Cardiovascular Matters

Dr. Craig Walker and Terry Roberts discuss varicose veins and other venous disorders on this episode of Cardiovascular Matters. They delve deeper into obstructive venous disorders like iliac vein compression syndrome, also known as May-Thurner syndrome
In this episode, Dr. Walker sits down with host Terry Roberts to explore causes of venous obstruction beyond simple varicose veins. They discuss conditions like first rib syndrome that can compress veins as well as how cancer and infections can indirectly cause obstructions. However, Dr. Walker focuses particular attention on iliac vein compression syndrome, otherwise known as May-Thurner syndrome. He explains in detail how the iliac artery can compress and reduce blood flow through the iliac vein at the spine. Left untreated, this puts patients at higher risk of dangerous blood clots and prevents healing of chronic venous ulcers.
Listeners learn the importance of considering iliac vein compression when evaluating patients with severe leg swelling, ulcers, or large clots found predominantly on one side. Dr. Walker outlines the diagnostic process which may involve ultrasound, venography, and intravascular ultrasound to visualize compression sites. He also shares how balloon angioplasty and stent placement have transformed the lives of patients who suffered for decades before receiving proper treatment.
Beyond individual patient stories, the episode offers insights into symptoms of venous obstruction and how it can impact exercise capacity and hemodialysis access. Dr. Walker contrasts treating venous strictures to arterial blockages as well. The discussion wraps by emphasizing this common problem is frequently overlooked and how advanced endovascular techniques now offer hope.
***------------- Key points discussed -------------***

• Dr. Walker discusses varicose veins and delves deeper into obstructive venous disorders like iliac vein compression syndrome (May-Thurner syndrome).
• Conditions beyond varicose veins that can cause venous obstructions include first rib syndrome, cancer, infections.
• Iliac vein compression occurs when the iliac artery crosses and compresses the iliac vein against the spine, increasing risk of clots and preventing ulcer healing.
• Diagnosis involves ultrasound initially but may require venography and intravascular ultrasound to visualize compression sites.
• Treatment is usually balloon angioplasty and stent placement to hold the vein open.
• Stories shared of life-changing impacts proper venous treatment has had for long-term patients.
• Symptoms discussed include leg swelling and shortness of breath.
• Venous disease importance for hemodialysis patients is covered.
• Venous strictures are harder to treat than arterial blockages.
• Advanced stents are now available to treat various venous obstructions

Listeners learn this common cardiovascular problem is often underdiagnosed and underestimated. Identifying and addressing venous issues can transform a patient's quality of life. This episode provides valuable information for those experiencing related symptoms.
We hope you will take the time to listen to this informative podcast. Please feel free to share it with others who may benefit from a deeper understanding of venous disorders. As always, thank you for your ongoing support of Cardiovascular Matters.

In this powerful episode, host Terry Roberts sits down with Dr. Craig Walker, the founder of Cardiovascular Institute of the South, to discuss his lifelong mission to prevent unnecessary amputations for patients suffering from peripheral vascular disease and critical limb ischemia.
Dr. Walker shares how he became deeply committed to this cause, recognizing that far too many amputations were being performed without even a basic vascular assessment. He describes how he set out to change this, not only through his own clinical work, but by establishing a groundbreaking training program to educate physicians across the country on the latest limb salvage techniques.
The conversation delves into the remarkable impact of Dr. Walker's efforts, highlighting how his innovative approaches have allowed him and his team to save the limbs of over 90% of patients who were previously told amputation was their only option. The profound benefits of this work are explored, from the dramatic improvements in patient quality of life to the substantial cost savings for the healthcare system.
Listeners will gain a deep appreciation for the sheer scale of the peripheral artery disease epidemic, as well as the urgent need for more widespread adoption of limb salvage best practices. Dr. Walker's passion for this cause shines through, as he makes a compelling case that saving limbs truly means saving lives.
This is a must-listen episode for anyone concerned about the growing burden of vascular disease, and who wants to learn about the innovative solutions being pioneered by trailblazers like Dr. Craig Walker. Viewers will come away inspired by his tireless efforts, and armed with a better understanding of how to ensure patients receive the comprehensive, proactive care they deserve.
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In the premiere episode of Cardiovascular Matters, hosts Dr. Craig Walker and Terry Roberts delve into a comprehensive explanation of varicose veins and venous insufficiency.

Dr. Walker begins by providing context on the prevalence of venous disease, affecting over half of Americans. However, it is often misunderstood due to a lack of public education. He underscores that veins play a critical yet underappreciated role in circulating blood back to the heart for oxygenation.

A detailed description of venous anatomy and physiology is given. Valves in the veins help blood flow against gravity but can become dysfunctional, causing venous insufficiency. Signs like leg swelling and spider veins appear as a result of increased pressures within the veins.

Risk factors for developing insufficiency are explored. Jobs requiring long periods of standing, multiple pregnancies stretching veins, family history and weight all influence one's risk. Listeners gain valuable insights into what may predispose them.

