For many patients, vascular conditions and chronic wounds affecting the legs and feet can be related. Coordinated care at Southwest Healthcare System can provide the comprehensive treatment approach that is needed.
An example is peripheral artery disease (PAD), which occurs when plaque builds up in the arteries and restricts blood flow to the legs. If left untreated, PAD can cause pain in the legs and lead to wounds that do not heal. In severe cases, PAD may lead to amputation and also increase your risk of heart disease.
Listen as Yara Gorski, MD, Vascular Surgeon, discusses the importance of vascular health to help combat Peripheral Vascular Disease and when to know if surgery is necessary.
Selected Podcast
What You Need to Know About Peripheral Vascular Disease
Featured Speaker:
Yara Gorski, MD
Yara Gorski, MD is a Vascular Surgeon and a member of the medical staff at Southwest Healthcare System. Transcription:
What You Need to Know About Peripheral Vascular Disease
Melanie Cole (Host): Your body relies on healthy blood flow to carry oxygen to your legs, feet and other parts of your body. When problems develop in your circulatory system, painful and sometimes serious health issues can result. One example is peripheral arterial disease, which can occur when plaque builds up in the arteries and restricts blood flow to the legs. My guest today is, Dr. Yara Gorski, she’s a vascular surgeon and a member of Medical staff at Southwest Healthcare System. Welcome to the show, Dr. Gorski. So, when we’re talking about peripheral vascular disease, what exactly is that?
Dr. Yara Gorski (Guest): Good morning, thank you for having me. Yes, I’ll be happy to speak about the peripheral artery disease. It builds up in the arteries, blockage in the arteries. It’s usually caused by a variety of reasons, most importantly it’s hereditary. A lot of patients carry a genetic disposition for atherosclerosis, hardening of the arteries.
A second important cause is the smoking. Smoking is one of the major reasons why patients develop plaque in their arteries. Smoking can make the blood thicker, produce blood clots, and also increase the deposits of plaque in the arteries.
After that, there are risk factors like diabetes, high blood pressure, high cholesterol. Those are the main causes for buildup of plaque in your arteries.
Melanie: So, how would anybody even know? If you go in for your annual physical, and maybe you have your cholesterol levels checked, that doesn’t really check for that atherosclerosis, Dr. Gorski. So, how would somebody know?
Dr. Gorski: Well, it’s very important, as you said, that you have your annual checks, that you follow-up, that you take care of your health issues with your primary care physician, but a lot of times, it takes to be asked the right questions, to understand if you have atherosclerosis or not. And a simple test in the office where the primary care doctor check for your pulses, ask for symptoms of peripheral vascular disease, like for example, you have pain when you walk, or you getting your legs are feeling tired, or are you having wounds in your legs that are not healing? Those are symptoms that might trigger your primary care physician to consider ordering a further testing to identify if you have peripheral vascular disease or not. In case you have decreased pulses, and a lot of times it’s just a blood pressure check on your legs, and a sonogram.
Melanie: Okay. So, who would they go to see to get those kinds of tests?
Dr. Gorski: They will be sent to a vascular surgeon, who’s a specialist, who can evaluate the circulatory system and identify if they do have peripheral vascular disease or not, and offer them treatments.
Melanie: So, we hear about, for heart disease, in general, Dr. Gorski, how great exercise is to help with that, but in peripheral vascular situations, exercise could be a limiting factor because it could hurt claudication in their legs. So, what do you tell patients that say, “Well, I really want to exercise or ride a bike or go on the treadmill and help myself, but it hurts.”
Dr. Gorski: That’s a great question. A lot of patients with peripheral vascular disease decrease, they exercise, they have this kind of limitation, and they don’t know that there’s treatment for that. So, essentially the same causes for peripheral vascular disease will cause blockages in other arteries. So, patients that have peripheral vascular disease, they are diagnosed with blockage in their leg arteries. They actually at risk for having blockages in their coronaries, and also their carotid arteries. So, technically they are at risk for having heart attacks and strokes. So, it’s very important of both to be diagnosed, to understand the disease process, to understand the risk factors, and find especially if they can offer you treatment.
And how do we treat peripheral vascular disease? Peripheral vascular disease most of time, is just treated medically, and by that means control all your risk factors, as we just discussed. Quit smoking, take medication, do our drugs that’s specifically designed to improve the blood circulation in the leg, and a vascular surgeon, a vascular specialist, can discuss the use of those drugs with you. A lot of times patients will be also prescribed a blood thinner, that can be just a plain 81 milligrams aspirin, that taking daily, can improve the circulation to your legs.
