Live Webchat Transcript: Diseases of the Blood Vessels
June 13, 2007
Heather Gornik, MD
Miller Family Heart & Vascular Institute at Cleveland Clinic
Staff Physician
Medical Director of the Non-Invasive Vascular Laboratory.
More information:
Cleveland_Clinic_Host: Welcome Dr. Gornik and thank you for being with us today. Let's begin!
Speaker_-_Dr__Gornik: Thank you for having me. It is a pleasure to be here. Let's get started.
Screening tests
johnnyk: I heard there is a test you should have to make sure you don't die from a stroke or aneurysm. What are those tests that you should have. I think I read about it in the paper but I can't find the article.
Speaker_-_Dr__Gornik: There has been much press recently about different vascular screening tests, but if you look at the actual published guidelines from the professional medical societies, there are only a few tests that are definitely recommended to screen for vascular disease. Certain patients should be screened for abdominal aortic aneurysm with an ultrasound test. Patients with leg symptoms or risk factors for peripheral arterial disease (PAD) should have a simple test to measure blood pressures in the arms and legs. This test is called the ankle-brachial index (ABI) test. Some patients should undergo a carotid ultrasound study to look for blocked carotid arteries. ALL patients should be screened for high blood pressure --- which is a leading, treatable cause of stroke in the United States. In addition to blood pressure screening, ask your internist or family doctor if you should be screened for any other vascular disorders
Restenosis
greatmema1: July 2001--I had an angioplasty followed by a left abdominal stent. Both procedures were at MCO . This past year I have experienced the all familiar pain in my lower extremities. Any suggestions as to why? Is extreme stress a factor. Better question what can I do besides the walking that I do now to help myself. No medical insurance yet. I'm on my own. A million thanks to you for being here.
Speaker_-_Dr__Gornik: Without knowing the details of your stenting procedure, it is a bit difficult to answer your questions. It sounds as if the leg pains you experienced before the stent may have returned. It is possible that the stent has narrowed over time. This is uncommon for stents placed in the abdomen, but can happen in ~ 20% of cases. Extreme stress is not known to be a risk factor for stent occlusion. There are technical issues that can increase the risk of stent occlusion. Tobacco smoking has also been shown to increase the likelihood of stent occlusion down the road. It sounds like you should be re-evaluated by your vascular specialist soon to reassess the status of your stents. As for exercise, walking exercise can definitely help treat vascular leg pains, or claudication, and this is one of the most beneficial things you can do. I would recommend walking for at least 30 minutes at least 5 days of the week. You should walk until you feel you can’t walk much further, rest until the pain subsides, and then resume walking. The goal is go get your total walking time (not the rest periods) up to 30 minutes. Good luck to you
Exercise
ashgrtlaw: Exercise parameters i.e. beats per minute maximum recommendations, for AAA patients (4.2 cm) ?
Speaker_-_Dr__Gornik: This is a very good question. Unfortunately, there is very little information in the published medical literature. A 4.2 centimeter abdominal aortic aneurysm is considered a small aneurysm. From what safety information we have available, moderate aerobic exercise is generally safe. This would include walking, cycling, swimming, aerobic dance, tennis, golf, etc. In general, your heart rate during an exercise session should be kept in between 65-85% of the maximal predicted heart rate for your age. To calculate your maximum heart rate, subtract your age from 220. If you were 60 years old, your maximum heart rate would be 160 beats per minute. 65-85% target range would be around 104-136 beats per minute. In general, I would avoid heavy lifting, such as weight lifting for patients with aneurysm disease. As always, consult with your physician before beginning an exercise program
angel: What are the typical recommendations for a PAD walking program? Should I see a physical therapist to help me get started on a walking program?
Speaker_-_Dr__Gornik: Fantastic question. There are special supervised rehabilitation programs for exercise training for PAD. These programs are not widely available, but we do have a wonderful program here at the Cleveland Clinic. If a program is not available in your area, you may want to contact a cardiac rehabilitation center to see if you can have a one time exercise consultation to design a program for PAD. In general, exercise training most effective for PAD is walking to near maximal pain, stopping to rest, and resuming walking. These walk-rest cycles are repeated over and over again until the total walking time is 30 minutes or more.
Research and clinical trials
lilybean15: For Dr. Gornik: I understand that current clinical trials are examining the use of HIF for PAD?
