The Story Behind the Vascular Institute: An Amputation Prevention Center

Navigating the medical system for patients and families is a daunting task filled with many uncertainties and challenges. When problems are severe, seeking specialty care can be a complicated process requiring distance travel and prolonged waits for the initial encounter. Evaluating all medical conditions requires a triage process, a medical evaluation to diagnose the problem, and a treatment plan that needs to be carried out. “What I realized was there had to be a better way to speed up the care for patients and create a better system. It is unreasonable for patients to wait a 4–6-week period for an appointment with a vascular specialist, and ‘finding a better way’ is a core belief at VIC,” said Dr. Chris LeSar.

Vascular Institute was developed in late 2015 with a specific plan to care for patients differently, having a mission to prevent unnecessary amputations for the region, and provide state-of-the-art vascular care. The practice made the commitment for easy access to care, focusing on what was in the patient’s best interest, how the patient would be treated, and how to triage, evaluate, and treat vascular problems in a timely manner without exception.

This lofty goal was not a task that one person alone could accomplish; it could only be achieved with a strong team dedicated to their patients, with love and a passion for vascular care. By November of 2016, the doors were open, and Vascular Institute began greeting patients with our new paradigm for this practice for the greater Chattanooga region. No longer would patients wait weeks for an appointment, but a planned approach to care was laid out for every patient encounter, ensuring that they were the priority for us.

Today, over 22.3 million Americans suffer from Peripheral Arterial Disease (PAD) or blocked arteries, which causes over 185,000 amputations to be performed in the United States each year. Additionally, there is a regional disparity, with 40% of these surgeries occurring in the Southern states. This region needed a team with the knowledge, passion, and dedication to eliminate unnecessary amputations. Access to care at VIC encompasses a rapid triage approach. Within three days, patients see one of our providers, undergo a diagnostic ultrasound test, and if appropriate interventional and surgical therapy is needed, it can be performed at either our Chattanooga or Cleveland outpatient surgical centers or the regional hospitals.

Many patients present with painful walking as their primary symptom. However, 40% of patients diagnosed with PAD have an asymptomatic presentation or blame their leg issues on something other than PAD. The bottom line—PAD puts patients at a greater risk for heart attack, stroke, and limb loss. A simple ankle-brachial blood pressure test can be performed, which is the first key in detecting disease. If the diagnosis of PAD is made, then a medical treatment plan can be put into place to reduce further damage to the arteries. Leg amputations can be prevented with combined support from primary care, podiatry, wound care centers, and the VIC team. Aggressive medical management and appropriate interventional or surgical care, along with patient risk factor modification and lifestyle changes have allowed for a 97.4%, 60-day, and 93%, 5-year limb salvage rate at VIC. Vascular Institute

Lifestyle Changes: has set its goal • Quit Smoking to be a leader for comprehensive arterial • Manage Diabetes and venous vascular • Control Blood Pressure care. We approach our • Reduce Cholesterol patients as a team, which allows us to • Eat a Healthy Diet assess them quickly, • Exercise Regularly perform diagnostic • Establish Primary Care ultrasounds the same day, and offer an initial visit with a provider to discuss their issue. Patients want to be treated well and in as few visits as possible. If you or a loved one are at risk for a blood FLOW problem— Feeling of pain in the legs, Loss of sensation in the legs or feet, Open sores that won’t heal, or Weakness with walking—be evaluated by your doctor.

The Vascular Institute has embraced the Cleveland community and we are so grateful for the support we have received since establishing our office three years ago. We now have expanded our facilities to include an outpatient interventional surgical suite, giving the patient a choice on where they would like to be seen and treated. VIC is community-focused as part of our core beliefs and principles. Through the partnership with the Hamilton County Medical Society/Foundation, we have been able to help patients affected with critical limb disease throughout the Greater Chattanooga Area. The Critical Limb Fund is available for patients without financial means to access care, to receive the treatment they need to save their legs and continue to live their lives to their fullest capacity.

Our team has grown from the initial three staff members to three Board Certified Vascular Surgeons and ten Nurse Practitioners, with a staff of just about 100 employees. We currently have four offices, and in 2022 will be opening our 5th office to continue serving the patients in this region. The VIC vascular team will continue to promote our objectives of bringing victory over amputations and delivering state-ofthe-art vascular care to this region. This amazing team-based approach to care allows us to offer hope to so many people, and deliver the care patients need in a compassionate and loving environment. These are not just patients we treat, they become our family!