(upbeat music) - We're pleased to be joined by Dr. Thomas Bernik, who's chief vascular surgeon at Englewood Health, to disclose one of the underwriters of our health programming.

Doctor, great to have you with us.

- Thank you for having me, Steve.

- We were just talking before we got on the air.

I will not go through the details of the vascular issues that have been in my family that I've become all too familiar with.

But here's the question, what is vascular disease?

- So, vascular disease is a disease of the arteries in the body, which affect really all the arteries, but primarily the heart, the great vessels, the vessels that lead to the arms and legs in particular, and also the carotid arteries that lead to the brain.

- This area, right?

- Yeah, the carotid arteries run along the front, the anterior border of the neck, and the vertebral arteries run along the back and supply the back of the brain.

- How do we know?

Because everything is going on inside us, how do we know that there's reason to be concerned about potential vascular disease?

- Well, so risk factors are a big part of it, of course.

You know, genetic history, family history, is something that is, you know, that is really very important to identify early on as you age, 40, 50, 60 for certain vascular conditions.

Other vascular conditions, for instance, atherosclerosis, is picked up either when someone is symptomatic, and there's different types of symptoms, mini-strokes, for instance, for carotid artery disease, or pain in the legs when you walk for lower extremities.

And so, you know, you have to break up vascular disease into the narrowing of the arteries.

And also then you have other entities such as aneurysms which is a completely different disease pattern.

- Obesity play a role here?

- Interestingly, yes and no.

I mean, the link between, you know, increased cholesterol and lipid management is clear in vascular disease, but the prevalence of vascular disease in obesity is not what we would think.

The main players for atherosclerotic, narrowing of the artery vascular disease, is really genetics, smoking and diabetes.

- Go back to the atherosclerosis issue.

Are we really talking about plaque?

Because without going too much into the detail about my own family situation, and I'm constantly getting the level of plaque buildup checked.

- Correct.

- The reason for that is not for me, but for anybody, why is that?

- Well, multiple reasons.

Plaque buildup is a buildup of cholesterol, calcium deposits, which builds up within the vessel wall.

It can be anywhere.

And again, if it's in the neck, it can lead to stroke, if it's in a low extremities or in the abdomen, it can lead to narrowing and lack of blood flow.

And the reason it's important is because as the plaque builds up, just like you're looking at a river, if rocks build up in a certain area there's a restriction of flow.

The body needs flow in order to survive.

So a leg needs oxygen and blood.

And so if you have a narrowing somewhere in the pelvis or the upper leg, the leg will have trouble functioning.

And in extreme cases, a lack of blood flow can lead to, you know, to gangrene and potential limb loss.

- Surgeries, meaning, well, not just surgery, medical intervention dealing with vascular disease, how much different is it today, 2023, versus 5, 10, 15 years ago?

- Vastly different.

Most of the major, major surgeries that we do particularly revolving around, let's say, aneurysmal disease, 95% of the aneurysmal disease, and that's basically a weakening in the artery, it's just opposite of what we're talking about.

Atherosclerosis can lead to that.

But aneurysm surgery has completely been turned upside down with endovascular stent grafting where previously patients would stay for five days, more depending, with a fairly significant mortality and morbidity, opening the belly, opening the chest.

Now we can do it with a stent graft overnight.

Similar for atherosclerosis of the legs, where we do majority of endovascular treatments now, which are with catheters, Roto-Rooter type of devices, stents and that sort of thing.

- It's so interesting because, you know, again, genetics play a part of it, but, again without disclosing too much, my dad had a whole range of vascular issues, but also there are other risk factors involved.

And because I knew it, and this is for anybody who has family history, and there are millions of people who do, there are things that we can and should be doing for ourselves.

It doesn't guarantee the outcome, but it does help us.

Does it not doctor?

- It does.

I mean, whatever's in your control as far as risk factor modification is obvious, right?

Smoking cessation, you know, lipid lowering drugs, statins, blood pressure control, control of diabetes.

You can only do so much with diabetes, but obviously control of diabetes, and high blood pressure.

The genetic factors, if they do exist, you know, you can do genetic testing of course.

- Yep.

- And genetic counseling to follow.

That's unfortunately out of your control, but it's gonna be risk factor modification, you know, after that.

- Sorry for sharing so much about my own situation and my family history.

It's just that I've learned that so many others are dealing with this, or may not even be aware of it.

So Doctor, you did a great public service by joining us.

Dr. Thomas Bernik, Chief Vascular Surgeon at Englewood Health.

Thank you, Doctor, for joining us.

We appreciate it.

- Thank you very much.

Have a good day.

- I'm Steve Adubato.

We thank you so much for joining us.

Be well.

See you next time.

- [Narrator] One-On-One with Steve Adubato has been a production of the Caucus Educational Corporation.

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