VASCULAR CENTER

UH Harrington Heart & Vascular Institute

 

 

OVERVIEW

The Vascular Center of University Hospitals Harrington Heart & Vascular Institute is dedicated to the diagnosis and treatment of patients with any condition that affects the body’s blood vessels, including arteries, veins and lymphatic system. Our team includes vascular surgeons, interventional cardiologists, vascular medicine specialists, radiologists, anesthesiologists and specially trained nursing staff. The center provides a complete range of services, from routine examinations and medical treatments to the most advanced surgical interventions and post-treatment follow-up.

As one of a select number of institutions across the country, our center offers leading minimally invasive therapies for aortic disease, including branched and fenestrated endovascular aortic repair, thoracic endovascular aortic repair (TEVAR) and transcarotid stenting – techniques shown to significantly reduce mortality compared with traditional open surgical techniques. In addition to these innovative aortic procedures, we specialize in stem cell therapy to prevent amputation in patients with severe arterial disease, and carotid surgery and stenting for extracranial cerebrovascular disease.

CONDITIONS TREATED

  • Aortic aneurysm
  • Aortic dissection
  • Arterio-venous malformations
  • Atherosclerosis
  • Carotid artery disease
  • Clinical thrombosis and thrombophilia
  • Deep venous thrombosis
  • End-stage renal disease
  • Lymphatic disorders
  • Mesenteric ischemia
  • Peripheral artery disease
  • Pulmonary embolism
  • Renal artery disease
  • Small vessel ischemia
  • Thoracic outlet syndrome
  • Varicose veins
  • Vasculitis
  • Vascular problems caused by underlying disease, such as diabetes
  • Venous insufficiency
  • Venous thromboembolism
  • Wounds (chronic, nonhealing)

ADVANCED DIAGNOSTIC TESTING

Our accredited vascular laboratories across the system provide both physiologic (nonimaging) and ultrasound (imaging) testing including duplex ultrasound, noninvasive evaluation of arterial and venous disease, transcranial doppler, carotid ultrasound, evaluation for abdominal aortic aneurysms and renal artery stenosis, lower extremity perfusion and deep vein thrombosis.

Preliminary results are available the day of the test with final results available within 48 hours.

 

 

SPECIALIZED SERVICES

  • Medical evaluation and treatment of aortic pathologies, cerebrovascular disease and peripheral occlusive disease (PAD/PVD)
  • Complex aortic and/or peripheral reconstruction, revascularization or aneurysm repair
  • Endovascular treatment of thoracic and abdominal aneurysms
  • Hybrid cardiovascular surgery for ascending and arch aortic pathologies
  • Percutaneous interventions, including angioplasty, thrombolysis and stenting of peripheral vessels, including renals, mesenteric, upper and lower extremities
  • Hemodialysis access procedures
  • Carotid stenting or endarterectomy
  • Laser and radiofrequency ablation for varicose veins
  • Complex wound consultation and managementQuality Outcome

Vascular Surgery Volume

 

QUALITY OUTCOMES

Vascular Surgery Percent Inpatient MortalityVascular Surgery Inpatient Length of Stay

Vascular Surgery Percent 30-Day Readmissions

Vascular Surgery Percent Inpatients with Complications

 

AORTIC PATHOLOGIES TREATED AT THE AORTIC CENTER

  • Aorto-annular ectasia
  • Aortic root aneurysm
  • Aneurysms of the ascending aorta, aortic arch, and descending thoracic and abdominal aorta
  • Thoraco-abdominal aortic aneurysms
  • Aortoiliac occlusive disease
  • Acute and chronic aortic dissections
  • Penetrating aortic ulceration
  • Intramural hematoma
  • Aortic atherosclerosis
  • Marfan’s syndrome
  • Loeys-Dietz syndrome
  • Vasculitis

AORTA ADVANTAGE

Vascular and cardiac surgeons team up in new multidisciplinary Aortic Center Patients at University Hospitals Harrington Heart & Vascular Institute have access to a new multidisciplinary center that provides coordinated evaluations and treatment options for aortic pathologies. The new Aortic Center draws on the expertise of vascular and cardiac surgeons, interventional cardiologists, cardiovascular medicine, imaging and genetics to provide highly skilled interventions for these very complex conditions.

