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Originally printed in the SpaceMed Newsletter Spring 2011 www.spacemed.com

Vascular Centers Are Addressing an Unmet Demand By Cynthia Hayward

BACKGROUND Historically, hospitals have focused on growing their cardiology programs and services that treat atherosclerosis, or hardening of the arter-ies, and other heart conditions. However, it is becoming increasingly evident that programs to address systemic vascular disease ― cerebro-vascular, carotid, aortic, and peripheral vascu-lar are needed to address a growing and unmet need.

The National Institutes of Health (NIH) reports that non-coronary vascular stenosis and arterial breakdown is a prevalent disease in the United States. Up to 12 million people are estimated to have peripheral arterial disease (PAD) com-pared to the same number (12 to 13 million) with coronary artery disease (CAD). With the emphases on CAD as a serious health problem in the U.S., vascular disease is more often under-diagnosed and as a result is frequently under-treated.

CURRENT TREND Diagnosis and treatment of vascular diseases which include any arterial system outside the region of the heart has rapidly transitioned to less–invasive modali-ties performed by different subspecialists such as vascular surgeons, cardiologists, radiologists, neurologists, and nephrologists. Sophisticated imaging such as com-puterized tomography (CT), CT/angiography, magnetic resonance imaging (MRI) and MRI/angiography, and positron emission tomography (PET) scans along with the latest endovascular tools, equipment, and devices provide a tremen-dous arsenal for treating the debilitating effects of vascular disease. All of these approaches are less traumatic than older open surgical procedures.

When developing a vascular center, endovascular workload volumes are generally estimated at three times the number of coronary interventional procedures. If a pa-tient has coronary artery disease, there is an increased probability that there may be disease and possible serious stenosis in other blood vessels throughout the body.

VASCULAR CENTERS OF EXCELLENCE A vascular “center of excellence” generally includes an endovascular suite to pro-vide minimally invasive vascular surgery procedures along with specialized and hy-brid CT, MR, and angiography. Associated programs may also include cardiac re-habilitation, smoking cessation, wound care management, and diabetes care. With the cost of a state-of-art endovascular suite at $2 million or more, prudent healthcare organizations are designing dual-purpose facilities that can service the vascular and cardiac populations to optimize limited capital dollars.

Cynthia Hayward, AIA, is founder and principal of Hayward & Associates LLC.

About Vascular Disease Vascular disease affects the arteries. Common terms include:

Cerebrovascular affecting the blood flow to the brain

Carotid arteries in the neck that lead to the brain

Aortic the largest artery in the body that extends from the heart into the abdomen

Peripheral affecting the blood flow to limbs