WEST PALM BEACH, Fla. – Sept. 30^th, 2024 – Palm Beach Health Network vascular surgeons and endovascular specialists provide comprehensive, advanced diagnosis and treatment of peripheral arterial disease (PAD), a common cardiovascular disease associated with increased risk of amputation, heart attack, stroke, and death. September is National Peripheral Arterial Disease Awareness Month.

Led by Joseph Ricotta, MD, Chairman of the Department of Vascular Surgery at Delray Medical Center and one of the nation’s leading vascular surgeons, the Palm Beach Health Network’s Limb Salvage and Amputation Prevention Program offers specialized procedures that are designed to spare tissue, repair damage, and help maintain and restore function in limbs that would otherwise have to be amputated.

Since Dr. Ricotta joined the medical staff at Delray Medical Center in 2016, the amputation rate has dropped significantly.  In 2016 it was 3.6% compared to just 0.64% in 2023.

Other members of the program’s interdisciplinary team include vascular surgeons Lauren Huntress, MD, at West Boca Medical Center in Boca Raton, and Joseph Savarese, MD, at Palm Beach Gardens Medical Center, as well as endovascular interventionalists, vascular medicine specialists, podiatrists and wound care experts.

According to the American Heart Association, PAD is the third most common indication of atherosclerotic disease, after coronary artery disease and stroke. In the U.S., PAD affects about 8-10 million adults and causes approximately 150,000 non-traumatic limb amputations per year. PAD typically results from hardening of the arteries and plaque buildup as people age, but certain risk factors – such as diabetes, smoking, hypertension, high cholesterol, obesity, a family history of PAD, and being over 50 – can lead to developing the disease earlier.

While PAD can often be asymptomatic, the most common sign of the disease is pain or cramping in the hips, thighs or calves when walking. Other symptoms include fatigue or heaviness in the leg, foot pain while at rest, numbness or tingling in the legs or feet, burning in the feet, loss of hair on the feet or toes, coldness or weak pulse in the lower legs or feet, and sores or ulcers on the legs or feet.

The Palm Beach Health Network specialists diagnose PAD by conducting tests and examinations that measure blood flow through the arteries. The ankle-brachial index (ABI) test, which compares blood pressure measured in the ankle to blood pressure measured in the arm, is a simple, quick test for PAD. Ultrasound can be used to evaluate blood flow and narrowing or blockages in the blood vessels. Blockages may also be detected with computerized tomography (CT) or magnetic resonance imaging (MRI) scans, while angiograms can pinpoint the exact location of a blockage.

In some cases, PAD can be treated with medications or lifestyle modification, such as stopping smoking, lowering blood pressure and cholesterol, blood sugar control in diabetics, or supervised exercise programs. More severe cases may require surgery to restore blood flow to the legs and feet. In endovascular repair surgery, a minimally invasive outpatient procedure, a stent or balloon is inserted via a catheter through a small puncture in the patient’s groin and placed at the blockage site to keep the artery open. Atherectomy, another minimally invasive procedure, removes plaque buildup from within the artery using a revolving blade in a catheter.

Some PAD patients may require open bypass surgery, which involves making incisions above and below the blocked or narrowed artery and attaching a blood vessel made of the patient’s vein or a synthetic material to create an alternate route around the blockage for the blood to pass through.

At Delray Medical Center, physicians can perform robotic-assisted vascular interventions utilizing the Siemens Artis Pheno, a robotic C-arm angiopathy system used in minimally invasive interventional procedures. The Delray Artis Pheno is the only one of its kind in Palm Beach County.

Dr. Ricotta serves as National Medical Director of Vascular Surgery and Endovascular Surgery for Tenet Healthcare and founded and directs the FAU Vascular Surgery Fellowship and is a professor of surgery at FAU School of Medicine. He is a nationally and internationally recognized expert in the field of vascular and endovascular surgery, earned his undergraduate degree at Yale University and his medical degree from Jefferson Medical College. He completed his residency in general surgery at Johns Hopkins Hospital and was a traveling scholar and specialist registrar in vascular surgery at Oxford University in England. In addition, he completed a vascular and endovascular surgery fellowship at the Mayo Clinic in Rochester, Minnesota, followed by an advanced endovascular surgery fellowship at the Cleveland Clinic. He is the first surgeon in the U.S. to use endovascular robotics to perform minimally invasive vascular surgery and has authored more than 300 publications and delivered more than 500 lectures on the national and international stage.  He has been named a Castle Connolly “America’s Top Doctor” 13 years in a row and earned a position on Newsweek’s “America’s Best Vascular Surgeons 2024” list.

For more information about the Palm Beach Health Network Limb Salvage and Amputation Prevention Program, visit our website