Speaker_-_Dr__Gornik: Thank you for your question. HIF is hypoxia inducible factor. It is a factor that is felt to regulate growth of new blood vessels or angiogenesis. There is one large clinical trial investigating the use of HIF for peripheral arterial disease - PAD. We, at the Cleveland CLinic are very excited to be a site for this research. For additional information, please contact our Vascular Research Line at 216-445-4522.
bob: Are there any clinical trials for angiogenesis for the arteries in the legs?
Speaker_-_Dr__Gornik: Yes. There are a handful of angiogenesis trials ongoing in the United States. We are involved in one here at The Cleveland Clinic. For those in the audience who are not familiar with the term, angiogenesis means “growing of new blood vessels”. For more information on the angiogenesis trial at The Cleveland Clinic, please contact our vascular research line at 216-445-4522.
dickran: I am a 49 yo male w hx of IWMI 20 yrs ago, in 1997 has CABG. Still have chronic stable angina. Only a modified cabg could be done due to aorta calcification. Lat cath in Jan 07 shows al native vessels closed and only LIMA to LAD open. Are there any meaningful angiogenisis treatments available?
Speaker_-_Dr__Gornik: I am involved in research related to angiogenesis for peripheral arterial disease. I am afraid I do not know the current status of research trials for angiogenesis for severe coronary artery disease. I would suggest you log on to http://www.clinicaltrials.gov and search by key word "angiogenesis" for current trials for patients with severe coronary artery disease. Good luck to you.
Arteriovenous fistula
KARENP: My doctor said I have a arteriovenous fistula. What is that? Is it dangerous? Do I need it treated?
Speaker_-_Dr__Gornik: In general AV fistula are not life threatening or dangerous. Arteriovenous fistulas (AV fistula) are areas of abnormal communication between an artery and a vein (or multiple arteries and veins). There are 2 types: the first type is the congenital type which people are born with. The second type occurs as a result of trauma to the blood vessels. Generally the result of an invasive procedure, such as a heart catheterization, where catheters were placed in the arteries and veins. Most AV fistulas are entirely asymptomatic and are only diagnosed when a doctor may hear a swishing sound over the blood vessels or during an imaging test, such as an ultrasound, performed for another reason. In some cases, AV fistulas can cause swelling and pain in the limb and in rare cases can cause stress on the heart and congestive heart failure. In most cases when there are no symptoms due to the AV fistula, they require no further treatment and often heal on their own. In cases of large AV fistulas that are causing severe symptoms, surgical or catheter-based repair options are available.
Leg swelling
deedo12: I have had swelling in my lower legs for sometime and I have had all the test which come back negative. Also I have heart disease and all the test for that have come back negative. Don't know what else to do.
Speaker_-_Dr__Gornik: It sounds as if you might benefit from an evaluation by a vascular specialist. As you know, many things can cause leg swelling and there are some new technologies available to pinpoint a cause of leg swelling when other tests, such as ultrasound to rule out a blood clot, have been negative. Here at the Cleveland Clinic, we have physicians who are both heart and vascular specialists who would be able to use these new technologies to help figure out what is causing your leg swelling. Compression stockings might be helpful for swelling, regardless of the cause. Ask your doctor if you should be referred to a specialist
Leg arteries, varicose veins, and spider veins
marybh : I have had sclerotherapy for Varicose veins on my leg on 2 separate occasions. After several years, I have more. How often can I have this done without comprising the circulation in my legs? Is is time for one of those Ablations procedures? I heard of the Elvis procedure, and the closure procedure. Would these be more effective?
Speaker_-_Dr__Gornik: How often sclerotherapy can be performed depends on the number and the size of the veins that were treated. Certainly after several years, it is generally not a problem to undergo additional treatment. The ablation and endovascular laser therapy procedures that you describe are generally reserved for the treatment of much larger varicose veins. I would recommend seeing a vein specialist in your area. Our vascular medicine clinic includes a special program in sclerotherapy - you can contact us for appointments.
southernlady: I have plaque in the arteries of my legs? Is that hardening of the arteries? Can diet take care of that? I don't want to take medications if I don't have to
Speaker_-_Dr__Gornik: All patients with atherosclerosis in the legs should generally be treated very aggressive, because atherosclerosis is generally a process that is present head-to-toe. For most of my patients with atherosclerosis and plaque in the leg arteries (PAD), I treat them with multiple medications, including blood pressure lowing medicine, statin drugs to keep the cholesterol low, and aspirin. Diet can help, but unfortunately is not enough. Multiple research studies, enrolling tens of thousands of patients, have now shown that this aggressive medical therapy can prevent heart attack, stroke, and prolong the lives of patients with atherosclerosis or clogged arteries. I know that few people like to take medications --- but in the case of PAD, medications can prolong your life. Talk to you doctor about your atherosclerosis (hardening of the arteries)
kathrynt: What is the difference between varicose veins and spider veins? If I want to get rid of bulging veins what is the best treatment - seems like there are a lot of type of ways to treat. Is there anything like a cream that will help?
