Modern Vascular Quarterly Newsletter, Fall 2021

A Message from Yury Gampel, CEO of Modern Vascular

While preventing amputation using minimally invasive endovascular procedures remains our focus, we are ecstatic to announce that our menu of clinical services will increase significantly in 2022. As we launch new service lines and processes, the number of patients we are able to help continues to grow. Case studies, reviews, and testimonials about patients receiving treatment for peripheral artery disease, non-healing wounds, and knee pain have continued to make us proud to be a part of Modern Vascular. With the implementation of a nurse-guided walking program for PAD, patients are able to participate in their treatment while having an informed guide to customize their plan and manage their disease. With each of these services, in addition to our continued goal of amputation prevention, we aim to give our patients a gift: pain-free living or decreased pain. This is what started our journey and why we continue to expand our minimally-invasive vascular solutions.

Yury Gampel, CEO

Nurse-Guided Walking Program Launched; Extends Modern Vascular PAD Care to More Patients

Since only about 30% of Modern Vascular’s patients are recommended for a procedure during their initial evaluation (based on data from 2021), it is important to have a safe, effective way to help patients whose disease is not advanced enough to recommend an endovascular intervention. This includes lifestyle changes in many cases and a walking program. Unfortunately though, walking programs are often abandoned, or worse yet never started, as they can be too painful for a patient to push through when trying to follow a one-size-fits-all program. For this reason, Modern Vascular has launched a nurse-guided walking program in our Fairfax, Tucson, and Denver clinics, with registered nurse Brenda Liberato customizing the program for each participating patient, so it becomes more feasible. Most patients are started on 5 minute walks and given a booklet with an outline of their plan, which they can use to track their progress. Brenda may adjust recommended walk length, as decided during follow-up calls.

“In the month that I have been doing the program, I have gotten nothing but positive feedback from all the patients that I have spoken to. All of them have been very receptive about starting the program and are hopeful that this program will help alleviate some of their symptoms.” – Brenda Liberato, RN

Modern Vascular will expand the program to its Houston, Fort Worth, and both San Antonio clinics in December and hopes to extend our full footprint in early 2022.

Wound Care in Southaven

Since beginning wound care services in June, Modern Vascular in Southaven has had great success. Wound care coincides with Modern Vascular’s mission to eradicate lower limb amputation since 80% diabetes-related of amputations first show a non-healing ulcer according to the Journal of Vascular Surgery (February Supplement 2016). Jessica Brown, NP, has enjoyed her work in the wound care clinic. “I did wound care at the hospital for 8 years prior to becoming a nurse practitioner, so I was familiar with some of the patients that ended up coming to Modern Vascular. It used to be that they didn’t have anywhere to go and I’m so thankful to be the one to help them.” Her patients feel the same. In one patient’s testimonial, she says tearfully, “I can’t give enough stars to these ladies in this office. I can only give heartfelt gratitude for everything that they’ve done for me because I do believe that I would have probably lost an arm or lost a leg.”

Provided is a case study that shows Jessica Brown’s major successes.

Featured Case Overview

This particular patient was originally seen on 6/7/21 for Covid related wounds. She is a 72 y/o female who first noticed the ulcerations on 5/14/21 after they began as “bruises that oozed”. She was diagnosed with Covid-19 two weeks prior.

Her history is HTN, HLD, Depression, PAD, and Covid. She went to both the ER and urgent care who stated the ulcers were due to Covid and destruction of the tissues. She was started on Keflex PO and mupirocin to the wounds on 6/4/21. Wounds on arrival were necrotic and malodorous.

Cultures were also obtained on the first visit. Sharp debridement was performed weekly for the first 4 -6 weeks. She was started on Bactrim DS on 6/9/21 and wounds were dressed with silver alginate (decrease bacterial load) and legs wrapped with an ACE bandage. On 6/17/21 wounds were then dressed with triad hydrophilic paste (facilitate autolytic debridement) and xeroform. By 7/20/21 the Left anterior leg was healed. The remaining wounds were healed by 9/8/21.

Left Anterior Lower Leg

Left Leg After Wound Care Treatment — **Day 43 of Treatment**

Right Posterior Upper Arm

Left Posterior Upper Arm Before Image — **Day 1 of Treatment**

Upper Arm Wound Care After Day 58 — **Day 58 of Treatment**

View the Full Case Study

New Service Line: Vein Treatment

Modern Vascular is launching a new service line to treat venous insufficiency. Treatments offered include thermal ablation and non-thermal ablation, both of which are minimally invasive, non-surgical, and do not require general anesthesia or stitches. These services have been launched in our 4 Phoenix clinics – East Mesa, North Mesa, Glendale, and Surprise. Our goal is to offer venous procedures in all clinics by July 2022.

Kickstarting GAE Procedures

Modern Vascular has just begun performing Genicular Artery Embolization (GAE) procedures, which use embolization to reduce knee pain for patients with osteoarthritis. Because GAE is a safe, effective, and minimally-invasive procedure, it aligns with Modern Vascular’s purpose of providing minimally invasive vascular solutions. Provided is a case study featuring a Genicular Artery Embolization by Dr. Zagum Bhatti in Houston, TX. The service line was launched in Denver and Houston and is positioned to expand soon to Southaven, Fairfax, Phoenix, and our Memphis clinic upon its opening in early 2022.