After that, your vascular surgeon will discuss with the patient with you, how can we actually do exercise? What kind of exercises can be monitored for patients with peripheral vascular disease? And getting to a program, so they will build up this exercises with the peripheral vascular disease, and will develop more blood flow to their legs.
Melanie: Dr. Gorski, what about the risk for non-healing wounds. If someone has poor circulation in their legs, are they then at risk for wounds that do not heal or wounds that they do not recognize are there?
Dr. Gorski: That’s another excellent question. So, we do see a lot of patients that come to our office, yeah, vascular surgeons, they were risk for it because they’re primary care physician diagnosed them with PAT. They say, “Look, you have decreased pulses or you don’t have any pulses. You start to have pain when you’re walking and that’s called claudication.” That’s a lot of times is how the patients present with peripheral vascular disease, and we see them in the office, and we discuss options, treatments, and one of the key issues is you must be very careful with your feet and legs as far as any kind of trauma or exposure to warts.
So, that covers two key questions. Do you have any non-healing wounds? Do you have any ulcers on your feet? And what are you doing to take care of it? So, there are different specialists who will work very closely with those patients. Some of them are diabetic, some of them have also neuropathy. They have poor… other than the peripheral artery disease, they don’t have a lot of sensation in their feet. So, they can actually develop wounds or ulcers because they just don’t feel their foot. They have a poor feet in shoe, and they these ulcers without even feeling for them. So, it’s a very important when we talk to them, that they take care of their feet, that they take care of their wounds, and a lot of times, as I said, we work in conjunction with different specialists, we recommend the patients to see a podiatrist. And that if they do have wounds, we work in close relations with a wound care specialist.
Melanie: So, in just the last few minutes, Dr. Gorski, what would you like people with peripheral vascular disease who, or maybe are at risk for this, to know and give us some good information about preventing it in the first place.
Dr. Gorski: Yes, that’s great. I think what we need to make people aware of is peripheral vascular disease is very prevalent. As you just brought it up in the beginning, I think the number is close to 80 million in the U.S., that they have peripheral artery disease, but a very small percentage of those patients are actually offered treatment, and treatment it starts just preventing and working with the risk factors. As simple as quit smoking, taking an aspirin a day, and taking of your diabetes, high blood pressure, and high cholesterol. Then once you were diagnosed with PAD, you must see a specialist, you must see a vascular surgeon, who can discuss with you, what are your options to treat that diagnosis? And it can be, as I said, starts medically, it can be with drugs, it can be with exercises, but in advanced cases, a vascular surgeon can actually offer treatment before you develop significant tissue loss, before you at risk for repetition. And that treatment can be a balloon in your plastic, can be a stent placement, can sometimes even be surgery, but a lot of these patients with peripheral vascular disease, they are at risk for progression of the peripheral artery disease at forelimb off for amputation.
So, it’s very important that as soon as they are diagnosed, that they see a specialist, that they see a vascular surgeon, who can discuss with them management, and they can monitor them over the years. And if they do develop wounds, they will need to see a wound care specialist early in the stages of this wound, so it will not progress to tissue loss that’s not reversible.
Melanie: And why should they come to Southwest Healthcare System for their care? Tell us about your team.
Dr. Gorski: We have great team at Southwest, and I’m very proud to say that because I’ve been at Southwest for almost 20 years, and we have been pioneers in a lot of procedures in the valley. And one of things that we do that makes us a great resource to our community is the teamwork, we do have a diagnostic department where we can diagnose PAD from it’s very early stages.
We have an excellent laboratory where we perform ultrasonography and measuring of pressures in the legs. We have state of the art CT scan, and MRI, we have an interventional CAT lab, where we perform, again, state of art interventions. We do angiograms, we perform angioplasty with balloons. We use atherectomy devices, that we can actually debug plaque. We can do what a lot of people use in late terms, like rode a router off arteries. We have a variety of skins available in the market, and this can all be done as an outpatient. And Southwest has a great team, we have a great success with both of those procedures. We also have a one-care center, associated to Southwest, where we work very closely.
I do work with Dr. Khateeb for a few years now, and he’s an excellent one-care specialist. Dr. Khateeb is a surgeon, who has been dedicated, his last year’s just for one-care. We have a great one-care center, we offer hyper- Baraty therapy, and in a lot of patients, that’s critical to prevent them from having an amputation and limb loss. So, close relation, close work with the one-care center, one-care specialist, great tools for diagnostic, and for minimally invasive treatment. Right there in… for our communities in their backyard. I’m very fortunate to be able to practice there.