Speaker_-_Dr__Gornik: Spider veins are a certain type of varicose vein. In fact, they are the smallest varicose veins that generally look like tiny spider’s legs. The most important thing for you to do if you have varicose veins of any size is wear prescription compression stockings to decrease leg swelling and help with the high pressures in your legs when you are standing for long periods of time. Your doctor should be able to prescribe these. To my knowledge, there are no creams that can eliminate spider veins or other varicose veins. Some cosmetics might be able to make the veins less prominent by coloring the skin (for example, a concealer or bronzer). There are a number of new treatments available to treat veins of all sizes, including the smaller spider veins and the bigger ropey varicose veins that you describe.
jj33: I have varicose and spider veins. The left leg is worse than the right and hurts all the time. My doctor said the valves in my legs are "shot". Can the valves in the legs be repaired or replaced with surgery?
Speaker_-_Dr__Gornik: Unfortunately, repair or replacement of venous valves is something that has not yet “panned out” as an effective treatment for venous insufficiency and has only been done on a research basis. Fortunately, there are other treatments available for spider and varicose veins using lasers or high frequency energy to ablate (or essentially eliminate) the vein. Some procedures are also performed to inject a material into the varicose vein or spider vein which causes it to clot off and eventually nearly disappear. Ask your doctor to refer you to a vein specialist for a full discussion of your treatment options. Certainly for all patients with varicose veins, wearing prescription strength elastic compression stockings is very important and can greatly relief symptoms.
mayhill: I have been told I have a totally occluded artery in my leg. They said there are some hospitals that have devices for this type of occlusion. I looked on the internet and saw these names. Do you use the Silver–Hawk, the Frontrunner, Foxhollow, SafeCross Wire device, or some other system? How do you choose? How effective are they?
Speaker_-_Dr__Gornik: Our vascular specialists use a number of cutting edge technologies, some of which you mention, to open totally-occluded blood vessels in the legs. The specific type of device used depends on the location, length, and other features of the blockage. Contact us to arrange for consultation.
Raynaud’s phenomenon
carolmay: My fingers turn blue sometimes. Why does that happen? My hands and feet are cold. Is that bad? Should I see my doctor?
Speaker_-_Dr__Gornik: It sounds as if you may have Raynaud’s phenomenon, which is spasm of the small blood vessels in the hands and feet which causes discoloration and coolness. In general, this is a benign condition, and is very common among younger and middle aged women. In rare cases, the Raynaud’s can be a sign of an underlying arthritis-like disorder. In these more severe cases, the discoloration of the hands is very severe, is present all the time, and results in sores in the fingers and toes. I would discuss this condition with your doctor. The first treatment for Raynaud’s is generally very simple --- keeping the hands and feet and rest of the body warm and avoiding triggers. Simple interventions such as wearing gloves when going into the frozen food aisle of the grocery store and wearing a sweater at work when the air conditioning is very high can be helpful.
Foot ulcers and pressure sores
writerC: How can I prevent a foot ulcer if I have diabetes? What should I do if I develop a foot ulcer?
Speaker_-_Dr__Gornik: Most importantly, you need to work with your doctor on careful control of your blood sugar. Meticulous foot care is very important for diabetic patients. This includes washing the feet daily, applying a moisturizer or cream to the feet (avoiding the spaces in between the toes), inspecting the feet daily for sores, and wearing appropriately fitting shoes. Some medicare patients with diabetes may qualify for special diabetic footwear. Ask your doctor about this.
Speaker_-_Dr__Gornik: If you notice a sore on your foot, you should contact your physician as soon as possible for further instructions. Diabetic patients with PAD have double the risk of getting into trouble with foot ulcers and risk of amputation. If you have any specific concerns regarding your feet, ask your doctor if you should be evaluated by a podiatrist.
mbhmay: I have a 2 inch wound on my lower leg from a pressure blister I had from an ankle brace. It just won't go away. I am not diabetic, and my doctor has prescribed a wet to dry daily dressing. It seems better, but it is so slow to heal. It's not infected he said. What is the best treatment. I hear about oxygen being used, or even a type of pump. What is that?
