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Community-Based Collaborative Care: A Model for Realizing High Quality, Cost-Effective Outcomes

Vascular Access Centers, Community-Based Collaborative Care: A Model for Realizing High Quality, Cost-Effective

Peripheral Artery Disease (PAD) affects 8 to 12 million people in the US, including 20% of people over 65. This circulatory disease is caused by the narrowing or blockage of the vessels that carry blood from the heart to the legs, due to fatty plaque buildup called atherosclerosis (Figure 1).

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Vascular Access Centers, LP celebrates 10 years and over 160,000 patient encounters

vac-10years-logoVascular Access Centers, LP, the largest independent integrated group of vascular access centers in the country, is excited to announce its 10-year anniversary as the leading provider of endovascular outpatient care.

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Stille and Vascular Access Centers partner to develop and enable safer treatments of vascular diseases

news-stilleThe Vascular Access Centers (VAC) and Stille have partnered with the goal of developing new state-of-the-art clinical solutions that enable improved patient care, reduced X-ray dosing and potential for higher patient capacity.

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Peripheral Arterial Disease and the CKD Patient: The Case for Early Screening, Diagnosis, and Minimally Invasive Revascularization

thumb_padartPeripheral arterial disease (PAD) is a general term used to describe obstructive atherosclerosis of the lower extremities. PAD occurs when cholesterol or plaque builds up in the arteries outside the heart—typically in the legs or pelvis—limiting normal blood flow and increasing the risk of heart attack or stroke. PAD is more common in patients with chronic kidney disease than in the general population. Patients with impaired renal function have a greater than twofold risk of developing PAD, and in the dialysis population, the incidence of clinical PAD is 15%. We discuss the importance of early screening and diagnosis of this serious circulatory problem, and include a checklist that any member of the renal team can use to discuss symptoms with patients.

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A New Pathway for Central Venous Occlusion After the failure of conventional techniques, a radiofrequency energy guidewire may be a useful treatment option.

A New Pathway for Central Venous OcclusionCentral venous occlusions (CVOs) are a common complication that may be observed subsequent to the placement of central venous catheters. Previous studies have reported the incidence of venous thrombosis, the formation of which may result in CVOs, to be between approximately 3% and 38% after the placement of peripherally inserted central venous catheters and venous ports.1 The most common etiology of symptomatic lesions results from the long-term catheterization of patients for hemodialysis to treat end-stage renal disease (ESRD). The presence of an ipsilateral vascular access greatly increases the blood flow in an upper extremity such that 70% of patients who have an ipsilateral hemodialysis access will become symptomatic with a CVO as compared to the 10% of non-dialysis patients that become symptomatic. Ipsilateral hemodialysis access with a pacemaker are compounding risk variables. Symptoms that may develop due to a CVO include an acutely swollen arm, neck pain, facial swelling, and chest wall varicosities. Percutaneous treatment is a more common choice than thoracic surgery for alleviating these symptoms due to the high morbidity and mortality rates in ESRD patients with high upper extremity blood flow.

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Recanalization of a Central Venous Occlusion

Recanalization of a Central Venous OcclusionFailed central venous occlusion (CVO) recanalization leads to several unpalatable treatment options: surgical banding or take down of the ipsilateral dialysis access, surgical reconstruction with possible rib resection/thoracotomy, or the need for the patient to tolerate underlying symptoms secondary to the obstruction and possibly poor quality of hemodialysis related to recirculation.

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Radiofrequency Device Opens Stubborn Chronic Venous Occlusions

ISETNewsBriefs_paperA new device provides relief to patients with swollen arms and legs as a result of their medical conditions, such as those who are on dialysis for kidney failure, or who have pacemakers. These patients have permanent devices in their veins, which can causes scarring and reduce blood flow, leading to swollen extremities. Doctors use a variety of techniques to open up the completely blocked veins (called a central venous occlusion, or CVO), but efforts fail 10 to 12 percent of the time, and those patients are miserable because their extremities are very swollen. The new device, the Baylis PowerWire™ Radiofrequency (RF) Guidewire, is advanced to the site of the scarring using minimally invasive techniques. RF energy is used to burn through the blockage.

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Endovenous Laser Therapy in the Treatment of Lower-Limb Venous Ulcers

Endovenous Laser Therapy in the Treatment of Lower-Limb Venous UlcersLower-limb chronic venous insufficiency is a common clinical condition that affects 25% of women and 15% of men in the United States. If left untreated, approximately 50% of patients with significant superficial venous insufficiency will develop chronic symptoms of lower-limb edema, eczema, pigmentation, hemorrhage, and ulceration. Valvular incompetence at the saphenofemoral junction (SFJ) with great saphenous vein (GSV) reflux is the most common cause of chronic venous insufficiency. Endovenous Laser Therapy (EVLT) is an alternative that is minimally invasive compared with surgery for the treatment of (GSV) reflux, especially in patients who are poor surgical candidates.

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Taking Strides ~ The Peripheral Vascular Institute of Philadelphia helps people with PAD retain their independence.

Taking Strides ~ The Peripheral Vascular Institute of Philadelphia helps people with PAD retain their independence.Led by Dr. James F. McGuckin Jr., founder and Chief Executive Officer of Vascular Access Centers, the Peripheral Vascular Institute of Philadelphia (PVIP) is on the forefront in treating PAD—a debilitating condition that can be successfully treated. According to Dr. McGuckin, “Over the past five years, we have seen a great number of technological advances that have changed the dynamics of treatment. No longer do patients require major surgery in order to resume regular activity.”

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Dr. Jorge Salazar: Interventional Radiologist at the VAC of Memphis Speaks About Peripheral Arterial Disease

DrSalazarVascularAccessCheck Out Dr. Jorge Salazar, Interventional Radiologist at the VAC of Memphis, on Fox 13 in Memphis! In this segment, Dr. Salazar takes some time out of his busy morning to visit with the local station to talk about Peripheral Arterial Disease. Click here to take a look.

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