Saving Life and Limb
New Vascular Center unites experts to
diagnose, treat vascular disease
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When Karen Sunderlage woke up at 3 a.m. one cold January morning in her Milford home, her left foot remained asleep. She wasn’t concerned until she tried to move it. Regardless of how hard she tried, her foot remained numb and lifeless. Then she turned on the light. Her foot and calf were alarmingly white and cold. “There was no color at all,” Sunderlage remembers with a shudder. “I woke my husband and told him to call the life squad.”
When the life squad arrived, Sunderlage’s leg strangely had begun to improve. Relieved, her husband went about his morning and headed in to work. At about 6 a.m., Sunderlage experienced what felt like a highly intense Charley horse, and her leg had become numb again. She knew something was wrong. This time when the life squad came, they rushed her to Bethesda North Hospital.
Vascular Center Snapshot
Open since January 2008, the Bethesda North Vascular Center provides a fully integrated approach to detection and treatment of vascular disease. Providing the only comprehensive service of its kind in the Greater Cincinnati area, it offers a one-stop shop for detecting and treating vascular disease by involving varied medical specialties, including interventional cardiology, interventional radiology, cardiothoracic surgery and vascular surgery.
Cardiothoracic Surgery
The surgical treatment of diseases affecting organs inside the chest such as the heart and lungs.
Interventional Cardiology
A branch of cardiology that uses catheters to treat heart problems without major surgery. A large number of procedures can be performed on the heart by catheterization.
Interventional Radiology
An area of specialty within radiology that offers minimally invasive surgery using radiological techniques that help guide radiologists in placing wires, tubes or other instruments inside a patient for diagnosis and treatment.
Vascular Surgery
A subspecialty of general surgery that focuses on the treatment of diseases of the vascular system – arteries and veins, excluding the heart and brain – managed largely via surgical intervention. |
Expert diagnosis
After Sunderlage arrived at Bethesda North’s Emergency Department, the staff consulted the new Bethesda North Vascular Center, and Olivia Lally RN, Vascular Center nurse practitioner, hurried over to assess her. “I was surprised when I first met Karen, because she did not have the typical risk factors for peripheral vascular disease,” says Lally. “She was quite young and wasn’t a diabetic.”
With extensive nursing experience in both cardiology and peripheral vascular disease, Lally triages patients to the appropriate vascular specialist. “We are very fortunate to have Olivia as part of the Vascular Center,” comments Matthew Recht MD, vascular surgeon. “She has a great knowledge base and is very personable. She really gets to know the patients.”
Lally immediately realized that Sunderlage was in trouble. “Her left leg was very cool and I could not feel a pulse in her foot,” she remembers. Lally rushed Sunderlage to James Hankin MD, an interventional radiologist with the Vascular Center, who performed an angiogram on Sunderlage’s leg. This test uses dye to help visualize specific blood vessels. Narrowing, blockage, enlargement and malformation in the arteries and veins are also visible with this test.
“The angiogram showed complete obstruction at the level of her calf,” Dr. Hankin explains. “Karen was in danger of losing her foot.”
Lally remembers that everything about Sunderlage’s care was expedited. “She went straight from the Emergency Department to see the interventional radiologist to the intensive care unit.” Thrombolysis was started on her left calf to break up the blood clot. Meanwhile, Drs. Hankin and Recht discussed the possibility of surgery if the clot did not begin to dissolve.
Team approach
One of the main advantages the Vascular Center offers patients is the combined expertise of varied specialists in diagnosing and treating vascular disease. “We have regular meetings where each patient’s vascular issue is presented and discussed,” Dr. Hankin explains. “We agree as a team on the best treatment plan. Because each of us has a different approach, we may come up with something as a team that I would not have thought of on my own.”
Dr. Recht agrees. “It really is a multi-disciplinary approach,” he says. “By getting all of these vascular specialties working together, you really do get the best treatment plan for the patient.”
There are other advantages to putting related specialists together under the same roof. Increased volume means greater access to the newest technologies. “We are working with the TriHealth Hatton Institute so our patients will have the potential to participate in clinical trials to receive the most cutting-edge treatment possible,” Dr. Recht says.
Broad reach
The varied experts at the Vascular Center bring comprehensive knowledge to the table, diagnosing a wide range of vascular issues. “Having the center on the Bethesda North campus means that patients get expert, specialized care quickly and seamlessly,” Lally explains.
One patient was in the hospital for testing on her gall bladder when the technician noticed a bulge on her abdominal aortic artery (AAA). She was referred to the Vascular Center, where she was diagnosed with an AAA aneurysm.
A stroke patient was referred to the Vascular Center for assessment due to a suspected underlying vascular issue that likely was contributing to her decreased mobility. The Vascular Center team diagnosed and treated the patient, which allowed her to walk free of a walker for the first time in years.
Other diseases commonly diagnosed and treated by the Vascular Center include:
• Lower Extremity Peripheral Artery Disease
• Carotid Stenosis
• Renal Artery Stenosis
• Aortic Aneurysm
• Thoracic Aneurysm
• Visceral Arterial Disease
No stone unturned
While Dr. Hankin focused on getting Sunderlage’s clot dissolved, the other vascular specialists ran tests to determine the cause of the clot and to ensure there were no other underlying problems. “All of the physicians in the Vascular Center saw her,” says Lally. “We were concerned the clot may have come from her heart, putting her at risk for a life-threatening complication if another clot were to break off and drift to her lungs or brain.”
After several days in the ICU, the thrombolysis was successful in breaking up the clot in Sunderlage’s leg. The Vascular Center team was able to rule out other vascular issues in the same hospital visit, eliminating the need for her to return for additional testing.
Today, Sunderlage is still recovering from the nerve damage in her foot caused by the lack of blood flow. “I’m working with an orthopedic specialist and doing physical therapy to regain full use of my foot,” she says. “I’m told it’s really important to keep the muscles working while the nerves heal.”
The Vascular Center team will continue to provide follow-up care to Sunderlage for a minimum of one year. Her leg will be scanned at six-month intervals to ensure no other circulation issues have developed. Since the Vascular Center is located in the hospital, Sunderlage can take care of her testing and physician appointment all in one visit.
When Sunderlage reflects on her traumatic experience, she looks down, pausing in appreciation. She says had it not been for Bethesda North, she might have lost her foot. “I thank God they sent Olivia into that Emergency Department,” she praises.
Are you at risk?
People at high risk for vascular disease typically include adults over the age of 55 and anyone with the following risk factors:
- Diabetes
- High blood pressure
- Smoking
- High blood cholesterol
- Family history of atherosclerotic and circulatory problems
If you are concerned about your vascular health, call the Bethesda North Vascular Center at
513-745-1656. |
