Services

Services - Sub Menu

Vascular Care

Northern Light Health has the only full service clinical center in Maine dedicated to vascular care. There our team uses the latest technology and surgical techniques to address conditions affecting the carotid artery, abdominal aortic aneurysm, the venous system, poor circulation, and varicose veins. 

Vascular Conditions

Varicose Veins

Varicose veins develop near the surface of the skin, and they are usually easy to spot by their swollen, twisted, and knotted appearance. Symptoms include leg fatigue, aching, burning, night cramps, leg and ankle swelling, and pain, especially after standing for a long time. Women may experience an increase in symptoms during their menstrual cycle.

Risk Factors for Varicose Veins

Many factors play a part in the development of varicose veins. They can affect adults of all ages, but there are certain factors that make you more likely to develop them:

  • Heredity – if your mother or father has varicose veins, there is a greater likelihood you will develop them.

  • Age – the development of varicose veins can happen at any age, but usually occurs between the ages of 18 and 35 years, and peaks between 50 and 60 years.

  • Gender – females are affected approximately four times as much as males.

  • Pregnancy – during pregnancy varicose veins can form, but may disappear after the delivery of the baby. A vascular specialist can discuss your situation with you three to six months after birth and after you have stopped breastfeeding, and if needed, a treatment plan can be developed. 

Read More

Diagnosis and Treatment of Varicose Veins

The veins that cause symptoms do not play an important role in transporting blood back to the heart; therefore, they can be closed off or removed without causing problems. In fact, removing them improves venous circulation.

Diagnosis is pain-free and is offered in our office. Treatment may begin with things you can do on your own under the direction of your doctor and progress to other options if necessary. Treatment options your healthcare provider may discuss with you include:

  • Elevating your legs when possible, keeping your feet positioned higher than heart level.

  • Exercising daily. Walking, climbing stairs, cycling and swimming keep your calf muscles in motion and improve circulation. 

  • Moving your legs frequently by taking short walks.

  • Using compression hose. This provides pressure on your legs which can aid in blood flow to the heart. 

  • Sclerotherapy, which involves injecting a solution into your legs to close smaller veins.

  • Laser or radiofrequency endovenous ablation, which heats the veins and results in their closure.

  • When other approaches are not effective, surgery is an option. 

Read More

Your First Visit

During your initial appointment, a member of our team will review your medical history, discuss your diagnosis, and answer any questions you may have. Varicose veins can cause both physical pain and cosmetic concerns, and our goal is to help you understand your treatment options and help you start on a path to looking and feeling your best.

Read More

Health Insurance Regarding Varicose Veins

Most health insurance plans cover your initial evaluation, and many cover treatment of varicose veins. To find out if your insurance plan covers treatment for varicose veins, please call us at 207-973-6670. Your insurance may require a referral from your primary care provider. We can help you determine your next steps for care.

Read More

Read More

Aortic Abdominal Aneurysm (AAA)

Arteries are the tubes carrying blood from the heart to the rest of the body. An aneurysm is a weak area in the wall of an artery that can bulge like a balloon, and can cause problems related to either bleeding or blood clotting. Aneurysms can occur throughout the body, but one of the most common locations is in the aorta. The aorta is the largest artery of the body, carrying blood directly from the heart through the chest and abdomen to the rest of the body.

Aneurysms of the aorta are worrisome because they can burst or rupture resulting in excessive bleeding and usually causing death. A small aneurysm may require no immediate treatment other than "watchful waiting." The aneurysm should be monitored by a vascular specialist who will order periodic ultrasound exams or other tests to make sure that the aneurysm is not growing. Many times aneurysms remain small and pose no significant problems.

If an aneurysm reaches a certain size between 5 and 5.5 cm, your healthcare provider may refer you for aneurysm repair. Aneurysms can be repaired in two ways, depending on the actual dimensions of the aneurysm and relation to surrounding structures, age and health of the individual, willingness to return for regular follow-up, and other factors.

Open Surgical Repair

Direct surgical repair of the aneurysm has been the standard approach for over 50 years. An incision is made in the abdomen, the aneurysm is isolated and opened, and a synthetic graft is sewn to the aorta. The vascular graft is usually made of a polyester type material, and essentially replaces the diseased portion of the aorta. This is a major surgery performed under general anesthesia. Recovery from the operation typically requires 7 to 10 days in the hospital and another 6 to 8 weeks of convalescence at home. Although this is a significant undertaking, results of this operation are generally good, and the chances of further problems are remote.

Read More

Endovascular Repair

This procedure has been developed over the past 10–15 years to repair an aneurysm with surgery that is less invasive. Incisions are made in the groins, and a device is maneuvered through the...

Read More

Best Treatment for an Aortic Abdominal Aneurysm

The best treatment for an abdominal aortic aneurysm depends on a number of factors, including the size and location of the aneurysm, whether or not it is causing symptoms, and the age and general health of the patient. Many aneurysms can only be repaired with the open operation. While this is a major operation, the outcomes are generally very good. Other aneurysms may be candidates for either open or endovascular repair. Both approaches have advantages and disadvantages in this circumstance, and you should understand the pros and cons of both approaches before deciding how to proceed. We encourage you to discuss all of these factors and any other questions you have with your primary care provider and vascular specialist.