Speaker_-_Dr__Gornik: It sounds as if you would benefit from evaluation in a specialized wound clinic. We do have a full service lower extremity wound clinic in our vascular medicine program. If you are not in the area, ask your family physician if you should be evaluated by a wound specialist. It sounds as if you may need additional treatment aside from dressing changes.
Coronary artery disease and peripheral vascular disease
fiddleplayer: I have a ccs of 2160. I am soon to have a heart cath procedure after an abnormal echo stress test. In your opinion, what is the per cent blockage that should be present in an artery before a stent is placed, also do you have an upper limit on the number of stents before you consider by-pass a better option? I will appreciate any observations and suggestions.
Speaker_-_Dr__Gornik: Another good question, and perhaps one a bit off topic. In general, coronary interventions are not performed for narrowing of less than 50% of the diameter of the vessel, and are generally reserved for much more severe narrowing (e.g., 60%+ blocked). For patients with one or two narrowings, the decision to perform angioplasty and stenting is generally straight forward. The more blockages that are present --- in more coronary vessels --- makes the decision making for difficult. Factors which would favor coronary artery bypass would include --- multiple narrowings in multiple coronary vessels, reduced heart muscle function (ejection fraction), the presence of diabetes mellitus, and the location of narrowings in certain areas that are better treated with open heart surgery (such as in the left main coronary artery). Each case of multi-vessel coronary artery disease requires an individualized weighing of the options.
camden: If you have clogged arteries in your legs - is it also in your heart?
Speaker_-_Dr__Gornik: Absolutely. Up to 60-80% of patients with clogged leg arteries have a significant blockage of at least one heart (coronary) artery. More importantly, having clogged arteries in the legs is a major risk factor for stroke and heart attack. That’s why all patients with clogged arteries in the legs need to be treated with the same aggressive preventive therapies that are given to patients who have clogged heart arteries, such as aspirin or other antiplatelet medications, cholesterol lowing medications (statins), and blood pressure lowing medications
Carotid artery disease
danielm: my dad has 100% blockage in his carotid artery but his doctor said he can't do anything. I am scared he will have a stroke. Isn't there anything you can do?
Speaker_-_Dr__Gornik: A carotid artery that is entirely blocked generally does not cause stroke. There are no good treatment options for opening an entirely blocked carotid artery. The good news is that he seems to have tolerated the blockage fine up to this point, and we would not expect symptoms from this total blockage at this time. What is most important is a program of surveillance to make sure there are no blockages developing in the carotid artery on the other side of the neck. In addition, your dad needs to be on very aggressive medical therapy to prevent all vascular events --- including stroke and heart attack. He needs to have good blood pressure control, aggressive treatment for his cholesterol, and should be on an anti-platelet agent (such as aspirin). Talk to you dad’s doctor about your concerns.
toppycat: 100% blocked right carotid artery. Can this be opened with a special device and without a stent?
Speaker_-_Dr__Gornik: Please see the prior response to a similar question. Carotid arteries that are entirely occluded are generally not reopened by any means.
Renal artery stenosis
kansascity: I have high blood pressure. I am young. My doctor said I have renal artery stenosis. I think that is related to the kidney. why would that affect my blood pressure. Is there a special doctor that treats that? Can I get a stent to open it up?
Speaker_-_Dr__Gornik: Renal artery stenosis is a narrowed kidney artery which results in release of certain hormones that cause high blood pressure. There are treatments available to treat the kidney artery narrowings, and this may help with your blood pressure. In many cases, however, patients still need some blood pressure lowering medication after the stent is placed --- but the blood pressure is better controlled. You need to see a vascular specialist with expertise in doing catheter-based procedures (i.e., angioplasty and stenting). This vascular specialist may be a vascular surgeon, a cardiologist, an interventional radiologist, or a specially treated vascular internist. Good luck
Non-surgical treatments for peripheral arterial disease
lilybean15: Please describe any new non-surgical treatments for intermittent claudication.
Speaker_-_Dr__Gornik: Another good question. There has been a recent explosion of minimally-invasive, catheter based treatments to open blocked arteries in the legs with balloons and stents. There are also some new advances in medical therapy for PAD, and this is an active area of research here at the Cleveland Clinic.
margaretMom: I have peripheral vascular disease. The veins or arteries in my legs are blocked with plague. Is that something that needs to be treated with surgery. I don't want big scars on my legs. Any other treatments?
