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to be controlled. That's the most important thing — risk factor modification." He explains that 90 percent of PAD diag- noses can be made with ultrasound. Lake Health's vascular ultrasound laboratory, which is recognized by the Intersocietal Commission for the Accreditation of Vascular Laboratories for providing the most accurate noninvasive testing, offers a broad range of state-of-the-art diagnostic technologies to detect and analyze virtually any known vascular disorder, including PAD, carotid artery disease, abdominal aortic aneurysms, and renal artery stenosis. Early detection and treatment are critical for patients with any vascular disease. "If a patient is symptomatic, where he has difficulty walking, rest pain, or non-healing foot ulcers due to lack of blood flow, immedi- ate treatment is needed," says Dr. Rao. "We treat about 80 percent of patients with PAD with minimally invasive techniques." In the past, blockages of arteries in the leg caused by atherosclerosis were treated via surgical bypass. Advances in endovascular technologies and techniques now make it possible to treat these blockages minimally invasively through a tiny incision. The result is less pain and a faster recovery. Most patients go home the same day as the procedure. Minimally Invasive Treatment for Carotid Artery Disease Carotid artery disease causes more than half of the strokes that occur in the United States, according to the National Heart, Lung and Blood Institute. Risk factors are similar to those for PAD. Diagnosis can be made via ultrasound, MRI or CT. At Lake Health, Dr. Rao and his vas- cular surgeon colleagues offer the full gamut of treatment for carotid artery disease — from traditional open carotid endarterectomy to carotid stenting. The latter involves threading a tiny wire mesh stent through a catheter, inserted through a small incision in the groin, into the blocked blood vessel. The stent compresses the plaque, opening the blocked artery and restoring blood flow. No general anesthesia is needed, which reduces recovery time. "In the eastern side of Cleveland, we are one of only two community hospitals that consistently perform carotid stenting. And we're the only hospital between Lake County, Ohio and Erie, Pennsylvania to do this," says Dr. Rao. "We are involved in four or five different carotid stent trials, so we have access to the latest devices and stents. And we have a multidisciplinary team of neurologists, vascular surgeons and interventional radiologists to treat this disease and the entire spectrum of stroke." All of Lake Health's vascular surgeons are available 24/7 for emergent care. They also see patients that need urgent care within 24 hours of physician referral. SAV I N G LI M B S , SAV I N G LI V ES A 69 -YEAR- OLD MALE with critical limb ischemia — the most advanced stage of PAD — was referred to Dr. Rao for a second opinion. A security officer, he had been experiencing persistent pain and cramping in his right leg 'for months' before deciding to see a specialist at another hospital. At that time, blood flow to his leg was so severely limited that he was in danger of losing his right foot, so an angioplasty and open bypass were performed at that hospital. When these procedures did not resolve the problem, an amputation was recommended. According to the Centers for Disease Control and Prevention, more than 30,000 Americans undergo amputation annually. Amputation is a devastating event and is not only lifestyle limiting but also life limiting. Approximately 50 percent of patients undergoing an amputation die within one year. "With the advanced endovascular therapies available today, amputation should be the treatment of last resort," explains Dr. Rao. "At Lake Health, we treat blocked arteries anywhere in the vascular system and, because of our comprehensive expertise, many times we can save a limb that would otherwise have been amputated. In 90 percent of cases, we can prevent amputation." Using an innovative catheterization technique, Dr. Rao snaked tiny wires and balloons through a small puncture in the patient's groin area, slowly working downward to clear blockages and restore blood flow. The incision-less procedure lasted one and a half hours. The patient was discharged to his home the next day. Today, the patient reports being pain-free and has returned to his job. Clinic hours are Monday through Friday, 8 a.m. to 5 p.m. F o r m o r e i n f o r m a t i o n a b o u t e n d o v a s c u l a r t r e a t m e n t s a t L a k e Health, vi sit w w w.lakehealth.org or www.neo-vascular.com. To refer a patient, call Northeast Ohio Vascular Associates at 440-269-8346. ■ 2 0 1 4 S E P T E M B E R /O C T O B E R ■ M D N E W S . CO M ■ MD NEWS Cleveland/Akron/Canton | 2 7