Melanie: Thank you so much, Dr. Gorski, for being with us. It’s really great information. You’re listening to Southwest Health Talk, with Southwest Healthcare System, building relationships that touch the heart. For more information, please visit, SWHealthcareSystem.com, that’s SWHealthcareSystem.com. Physicians are independent practitioners who are not employees or agents of Southwest Healthcare System. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole, thanks so much for listening.
What You Need to Know About Peripheral Vascular Disease
Melanie Cole (Host): Your body relies on healthy blood flow to carry oxygen to your legs, feet and other parts of your body. When problems develop in your circulatory system, painful and sometimes serious health issues can result. One example is peripheral arterial disease, which can occur when plaque builds up in the arteries and restricts blood flow to the legs. My guest today is, Dr. Yara Gorski, she’s a vascular surgeon and a member of Medical staff at Southwest Healthcare System. Welcome to the show, Dr. Gorski. So, when we’re talking about peripheral vascular disease, what exactly is that?
Dr. Yara Gorski (Guest): Good morning, thank you for having me. Yes, I’ll be happy to speak about the peripheral artery disease. It builds up in the arteries, blockage in the arteries. It’s usually caused by a variety of reasons, most importantly it’s hereditary. A lot of patients carry a genetic disposition for atherosclerosis, hardening of the arteries.
A second important cause is the smoking. Smoking is one of the major reasons why patients develop plaque in their arteries. Smoking can make the blood thicker, produce blood clots, and also increase the deposits of plaque in the arteries.
After that, there are risk factors like diabetes, high blood pressure, high cholesterol. Those are the main causes for buildup of plaque in your arteries.
Melanie: So, how would anybody even know? If you go in for your annual physical, and maybe you have your cholesterol levels checked, that doesn’t really check for that atherosclerosis, Dr. Gorski. So, how would somebody know?
Dr. Gorski: Well, it’s very important, as you said, that you have your annual checks, that you follow-up, that you take care of your health issues with your primary care physician, but a lot of times, it takes to be asked the right questions, to understand if you have atherosclerosis or not. And a simple test in the office where the primary care doctor check for your pulses, ask for symptoms of peripheral vascular disease, like for example, you have pain when you walk, or you getting your legs are feeling tired, or are you having wounds in your legs that are not healing? Those are symptoms that might trigger your primary care physician to consider ordering a further testing to identify if you have peripheral vascular disease or not. In case you have decreased pulses, and a lot of times it’s just a blood pressure check on your legs, and a sonogram.
Melanie: Okay. So, who would they go to see to get those kinds of tests?
Dr. Gorski: They will be sent to a vascular surgeon, who’s a specialist, who can evaluate the circulatory system and identify if they do have peripheral vascular disease or not, and offer them treatments.
Melanie: So, we hear about, for heart disease, in general, Dr. Gorski, how great exercise is to help with that, but in peripheral vascular situations, exercise could be a limiting factor because it could hurt claudication in their legs. So, what do you tell patients that say, “Well, I really want to exercise or ride a bike or go on the treadmill and help myself, but it hurts.”
Dr. Gorski: That’s a great question. A lot of patients with peripheral vascular disease decrease, they exercise, they have this kind of limitation, and they don’t know that there’s treatment for that. So, essentially the same causes for peripheral vascular disease will cause blockages in other arteries. So, patients that have peripheral vascular disease, they are diagnosed with blockage in their leg arteries. They actually at risk for having blockages in their coronaries, and also their carotid arteries. So, technically they are at risk for having heart attacks and strokes. So, it’s very important of both to be diagnosed, to understand the disease process, to understand the risk factors, and find especially if they can offer you treatment.
And how do we treat peripheral vascular disease? Peripheral vascular disease most of time, is just treated medically, and by that means control all your risk factors, as we just discussed. Quit smoking, take medication, do our drugs that’s specifically designed to improve the blood circulation in the leg, and a vascular surgeon, a vascular specialist, can discuss the use of those drugs with you. A lot of times patients will be also prescribed a blood thinner, that can be just a plain 81 milligrams aspirin, that taking daily, can improve the circulation to your legs.
After that, your vascular surgeon will discuss with the patient with you, how can we actually do exercise? What kind of exercises can be monitored for patients with peripheral vascular disease? And getting to a program, so they will build up this exercises with the peripheral vascular disease, and will develop more blood flow to their legs.
Melanie: Dr. Gorski, what about the risk for non-healing wounds. If someone has poor circulation in their legs, are they then at risk for wounds that do not heal or wounds that they do not recognize are there?
