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Definition
Vascular Medicine is a rapidly expanding and relatively new subspecialty of internal medicine. It was first recognized by the American Medical Association in 1998, and the first board exam was offered through the American Board of Vascular Medicine (www.vascularboard.org) in 2005. The field of Vascular Medicine focuses on the non-invasive diagnosis and treatment of all problems involving the circulatory system (arteries, veins, and lymphatics).
History of Vascular Medicine at CUMC
The Vascular Medicine Program in the Division of Cardiology at Columbia University Medical Center began in 2003 under the direction of Dr. Elizabeth Ratchford. The Division recognizes the importance of early diagnosis and treatment of patients with vascular disease, particularly because it is so often associated with heart disease and cerebrovascular disease. The Vascular Medicine Program has expanded over the years and now includes Dr. Maya Salameh (Director), Dr. Timothy Crimmins (Faculty), Dr. Elizabeth Ratchford (Adjunct Faculty), Eliseo “Ogie” Parado (Vascular Technologist), and Farina Pathan (Vascular Technologist).
Cardiovascular Ultrasound Laboratory
The Vascular Medicine program runs the vascular section of the Cardiovascular Ultrasound Laboratory located in the Flanzer Cardiac Center on the second floor of the Milstein Hospital Building. The laboratory is accredited by the Intersocietal Commision for the Accreditation of Vascular Laboratories (ICAVL; www.icavl.org) in the areas of extracranial cerebrovascular and peripheral arterial testing. The laboratory offers a comprehensive range of vascular ultrasound services including:
- Non-invasive flow studies
- Carotid Dopplers
- Venous ultrasound
- Arterial ultrasound
- Abdominal aortic aneurysm ultrasound screening
Clinical Practice
Dr. Salameh and Dr. Crimmins have a clinical Vascular Medicine practice on the 5th floor of the Herbert Irving Pavilion (Suite 533; 212-305-1467). Their practice focuses on the non-invasive diagnosis and medical treatment of conditions such as peripheral arterial disease, carotid artery stenosis, renal artery stenosis, aneurysms, and deep venous thrombosis. Their major goals in patient care are aggressive risk factor modification including management of diabetes, hypertension, high cholesterol; lifestyle modification with smoking cessation, weight loss, and exercise; and medical treatment of claudication symptoms. The physicians work closely with the patient and his or her other physicians to achieve treatment goals in order to prevent disease progression and to improve quality of life.
In some cases, medical therapy may be inadequate and the patient may face the decision of whether to undergo an endovascular procedure such as angioplasty and stenting or perhaps a surgical procedure. Dr. Salameh and Dr. Crimmins will discuss all options with the patient and coordinate care with the interventionalist, for example in the Center for Interventional Vascular Therapy (CIVT), or with the vascular surgeon. They will also coordinate any additional imaging tests such as magnetic resonance angiography (MRA) or ultrasound prior to the procedure, as well as necessary follow-up testing. The partnership between the patient and the Vascular Medicine specialist is paramount; medical therapy remains critical regardless of whether or not the patient undergoes an endovascular procedure.
Research
Dr. Maya Salameh is actively involved in a research project investigating peripheral arterial disease in the Northern Manhattan Stroke Study (NOMAS) with Dr. Ralph Sacco. Her project focuses on the relationship between self-reported peripheral arterial disease and long-term vascular events (myocardial infarction, ischemic stroke, and vascular death) in a multi-ethnic population residing in Northern Manhattan.
The Cardiovascular Ultrasound Laboratory serves as the carotid ultrasound core laboratory for a major clinical trial known as the Rheos Pivotal Clinical Trial sponsored by CVRx ®. This trial is a prospective, randomized, multi-center trial looking at a device for the control of resistant hypertension at approximately 50 sites across North America and Europe.
Teaching
Dr. Salameh and Dr. Crimmins are committed to the care of their patients as well as to the education of medical students, residents, fellows, and fellow physicians. They are particularly dedicated to raising the level of awareness in the community to improve the recognition of vascular disease. To this end, they routinely give lectures and conferences on topics such as peripheral arterial disease. Dr. Salameh runs a bimonthly vascular case conference and directs the Vascular Medicine rotation for the Cardiology fellows, a requirement of the Accreditation Council for Graduate Medical Education (ACGME). Both Dr. Salameh and Dr. Crimmins hold joint appointments in the Division of General Medicine and spend a significant amount of time each week teaching residents in the Associates in Internal Medicine Clinic (Vanderbilt Clinic, 2nd floor).
Contact Information
To make an office appointment with Dr. Maya Salameh or Dr. Timothy Crimmins, please call 212-305-1467. Their office is located on the 5th floor of the Herbert Irving Pavilion in Suite 533.
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