Read More

Read More

Carotid Artery Disease

The carotid arteries are the blood vessels located on both sides of your neck that carry blood to the head and brain. Carotid artery disease is the buildup of plaque in these arteries, causing a narrowing, or blockage, of the artery. Carotid artery disease can lead to a stroke or transient ischemic attacks (also called TIAs or mini-strokes).

Most often, carotid artery disease is silent and unsuspected. Occasionally, the narrowed arteries produce a noise that can be heard with a stethoscope over the neck. If your healthcare provider suspects that you have carotid artery disease, he or she will ask you specific questions, examine you, and may order a diagnostic test such as carotid duplex imaging, computed axial tomography (CAT scan), magnetic resonance angiography (MRA), or an angiogram.

Treatments for Carotid Artery Disease

The treatment for carotid artery disease depends on the severity, the symptoms you have experienced, and your overall state of health. Mild or moderate stenosis may be treated with medication and by reducing as many risk factors as possible to slow the growth of the stenosis. Your healthcare provider will discuss the importance of reducing your risk factors and regular medical follow-up.

More severe carotid artery stenosis may sometimes be treated with an operation know as carotid endarterectomy (CEA). This is a surgical procedure in which the plaque and inner lining of the artery is removed. An incision is made, the carotid arteries are located; clamps are placed above and below the surgical site; the carotid artery is opened; and the plaque is carefully removed. The artery is then closed with a patch of a vein or an artificial/synthetic material; sutures or staples are applied to the skin and the area is covered with a dressing. In certain instances, it may be possible to treat carotid stenosis through catheters inserted in the groin with stents placed in the carotid artery to improve the flow through the region. This approach is very new and the devices have only recently been approved for use by the FDA. As the technology develops, more and more patients will be candidates for this procedure.

We offer TransCarotid Artery Revascularization, or TCAR, a minimally invasive procedure for patients with carotid artery disease. TCAR is a less invasive alternative to a carotid endarterectomy (CEA), the procedure that is most commonly used to treat severe carotid artery disease. CEA starts with a three to four inch incision at the front of the neck, where TCAR gains direct access to the common carotid artery through a much smaller incision above the collarbone, allowing just enough room to place a sheath into the artery and place a stent. The stent is then inserted in the artery to open and stabilize the narrowing and help protect patients from future stroke risk. Throughout the procedure, blood flow is temporarily reversed in the carotid artery to divert dangerous debris away from the brain, preventing a procedural stroke. 

The best treatment for carotid artery disease depends on a number of factors, including the size and location of the stenosis, whether or not it is causing symptoms, and the age and general health of the patient. You should discuss all of these factors and any other questions you have with your primary care physician. 

Read More

Read More

Peripheral Vascular Disease (PVD)

Peripheral vascular disease, or PVD, is the narrowing or blockage of arteries that carry blood throughout the body. The most common cause of PVD is atherosclerosis, or the hardening of the arteries. Atherosclerosis is a gradual process in which cholesterol and scar tissue build up, forming a substance called plaque that narrows the blood vessels. Eventually, if an artery becomes very narrow, clot can form within it and prevent any blood from flowing beyond the blockage.

Treatments Peripheral Vascular Disease

Treatment of PVD has three aims, some of which overlap.

  1. The first important aim is to treat the systemic disease of atherosclerosis. People with PVD are at increased risk of suffering a heart attack. Treatment for this purpose consists of lifestyle modifications and medication, including quitting cigarette smoking, maintaining a healthy diet, and increasing activity levels. Medications designed to inhibit platelets (aspirin) and control cholesterol are frequently recommended.

  2. The next aim in treating PVD is to increase the ability to walk. Smoking cessation alone usually increases pain free walking distance. Exercise programs are also effective. There are medications that can improve the walking distance as well, and these may be recommended by your doctor in certain instances. In the most severe cases, or in otherwise young healthy individuals, your doctor may recommend repair or bypass of blocked arteries to improve the circulation and increase exercise tolerance.

  3. The final aim in the treatment of PVD is to increase the circulation to the extremity by either addressing the blockages directly or by performing bypass procedures around the blockage. These types of treatment are generally reserved for those with more severe degrees of blockage, or for otherwise healthy patients who are very limited by their circulation. Two general options are available to increase the circulation of the leg. The first approach is called endovascular or percutaneous therapy. This is a minimally invasive procedure where catheters and other devices are used to treat the blockages directly without the need for open operation. These types of procedures can frequently be done as an outpatient, or with an overnight stay. When feasible, this approach is well tolerated and can provide durable relief of symptoms.

