Treatment Programs

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Peripheral Artery Disease Treatment Program

The Peripheral Artery Disease Program at the Massachusetts General Hospital Fireman Vascular Center provides specialized diagnosis and treatment options as well as ongoing care for patients with peripheral artery disease of the extremities.

Our Approach

Clinicians at the Massachusetts General Hospital Fireman Vascular Center are leaders in the development and use of medical, endovascular and surgical interventions to diagnose, treat and prevent complications of peripheral artery disease (PAD), a circulatory condition in which arteries narrowed by atherosclerosis (buildup of plaque within the arteries) reduce blood flow to the limbs, particularly to the legs and arms.

A Multidisciplinary Approach to Vascular Care

The Mass General Fireman Vascular Center is one of the only vascular centers in the country with specialists in every area of vascular disease. Our Peripheral Artery Disease Program brings together a team of clinicians from multiple disciplines to provide care from many perspectives, including:

  • Endocrinology
  • Foot and ankle orthopedics 
  • Nutrition
  • Physical therapy
  • Podiatric medicine
  • Vascular and endovascular surgery
  • Vascular imaging and intervention
  • Vascular medicine and cardiology
  • Vascular and cardiovascular nursing services
  • Wound care

We work together with each patient and their referring physician to coordinate a personalized treatment plan.

Specialists Dedicated to Noninvasive Vascular Imaging

Our team includes experts in diagnostic imaging who are specially trained to detect abnormalities in the vascular system and whose practice focuses specifically on vascular disease. These vascular imaging specialists are board certified in vascular medicine, vascular surgery, vascular radiology and imaging, and are fellowship-trained with additional specialization in vascular procedures.

To diagnose PAD accurately, our specialists rely on noninvasive tests that use inflatable cuffs similar to those used to measure blood pressure. These tests can be performed during a regular office visit and include:

  • Ankle-brachial index (ABI), a test that measures blood pressure at the ankle and in the arm to determine the severity of PAD
  • Pulse volume recording (PVR), a noninvasive technique developed and introduced by clinicians at Mass General to measure the blood flow in the upper and lower extremities

Other diagnostic techniques include:

  • Duplex ultrasound, which uses sound waves to evaluate blood flow
  • Computed tomography angiography (CTA), where dye is injected into the vein to get detailed images of blood vessels and tissue
  • Magnetic resonance angiography (MRA), a type of MRI that provides images of blood vessels

All of our diagnostic tests may also be performed at our convenient Waltham location

Treatment Plans to Help Patients Live Active Lifestyles

Depending on the disease severity, PAD symptoms may range from leg discomfort while walking to severe pain at rest or skin breakdown with ulceration. Our goal is to design individualized treatment plans that enable patients to lead active lifestyles and minimize the risk of cardiovascular complications. To treat PAD, our clinicians consider several therapeutic options, including:

  • Medical therapy: Medications are used to reduce the cardiovascular risk and/or symptoms associated with PAD. These important therapies control blood pressure, cholesterol and diabetes, and block platelet activity (blood clotting). Novel therapies under investigation at Mass General may be considered where appropriate to reduce symptoms or risk associated with PAD
  • Smoking cessation: Preventive care is central to the treatment process. Our vascular specialists guide patients through smoking cessation and other lifestyle changes to treat associated conditions
  • Exercise therapy: This approach helps patients walk further without pain and enjoy the benefits of greater cardiovascular fitness. Exercise sessions involve walking on a treadmill and performing other lower body training exercises
  • Endovascular therapies: These minimally invasive treatments offer an alternative to conventional surgery, do not require an incision in the skin and typically offer a shorter recovery time. By inserting narrow plastic tubes, or catheters, into the blood vessels, our specialists are able to access and open sites with cholesterol plaque blockage through a variety of techniques:
    • Angioplasty: A balloon-tipped catheter is placed into the artery and advanced to the obstructed area. The balloon is inflated to expand the blockage, and then deflated and retrieved, widening the narrowed artery
    • Stenting: Often performed during angioplasty, this technique inserts a mesh-like device at the point of the cholesterol blockage and is expanded permanently into the vessel wall, propping open the blockage
    • Atherectomy: A specialized catheter with directable cutting blades, laser tip or polishing drill is advanced through the cholesterol plaque repeatedly, removing plaque debris from the vessel wall to restore flow in the channel
  • Surgical techniques such as:
    • Endarterectomy: Through a surgical incision, the blocked artery is exposed and opened. The plaque is then removed, resulting in a widening of the blocked artery
    • Surgical bypass: Blood flow is rerouted around the blocked blood vessel by attaching a conduit (either a vein harvested from the body or a prosthetic tube) above and below the point of obstruction

Additionally, we work in close collaboration with cardiologists at the Mass General Corrigan Minehan Heart Center to treat associated cardiac conditions. Our clinicians follow patients long-term to ensure ongoing, personalized care over a lifetime.