Dr. Gorski: That’s another excellent question. So, we do see a lot of patients that come to our office, yeah, vascular surgeons, they were risk for it because they’re primary care physician diagnosed them with PAT. They say, “Look, you have decreased pulses or you don’t have any pulses. You start to have pain when you’re walking and that’s called claudication.” That’s a lot of times is how the patients present with peripheral vascular disease, and we see them in the office, and we discuss options, treatments, and one of the key issues is you must be very careful with your feet and legs as far as any kind of trauma or exposure to warts.
So, that covers two key questions. Do you have any non-healing wounds? Do you have any ulcers on your feet? And what are you doing to take care of it? So, there are different specialists who will work very closely with those patients. Some of them are diabetic, some of them have also neuropathy. They have poor… other than the peripheral artery disease, they don’t have a lot of sensation in their feet. So, they can actually develop wounds or ulcers because they just don’t feel their foot. They have a poor feet in shoe, and they these ulcers without even feeling for them. So, it’s a very important when we talk to them, that they take care of their feet, that they take care of their wounds, and a lot of times, as I said, we work in conjunction with different specialists, we recommend the patients to see a podiatrist. And that if they do have wounds, we work in close relations with a wound care specialist.
Melanie: So, in just the last few minutes, Dr. Gorski, what would you like people with peripheral vascular disease who, or maybe are at risk for this, to know and give us some good information about preventing it in the first place.
Dr. Gorski: Yes, that’s great. I think what we need to make people aware of is peripheral vascular disease is very prevalent. As you just brought it up in the beginning, I think the number is close to 80 million in the U.S., that they have peripheral artery disease, but a very small percentage of those patients are actually offered treatment, and treatment it starts just preventing and working with the risk factors. As simple as quit smoking, taking an aspirin a day, and taking of your diabetes, high blood pressure, and high cholesterol. Then once you were diagnosed with PAD, you must see a specialist, you must see a vascular surgeon, who can discuss with you, what are your options to treat that diagnosis? And it can be, as I said, starts medically, it can be with drugs, it can be with exercises, but in advanced cases, a vascular surgeon can actually offer treatment before you develop significant tissue loss, before you at risk for repetition. And that treatment can be a balloon in your plastic, can be a stent placement, can sometimes even be surgery, but a lot of these patients with peripheral vascular disease, they are at risk for progression of the peripheral artery disease at forelimb off for amputation.
So, it’s very important that as soon as they are diagnosed, that they see a specialist, that they see a vascular surgeon, who can discuss with them management, and they can monitor them over the years. And if they do develop wounds, they will need to see a wound care specialist early in the stages of this wound, so it will not progress to tissue loss that’s not reversible.
Melanie: And why should they come to Southwest Healthcare System for their care? Tell us about your team.
Dr. Gorski: We have great team at Southwest, and I’m very proud to say that because I’ve been at Southwest for almost 20 years, and we have been pioneers in a lot of procedures in the valley. And one of things that we do that makes us a great resource to our community is the teamwork, we do have a diagnostic department where we can diagnose PAD from it’s very early stages.
We have an excellent laboratory where we perform ultrasonography and measuring of pressures in the legs. We have state of the art CT scan, and MRI, we have an interventional CAT lab, where we perform, again, state of art interventions. We do angiograms, we perform angioplasty with balloons. We use atherectomy devices, that we can actually debug plaque. We can do what a lot of people use in late terms, like rode a router off arteries. We have a variety of skins available in the market, and this can all be done as an outpatient. And Southwest has a great team, we have a great success with both of those procedures. We also have a one-care center, associated to Southwest, where we work very closely.
I do work with Dr. Khateeb for a few years now, and he’s an excellent one-care specialist. Dr. Khateeb is a surgeon, who has been dedicated, his last year’s just for one-care. We have a great one-care center, we offer hyper- Baraty therapy, and in a lot of patients, that’s critical to prevent them from having an amputation and limb loss. So, close relation, close work with the one-care center, one-care specialist, great tools for diagnostic, and for minimally invasive treatment. Right there in… for our communities in their backyard. I’m very fortunate to be able to practice there.
Melanie: Thank you so much, Dr. Gorski, for being with us. It’s really great information. You’re listening to Southwest Health Talk, with Southwest Healthcare System, building relationships that touch the heart. For more information, please visit, SWHealthcareSystem.com, that’s SWHealthcareSystem.com. Physicians are independent practitioners who are not employees or agents of Southwest Healthcare System. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole, thanks so much for listening.