Vascular Screening Specialist

The best vascular care

Our Vascular Lab provides comprehensive services for the evaluation, diagnosis, and treatment of a full range of vascular diseases. Our specialty trained physicians and staff, combined with state-of-the-art diagnostic equipment, are all focused on providing the best healthcare experience for patients.

Our Locations:

GERMANTOWN:

20528 Boland Farm Road, #210

Germantown, Maryland 20876

PHONE: 301-251-0070

PHONE: 240-912-4576

FAX: 301-251-0071

LANHAM:

7501 Forbes Boulevard #103

Lanham, Maryland 20706

PHONE: 301-850-4401

Peripheral Arterial Disease (PAD)

What is Peripheral Arterial Disease (PAD)?

One in every 20 Americans over the age of 50 has peripheral Artery Disease (PAD), a condition that raises the risk for heart attack and stroke.

PAD is caused by a thickening of the inside walls of the arteries due to the build up of plaque from extra cholesterol and other fats circulating in the blood.

This thickening, called atherosclerosis narrow the space through which blood can flow, decreasing the supply of oxygen and nutrients to the leg muscles.

Timely detection and treatment of PAD can improve the quality of your life; and reduce your risk of heart attack, stroke, leg amputation and even death.

Right now your symptoms suggest that you have peripheral artery disease. If that is the case, your doctor will recommend changes in your lifestyle, procedures to improve blood flow to the leg muscles. But first it's important to confirm that your symptoms are caused by blockages, in the arteries of your legs. If there are blockage, it's important to see just how serious the blockage is. All this can be done with an angiography.

Risk Factors

Factors that increase your risk of developing peripheral artery disease include:

Smoking
Diabetes
Obesity (a body mass index over 30)
High blood pressure
High cholesterol
Increasing age, especially after reaching 50 years of age
A family history of peripheral artery disease, heart disease or stroke
High levels of homocysteine, a protein component that helps build and maintain tissue

People who smoke or have diabetes have the greatest risk of developing peripheral artery disease due to reduced blood flow.

Symptoms

While many people with peripheral artery disease have mild or no symptoms, some people have leg pain when walking (claudication).

Claudication symptoms include muscle pain or cramping in your legs or arms that's triggered by activity, such as walking, but disappears after a few minutes of rest. The location of the pain depends on the location of the clogged or narrowed artery. Calf pain is the most common location.

The severity of claudication varies widely, from mild discomfort to debilitating pain. Severe claudication can make it hard for you to walk or do other types of physical activity.

Peripheral artery disease signs and symptoms include:

Painful cramping in one or both of your hips, thighs or calf muscles after certain activities, such as walking or climbing stairs (claudication)
Leg numbness or weakness
Coldness in your lower leg or foot, especially when compared with the other side
Sores on your toes, feet or legs that won't heal
A change in the color of your legs
Hair loss or slower hair growth on your feet and legs
Slower growth of your toenails
Shiny skin on your legs
No pulse or a weak pulse in your legs or feet
Erectile dysfunction in men

If peripheral artery disease progresses, pain may even occur when you're at rest or when you're lying down (ischemic rest pain). It may be intense enough to disrupt sleep. Hanging your legs over the edge of your bed or walking around your room may temporarily relieve the pain.

Smokers have the greatest risk of developing peripheral artery disease due to reduced blood flow.

How is Peripheral Arterial Disease (PAD) Diagnosed?

Diagnostic Tests

Ankle-Brachial Index

A simple test called an ankle-brachial index (ABI) often is used to diagnose PAD. The ABI compares blood pressure in your ankle to blood pressure in your arm. This test shows how well blood is flowing in your limbs.

ABI can show whether PAD is affecting your limbs, but it won't show which blood vessels are narrowed or blocked.

A normal ABI result is 1.0 or greater (with a range of 0.90 to 1.30). The test takes about 10 to 15 minutes to measure both arms and both ankles. This test may be done yearly to see whether PAD is getting worse.

