  • Doppler Ultrasound — This noninvasive method visualizes the blood flow in an artery to indicate blockages or narrowing.
  • Computed Tomographic Angiography (CTA) — A CTA is a noninvasive test that can show the arteries in your abdomen, pelvis and legs. It can be useful for patients with pacemakers or stents.
  • Magnetic Resonance Angiography (MRA) — This noninvasive test gives information similar to that of a CT without using X-rays.
  • Angiogram — During an angiogram, also called an arteriogram, a contrast agent is injected into the arteries to pinpoint any blockages that may be present. At the same time, minimally invasive treatments, including opening the occluded arteries, can be performed.

Treatments

The goal of treating PAD is to return the flow of blood to the legs and feet. Treatment options for each individual can vary and may include several different therapies used over time.

  • Lifestyle Changes — Initial treatment of PAD includes making lifestyle changes to reduce your risk factors. Changes you can make to manage your condition include:
    • Quit smoking. Ask your doctor about smoking cessation programs available in your community.
    • Eat a balanced diet that is high in fiber and low in cholesterol, fat and sodium. Limit fat to 30 percent of your total daily calories. Saturated fat should account for no more than seven percent of your total calories. Avoid trans fats including products made with partially-hydrogenated and hydrogenated vegetable oils. If you are overweight, losing weight will help you lower your total cholesterol and raise your HDL (good) cholesterol. A registered dietitian can help you make the right dietary changes.
    • Exercise. Begin a regular exercise program, such as walking. Walking is very important and can aid the treatment of PAD. Patients who walk regularly can expect a marked improvement in the distance they are able to walk before experiencing leg pain.
    • Manage other health conditions, such as high blood pressure, diabetes or high cholesterol.
    • Practice good foot and skin care to prevent infection and reduce the risk of complications.
  • Medications — Medications may be recommended to treat conditions such as high blood pressure (anti-hypertensive medications) or high cholesterol (statin medications).
  • Interventional Procedures — More advanced PAD can be treated with interventional procedures such as angioplasty (to widen or clear the blocked vessel), angioplasty with stent placement (to support the cleared vessel and keep it open), or atherectomy (to remove the blockage).