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Blood Flow –

Vascular Testing, Treatment Offered for Circulatory Diseases

By Andrew Gorosko

The organs of the human body, such as the heart, brain, and lungs, would not function unless they received a nourishing supply of blood, which flows through the arteries and veins of the circulatory system.

The circulatory system, or vascular system, moves blood out of the heart and through the arteries, and then moves it back to the heart via the veins. The system is sometimes described as the “vascular tree” due to its dendritic or treelike design.

The Non-Invasive Vascular Laboratory at Danbury Hospital offers a wide range of patient physiologic testing and evaluation of known or suspected diseases of the circulatory/vascular system.

Alan M. Dietzek, MD, who is a board-certified vascular surgeon and a registered vascular technologist, is the medical director of the laboratory. Dr Dietzek is the chief of vascular surgery at the hospital. He came to Danbury Hospital in August 2000 from North Shore University Hospital in New York.

Dr Dietzek has extensive training in diagnosing peripheral vascular disease and surgically treating it. His medical work includes treating arterial occlusive disease of the legs. He also performs endovascular aortic stent grafting and carotid artery surgery. Dr Dietzek treats all vascular disorders, except those present in the cranium and the heart.

Dr Dietzek works with other doctors and hospital staff members on the prevention, education, diagnosis, treatment, research, and rehabilitation of patients who have circulatory diseases, according to the hospital. 

The vascular laboratory, which has received partial accreditation from the Intersocietal Commission for the Accreditation of Vascular Laboratories, is now seeking full accreditation for its noninvasive testing from the commission. Dr Dietzek said he expects that the hospital laboratory will receive full accreditation.

The hospital has renovated and expanded its laboratory to provide advanced forms of vascular testing. Noninvasive testing provided at the laboratory includes extracranial cerebrovascular, intracranial cerebrovascular, peripheral venous, and peripheral arterial testing.

“We do some pretty exciting stuff,” Dr Dietzek said in an interview at his Danbury Hospital office.

Among some recent enhancements, the hospital is now using laser equipment to delicately vaporize certain blood vessel blockages, the doctor said. Known as a “laser atherectomy,” the procedure “debulks” the interior of a blocked blood vessel. The opened blood vessel is thus prepared for a balloon angioplasty or for stent implantation, which would allow the free flow of blood through the vessel.

Dr Dietzek performs what is known as an “endovascular stent graft procedure” to treat abdominal aortic aneurysms. The minimally invasive procedure, which is performed with the aid of interventional radiologists, provides patients with an alternative to conventional open surgery, according to the hospital. The stent is inserted into the aorta via small incisions in the groin. A stent is a miniature reinforcing structure. The aorta is the main artery of the body.

The doctor also performs a minimally invasive surgical procedure to treat venous insufficiency and varicose veins.

Minimally invasive surgical procedures reduce side effects, speed patient recovery times, and allow sicker patients to be treated surgically. 

In using noninvasive diagnostic equipment to find vascular system problems, the laboratory employs ultrasound and Doppler listening devices. The highly sensitive sonic devices provide doctors with detailed information about the circulatory system, such as blood flow velocity.

Besides detecting blockages in the circulatory system, the laboratory seeks to find aneurysms. An aneurysm is a sac formed by the local enlargement of a weakened wall of an artery or vein. Problems posed by aneurysms can be resolved through a vascular graft, which provides a safe pathway for blood flow.

The rupture of an aneurysm is the tenth most common cause of death in men over age 55 in the United States, Dr Dietzek noted.

The Non-Invasive Vascular Laboratory at the hospital is on the fourth floor in South Building. Luz Guzman-Restrepo, who is a registered vascular technologist, is the technical director of the facility.  The laboratory has approximately 5,500 patient visits annually.