Treatment approaches are separated into conservative and interventional options. Lifestyle changes like exercise and compression are first-line therapies if symptoms are mild. But more invasive procedures are needed for severe cases using laser, radiofrequency, foam and devices.

Terry asks thoughtful questions that provide opportunities for further explanation. Dr. Walker clarifies spider veins often signify deeper issues, and stresses the importance of upright ultrasound exams for accurate diagnosis.

This in-depth pilot episode leaves no stone unturned in the discussion of varicose veins. Listeners walk away with a comprehensive understanding of causes, signs, risk factors and a full spectrum of treatment strategies - both non-invasive and cutting-edge procedures. It establishes Cardiovascular Matters as must-listen resource for all seeking cardiovascular health insights.

In this insightful episode of Cardiovascular Matters, host Terry Roberts and renowned cardiologist Dr. Craig Walker delve into the groundbreaking technology of renal denervation and its profound implications for the treatment of hypertension.
High blood pressure, or hypertension, is a major risk factor for a host of cardiovascular complications, including heart attack, stroke, heart failure, and kidney damage. Traditionally, the management of hypertension has relied heavily on a pharmacological approach, with patients often required to take multiple medications to control their blood pressure. However, this approach can come with its own set of challenges, including medication side effects, adherence issues, and the ongoing financial burden of lifelong treatment.
Enter renal denervation - a minimally invasive, catheter-based procedure that targets the sympathetic nerves surrounding the kidney arteries. By disrupting these nerves, renal denervation has been shown to significantly lower blood pressure, often to the point where patients can reduce or even eliminate their reliance on antihypertensive medications.
Dr. Walker explains the underlying mechanisms behind renal denervation and how it can address the root causes of hypertension, rather than simply masking the symptoms. He shares insights from clinical trials, highlighting the impressive and sustained reductions in blood pressure achieved with this innovative approach.
Notably, the recent announcement that Medicare and CMS will provide coverage for renal denervation procedures starting in 2025 is a game-changer, making this transformative technology accessible to a wider patient population. This development holds the potential to revolutionize the way we manage hypertension, offering patients a viable alternative to lifelong medication dependence and the associated side effects and costs.
As Terry and Dr. Walker discuss, the implications of renal denervation extend beyond just blood pressure control. They explore the potential for this procedure to positively impact other cardiovascular conditions, such as heart failure, and how it may be utilized in earlier stages of hypertension to prevent the progression of cardiovascular disease.
Listeners will come away from this episode with a deeper understanding of the science behind renal denervation, the clinical evidence supporting its efficacy, and the exciting prospects for its future integration into the standard of care for hypertension management. Join us as we delve into this revolutionary advancement in cardiovascular care.
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In this episode of Cardiovascular Matters, Dr. Craig Walker and Terry Roberts delve into the critical topic of peripheral artery disease (PAD). They highlight the alarming prevalence of PAD, with an estimated 25 million Americans affected, and emphasize its deadly nature, noting that a person with a new PAD diagnosis is as likely to die of a heart attack as a heart attack survivor.
The discussion underscores the importance of early diagnosis, even in asymptomatic patients, as this presents a valuable opportunity to implement preventive measures and potentially save lives. Dr. Walker explains the various symptoms associated with PAD, ranging from claudication (pain in the muscles during walking) to critical limb ischemia, which can lead to non-healing wounds, ulcers, and even gangrene.
The key risk factors for PAD, such as advanced age, smoking, and diabetes, are explored in depth. The presenters stress the need for healthcare providers to actively screen for PAD, particularly in high-risk populations, through simple techniques like pulse checks and pressure measurements. They also emphasize the importance of a holistic approach, focusing on risk factor modification, including smoking cessation, cholesterol management, and the implementation of walking programs.
~~~~ Key Points Discussed ~~~~

• Prevalence of peripheral artery disease, with an estimated 25 million Americans affected
• Peripheral artery disease as a marker for increased risk of heart attack and stroke
• Importance of early diagnosis, even in asymptomatic patients, to implement preventive measures
• Common symptoms of peripheral artery disease, including claudication, loss of hair on the lower extremities, and critical limb ischemia
• Risk factors for peripheral artery disease, including advanced age, smoking, and diabetes
• Preventive measures, such as smoking cessation, cholesterol management, walking programs, and medication therapy
• Screening techniques, including pulse checks and pressure measurements, to diagnose peripheral artery disease

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The episode also touches on the various medical therapies available, such as the use of aspirin, antiplatelet agents, and the medication salostazole, which can improve blood flow to the legs. Additionally, the discussion highlights the significance of screening for associated conditions, such as coronary artery disease and carotid artery disease, to ensure a comprehensive approach to patient care.
By the end of this informative episode, viewers will have a deeper understanding of the prevalence, symptoms, and preventive measures for peripheral artery disease, empowering them to advocate for their own health and that of their loved ones.
For more information, visit:
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