Speaker_-_Dr__Gornik: Peripheral vascular disease is a broad term that refers to disorders of any blood vessels of the body. It sounds as if you may have PAD, or peripheral arterial disease, with clogged leg arteries. As previously discussed, medical therapy and exercise is generally the initial treatment for PAD. If this fails, more aggressive options are available including surgery, which would result in some scars, and the newer catheter based techniques of balloon angioplasty and stenting. You should be evaluated by a vascular specialist who is able to present the whole range of treatment options. We would be happy to see you in our vascular medicine program here at the Cleveland Clinic.
henryk: I have a blockage in the artery in my leg. How is that treated? Do I need to have surgery or are there other ways to treat leg blockage?
Speaker_-_Dr__Gornik: First of all, it depends on if you have symptoms. If you do not have leg pain when you walk, there is no need to do anything aggressive to treat the blockage in your legs. If you do have leg pain with walking, the first line therapy is generally a walking program and a trial of medication. There are 2 medications medically available to treat peripheral arterial disease (PAD), which your doctor can prescribe. Only in cases when medical therapy and exercise fail is there a need to consider more aggressive therapy. There are both surgical and catheter-based (balloon and stent) options to treat blocked leg arteries. It is very important that all patients with blocked arteries realize that they may have atherosclerosis in the coronary arteries and the arteries to the brain. It is very important that all patients with PAD have aggressive treatment of blood pressure, cholesterol, blood sugar, and be treated with anti-platelet therapy if appropriate (such as aspirin).
kaykay: We are interested in knowing if there are any new/cutting edge treatments for PVD as they relate to non invasive measures or options for pain management.
Speaker_-_Dr__Gornik: There are a number of research studies ongoing in the field of PAD, and we are participating in a number of these studies here at The Cleveland Clinic. For more information on PAD research, please contact our vascular research line at 216-445-4522. If you leave a detailed message that you are interested in PAD trials, someone will return your call promptly.
DVT
charlieo: I have a friend that has a DVt. Right now he has a dvt in his leg. He has had them before and was on coumadin. What should he be doing? Is there anything you can do to prevent them? How do you treat a dvt?
Speaker_-_Dr__Gornik: For the sake of the other audience members, DVT is a deep vein thrombosis, or a blood clot in a deep vein of the arms or legs. The legs are the most common site for DVT. Blood thinners, such as coumadin, are generally the first line treatment for DVT. I would be concerned about the fact that he has had multiple blood clots, and I do think he should talk to his doctor about whether he may have a predisposition to clotting or a clotting disorder. It is also important that patients with a blood clot in the legs wear prescription elastic compression stockings which can help prevent damage to the valves of the veins of the legs and problems with varicose veins and sores in the legs down the road. In general, blood clots can be prevented by leading an active lifestyle, maintaining normal body weight, possibly by eating a healthy diet (research is ongoing in this area), and most importantly being aware of high risk situations for a blood clot. High risk situations for DVT include: major surgery, orthopedic injury or trauma, being bed bound for a major medical illness, pregnancy, and cancer.
AVM -arterio-venous malformation
tomt: What is an AVM? Can someone die if they have an AVM? My friend was just diagnosed. Is there something I should tell him that would help him? He is scared.
Speaker_-_Dr__Gornik: An AVM is an arterio-venous malformation, which is a tangle of abnormal blood vessels that allow for a direct communication between arteries and veins. People are generally born with AVMs. The symptoms of the AVM depend on the location. Some are benign and may just cause a very prominent birthmark on the limbs or trunk. Other AVMs can be more serious, particularly AVMs in the brain. I would suggest that your friend ask his doctor to be referred to a specialized center in your area with expertise in AVMs to make sure that he is receiving the most up-to-date care.
Medication allergies
Karen: I am allergic to or have intolerable side effects from almost all the usual employed anti hypertensive medications. To name some of the medications Aldomet, hydralazine, Catapres, Inderal in various dosage regimens, hydrochlorthiazide, Hygroten, Dyazide, Aldoctane, and Aldoctezide and of course appropriate potassium replacement when hydrochlorthiazide has been used. In 1985 FDA approved VASOTEC manufactured by MERCK pharmacal in White House Station New Jersey USA---VASOTEC was " My Miracle" medication from 1985 until May 2007 when BIOVAIL who manufactures VASOTEC for Merck relocated the manufacturing site to Cramlington UK-----UK not only changed the shape of VASOTEC they have changed " OTHER INGREDIENTS " I am having allergic intolerable side effects starting over again---my doctor provided BENICAR and my system is again allergic to and having intolerable side effects. Thank You for the Chat !
