Listen Now!

Business Talk 24-7

Peripheral Arterial Disease

Peripheral Arterial Disease

As many as 12 million Americans are dealing with peripheral arterial disease (PAD), a progressive blockage of the blood vessels that carry blood to the lower extremities.  For many of these patients, amputation is the outcome, leaving them without a foot, or in others, half or more of their leg.  Medical literature has shown that in these patients, their risk of death within 1 to 5 years of their amputation they have a 40% likelihood of amputation of the remaining leg and a significant risk of death.  It’s clearly a serious problem.

But we can reduce the rate of amputation among these patients and we can also reduce the severity of intervention required to address the problem if we catch it early.  Dr. Joseph Ricotta, vascular surgeon and director of the Northside Hearth & Vascular program, stopped by the studio to talk about what can be done to improve patient outcomes for those with PAD.  We talked about the troublesome statistics around peripheral arterial disease, including the fact that among diabetics with PAD who develop a non-healing wound resulting in amputation, as many as 50% of them never receive a non-invasive study that could prevent the loss of their leg.

That means we need our partners in primary care and foot/ankle surgery to take an aggressive stance when presented with patients who are at risk for PAD or who have a poorly-healing wound on their leg or foot.  There are numerous non-invasive studies that take only minutes in the vascular surgeon’s office that can readily identify patients who have blockage affecting blood flow to their feet.  In these cases, if caught early, surgeons like Dr. Ricotta have more options and greater probability they can reestablish adequate blood flow that helps a wound to heal, preventing or mitigating extent of amputation.

We talked about the fact that Northside offers access to 2 of the country’s 10 robotic devices that significantly improves the effectiveness of minimally-invasive procedures by allowing the vascular surgeons to access and treat previously-inaccessible locations.  Additionally, with the assistance of the robot, the surgeons are able to reduce damage that can occur on the inside of the vessel being treated, which reduces the likelihood that scarring after the procedure will block the vessel off again (a leading cause of reocclusion in PAD lesions).

I also spoke with foot and ankle surgeon, Dr. Michael Bednarz of Ankle & Foot Centers of Georgia, whose office is located in Woodstock, just north of Marietta.  He talked about treating PAD patients with wounds from the perspective of the specialist who is tasked with managing the wound and ultimately, treating it surgically as necessary (including amputation when efforts to heal the wound fail and serious infection is a risk).

We talked about the fact that amputation should be viewed as a last-ditch option.  And Mike shared that no patient should face amputation without having had a vascular study to determine if poor flow is contributing to the wound not healing.  He talked about the fact that when he’s presented with a poorly-healing wound, particularly in a patient with PAD risk factors such as diabetes, one of the first things he does is request a vascular study to assess blood flow.  He also utilizes Transcutaneous Oximetry, a non-invasive test that shows how well the tissue at the surface where a wound is located is getting oxygen.

With the results of those studies, he is able to address poor blow flow by referral to a vascular surgeon and/or to hyperbaric medicine (readily available in Atlanta and surrounding suburbs) to address poor oxygen levels in the skin.  He also evaluates other risk factors such as glucose levels and presence of infection, often resulting in consults with infectious disease and/or endocrine specialists to help heal the limb-threatening wound.  We talked about the fact that a multi-specialty approach insures that more patients can avoid amputation and the resultant high mortality rates that come with them.

Early involvement with an experienced wound specialist, vascular diagnostics/intervention, infection control, and endocrinology are all vital in helping patients avoid an amputation that might also cost them their life.

Special Guests:

Joseph Ricotta, MD, Medical Director, Heart & Vascular Institute, Northside Hospital  linkedin_small1  twitter_logo_small  facebook_logo_small3  youtube logo

Northside Vascular

  • Doctor of Medicine, Thomas Jefferson University School of Medicine
  • Surgical Residency, Johns Hopkins University School of Medicine
  • Fellowship, Vascular Surgery, Mayo Clinic
  • Fellowship, Advanced Endovascular Surgery, Cleveland Clinic Foundation
  • Associate Professor of Surgery, Georgia Regents University, University of Georgia School of Medicine

Michael Bednarz, DPM, Ankle & Foot Centers of Georgia  linkedin_small1  facebook_logo_small3  twitter_logo_small  youtube logo

Ankle & Foot Centers of Georgia

  • Doctor of Podiatric Medicine, Kent State University School of Podiatric Medicine
  • Residency, Department of Veteran Affairs Medical Center, Miami
  • Board Certified, American Board of Foot/Ankle Surgery
  • Recognized as a “Top Doc” in the WellStar Health System

Dr. Rheudasil of Emory Heart and Vascular Institute and Georgia Vascular Society

Emory Heart and Vascular Institute and Georgia Vascular Society

Dr. Rheudasil talks about Emory Heart & Vascular Institute and GVS.

