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"Not everyone is a candidate for EVAR," Dr. Spirig notes. "We can't perform the procedure if the patient's blood vessels are too small to deliver the stent into the aorta, but we've found we can treat approximately 70–80 percent with EVAR. Those who are not candidates may be treated with traditional open surgical repair." Treatment options for TAA and thoracic aortic dissections are also available at VBMC. Treating TAA and aortic dissection requires a more sophisticated technique and approach. Endovascular capabilities make a particular difference in the care of these patients, as many of them are not candidates for open surgical repair. "The management of a TAA is much more complex than the management of an AAA, and the treatment is typically available only at tertiary medical centers," Dr. Spirig says. "VBMC has state-of-the-art imaging, technology and specialty expertise to provide these procedures to our com- munity, whose residents, in the past, had to leave the area for care." Removing a Life-Threatening Problem A deep vein thrombosis (DVT) is a blood clot in a vein. DVTs present in a variety of ways, including painful inflammation of the leg, tenderness in the extremity, leg pain that worsens when a person walks or stands, discoloration of the skin, or a warm sensation in the leg. With the potential for these clots to dislodge and travel to other areas of the body, such as the lungs, a DVT can lead to life-threatening events. Traditionally, the threat of clots was mediated with blood-thinning medication and compression socks, but Dr. Saltzberg explains that innovative techniques offer improved treatment methods. "Pharmacomechanical thrombectomy (PMT) utilizes a combination of clot-busting medications and mechanical thrombectomy devices that use different types of energy to break up and remove the clot," she says. "This treatment prevents weakening of the valves in a vein that can lead to long-term sequelae that put patients at increased risk of morbidity and disability. It also reduces painful symptoms associated with blood clots by restoring normal blood flow. The key for successful treatment is early referral because the sooner we're involved, the more treatment options we have." PMT is performed while the patient is under light sedation. The vascular physi- cians at VBMC, guided by X-ray images, use a minimally invasive device to break up as much of the clot as possible. The patient typically returns home a few hours after the surgery, and recovery time is minimal. Endovascular procedures are most suc- cessful within two weeks of diagnosis. If too much time elapses, the clot becomes sticky and more difficult to remove. If clots are allowed to fester, patients are at risk for developing post-thrombotic syndrome — a condition in which insufficient valves lead to chronic swelling with venous skin ulcers. Revolutionizing Venous Treatment Venous disease and varicose vein treat- ment are similarly being transformed by The multidisciplinary team at Vassar Brothers Medical Center provides comprehensive, compassionate care and innovative techniques. M D N E W S . CO M ■ MD NEWS Mid Hudson | 9