Advanced imaging includes coronary computed tomography angiography (CTA), magnetic resonance angiography (MRA), angiography and intravascular ultrasound (IVUS). Therapies include leading-edge surgical techniques, such as complex aortic root reconstructions (including valve-sparing aortic root replacement) and surgical reconstruction of ascending aneurysms, arch pathologies and thoraco-abdominal aneurysms. The Aortic Center also offers complex minimally invasive therapies including endovascular aortic repair (EVAR), fenestrated endovascular aortic repair (FEVAR and thoracic endovascular aortic repair (TEVAR). To treat descending aortic aneurysms, the Aortic Center at UH offers the staged and combined surgical-endovascular “elephant trunk”procedure. In addition, the center has surgical and stent-graft treatment options for type A and type B aortic dissections.

One hallmark of the new Aortic Center is its participation in clinical research. Appropriate patients treated for abdominal aortic aneurysm (AAA) or thoracic aortic aneurysm (TAA) with a Gore endovascular device are enrolled in the Global Registry for Endovascular Aortic Treatment (GREAT) registry, which is collecting 10 years of patient and device performance data. The Aortic Center at UH is also one of just 11 national sites participating in the Rehearsal clinical trial, a multicenter, randomized study to compare the performance of endovascular AAA procedures with and without prior rehearsal using a virtual procedure rehearsal studio. Select AAA patients at UH are also enrolled in the LEOPARD (Looking at EVAR Outcomes by Primary Analysis of Randomized Data) trial. This postmarket study aims to test which endovascular device approach is best for AAA patients – one that employs fixation of the endograft on the aortic bifurcation or one that relies on penetrating hooks and barbs for device fixation within the aorta.

Beyond surgical and endovascular approaches, the Aortic Center at UH provides medical therapies for vasculitis and nonatherosclerotic occlusive disease of the aorta and branches.

In addition, through the Center for Cardiovascular Genetics of UH Harrington Heart & Vascular Institute, the Aortic Center offers genetic evaluation and counseling for patients and families affected by Marfan’s syndrome and Loeys-Dietz syndrome and other aortopathies.

To refer a patient to the Aortic Center, call 216-844-3013. For emergency transfers, call 216-844-1111.

BRINGING SCIENTIFIC DISCOVERY TO PATIENT CARE

With Case Western Reserve University School of Medicine, physicians and clinical researchers at UH Cleveland Medical Center are leaders in their respective fields, and their ongoing clinical research programs push the boundaries of medical progress. Our strong emphasis on translational cardiovascular medicine and surgery means that newly developed drugs, treatments and medical advances transfer more rapidly from the research stage to actual patient care.

Current clinical trials include novel endovascular therapies for treatment of patients with resistant hypertension, aortic disease and occlusive disease; and trials for various stem cell therapies for patients with peripheral arterial disease.

For more information on active clinical trials, contact Stacey Mazzurco, RN, Director, Clinical Trials, at 216-844-3130 or Stacey.Mazzurco@UHhospitals.org.

TRANSCAROTID STENTING

Vascular surgeons at UH Cleveland Medical Center are participating in the ROADSTER trial of an investigational device used during transcarotid stenting. The investigational device, called the MICHI system and manufactured by Silk Road Medical, Inc., includes one sheath placed in the common carotid artery below the bifurcation and a second sheath placed in a femoral vein. The sheaths are connected to each other with a flow controller unit, which contains a 200-micron filter. When connected, the MICHI system reverses the flow of blood in the carotid artery. Any debris from stent deployment is caught in the filter before the blood is returned to the patient via the femoral venous sheath, minimizing the risk of embolization. In addition, all interventions, including guidewire traversal of the lesion and stent deployment, are done with robust flow reversal that carries any emboli away from the brain. Indicated for high-surgical-risk patients, the MICHI system received CE Mark approval in Europe in 2012 and recently received premarket U.S. FDA-approval. Preliminary results of the ROADSTER trial, presented at the 2014 Vascular Interventional Advances meeting and the 2015 International Symposium on Endovascular Therapy, showed a 30-day stroke rate of 1.4 percent – lower than that seen in the CREST trial and comparable to the stroke rate for standard-risk
patients as well as to outcomes from carotid endarterectomy.

OUR TEAM

For more information or to schedule an appointment, call 216-844-3800

ADDITIONAL REFERRAL AND OTHER INFORMATION

Download the Vascular Center brochure PDF