Vein & Vascular

The Vein & Vascular Institute Provides

• Physicians & Mid-level Providers dedicated to detection, treatment and management of PVD

• Compassionate & knowledgeable staff: Licensed, trained & Certified

• Highest-quality in patient care

• Comprehensive testing & vascular imaging

• Minimally invasive Endovascular procedures

• Screening programs for at risk patients

Who We Are

The Arkansas Heart Hospital’s Vein & Vascular Institute is the first and only institute in Arkansas dedicated to identifying, treating and managing Peripheral Vascular Disease (PVD) along with other circulatory conditions affecting the limbs such as Chronic Venous Insufficiency (CVI) and Lymphede- ma. Circulatory dysfunction can be in the arteries, veins or lymphatic symptoms and often lead to pain, swelling and impaired function. A visit to the Vein & Vascular Institute results in a comprehen- sive evaluation of the peripheral system by a team of experts dedicated to finding and fixing PVD.

What We Do

The Vein & Vascular Institute provides a complete complement of interventional and treatment options for patients suffering from decreased mobility, pain and dysfunction associated with PVD. Our team works in collaboration with physicians skilled in the treatment of vascular disease. We have a specially trained vascular staff and expert interventional cardiologists. Our goal is clearly stated: to keep PVD patients away from amputation and to restore function. Early detection is the key to improved outcomes and we strive to achieve the best possible outcomes through our multidisciplinary approach to patient care. Vascular testing can also aid in identifying other areas of risk, such as heart attack and stroke.

Understanding Circulation

With each beat, your heart pumps oxygen-rich blood throughout the body. Arteries carry this blood to your organs and muscles. Veins then return the oxygen-poor blood to your heart. This cycle works well when the arteries and veins are healthy. However, if a blood vessel is damaged, blood flow may be slowed or blocked. Consequently, your muscles and tissues don’t get all the oxygen they need or blood and lymphatic fluid may not return as it should.

Healthy Artery

An artery is a muscular tube. It has a smooth lining and flexible walls that allow blood to pass freely. When active, muscles need more oxygen, re- quiring increased blood flow. Healthy arteries can adapt to meet this need.

Damaged Artery

PVD begins when the lining of an artery is damaged. This is often due to a risk factor such as smoking or diabetes. Plaque then starts to form within the artery wall. At this stage, blood flows normally, so you’re not likely to have symptoms.

Narrowed Artery

If plaque continues to build up, space inside the artery narrows and artery walls become less able to expand. The artery still provides enough blood and oxy- gen to your muscles during rest. However, when you’re active, the increased demand for blood can’t be met. As a result, your leg may cramp or ache.

Blocked Artery

An artery can become blocked by plaque or by a blood clot lodged in a narrowed section. When this happens, oxygen can’t reach the muscle be- low the blockage. Then you may feel pain when lying down (rest pain). This type of pain is especially common at night when you’re lying flat. In time, the affected tissue can die. This can lead to the loss of a toe or foot.

Peripheral Vascular Disease (PVD/PAD)

Peripheral vascular disease (PVD) refers to diseas- es of blood vessels outside the heart and brain. It is a narrowing of vessels that carry blood to the legs, arms, stomach or kidneys. It is some- times referred to as PAD and can be caused by fatty buildups (atherosclerosis) in the inner walls of arteries. These deposits block or restrict nor- mal blood flow. PAD can lead to gangrene and amputation of limbs. If the blockage occurs in a carotid artery, it can cause a stroke. Patients with PAD have a higher risk of death from heart attack and stroke.

Diagnosing PAD begins with a medical history and physical exam. A simple test non-invasive test called the ABI (ankle brachial index) maybe done in the office to determine the likelihood of PAD. The ABI is much like taking a blood pressure in the legs.


Common symptoms of poor leg circulation are cramping, fatigue, heaviness, and pain or dis- comfort in the legs and buttocks during activity. This usually goes away when the activity stops. It’s called “intermittent claudication.”

Treatment Methods

Treatment includes lifestyle changes, medicines or both:

• stopping smoking

• controlling diabetes

• controlling blood pressure

• being physically active

• eating a diet low in saturated and trans fats

• antiplatelet agents to prevent blood clots • cholesterol-lowering medicine
• high blood pressure medicine

Causes/Risk Factors

Are you at risk for developing PVD? Common risk factors for PVD include:


(4x more likely to get PAD)

Heart Conditions & High Blood Pressure


Over 70 Years Of Age

Being Overweight or Obese

Family History of PVD

Do Your Legs Hurt?