 

Emory Heart and Vascular Institute and Georgia Vascular Society

This week on Top Docs RADIO we sat down with Dr. Mark Rheudasil of Emory Heart and Vascular Institute.  We talked about the specialty of vascular surgery, new advances in minimally-invasive endovascular procedures, and upcoming events with Georgia Vascular Society.  Dr. Rheudasil shared some feelings about why he enjoys his chosen specialty as much as he does and when it’s advisable to be seen by the specialists of Emory Heart and Vascular Institute.

He talked about his membership with the Georgia Vascular Society and how it helps the vascular specialists across the state of Georgia stay in contact with each other to share best practices, new research, and other important information they provide through their educational conferences.  Our physician practice has worked with Emory Heart and Vascular Institute for many years, collaborating on countless patients with limb-threatening wounds.  Be sure to consider a consult with this practice should you or a loved one find themselves in need of evaluation for vascular disease of the extremities, aorta, carotids, and more.

Special Guest:

Dr. Mark Rheudasil, MD of Emory Heart and Vascular Institute and Georgia Vascular Society

Emory Heart and Vascular Institute and Georgia Vascular Society

Dr. Mark Rheudasil

  • Doctorate of Medicine, University of Texas Southwestern Medical School
  • Residency, Emory University Hospital
  • Fellow, American College of Surgeons
  • Board Certified in surgery and vascular surgery
  • Published articles in several medical journals including The Journal of Vascular Surgery, American Surgeon and The Journal of the Medical Association of Georgia

Specialized Healthcare IT and Vascular Services

Tier3MD provides specialized IT services for medical groups.  Advanced Vascular Resources offer a full range of diagnostic vascular studies and minimally-invasive corrective procedures.

IT Services

Mike & Sheryl Cherico talk medical IT svcs and Sean Yanes discusses AVR’s benefits to patients, podiatrists, and primary care physicians.

TDR 812

 

Healthcare IT and Vascular Services

Today we learned how Tier3MD brings over 2 decades of healthcare IT installation and management to their medical clients.  Their full suite of IT services allow medical practices to reduce cost related to IT by  as much as half or more in some situations.  Mike & Sheryl Cherico discussed how provide consultation with practices considering a new EMR to help them choose the best one suited for their particular practice.  Their technologists are also versed in HIPAA requirements so they are able to insure their clients’ data controls are compliant with regulations.

Sean Yanes of Advanced Vascular Resources shared how AVR improves outcomes among patients suffering from PAD, carotid disease, migraine headaches, and many more problems related to vascular disease.  The multi-state physician practice takes a collaborative approach to their referral partners and work to compliment rather than replace their partners’ treatment plans.  AVR’s interventional radiologist, Dr. Doug Redd has been providing a high level of vascular interventions in the Atlanta area for many years.  Additionally, he served in academic roles at Emory prior to joining AVR’s Atlanta practice.

Special Guests:

Sheryl Cherico, CEO/Founder, Tier3MD  linkedin_small1  facebook_logo_small3  twitter_logo_small

  •  Licensed IT professional with over 20 years of experience in the field with heavy focus in medical practice IT needs
  • Oversaw installations of digital cardiac lab systems in numerous high-profile health systems nationally
  • Previous IT Director for one of the Southeast’s largest cardiology groups
  • Founder of Atlanta Medical Consulting Group
  • Volunteer, Georgia Breast Cancer Coalition

Sean Yanes, Director of Sales/Marketing, Advanced Vascular Resources  linkedin_small1  facebook_logo_small3  twitter_logo_small  google-plus-logo-red-265px

  • Extensive experience in management and relationship building within the healthcare device space, particularly within wound and vascular specialties
  • Multiple award winner for individual and team sales under his management
  • Has developed numerous programs for expanding physician practice referral bases
  • Education, Marketing/Business, Spring Hill College

Lower Extremity Amputation Prevention Discussion

Lower Extremity Amputation

Multi-Specialty Discussion On Prevention of Amputation

 

 

 

 

 

 

TOPIC:

Lower Extremity Amputation Prevention

In the US alone there are over 20,000 lower extremity amputations per month.  As many as 68% of them have not had a basic vascular study to determine if revascularization could help save the leg.  This week I’ll talk with Dr. Mohammad Sharif of Village Podiatry Centers, Dr. Doug Redd of Advanced Vascular Resources, and Dr. David Schwegman of Hyperbaric Physicians of Georgia.  They’ll be discussing the multi-specialty team approach that is necessary for the best outcomes in patients with limb-threatening wounds.  They will talk about important things patients need to know about.  This includes things such as how important it is to have a vascular study to see if peripheral vascular disease (PAD) is present.  It is important to know that simply checking pulses is not effective enough when lower extremity amputation is a potential outcome.  Patients with risk factors for lower extremity amputation need to be followed by a foot & ankle specialist such as a DPM for care along with a certified wound specialist (not just a doctor or nurse who does wound care).