Committed to Increasing Awareness of PAD

The Fireman Vascular Center has a long tradition of excellence in clinical care, with clinicians who are considered national leaders in the diagnosis and treatment of PAD. Our physicians are dedicated to pioneering research and serve on many national and international professional boards and societies, including the:

  • Society for Vascular Surgery
  • Society of Interventional Radiology
  • American College of Cardiology
  • American Heart Association
  • Society for Vascular Medicine
  • Society for Cardiovascular Angiography and Interventions
  • American Board of Vascular Medicine
  • Intersocietal Commission for the Accreditation of Vascular Laboratories

Our clinicians also are committed to educating patients regarding PAD and its risks. Mass General was the first hospital in the United States to partner with the Peripheral Arterial Disease Coalition, a national campaign funded by the National Heart, Lung and Blood Institute and designed to increase public awareness of PAD.

Evaluating New Technologies Through Research and Clinical Trials

The Fireman Vascular Center participates in major clinical studies that evaluate new technologies and devices to treat PAD. This allows us to bring our patients promising new treatments as quickly as possible. This innovative work is focused on:

  • New devices: Since 1997, the Fireman Vascular Center’s vascular ultrasound core laboratory (VasCore) has been a leader in the design, development and implementation of clinical trials on new endovascular devices
  • Drug-eluting stents and drug-coated balloons: Our clinicians are national leaders and pioneers in investigations to determine if the use of drug-eluting stents (stents that slowly release medication to prevent a recurring blockage) and drug-coated balloons can keep arteries open longer after minimally invasive PAD treatments. Read more
  • Surgical and endovascular treatment options: Our physicians focus on team-based care and are leading major national investigative efforts to determine the roles of surgery and endovascular treatment in patients with the most advanced forms of PAD

Patients interested in participating in clinical trials can browse online for open trials

Tracking Outcomes to Improve Care

The Fireman Vascular Center has taken the unprecedented step of independently following the outcomes of patients who are evaluated for PAD. While treating patients, we carefully document how they respond. These tracking systems ensure that we deliver quality care during a procedure and throughout a patient’s recovery.

Patients and family members can feel confident that our team is always striving to provide the best possible outcome.

One Call Coordinates Care

Our dedicated nurse coordinator is available Monday through Friday from 8:30 am to 5:00 pm to take relevant information about your condition and symptoms, and to make a timely appointment with the most appropriate specialist. Call 877-644-8346 to reach our nurse coordinator or request an appointment online

We strive to see patients as soon as possible and assign every patient one clinician to organize care between members of our multidisciplinary team. From diagnosis to treatment and follow-up, this physician guides patients through the care system and treatment process.

The Mass General Difference

Mass General is consistently ranked among the best hospitals in the country by U.S. News & World Report. Our ranking is based on our quality of care, patient safety and reputation in 16 different specialties. Our commitment to excellence means that we work to ensure that you can receive the best care at all points during your visit.

Conditions and DiseasesThe care team at the Fireman Vascular Center encourages all patients and family members to learn more about conditions and diseases that affect the cardiovascular system. The links below provide more information about vascular conditions and diseases that might be treated within this program.

Peripheral Vascular Disease

Peripheral vascular disease (PVD) is a slow and progressive circulation disorder. It may involve disease in any of the blood vessels outside of the heart and diseases of the lymph vessels - the arteries, veins, or lymphatic vessels.

Support and Wellness

Mass General is dedicated to ensuring that people understand their health care choices and have the necessary information to make decisions affecting their health and well being. The related support and wellness information listed below can play a role in treatment options.

Designing an Exercise Program

When you exercise, you'll breathe faster and more deeply. This maximizes the amount of oxygen in your blood.