Medial & Lateral Join Compartment — **Medial and lateral joint compartment OA.**

Nonselective angiogram — **Nonselective right leg angiogram at the level of the knee.**

Selective Angiogram Showing Synovial Hyperemia — **Selective angiogram from the inferior lateral genicular artery showing synovial hyperemia.**

Post embolism Hypervascularity Reduction — **Post embolization selective angiogram showing marked reduction of hypervascularity with preserved patency of the genicular artery.**

Featured Case Overview

A 58-year-old female presented to our clinic with complaints of chronic, worsening right knee pain. The pain mainly occurs along the lateral aspect of the knee and worsens with standing. She underwent bilateral knee arthroscopic surgery 10 years ago, without relief of right knee pain. She has received right knee intraarticular steroid and hyaluronic injections every six months for the past 2 years, which provided only transient relief. She has also tried physical therapy with limited results. Ultimately, she was offered total knee replacement which she declined. Detailed knee examination performed in our clinic revealed focal tenderness along the lateral knee joint. There was no evidence of other internal derangements. Right knee radiographs demonstrated medial and lateral compartment narrowing and mild osteophyte formation. Her WOMAC pain score was 78.

Ipsilateral antegrade common femoral artery access was obtained and a 5 French sheath was placed. A 5 French Berenstein catheter was advanced into the mid superficial femoral artery and angiography was performed. Given the patient’s symptoms were primarily along the lateral aspect of her knee, the superior lateral genicular artery was first selectively catheterized with a 2.4 Fr microcatheter and angiography performed. This showed no abnormal synovial perfusion. Next, the inferior lateral genicular artery was selectively catheterized with the microcatheter.

Angiography performed within this artery showed prominent hypervascularity of the synovium. The hyperemic synovium was then embolized with 0.5 cc of 100-300 um microspheres diluted in 10 cc of contrast. Post embolization angiogram showed satisfactory results with resolution of hypervascularity but the preservation of the inferior lateral genicular artery. Finally, super selection of the anterior tibial recurrent genicular artery was performed with angiography showing no synovial hyperemia.

The patient was seen in the clinic 1 week after her embolization. She reported a complete resolution of knee pain. Our clinic will follow up with her in 3 months and, subsequently, at 6-month intervals.

View the Full Case Study

Modern Vascular in the News

Modern Vascular Chief of Endovascular Surgery Dr. Scott Brannan Interviewed with KFNX 1100 AM Radio Program “Networking Arizona”

Phoenix, October 28, 2021 / Dr. Scott Brannan, Chief of Endovascular Surgery for Modern Vascular, did a radio interview with Carol Blonder for the program “Networking Arizona” on KFNX 1100 AM. He discusses peripheral arterial disease, what it is, who is most at risk, the symptoms, and what happens at a vascular evaluation. Dr. Brannan will be returning to “Networking Arizona” as a guest again on December 13th, 2021.

Listen to the radio interview

Dr. Jeffrey Martinez Interviewed on NBC News 4 San Antonio for Peripheral Artery Disease Awareness Month

San Antonio, September 28, 2021 / Dr. Jeffrey Martinez, the managing physician for Modern Vascular San Antonio, is interviewed on WAOI NBC News Channel 4 San Antonio for their San Antonio Living Segment. He speaks to Rebecca Sanchez about Peripheral Artery Disease for PAD Awareness Month. The prevalence of PAD in the population is about 10 – 15% and as the population gets close to 70 it can get up to 20%. It is important to get PAD treated to prevent any complications.

Watch the video on NBC News 4 San Antonio

Dr. Juan Carlos Correa Featured Speaker at Kansas Podiatric Medical Association Fall 2021 Meeting in Kansas City

Kansas City, October 1, 2021 / Dr. Juan Carlos Correa, Board Certified Vascular Surgeon and the Managing Physician for Modern Vascular in Kansas City, was a featured speaker at the KPMA 2021 Fall Meeting. His presentation was entitled “The Future is Here: Below the Ankle Endovascular Interventions.”

See the event on the KPMA website

Dr. Samuel Putnam Featured on the FOX31 Denver Program “Colorado Health Matters”

Denver, October 17, 2021 / Dr. Samuel Putnam, MD, FSIR, the managing physician for Modern Vascular in Denver, was interviewed by Tom Parkin for the program “Colorado Health Matters”. The show plays every Sunday morning exclusively on Fox31 Denver News.

Watch the video interview

Modern Vascular Celebrates Continued Growth with Two New Midwest Clinics

Modern Vascular in St. Louis Ribbon-Cutting Ceremony

Dr. Wande Pratt leads Modern Vascular’s new clinic in St. Louis, MO. Dr. Pratt is board-certified vascular surgeon. Dr. Pratt assisted Modern Vascular clinics in Southaven and Fort Worth before finding his forever-home in St. Louis.

Modern Vascular in Kansas City Opening Ribbon-Cutting Ceremony

Modern Vascular’s clinic in Kansas City (located in Overland Park) is led by Dr. Juan Carlos Correa, a board-certified vascular surgeon with extensive expertise in treating complex arterial disease.

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