Special Guests:

Dr. Mohammad Sharif, DPM of Village Podiatry Centers

  •  Doctorate of Podiatric Medicine, Dr. William Scholl College of Podiatric Medicine
  • Internship, University of Texas Health Science Center
  • Surgical Residency, Harris County Podiatric Surgical Residency Program
  • Board Certified in Foot & Reconstructive Ankle Surgery
  • Certified in Microvascular Surgery, MD Anderson Cancer Center

Dr. Doug Redd, MD of Advanced Vascular Resources of Atlanta

  •  Doctorate of Medicine, Emory University School of Medicine
  • Internship, Emory University Hospital
  • Residency, Diagnostic Radiology, Emory University Hospital
  • Fellowship, Angiography & Interventional Radiology, Hospital of the University of Pennsylvania

Dr. David Schwegman, MD of Hyperbaric Physicians of Georgia

  •  Doctorate of Medicine, University of Cincinnati College of Medicine
  • Residency, Emergency Medicine, Ohio State University
  • Board Certified, Emergency Medicine
  • Certified Wound Specialist
  • Former Assist. Professor, Emergency Medicine, Emory University School of Medicine

Treating Diabetic Ulcer Patients

Top Docs

Top Docs Radio features healthcare providers and professionals sharing their expertise to “Get the Word Out” about a variety of health problems, treatments and community concerns to elevate our community’s well-being.

Treating Diabetic Ulcer Patients

According to recent data from the CDC, diabetes affects over 25.8 million people in the US (roughly 8% of the population).  Coupled with data that shows another 79 million persons in the US have pre-diabetes (A1C levels above normal) or 35% of the population.  Obviously, it’s a serious problem.  Diabetes is a major contributor to stroke, heart disease and peripheral vascular disease (PAD).  Roughly 1:6 diabetics will develop a diabetic ulcer on their foot or lower extremity and many of them will ultimately require amputation of part of the foot or leg.  After amputation for an ulcer, studies have shown diabetics’ 5 year mortality rates rise significantly — to as high as 45-60%.  It is critical that these patients receive rapid, aggressive care from a spectrum of specialists who must each address the various factors contributing to the ulcer.

Our guests this week include three such specialists who treat diabetic ulcer patients in their practice every day.  They will give insight about the role they play in saving the diabetic ulcer patient’s limb (and possibly their life).

The host of Top Docs Radio is Charles “CW” Hall with Hyperbaric Physicians of Georgia.

Dr. Shamir Bhikha, DPM

  • Doctorate with Honors, Podiatric Medicine, Barry University School of Podiatric Medicine
  • Residency, Inova Fairfax Hospital 2010-13 & Limb Salvage Center at Georgetown University Hospital 2013
  • Skilled in Sports Medicine/Trauma to the foot/ankle, Podopediatrics and Reconstructive foot/ankle surgery
  • Comprehensive training in diabetic limb salvage, plastic surgery and wound care

Dr. Andrew Pugliese, MD

  • Doctorate in Medicine, St. George University School of Medicine
  • Fellowship, Infectious Disease, Winthrop University Hospital
  • Triple Board Certified in Internal Medicine and Infectious Disease
  • Pioneer in non-surgical treatment of acute and chronic sinusitis and president of Sinus Solutions

Dr. Uthan Vivek, MD

  • Doctorate in Medicine, Madras Medical College, India
  • Board Certified in General Surgery and Vascular & Endovascular Surgery
  • Fellow, American College of Surgeons
  • Vascular Fellow, Wayne State, Detroit
  • General Surgery, Saint Vincent Catholic Medical Center, New York
  • Certified in Vascular Sonography, American Registry of Diagnostic Medical Sonography
  • Specialist in endovascular procedures for peripheral arterial disease/varicose veins, management of carotid artery disease, abdominal aortic aneurysm, deep vein thrombosis, diabetic foot ulcers and dialysis access
Charles "CW" Hall, Dr. Uthan Vivek, Dr. Andrew Pugliese, Dr. Shamir Bhikha

Charles “CW” Hall, Dr. Uthan Vivek, Dr. Andrew Pugliese, Dr. Shamir Bhikha