Millions of Americans are unable to remain physically active because of leg pain caused by PVD. If left untreated, PVD can lead to ampu- tation and can put you at greater risk for heart attack and stroke.


Lymphedema is a swelling of a body part, most often the extremities and is the result of an accu- mulation of protein-rich fluid in the superficial tissues, which can have significant consequences for the patient if left untreated.

Causes/Risk Factors

Primary lymphedema is caused by congenital malformations of the lymphatic system and may be present at birth or develop later in life. Primary forms usually affect the lower extremities but may also be present in upper extremities.

Secondary lymphedema is more common and often the result of surgery or radiation thera- py for cancer. Other causes include trauma or infection. Severe venous insufficiencies may also contribute to the onset of lymphedema. Secondary lymphedema may affect the upper or lower extremity.

Treatment Methods

Medication: Diuretics are often prescribed in order to control lymphedema but are proven to have very poor long-term results in the treatment of this condition.

Surgery: Surgical procedures for lymphedema do not show consistent results.

Pneumatic Compression Pumps: This mechanical device works with sleeves containing compressed air, which are applied to the patient’s swollen extremity and maybe effective if used under the supervision of a lymphedema therapist and/or physician.

Complete Decongestive Therapy (CDT): Since there is no cure for lymphedema, the goal of the therapy is to reduce the swelling and to maintain the reduction. For the majority of the patients, this can be achieved by the skillful application of this therapy, which is safe, reliable, and noninvasive. CDT shows good long-term results. It consists of two phases and the following combined modalities:

• Manual Lymph Drainage (MLD): This gentle manual treatment technique increases the activity of certain lymph vessels and manually moves the interstitial fluid. Applied correctly, a series of MLD treatments decreases the volume of the affected extremity to a normal or near normal size.

• Compression Therapy: Layered bandaging with foam or specially fitted garments that support the swollen area to control swelling.

• Exercises: A customized exercise program is designed by the therapist for each patient. With compression, special exercises will help to pump lymph out of the swollen area.

• Skin Care: Keeping the skin clean and moisturized will help to prevent infections that often can happen with lymphedema.


Lymphedema signs and symptoms include:

• Swelling of part or all of your arm or leg, including fingers or toes

• A feeling of heaviness or tightness

• Restricted range of motion

• Aching or discomfort

• Recurring infections

• Hardening and thickening of the skin (fibrosis)

Chronic Venous Insufficiency (CVI)

The veins in your legs carry blood back to your heart. They have one-way valves that keep blood from flowing backward. If you have CVI, the valves don’t work like they should and some of the blood may go back down into your legs. That causes blood to pool or collect in the veins. Over time, CVI can cause pain, swell- ing, and skin changes in your legs. Symptoms will worsen over time if left untreated.


You may notice these in your legs:

• Swelling or heaviness

• Pain or Itchiness

• Varicose veins

• Skin changes and ulcers

Without treatment, the pressure and swelling will burst the tiny blood vessels in your legs called capillaries. That could turn your skin red- dish-brown, especially near the ankles. This can lead to swelling and ulcers, which are tough to heal and more likely to get infected.

Causes/Risk Factors

Women are more likely than men to get CVI. Your chances also might be higher if you are:

A Smoker

Pregnant or Have Been Pregnant

Patient with History of Blood Clots

Over 50 Years Of Age

Overweight or Obese

Family History of CVI

Treatment Methods

Targeted Endovenous Therapy is a minimally invasive procedure that treats varicose veins and venous reflux, with little or no pain. With ultrasound, a catheter is positioned into the diseased vein through a small opening in the skin. The tiny catheter powered by radiofrequency (RF) energy delivers controlled heat to the vein wall causing the collagen in the wall to shrink and the vein to close. Once closed, blood will re-route itself to healthy veins. In some cases medications or med- ical grade adhesives are used to obtain these effects and aid in the re-routing process.

Procedure Highlights

• Relief of symptoms within a few days

• Minimally invasive Outpatient procedure

• Performed under local anesthesia

• Resume normal activities in a few days*

• May be beneficial in healing of long term venous ulcerations and wounds

Where We Go

PVD patients can be seen in con- venient locations around Arkansas through our outreach program in Arkansas Heart Hospital Clinics.

Our Team:

Visit us at our clinics in:


Encore Clinic (Bryant)





El Dorado


Hot Springs

Little Rock




North Little Rock

Pine Bluff