Dr. Christiane Werneck
ARTERIAL CONDITIONS
Please see brief description of most common arterial diseases such as atherosclerosis, aneurysms, dissections, stroke.
For more details and resources see appropriate Links and the Helpful Information Page.
PERIPHERAL ARTERIAL DISEASE (PAD)
Atherosclerosis or atherosclerotic disease is a condition where the arteries carrying blood from the heart to the rest of the body become blocked with a sticky substance called plaque. Plaque is made up of cholesterol, calcium and fibrous tissue. As plaque builds up, most commonly leg arteries become narrowed and stiff. Decreased blood flow to the legs can cause leg pain when walking (also called claudication), painful sores that won't heal and even tissue death (gangrene). Patients with PAD often require long-term regular monitoring to optimize outcomes. Lifestyle modification is extremely important to slow or even stop the process. That involves quitting smoking, controlling diabetes, high blood pressure, cholesterol and routine exercise.
For more details see: http://www.vascularweb.org/vascularhealth/Pages/PeripheralArteryDisease(PAD).aspx
ABDOMINAL AORTIC ANEURYSM (AAA)
An aortic aneurysm is a bulge in a weak part of the aorta, the largest artery in the body. Aortic aneurysms usually occur in the abdomen and less commonly in the chest. They are a health risk when they are large, because they can burst or rupture, which is often fatal. Small aneurysms are usually monitored with ultrasound. Different treatment options are available depending on your aneurysm and health conditions.
For more details see: http://www.vascularweb.org/vascularhealth/Pages/AbdominalAorticAneurysm.aspx
STROKE AND CAROTID DISEASE
Plaque build-up in the carotid arteries, the main arteries to the brain, can cause stroke. Patients after stroke, mini stroke or transient stroke (TIA) symptoms with severe blockages in the carotid arteries often require urgent treatment to prevent further episodes of stroke. Immediate medical attention is extremely important to improve your chances of recovery, protect the brain from having permanent damage and good outcomes.
For more details see: http://www.vascularweb.org/vascularhealth/Pages/CarotidArteryDisease,Stroke,TransientIschemicAttacks(TIAs).aspx
WOUND CARE AND CASE MANAGEMENT
Through this service, W Vascular Institute provides the high quality, personalized care required. With our experienced team and the best treatments available, you can rest assured that your health is in the best of hands. We work in close collaboration with Community Care.
OTHER SERVICES
We provide specialized service in other areas such as management of patient with Aortic Type B Dissection, Deep Vein Thrombosis, creation and management of Access for Patients on hemodialysis, in close collaboration with Cardiologists, Cardiac Surgeons, Nephrologists, Interventional Radiologists, Hematologists and other specialists. To learn more or ask questions, simply reach out .
TREATMENTS
AAA
The treatment of aortic aneurysm is determined by the size of the aneurysm, presence of symptoms or rupture, which is true medical emergency. The options of treatment are traditional open repair, replacing the segment of the aorta with a bypass graft, or endovascular repair with a stent graft (EVAR). The later is a much less invasive option, done under X-Ray guidance, and preferred choice for elderly patients, patients with several medical conditions and in emergent situations.
Small aneurysms (less than 5 cm in diameter) normally do not require surgery and the risk of rupture is reduced. They are followed by regular check-ups with abdominal ultrasounds since they can grow over time. Lifestyle changes like quitting smoking and having the blood pressure under control are extremely important to slow the speed in which those aneurysms can grow.
The method of treatment is determined for the most part by the aneurysm characteristics, patient's condition and preference.
PAD
Change in lifestyle is the key in the treatment along with medications. This includes quitting smoking, controlling blood pressure, cholesterol, diabetes, and losing weight. In addition, an exercise program such as regular walking, if followed faithfully, can significantly improve the symptoms of PAD in many cases.
Surgical options of treatment include balloon angioplasty with or without stents to open the obstructed arteries or surgical bypass for more extensive disease.
Chronic follow up of this condition is important to slow down or even prevent progression of the disease. In severe cases, PAD can cause constant pain, chronic sores that will not heal appropriately. These can lead to gangrene of toes or foot and/or amputation. It requires urgent assessment and treatment.
CAROTID DISEASE
Blockage of the carotid artery can lead to TIA or stroke. The risk is particularly high when there is more than 70% narrowing of the artery caused by the plaque build-up. The risk is also very high immediately after a TIA or stroke.
The type of treatment is dictated by the degree of the narrowing and presence of recent TIA or stroke.
The options currently available are medication to reduce the risk of forming clot and to lower the cholesterol; carotid stenting or carotid endarterectomy (surgery). Lesser degree of narrowing is normally treated with medications and lifestyle modification. In very narrowed arteries surgery or stent is indicated. The choice between surgery or stenting is based on type and location of the narrowing, age and medical conditions of the patient along with personal choice.
Surveillance is also very important to assess progression of the disease even after previous treatment.