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Why should you receive treatment
at the AMC Peripheral Vascular Disease Center?
Peripheral vascular disease (PVD) is a blood circulation disorder that occurs from insufficient blood flow to the muscles of the lower limb due to artherosclerosis or thrombosis. Normally, it occurs in vascular diseases such as arteriosclerosis as fatty deposits build-up within the blood vessel causing narrowing and restricted blood flow to the vessels. Diabetes, in particular, is a high-risk factor for PVD. It is known that around 20% of diabetes patients over the age of 40 have non-symptomatic PDA and that 20% of patients with symptomatic PDA have diabetes.
AMC’s Peripheral Vascular Disease Center provides total care services such as diagnosis, drug therapy, procedure and surgery, and rehabilitation for patients with carotid artery and peripheral vascular diseases. The center offers optimal treatment to PVD patients through advanced endovascular treatment as well as highly-sophisticated vascular surgeries performed by best medical professionals. It also operates a patient-centered multidisciplinary treatment system in close cooperation with the departments of cardiology, radiology, anesthesiology and pain medicine, nuclear medicine, plastic surgery, and endocrinology and metabolism in addition to the department of vascular surgery.
Treatment options
Patients diagnosed with PVD are treated through risk factor modification, exercise, and medication, and revascularization (percutaneous intervention or surgical treatment).
Risk factor modification
Major risk factors for PVD are smoking, diabetes, hypertension, and hyperlipidemia. Smoking is regarded as the most important risk factor. Stop smoking will inhibit disease progression and will decrease the risk of limb amputation and the frequency of symptoms during rest. Moreover, drug therapy such as aspirin or hyperlipidemia and diabetes medication combined with various lifestyle changes lower the risk of not only PVD but also frequently accompanying cardiovascular disorders.
Exercise rehabilitation
Exercise rehabilitation is proven to alleviate symptoms of claudication and to increase the patient’s range of motion. This therapy is effective in improving the functions of the vascular endothelium, removing peroxides within post-ischemic muscles, and creating new blood vessels from pre-existing vessels (angiogenesis). Regular exercise is also effective in relieving symptoms and controlling risk factors as it increases glucose metabolism, reduces blood cholesterol and fat, and facilitates smoking cessation. Therefore, exercising three times a week for more than 24 weeks is recommended. Each exercise session should be increased gradually, lasting from 35 to 50 minutes with an intensity level that causes slight aching. Continuous management such as regular cardio exercises including walking, biking, swimming in combination with strength training is needed. Exercise rehabilitation often serves as the basis for treating PVD’s for it increases the patient’s range of motion up to 2 to 2.5 times and alleviates symptoms.
Drug therapy
Antiplatelet medicine including aspirin may be used to treat intermittent claudication in PVD patients. Antiplatelet therapy is an essential in reducing the risk of heart attack, stroke, and vascular mortality in PVD patients. Other drugs including Clopidogrel, Cilostazol, Pentoxifylline, and PGE1 can be used based on each patient’s symptoms.
Revascularization
According to the American Heart Association (AHA), percutaneous or surgical revascularization can be considered in the following cases:
No response to or no response expected from exercise rehabilitation or drug therapy
If claudication is severe enough to limit the patient’s daily or major activities
If there are a lot of benefits from the alleviation of claudication
If a patient’s medical history and prognosis are suitable for the intervention
If revascularization interventions have minimal short- and long- term risks
If there is external iliac artery stenosis or occlusion
If there is pain at rest, ischemic ulcer, or gangrene
Revascularization is more helpful in improving postoperative symptoms and healing wounds than drug therapy. Percutaneous reperfusion or bypass surgery enhances blood flow. Which option to use is determined based on the lesion’s structure and length and the patient’s condition.
AMC’s treatment performance
Major surgeries and procedures / performance (As of 2017)
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Name
Performance
Remarks
CEA
1,300 (accumulated)
Bypass surgery
1,500 (accumulated)
PTA
2,500 (accumulated)
Runs a vascular disease exam room to timely and accurately detect peripheral vascular diseases
Performs angioplasty, stenting, and bypass surgery for reperfusion
Applies a rehabilitation program to prevent the relapse of peripheral vascular diseases after the procedures and surgery
