33 Sewall Street, Portland, Maine 04102 207.956.6650
Vascular Disease

Vascular Disease

Introduction

Peripheral vascular disease (PVD) usually results from atherosclerosis (plaque build up on the artery walls) in the arteries outside of the heart. Contributing causes include smoking, diabetes, obesity, sedentary lifestyle and genetic factors. This plaque can cause narrowing or blockages in the arteries in the legs, kidneys, intestines and carotids. PVD has been associated with a greater risk of cardiovascular morbidity and mortality than either heart attacks or stroke.

Symptoms

PVD – Legs

When they involve the arteries in the legs, the symptoms usually begin with pain in the calves or legs when walking, that is relieved by rest (this is called "claudication"). Hip and thigh pain may be caused by PVD, as may erectile dysfunction. As it becomes more severe, it can begin to cause pain even at night ("rest pain") which is relieved when the legs are dangled off the side of the bed or when standing up. This is the beginning of critical limb ischemia. The final stage is when skin ulcerations occur or areas of tissue breakdown which is known as gangrene.

PVD- Renal Artery Stenosis

When similar blockages occur in the kidney arteries, this may lead to high blood pressure which is difficult to control, poor kidney function, shrinkage of the kidneys and congestive heart failure.

PVD- Chronic Mesenteric Ischemia

Blockage in the intestine arteries may lead to pain or cramping shortly after eating. This pain can be quite severe such that patients may start to avoid eating and can lose significant amounts of weight unintentionally.

Treatment Options

Consultation

During initial consultation with Vascular & Interventional Physicians, we perform a thorough history and physical exam to confirm the presence of PVD and distinguish it from other potential causes of similar pain. If necessary, we may perform additional non-invasive imaging studies to better characterize the disease.

Vascular Imaging

At Vascular & Interventional Physicians, we are uniquely trained and Board-Certified in the performance and interpretation of all aspects of Vascular Imaging, including Angiography, Ultrasound, MRI and CT. In fact, we are the only group of vascular physicians in the area that have subspecialty training in all modalities of vascular imaging.

Minimally Invasive Care

After diagnosing the problem, we offer the latest in treatment options including conservative medical care to state-of-the-art minimally invasive options. Our physicians have undergone specialized training dedicated to the minimally invasive treatment of peripheral vascular disease, including balloon angioplasty and stent placement. We have performed these procedures for over 25 years, in thousands of patients.

Our physicians were the first in the area to develop the treatment of abdominal aortic aneurysms without surgery. Our physicians were the first to perform catheter-directed thrombolysis (CDT) for the removal of a clot from blood vessels and continue to have the most experience and expertise in this treatment modality.

Follow-up

Following the procedure, we see you back in our office with repeat assessment of the improved circulation. We also supervise non-procedural clinical exercise programs and medical therapy of PVD through our clinic.

Community Service

We are part of the Legs for Life Campaign, a national annual campaign to raise awareness of Peripheral Vascular Disease. During the month of September we conduct free screening and counseling for all patients that may have PVD. If the screening is positive for PVD, we can then discuss potential treatment options from conservative exercise and medical therapy to our minimally invasive treatment options.

Balloon Angioplasty

This procedure can open blocked arteries by expanding the inner diameter with a balloon mounted on a thin tube. The catheter is inserted via a tiny nick in the skin, usually in the groin area (see photo). Cardiologists are trained to do this procedure in the heart. Interventional radiologists are trained to do balloon angioplasty in vessels outside the heart. Studies from the interventional radiology literature show the procedure is longer lasting in the larger arteries supplying the legs.

Balloon Angioplasty

A catheter enters the artery via a tiny skin nick. This is not painful.

Balloon Angioplasty

Stenting Stenting
Atherectomy
An atherectomy catheter scrapes plaque out of an artery.
Atherectomy

A special catheter can scrape out deposits blocking an artery to open it.

Testimonials

August 26, 2009
L. Bosse

I'm a 68 y.o. male and in early 2008 starting having leg pain during short walks and at night. I thought it was due to a back injury from several years back. But tests proved it was poor circulation. My PCP referred me to Dr. Kim. He did an ultrasound to determine where the obstruction was and decided to insert stents. After 5 stents and one shunt I now am pain free, and can walk, climb stairs, ladders etc. without pain.

Dr. Kim has an excellent bedside manner and explains everything in detail. On the day of procedure, he took the time to meet with me and once again explain the procedure.

Thank you Dr. Kim. I would recommend you to anyone with similar problems.


D. Smith

I couldn't have asked for better treatment. The physician and staff had good bedside manner. Dr. Kim was very thorough explaining the procedure, recovery and overall outcome. Everyone was very caring.


L. Vigil

The staff was very thorough, quite conscientious, and I had no problems during or after the procedure. I was completely amazed. No pain post procedure and my legs seem to be working better than before. Dr. Kim and staff are excellent. Definitely would give VIP an A rating.

Technology Updated


Did You Know? We treat varicose veins and spider veins? Varicose veins are swollen veins which protrude in a rope-like manner under the skin. Normal veins, by virtue of one-way valves, channel blood against gravity up the leg and back to the heart. When a valve becomes defective, it allows blood flow to leak back down the leg resulting in congestion and swelling of the vein. This is a medical condition called Venous Insufficiency.
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