When Do You Refer A Patient For Vascular Intervention?

Desmond Bell, DPM, CWS

   When seeking out a vascular interventionalist, keep in mind a few last points. Not all interventionalists have the same level of training or skill set. In other words, not every interventionalist is comfortable going beyond the superficial femoral artery and below the knee in an attempt to “target the lesion.” Targeting the lesion involves identifying the location of an ulcer or gangrenous changes, and following the angiosome map of the lower extremity along with information obtained from an arteriogram or a magnetic resonance angiogram (MRA) that reveals the precise location of an occlusion. Interventionalists can subsequently use any of the technology and various devices available in an attempt to open the blocked artery.

   Finding such a partner in the quest for saving legs and lives may take some trial and error. The good news is that the endovascular device industry has become increasingly aware of the value of teaming podiatrists with vascular interventionalists, and have increasingly developed programs and sponsored educational meetings to introduce members from the respective professions.

   Organizations such as the Vascular Disease Foundation (http://vasculardisease.org/ ), the Society for Vascular Surgery (http://www.vascularweb.org/ ), the PAD Coalition (http://vasculardisease.org/padcoalition/ ) and the Save A Leg, Save A Life Foundation (http://savealegsavealife.org/ ) all can potentially assist podiatrists in locating interventionalists in their communities, and can help in facilitating better patient care and outcomes.

   Dr. Bell is a board certified wound specialist of the American Academy of Wound Management and a Fellow of the American College of Certified Wound Specialists. He is the founder of the “Save a Leg, Save a Life” Foundation, a multidisciplinary, non-profit organization dedicated to the reduction of lower extremity amputations and improving wound healing outcomes through evidence-based methodology and community outreach.


Being in home health definitely puts us in the frontlines. Thank you for your article.

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