Vascular Medicine
Vascular medicine focuses on conditions and diseases that affect arteries and veins and impair blood flow. Vascular disease can contribute to coronary artery disease (heart attack) and stroke, two of the leading causes of death and disability in the United States. MountainView Regional Medical Center offers a range of services for prevention and treatment of vascular diseases. Vascular specialists provide care for conditions such as:
- Aneurysm
- Atherosclerosis
- Deep vein thrombosis
- Peripheral vascular disease
- Pulmonary embolism
- Varicose veins
The vascular medicine team at MountainView Regional Medical Center provides a range of care, including:
- Diagnostic technology - Heart and vascular specialists utilize imaging technology such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA), or a minimally invasive coronary angiogram, to evaluate and diagnose heart and vascular disease.
- Risk-factor management - Diabetes, high blood pressure, obesity and unhealthful habits such as a sedentary lifestyle, smoking and improper diet can contribute to vascular disease. MountainView Regional Medical Center offers educational and preventive-screening services to help promote healthful practices that contribute to heart and vascular health. A multidisciplinary team can provide a treatment program to manage risk factors to minimize the risk of developing or aggravating vascular disease.
- Surgical interventions - Minimally invasive catheter-assisted techniques such as angioplasty, atherectomy and stent placement can be used to remove plaque and reopen blocked arteries. Vascular specialists use minimally invasive procedures whenever possible.
For high risk complex coronary artery disease, physicians at MountainView Regional Medical Center may perform a high-risk percutaneous coronary intervention (PCI). This is an advanced catheter-based procedure to implant a medical device for temporary ventricular support in patients with advanced coronary artery disease. These patients may be in need of a stent PCI or coronary artery bypass graft surgery, but have been told they are too high-risk for complications that may occur. This procedure may now allow them to safely undergo surgery.
Treating Carotid Artery Disease
Most cases of carotid artery disease are medically managed. When intervention is recommended, carotid endarterectomy (CEA) has long been considered the gold standard treatment with its low procedural stroke rate. However, CEA carries a higher risk of heart attack and cranial nerve damage due to a larger incision. Transcarotid artery revascularization (TCAR) is a new, less invasive procedure, reporting the lowest carotid stenting stroke rate of 0.6%.
What is TCAR?
TCAR is an endovascular procedure used to treat carotid artery disease and help prevent future strokes. It also reduces the risk of post-procedure heart attack and nerve injury. The procedure is done in an operating room using local or general anesthesia. During the TCAR procedure, blood flow is temporarily reversed away from the brain, collecting any potential debris in a filter before returning the blood to a vessel in the leg. This is called "reverse flow" and allows your physician to place a stent at the site of the disease. After the stent is successfully placed, blood flow resumes in its normal direction.
TCAR is recommended for patients at a higher risk of surgical complications due to age, comorbidities and/or medical or anatomical issues. More than 10,000 TCAR procedures have been performed worldwide. The Centers for Medicare and Medicaid Services (CMS) approved coverage and reimbursement of the TCAR procedure in 2016, and it is covered by most insurances for patients at high risk for open surgery.
What to Expect
It is important to follow your physician's instructions before and after your procedure. Most patients who undergo the TCAR procedure will recover quickly, typically spending only one night in the hospital. Before you leave the hospital, your doctor will give you instructions for activity, diet and medications, including:
- Avoid strenuous activities like lifting for at least a week. Your doctor will let you know when you can resume your normal activities and return to work.
- You will be prescribed medications to prevent blood clots from forming in your newly opened artery.
- After your procedure, you will be followed closely to monitor your recovery. You will be asked to have an ultrasound to determine if narrowing has occurred in the treated artery.
- To reduce the risk of recurring blockage in your artery, you may be encouraged to make lifestyle changes, including diet and exercise and, if you smoke, to quit smoking.