Healthy Eating

Many vascular conditions can be improved by changing certain lifestyle factors. Maintaining a healthy weight is one of many factors. If you are trying to make heart-healthy changes to your diet, it is helpful to know some basics about nutrition, starting with the components of food.

Smoking and Cardiovascular Disease

Diseases caused by smoking kill more than 437,900 people in the United States each year. Around 35 percent of these deaths were cardiovascular related.

Determining Your Body Mass Index

A good indicator of how much fat you carry is the Body Mass Index (BMI). Although it is not a perfect measure, it gives a fairly accurate assessment of how much of your body is composed of fat.

The following related clinical trials and research studies are currently seeking participants at Massachusetts General Hospital. Search for clinical trials and studies in another area of interest.

Man gets walking to improve blood flow and overall health

Eugene Tarsky, 73, had never heard of peripheral artery disease (PAD) when he was first diagnosed three years ago. But careful monitoring by doctors and a commitment to reducing his risk factors have kept him healthy and free from complications.

Active again: persevering with PAD

PAD affects more than 9 million people in the United States, but the disease is often underrecognized by both patients and physicians.

First U.S.-based trial supports the effectiveness of a drug-coated balloon for patients with PAD

In January 2015, the U.S. FDA approved the use of a drug-coated balloon to treat peripheral artery disease (PAD) based on research spearheaded by Kenneth Rosenfield, MD, and Michael R. Jaff, DO.

Providing patient education during PAD Awareness Month

Each September, the MGH recognizes PAD Awareness month to educate the public about this little known disease. Michael R. Jaff, DO answers some commonly asked questions.

CNN segment on Peripheral Arterial Disease featuring Dr. Michael Jaff

Dr. Michael Jaff, Medical Director of the Massachusetts General Hospital Fireman Vascular Center, is featured in a CNN segment on Peripheral Arterial Disease.

Talk with your doctor about peripheral artery disease

Deborah Hines, NP, encourages talking with your doctor about peripheral artery disease, a circulatory condition in which arteries narrowed by atherosclerosis reduce blood flow to the limbs, particularly to the legs and arms.

Recognize the symptoms of peripheral artery disease

Michael Jaff, DO, encourages the public to recognize the symptoms of peripheral artery disease, a circulatory condition in which arteries narrowed by atherosclerosis reduce blood flow to the limbs, particularly to the legs and arms.

Access to new treatments

Fireman Vascular Center physicians and scientists participate in international research and lead more than 70 clinical trials that evaluate current therapies and investigate new devices to treat vascular disease. These research efforts have led to a number of groundbreaking firsts, bringing innovative new treatments to the patient’s bedside.

Michael Jaff, DO, discusses diabetes and its potential complications, such as peripheral artery disease

Michael Jaff, DO, Medical Director of the Massachusetts General Hospital Fireman Vascular Center, says that if you have diabetes, your odds are 1 in 3 of developing peripheral artery disease, with potentially serious consequences. Learn more about why peripheral artery disease often goes undetected, and how it can be diagnosed and treated.

Designing an Exercise Program

When you exercise, you'll breathe faster and more deeply. This maximizes the amount of oxygen in your blood.

Healthy Eating

Many vascular conditions can be improved by changing certain lifestyle factors. Maintaining a healthy weight is one of many factors. If you are trying to make heart-healthy changes to your diet, it is helpful to know some basics about nutrition, starting with the components of food.

Smoking and Cardiovascular Disease

Diseases caused by smoking kill more than 437,900 people in the United States each year. Around 35 percent of these deaths were cardiovascular related.

Determining Your Body Mass Index

A good indicator of how much fat you carry is the Body Mass Index (BMI). Although it is not a perfect measure, it gives a fairly accurate assessment of how much of your body is composed of fat.

Vascular Center

55 Fruit Street
Boston, MA 02114

Phone: 877-644-8346
Hours: 9:00 am to 5:00 pm


Vascular Center at Waltham52 Second Avenue, Suite 2100
Waltham, MA 02451
Phone: 
877-644-8346
Hours:
8:00 am to 5:00 pm
Learn about our convenient Waltham location

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Request an appointment at the Fireman Vascular Center

Contact the Fireman Vascular Center to schedule an appointment with one of our vascular specialists

Learn about the Fireman Vascular Center in Waltham

Did you know the Fireman Vascular Center has a convenient location in Waltham? Learn about treatments and services at our outpatient care center.