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  1. 1. Vascular Disease <ul><li>William R. Flinn, MD </li></ul><ul><li>Professor, Department of Surgery, and Chief, Division of Vascular Surgery </li></ul><ul><li>University of Maryland </li></ul><ul><li>School of Medicine </li></ul>
  2. 2. Cardiovascular Disease <ul><li>The #1 killer of Americans </li></ul><ul><li>Approximately 1,000,000 deaths annually </li></ul><ul><li>An American dies from cardiovascular disease every 30 seconds </li></ul><ul><li>More than any cancer </li></ul><ul><ul><li>2-3 times more than any single (lung) cancer </li></ul></ul><ul><ul><li>Almost more than all cancer deaths combined </li></ul></ul>
  3. 3. CARDIO vascular
  4. 4. Vascular Disease <ul><li>Abdominal aortic aneurysm (AAA) </li></ul><ul><li>Carotid artery disease </li></ul><ul><li>Peripheral arterial disease (PAD) </li></ul>
  5. 5. Vascular Disease <ul><li>Abdominal Aortic Aneurysm (AAA) </li></ul><ul><ul><li>An aneurysm is a ballooning of the aorta. As the vessel gets larger, like a balloon it can rupture! </li></ul></ul><ul><ul><li>Aortic aneurysm rupture is the 10th leading cause of death in men over 50. </li></ul></ul><ul><ul><li>More than 15,000 people die needlessly each year in this country from the rupture of an aortic aneurysm. </li></ul></ul>
  6. 6. Vascular Disease <ul><li>Carotid Artery Disease </li></ul><ul><ul><li>Vascular disease can block the carotid arteries to the brain and cause paralyzing strokes. </li></ul></ul><ul><ul><li>Stroke is the third leading cause of death in this country and the leading cause of permanent disability among older Americans. </li></ul></ul><ul><ul><li>More than $50 billion is spent annually on the care of stroke patients. </li></ul></ul>
  7. 7. Vascular Disease <ul><li>Peripheral Arterial Disease (PAD) </li></ul><ul><ul><li>Vascular disease can block circulation to the legs, leading to serious disability. </li></ul></ul><ul><ul><li>Between 25 and 30 million people over 70 years of age have peripheral arterial disease (PAD). </li></ul></ul><ul><ul><li>PAD begins by simply limiting the amount you can walk, but when it worsens it could lead to gangrene and leg amputation. </li></ul></ul><ul><ul><li>Even people with mild PAD are three times as likely to die of heart attacks and strokes as those without the disease. </li></ul></ul>
  8. 8. The AVA is a Foundation within SVS. Its goal is to increase public awareness of vascular disease. American Vascular Association The AVA is a public health advocacy organization whose mission is to reduce death and disability due to vascular disease. American Vascular Association
  9. 9. CAROTID SCAN - A painless ultrasound test to reduce the risk of stroke AORTIC SCAN - To detect aneurysms that could rupture and be fatal PAD Testing - Measurement of circulation to your legs to detect peripheral arterial disease (PAD) American Vascular Association National Screening Program
  10. 10. 132 Centers - 40 States American Vascular Association Screening Program 2004
  11. 11. American Vascular Association National Screening Program
  12. 12. Over 5000 older Americans American Vascular Association Screening Program 2004
  13. 13. Hypertension was found in 22% of older Americans Hypertension - BP > 160mmHg 22% 63% 30%
  14. 14. PAD (ABI < 0.85) was found in 9% of older Americans 7% 10% 10.5% 12% 9.6% p = 0.001 Peripheral Arterial Disease
  15. 15. PAD (ABI < 0.85) was found in 10.5% of older Americans Peripheral Arterial Disease 10.5% 52% 50%
  16. 16. Women with PAD were significantly less likely to be receiving antiplatelet medications. Peripheral Arterial Disease 11% 43% 54% 7.5 % 42% 57% p=0.008
  17. 17. Carotid disease was found in 7.6% of older Americans. 7.8% 7.4% 7.6% 8% 5.8% p = 0.03 Carotid Artery Disease
  18. 18. Carotid disease was found in 7.6% of older Americans. Carotid Artery Disease 7.6% 48% 50%
  19. 19. Women with Carotid disease were significantly less likely to be receiving lipid-lowering medication and antiplatelet medications. 8% 42% 56% 5.8 % 32% 60% p=0.03 Carotid Artery Disease p=0.001
  20. 20. 16% Abdominal Aortic Aneurysms
  21. 21. Hypertension – BP > 160 systolic P < 0.03 30% 22% AAA No AAA
  22. 22. P < 0.0001 Abdominal Aortic Aneurysms
  23. 23. AAA - Men & Women
  24. 24. <ul><li>There is significant undiagnosed noncardiac vascular disease in a broad segment of our population. </li></ul><ul><li>30% - 50% of patients with vascular disease are not receiving treatments that might be significantly beneficial. </li></ul><ul><li>There is a significantly higher prevalence among women than has been historically reported. </li></ul><ul><li>Women receive a significantly lower intensity of treatment. </li></ul><ul><li>There is significant opportunity for patient and physician education with the potential for measurably improved outcomes. </li></ul>AVA National Screening Program
  25. 26. <ul><li>64 year old man </li></ul><ul><ul><li>NFL quarterback for 17 years </li></ul></ul><ul><ul><li>Senior Pro golf circuit for 13 years </li></ul></ul><ul><li>Acute stroke without prior symptoms </li></ul><ul><li>Urgent CEA </li></ul><ul><li>Prolonged rehab with permanent disability </li></ul><ul><li>All potentially preventable with screening </li></ul>
  26. 27. &quot;Healthy Vessels 2010&quot;