Not all patients can be treated with endovascular therapy. In those individuals, open surgical approaches to remove or bypass the blockages in the arteries are necessary. These are major surgical procedures, and are usually only performed when the disease is advanced and there are no other alternative to save the limb. These types of procedures are generally very successful however, and long term durability is quite good.

Treatments for PVD are chosen carefully for the individual patient. In those with minimal symptoms, lifestyle modification and medication are typically all that is required. Please be sure to discuss all options with your healthcare provider and understand why a particular course of action has been planned for your situation.  

Read More

Read More

Vascular Diagnostics

Abdominal Vessels Ultrasound

An Abdominal Vessels Ultrasound is an exam to look at the vessels within the abdomen by using sound waves. Here is what you will experience:

PREPARATION: Nothing to eat or drink eight hours prior to exam time. No chewing gum, smoking, or tobacco as well. If medications are needed you may take these with small sips of water.

PROCEDURE: You will lie on your back on the ultrasound stretcher for much of the exam. You may be asked to hold your breath for short periods of time. Warm acoustic gel is spread over the abdomen so that when the ultrasound probe is placed on your stomach, sound waves can be transmitted. The ultrasound probe is passed back and forth over the area of interest in order to take pictures of the vessels. You may here swishing sounds coming from the ultrasound machine; this is simply the sonographer listening to the blood flow of your vessels.

This exam will take approximately 60 minutes

Read More

Carotid Ultrasound (VL Carotid Scan)

A carotid ultrasound, also known as a VL Carotid Scan, is a non-invasive test that is used to determine if a patient has blockage or narrowing in the arteries in the neck (carotid arteries). Here is what you will experience:

PREPARATION:  Please wear a loosely collared shirt. Turtle-necks and high collared shirts are discouraged. 

PROCEDURE: A small amount of transmission gel is placed on the side of the neck. An Ultrasound probe is gently run up and down the neck through the gel. During this time, the sonographer or technologist will take pictures of the arteries, listen to and measure blood flow in the arteries and record these for the interpreting physician. From these pictures and measurements, a physician can determine the level of blockage or narrowing. 

The exam will take approximately 60 minutes.

Read More

Extremity Ultrasound

An ultrasound of the arm or leg is a non-invasive exam that uses sound waves to evaluate the arteries and/or veins. Here is what you will experience:

PREPARATION: None

PROCEDURE: To begin the exam, you will be asked to lie on the exam table with a sheet draped over you. If your examination is for your legs, you will be asked to remove your shoes, socks and pants.

Warm transmission gel is spread over the area of interest. An Ultrasound probe is passed over the gel. During this time, the sonographer or technologist will take pictures, listen to and measure blood flow velocity and record these for the interpreting physician. From these pictures and measurements, a physician can determine any abnormalities within the arteries and /or veins.

The exam will take approximately 60 minutes

Read More

Pulse Volume Recordings (VL PVR)

Pulse Volume Recordings, also known as a VL PVR exam, is a non-invasive test that is designed to measure the volume of arterial blood flow (circulation) in the legs or arms. It is a blood pressure test. Here is what you will experience:

PREPARATION: Please bring comfortable clothing and shoes to your exam.

PROCEDURE: For the Legs: To begin the exam, you will be asked to remove your shoes, socks and pants and to lie on the exam table with a sheet draped over you. Blood pressure cuffs will be placed on your arms, thighs, calves, ankles and feet. These cuffs will be inflated twice. The first time the cuffs are inflated, they will measure the volume of blood that passes through the artery underneath the cuff. This volume is registered as a waveform on the PVR machine. The physician can determine if there is any blockage in the arteries above or at the level of the cuff by looking at the size and shape of the waveform.

The second time the cuffs are inflated, an actual blood pressure is taken. Pressures obtained by the cuffs on the legs are compared to the pressures obtained in the arms. This comparison is called the Ankle Brachial Index. The physician can determine the severity of decreased blood flow of the legs by this index.

The technologist may decide to exercise you by having you walk on the treadmill or stand on the floor and perform heel raises. Ankle waveforms and pressures are obtained immediately after exercise and compared to the ankle waveforms and pressures before exercise. This can also help the physician determine the severity of decreased blood flow in the legs.

PROCEDURE: For the Arms: To begin the exam you will be asked to remove your shirt and a short hospital gown will be given to you to put on. You will be asked to sit on the side of the exam table. Blood pressure cuffs will be placed on the upper arms, forearms and wrists. The first time the cuffs inflate with air, they will measure the volume of blood that passes through the arteries in your arms. The cuff will measure this volume as a waveform. The physician can determine by the size and shape of the waveform if there is any blockage in your arteries.

The second time the cuffs inflate, they will obtain an actual blood pressure. If you do have blockage in your arteries, the physician can determine the severity by your blood pressure in each cuff.

This exam will take approximately 60 minutes.

Read More

Contact us today to get help with your Vascular Care needs.

Address
489 State Street
Kagan Building, Level 2
Bangor, ME 04401-6616

Contact
Phone: 207-973-6670
Fax: 207-973-5226