Advanced Treatment, Comfortable Care for Vascular Conditions

Thursday, May 2, 2013
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Advanced technology coupled with the intimacy of a community hospital make St. John’s Riverside Hospital the ideal location for patients to receive leading-edge care for difficult-to-heal wounds, aneurysms and vascular disease without leaving Westchester County.

“The hospital has been supportive of bringing in new technologies and allowing us to grow special programs,” says Gary Tannenbaum, M.D., Director of the Department of Surgery and Medical Director of the Wound Healing and Hyperbaric Oxygen Center. “In turn, that allows us to offer the community programs and treatments that might not be offered in other community hospitals. Patients don’t have to seek out huge centers in the city, where they don’t know anyone and forgo the comfortable care only a community hospital can offer.”

One such specialty program the hospital has nurtured for 20 years is wound healing. In 2011, St. John’s Riverside Hospital expanded the program’s services with the addition of hyperbaric oxygen therapy (HBOT) inside its Wound Healing and Hyperbaric Oxygen Center. Now, patients with wounds that fail to heal with debridement, topical antibiotics, dressings, and wraps can benefit from adjuvant HBOT therapy.

“We typically use HBOT to treat patients — especially those with diabetes — who fit certain categories of wounds that have failed to heal,” Dr. Tannenbaum says. “We add HBOT to augment healing, while still treating them with standard wound-healing measures. In this manner, we’ve increased our healing rates and seen great results in our patients.”

As part of HBOT, patients lie on a stretcher inside the clear, plastic chamber through which they can watch TV or listen to music if they desire. Providers pump 100% oxygen into the chamber, which is kept at two to three atmospheres of pressure, according to Dr. Tannenbaum. For one hour each day, patients breathe the highly oxygenated air under this pressure, which diffuses oxygen into the wound’s surrounding tissues and promotes healing.

Expanded Access to Stenting Procedures

In addition to his appointments in the department of surgery and the Wound Healing and Hyperbaric Oxygen Center, Dr. Tannenbaum also serves as Chief of the Division of Vascular Surgery and Medical Director of the Vascular Laboratory at St. John’s Riverside Hospital. For aneurysm repair, he has adopted minimally invasive principles to improve patient recovery times and outcomes.

In the past, patients suffering from an abdominal aortic aneurysm were subjected to a large, muscle-lacerating incision in the abdomen. Dr. Tannenbaum now uses catheter-based methods to deploy a smaller, more pliable, fabric-covered stent graft through a 2-inch incision in the groin to repair the aneurysm. Newer devices allow treatment of aneurysms near or involving the renal arteries, greatly expanding the number of patients who can potentially be treated with these less invasive procedures.

“Aneurysm repair continually advances to incorporate smaller and smaller devices, making them more adaptable for patient anatomies that might have made the stent procedure impossible in the past,” Dr. Tannenbaum says. “Nowadays, we can usually implant these stent grafts under light anesthesia, and the patient spends one or two nights in the hospital before going home. Because we’re not making a large incision, the risk of cardiac or pulmonary complications is greatly reduced, and patients typically can resume normal activity without restriction.”

Dr. Tannenbaum hopes to further expand stent technology at St. John’s Riverside Hospital this summer with the addition of the Zilver PTX Drug-Eluting Peripheral Stent, which was approved by the U.S. Food and Drug Administration (FDA) in November 2012. While initial angioplasty treats stenosis in stenotic or occluded peripheral arteries, in some patients, narrowing can recur. However, the Zilver stent is coated with Paclitaxel, which releases medication into the artery walls around the stent to prevent overgrowth of normal tissue associated with the healing process, reports the FDA.

Dr. Tannenbaum says new stent grafts and other technologies continue to diminish contraindications and improve outcomes for patients in need of minimally invasive medical interventions. And their availability at St. John’s Riverside Hospital allows community care to flourish without sacrificing quality and skill of care.

“Twenty years ago, patients who had serious medical conditions went to tertiary care centers,” recalls Dr. Tannenbaum. “Now, the majority of patients with the same conditions can be successfully treated at our community hospital, receiving the same procedures and level of care they would experience at a larger hospital. Advanced technology allows us to do more and do better for our patients, while maintaining the friendly atmosphere that typifies the community hospital.”


For more information about how St. John’s Riverside Hospital incorporates innovative technology into treatments, please visit www.RiversideHealth.org.