Doppler Ultrasound

A Doppler ultrasound looks at blood flow in the major arteries and veins in the limbs. During this test, a handheld device is placed on your body and passed back and forth over the affected area. A computer converts sound waves into a picture of blood flow in the arteries and veins.

The results of this test can show whether a blood vessel is blocked. The results also can help show the severity of PAD.

How is Peripheral Arterial Disease (PAD) Treated?

Angiography. Using a dye (contrast material) injected into your blood vessels, this test allows your doctor to view blood flow through your arteries as it happens. Your doctor is able to trace the flow of the contrast material using imaging techniques, such as X-ray imaging or procedures called magnetic resonance angiography (MRA) or computerized tomography angiography (CTA).

Angioplasty. In this procedure, a small hollow tube (catheter) is threaded through a blood vessel to the affected artery. There, a small balloon on the tip of the catheter is inflated to reopen the artery and flatten the blockage into the artery wall, while at the same time stretching the artery open to increase blood flow.

Your doctor may also insert a mesh framework called a stent in the artery to help keep it open. This is the same procedure doctors use to open heart arteries.

What to Expect on the day of your procedure

Before your procedure

For your angiography there are a few guidelines that need to be follows.

Please do not eat any solid food the morning of your appointment. You may drink clear liquids, and continue to take any medications that your doctor has prescribed.
Arrange for transportation to and from our facility.
Please arrive at our facility at least 1 hour prior to surgery.

During your procedure

When you arrive at our facility on the of your procedure:

You will need to complete some paperwork and change into a gown.
We will place an IV in your arm.
Before we go to the lab, we will add a medication to your IV that will help you to relax.
In the lab, you will feel groggy, but you will be awake, and able to speak to the Doctor.
The large machine hanging over you in the X-ray camera that will take pictures continuously and display these pictures on the monitors.
The procedure begins with a small incision at the top of your leg. Through this small cut a thin tube is threaded into the artery.
A small amount of X-ray dye is released through the tube. If the X-ray dye does not circulate through your leg completely, we know there are blockages, and we know where they are.

After your procedure

When your angiography is done, a piece of tape will be placed over the cut. Although the incision is very small, the area needs to begin healing before you go home. you will rest in our recovery area for a few hours. Although you'll need to lie still, you will be able to eat and drink, and visitors are allowed. You will not be allowed to drive yourself, please arrange for a ride home.

Your Recovery:

Take it easy at first. Although you should be fine to return to desk work the day after your angiography, avoid lifting or straining for at least a week.

If you are uncomfortable, take Tylenol.

For the first few days, if you feel that you're about to cough or sneeze, put gentle pressure where the incision was.

During the healing process if something happens, and you do begin bleeding from your wound, put pressure on it, and call us. If we're not available, be safe, and get to an emergency room.

Meet our Vascular Surgeon

We are pleased to have Dr. Massoud Arbabzadeh as a Vascular Interventional Radiologist specializing in angiography, and angioplasty treatment of peripheral vascular disease (PVD) for The Surgery Clinics, LLC.

Dr. Arbabzadeh is passionate about helping patients improve their quality of life through minimally invasive angioplasty treatment procedures for the lower extremities. Here at our outpatient surgery center, Dr. Arbabzadeh uses innovative techniques to relieve feet and leg discomfort caused from narrowed or occluded peripheral arterial vessels.

Dr. Arbabzadeh attended medical school at Tehran University followed by residency programs at the State University of New York (SUNY) and Louisiana State University (LSU). White a resident at LSU School of Medicine, he received the Chairman's Award for Excellence from the American College of Radiology.

Dr. Arbabzadeh went on to pursue a clinical research fellowship in Interventional Radiology at the University of Maryland, Baltimore Shock Trauma Center, and a fellowship in Vascular and Interventional Radiology at Columbia University College of Physicians and Surgeons in New York, NY.

In addition to publishing numerous case reports and research studies, Dr. Arbabzadeh holds professional affiliations with the American College of Radiology, American Roentgen Ray Society, Society of Interventional Radiology, Cardiovascular & Interventional Society of Europe, Radiological Society of North America, and the American Medical Association.