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Timely vascular disease treatment can salvage limbs, says expert

Article-Timely vascular disease treatment can salvage limbs, says expert

Image via Canva Pro blood vessels
A hybrid operating room is key to performing both open surgery and minimally invasive endovascular procedures simultaneously to curb amputation.

Vascular diseases encompass a wide range of conditions that affect the circulatory system, including arteries, veins, and lymph vessels. These diseases pose significant health risks and require specialised treatment to ensure optimal outcomes for patients.  

Dr. Houssam Younes, Department Chair of Vascular Surgery at the Heart, Vascular and Thoracic Institute of Cleveland Clinic Abu Dhabi, says that vascular diseases can affect different parts of the body, including the arteries, veins, and blood vessels. Some common conditions include peripheral artery disease, carotid artery issues, venous disease, blood clots, aortic aneurysm, fibromuscular dysplasia (FMD), lymphedema, and vasculitis. 

Dr. Younes explains: “Vascular disease encompasses a broad spectrum of conditions that affect blood circulation. It is crucial to understand each disease's unique characteristics to ensure accurate diagnosis and effective treatment.” 

Dr. Houssam Younes, Department Chair of Vascular Surgery

Dr. Houssam Younes, Department Chair of Vascular Surgery at the Heart, Vascular and Thoracic Institute of Cleveland Clinic Abu Dhabi


Peripheral artery disease occurs when arteries outside the heart develop atherosclerosis, a condition characterised by the build-up of plaque inside the blood vessels. This narrowing of the arteries leads to reduced blood flow and potential tissue ischemia. Venous disease, on the other hand, affects the veins and can cause symptoms such as swelling, pain, and the formation of blood clots. Blood clots can have serious consequences, including deep vein thrombosis and pulmonary embolism. 

He also says that aortic aneurysm, an abnormal bulge in the aorta, poses a significant risk to patients. Fibromuscular dysplasia (FMD) is a rare condition that causes abnormal cellular growth in the medium and large arteries, leading to narrowing, aneurysms, or tears. Lymphoedema occurs when there is an abnormal buildup of fluid due to damage or removal of lymph vessels or nodes. Vasculitis, the inflammation of blood vessels, can also contribute to the development of aneurysms. 

Several factors increase the risk of developing vascular diseases. These include smoking, high cholesterol, high blood pressure, diabetes, and genetic predisposition. Dr. Younes emphasises: “It is essential for individuals to adopt healthier lifestyles, including regular exercise and a balanced diet, to prevent the onset of vascular diseases. Early detection and management of underlying risk factors are crucial.” 

Healthcare providers such as Cleveland Clinic Abu Dhabi employ innovative surgical techniques and clinical first treatment methods to deliver exceptional patient care. “Cleveland Clinic Abu Dhabi has a unique set-up of a hybrid operating room that enables us to perform both open surgery and minimally invasive endovascular procedures simultaneously.” 

The multidisciplinary approach plays a vital role in their limb salvage programme that aims to treat patients with diabetic foot and critical limb ischemia with the objective of saving limbs from amputation or minimising the extent of amputation if necessary.  

As of 2021, 11.8 per cent of people between the ages of 20 and 79 in the UAE were affected by diabetes.  

“A very common complication of diabetes mellitus is developing foot wounds and blockage in blood vessels causing gangrene with sequela of amputation,” he says, adding that major amputation causes economic burden due to disability requiring long rehabilitation and expensive prosthesis and diminishing quality of life and life expectancy of affected patients.  

Dr. Younes adds that with the growing diabetes foot prevalence, Cleveland Clinic Abu Dhabi established a comprehensive multidisciplinary centre in 2019. “Within a year of launch of the limb salvage programme, the hospital was able to triple the number of patients who were treated and was able to reduce the amputation rate in the patients by 50 per cent,” he notes. 

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