Speaker_-_Dr__Gornik: I am sorry you have had such a rough time with your medications. As you know, treatment of high blood pressure is critical to prevent stroke, heart failure, and even death. I suggest you work with your doctor or even a hypertension specialist to find a combination of medications that you can tolerate
Inflammation of the blood vessels - arteritis
brenda: what kind of doctor treats inflammation of the blood vessels. My dad has this. Are there pills you can take for that?
Speaker_-_Dr__Gornik: I believe you are referring to arteritis, or inflammation of the blood vessel wall. In general, these disorders are treated by rheumatologists, but some vascular specialists also take care of these patients. Arteritis is generally treated with medications that suppress the immune system, such as steroids and other agents.
Vascular surgery
PAgirl: If my dad has blocked arteries in his legs and neck, can they operate on both at the same time?
Speaker_-_Dr__Gornik: In general carotid and lower extremity procedures are done in a staged fashion, that is one part of the body at a time with a recovery period of a number of weeks in between. In general, the part of the body that is causing the more severe symptoms will be addressed first.
margiek: I had several bypasses in my legs and they keep clogging. ARe there artificial arteries they can use if those close up again?
Speaker_-_Dr__Gornik: Unfortunately, artificial arteries have even worse outcomes that the vein material that is used for most bypasses, although there are artificial materials (such as Gortex) available for bypass grafts. Hopefully you are not smoking cigarettes — if so, you should quit — cigarette smoking is a significant risk factor for bypass grafts clogging.
Peripheral arterial disease symptoms and treatments
kevin: What is a symptoms of a blocked artery. If you have a blocked artery could you have pain in the groin when you walk?
Speaker_-_Dr__Gornik: Great question. Blocked arteries in the legs can present in many ways. There can be pain in the buttocks, hips, groins, thighs, or calves with walking. There could be a non-healing sore on the feet or toes. Erectile dysfunction can be a symptom of blocked arteries to the lower extremities too, believe it or not. Finally, many patients with blocked leg arteries have no symptoms at all and can only be diagnosed by a doctor’s examination or with the ankle-brachial index (ABI) test
lilybean15: Please discuss briefly new treatments for PAD. Thank you.
Speaker_-_Dr__Gornik: Thanks for your question. This has been a recurring theme this hour. PAD is a very common and under-recognized disorder. Up to 12 million Americans have PAD, and many of them do not know they have it. As we have discussed, there are many options for treatment of PAD. Exercise and medications are generally the first step. Surgery and catheter-based procedures are additional options, and there is a lot of exciting research going on to discover new treatments.
Speaker_-_Dr__Gornik: A vascular specialist can help you navigate these options and decide which is best for your symptoms. For more information about PAD, visit the NIH-sponsored website. We also have information about PAD on our website, - and you can get information through our webmail and chat with a nurse features on the website.
Lymphedema
jellybean: I was diagnosed with lymphedema in my legs. I had wrappings. I have pain in my legs and feet. I wonder if there are other treatments.
Speaker_-_Dr__Gornik: There are some other treatments available for lymphedema. It sounds as if you have had compression therapy. If you have not done so already, therapeutic massage (known as manual lymphatic drainage/complete decongestive physiotherapy) can also be very beneficial in reducing the swelling. There are also electronic compression pumps that are available for home use. Unfortunately, in 2007, this is the best we have to treat this challenging disorder.
Calciphylaxis
sistersue: My sister was diagnosed with Calciphylaxis 3 years ago. It has progressed until she is in extreme pain and in fear of losing her legs. What kind of treatment is available for her.
Speaker_-_Dr__Gornik: I am sorry to hear your sister is having such a difficult time. As you know, calciphylaxis is a rare disorder. Treatment is generally focused on lowering calcium and phosphate levels in the blood and care of wounds. There are newer and experimental treatments available, but I fear this is not my area of expertise. I would direct you to the specialty care of a nephrologist or rheumatologist for additional treatment
Cleveland_Clinic_Host: I'm sorry to say that our time with Dr. Heather Gornik is up. Dr. Gornik thank you again for taking the time to answer our questions today.
Speaker_-_Dr__Gornik: It has been a pleasure to be here. The questions were fantastic, and I appreciate the interest in learning more about vascular
Technology for web chats paid in part by an educational grant from AT&T Ohio and the AT&T Foundation (formerly SBC).
© Copyright 1995-2009 The Cleveland Clinic Foundation. All rights reserved. rev. 6/07
