A modern approach to treating peripheral vascular disease

PERIPHERAL VASCULAR PROGRAM A modern approach to treating peripheral vascular disease

Cardiologists with Baptist Heart Specialists do more than just clean coronary arteries and fix blockages in the heart. They can also fix blockages in veins, arteries and lymph vessels that cause pain and poor circulation known as Peripheral Vascular Disease (PVD). Similar to Coronary Artery Disease (CAD), PVD is a slow, progressive circulatory disorder caused by a clogged or narrowed artery or blood vessel, often due to a buildup of plaque, known as atherosclerosis. The legs and feet are most commonly affected. Risk factors include smoking, diabetes, hyperlipidemia and hypertension. PVD is very common in men over age 50 and affects more than 8 million people in the United States. Baptist has several cardiologists who specialize in peripheral vascular interventions, including Nayan Agarwal, MD; Bharat Gummadi, MD; Ankur Jain, MD; Nehu Patel, MD; Salil Patel, MD, FACC; and Siddharth Wayangankar, MD, FACC. “The field of Interventional Cardiology has really exploded into areas beyond the heart,” said Dr. Wayangankar, medical director of the Peripheral Vascular Program. “With extensive experience with wires and catheters, cardiologists are spearheading treatments concerning arteries and veins across the entire body. We at Baptist Health currently offer treatment from neck to toe – from carotid artery stenting in the neck to angioplasty in the toes.” Dr. Wayangankar serves on several national cardiovascular committees and editorial boards and is also an investigator for the CREST-2 trial which compares medical therapy versus carotid artery stenting in patients with more than 70% blockage in the carotid arteries. The treatment procedures for PVD at Baptist Health encompass all vascular systems in the body, including: • Carotid arteries stenting for patients with a history of stroke, transient loss of vision and abnormal carotid duplex • Renal artery (kidney) angioplasty and stenting for difficult-to-control blood pressure • Lower extremity arterial endovascular procedures (angioplasty, stenting, atherectomy – removal of plaque/calcium using devices) for poor wound healing in legs/non-healing ulcer and gangrene or “claudication” defined as discomfort in calf, thighs and buttocks on exertion • Erectile dysfunction • Subclavian artery stenting for left arm pain or blood pressure differences in both arms • Thrombectomy – removal of fresh clot using devices that act like vacuum cleaners within arteries of the body • Venous procedures (superficial and deep)

Offering the latest technology

In 2021, cardiologists with Baptist Heart Specialists began performing minimally invasive procedures to remove blood clots in veins and arteries that can cause life-threatening conditions, such as pulmonary embolism. “We take pride in offering all the latest device treatments in the pulmonary thrombectomy space. Many of the devices that we use currently do not even need the assistance of clot busters – hence can be used in all patients regardless of age and comorbidities,” said Dr. Wayangankar.

Dr. Wayangankar and Dr. Salil Patel have been involved in performing clot removal procedures for patients with pulmonary artery embolism. “These procedures involve aspirating clots or masses by inserting a large suction catheter into a blood vessel to remove the blockage and restore blood flow to the lungs,” Dr. Salil Patel explained. “They are performed in our catheterization lab.” Recently, Dr. Wayangankar and Dr. Salil Patel performed the first right atrial vegetation extraction using these devices in a patient who could not have open-heart surgery. “Current technology allows innovative solutions to arcane problems, and we at Baptist Health are always striving to be on the forefront of this change,” explained Dr. Wayangankar.

Vein Clinic at Baptist Health

Venous reflux disease damages valves and restricts blood flow, leading to an elevation of venous pressure and problematic symptoms like: • Leg pain • Swollen limbs • Leg heaviness and fatigue • Skin changes (color and texture) • Varicose veins Dr. Nehu Patel has been performing venous procedures to help patients with venous reflux disease for more than 15 years in Jacksonville, all in the comfort and convenience of a traditional office setting. “We can do everything in the office, including vein mapping, without sedation,” said Dr. Nehu Patel, a fellowship-trained cardiologist with more than 25 years of experience, who was also the first cardiologist in Jacksonville to perform radiofrequency ablation. “I’ve been doing this since 2007, and while the technology is basically the same, the procedures are a lot more efficient and with fewer complications,” said Dr. Nehu Patel. Cardiologist Dr. Salil Patel also specializes in a number of vein therapies, including deep venous stenting, pulmonary artery thrombectomy and right atrial mass thrombectomy. He was also the first cardiologist at Baptist Heart Specialists to perform the deep venous stent procedure. Venous stents are metal mesh tubes that expand against blocked or narrowed vein walls and function as a scaffold to keep veins open. During a thrombectomy, a catheter is inserted into a blood vessel to remove the blockage and restore blood flow. “Anyone with problems of a vascular nature can feel comfortable being referred to Baptist Heart Specialists because we can treat superficial venous disease in our office as well as deep vein issues that may require an intervention in our catheterization lab,” said Dr. Salil Patel. Since establishing the Vein Clinic five years ago, Baptist Health has experienced a 300% growth rate in the venous space. A second Vein Clinic will soon be located at Baptist Medical Center South. Ongoing health care management is another differentiator of the venous specialists at Baptist Heart Specialists. “After their intervention, we have regular and ongoing follow-ups with the patients in our clinic,” Dr. Salil Patel added. “Continuity of care is one of the benefits of seeing a cardiologist in our group.”

Siddharth Wayangankar, MD, FACC, FSCAI, RPVI Interventional Cardiologist; Medical Director, Peripheral Vascular Program Nayan Agarwal, MD, FACC, RPVI Interventional Cardiologist, Pheripheral Vascular Intervention Bharat Gummadi, MD Interventional Cardiologist, Director, Cardiac Cath Lab at Baptist South Ankur Jain, MD, FACP, FACC, RPVI Interventional Cardiologist, Pheripheral Vascular Intervention Nehu Patel, MD, FACC Cardiologist, Director, Venous Program Salil Patel, MD, FACC Interventional Cardiologist, Peripheral Vascular Intervention, Chief of Cardiology at Baptist Jacksonville