Peripheral Vascular Disease
Marous Center for
Vascular Disease
Allegheny's approach to vascular disease mirrors the overall philosophy of the Cardiovascular Institute. Patients benefit from the coordination of the multiple specialties that focus on vascular disease — vascular surgery, vascular medicine, interventional radiology and cardiology — as well as Allegheny's participation in clinical research to chart new territory in surgical methods to treat vascular disease.
The most common vascular diseases often require uncommon care that focuses on pinpointing and treating narrowing and blockage of the blood vessels of the extremities.
Peripheral vascular disease (PVD/lower extremity vascular disease)
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A vascular ultrasound technician performs a carotid Doppler dtudy |
- Doppler wave form analysis
- Segmental pressures
- CT angiography
- Magnetic resonance angiography
- Arteriography (angiography)
Medication/compression treatment.
Deep venous insufficiency may be treated effectively with compression or medication therapy. Allegheny offers many options for compression treatment, including pump therapy, manual drainage through massage therapy and various wrappings.
Anticoagulation management.
Deep venous insufficiency may be managed with anticoagulation therapy, or blood-thinning medications. Through Allegheny's Anticoagulation Management Program, patients receive timely laboratory service and results in one place at one time.
Balloon angioplasty/stents.
Guided by imaging technology, doctors insert catheters tipped with inflatable balloons into arteries where plaques are located. The balloon is then inflated to stretch the artery and improve blood flow.
Thrombolytic therapy/mechanical thrombectomy.
Allegheny doctors can either direct clot-dissolving medication directly to the blockage via catheter (thrombolytic therapy), or place a catheter designed to disrupt and remove clots into the affected blood vessels.
Catheter Embolization.
Catheter embolization is a technique used by the Allegheny interventional radiology team to introduce medications or synthetic substances directly to vessels to control the blood supply to an aneurysm. Using imaging guidance, Allegheny interventional radiologists insert coils that can block the flow of blood. Coil embolization via catheters provides a less invasive option for a patient whose condition makes traditional surgical repair too risky.
Bypass surgery.
Allegheny General's vascular surgeons have extensive experience treating the most stubborn blockages, including those that require the creation of a blood-vessel detour around the affected area, much like that required to bypass blocked arteries in the heart.
Saphenous vein treatment.
Patients requiring intensive treatment have access to both traditional and novel methods for the removal or ablation of the saphenous vein, the primary source of venous valve failure for patients with superficial venous insufficiency. Radiofrequency (RF) ablation, for example, closes the saphenous vein by introducing radio waves through one tiny incision to shrink then collapse the vein. Patients who undergo RF ablation require no general anesthesia and usually resume normal activity in days.
Renal vascular hypertension.
Stent placement in these narrowed kidney arteries can eliminate or make high blood pressure easier to control and can preserve kidney function by maintaining a healthy blood supply.
Dialysis Access
For patients with end-stage renal disease requiring hemodialysis, Allegheny surgeons are experienced in creating natural fistulas and dialysis grafts, as well as implanting dialysis catheters, to access the bloodstream. Surgeons in Allegheny's Vascular Center also use a wide variety of technology to image the fistulas and techniques for re-opening the fistulas if they become blocked. Collaborating with radiology experts, Allegheny vascular surgeons can reopen these blockages using specially designed equipment or clot-busting medications — which may eliminate the need for additional surgery.Advanced Wound Healing and Lymphedema Center
Allegheny General's Advanced Wound Healing and Lymphedema Center is one of few in the United States dedicated to both wound care and specialized treatment for lymphedema. The Center's team at Allegheny combines the expertise of health professionals from vascular surgery and orthopaedic surgery, as well as the disciplines of plastic surgery, dermatology, endocrinology, physical therapy and nursing — resulting in a comprehensive approach to wound healing, limb preservation and followup care that promotes a better quality of life. Allegheny's professionals use sophisticated equipment to evaluate and manage wounds that have not responded to traditional treatment methods:
 Co-directors Stephen Conti, M.D. (center), and Satish Muluk, M.D. (right), examine a non-healing wound |
F-scan computerized plantar measurement system.In addition, Allegheny patients have access to a host of specialists in mobility training, physical therapy and nursing to help prevent the development of a variety of debilitating wounds that may be caused by disease or the skin pressure that results from extended bed confinement.
This technology pinpoints highpressure areas on the foot and determines the origin of foot wounds, which in turn makes possible the prescription of footwear and medical devices specifically designed to help prevent wound recurrences. This technology is particularly effective in aiding clinicians to devise treatment plans to help preserve the feet of patients with diabetic neuropathy — the main cause of non-traumatic amputation.
Hyperbaric oxygen therapy.
Through this treatment, patients are placed in a pressurized chamber that delivers increased amounts of oxygen to difficult-to-heal wounds, promoting healing.
Compression management.
Patients with venous disease and swelling have access to a wide array of techniques to control fluid accumulation, including sophisticated compression pumps, wraps and manual lymphatic drainage.
Arterial/ischemic disease.
Allegheny surgeons have the depth of expertise to apply innovative techniques for the treatment of these wounds caused by compromised arterial blood flow to the extremities.
Growth-factor therapy.
Platelet-derived growth factor is released during the body's normal reparative process and has been shown to promote a similar effect in nonhealing wounds. Allegheny wound specialists are working with advanced techniques to stimulate this effect using naturally circulating platelets.
