January-February 2013 | VEIN GLORIOUS



Dr. Douglas Wilhite of the Mid-Atlantic Surgical Group discusses some exciting developments in the treatment of vascular disease

Written By: Nick Brandi | Photographer: Grant L. Gursky

With over 30 years of service to the community under their collective belt, the skilled physicians of Mid-Atlantic Surgical Group have carved quite a credible niche for themselves as a vanguard of state-of-the-art surgical and treatment techniques. In addition to general surgery, they specialize in laparoscopic, thoracoscopic, vascular, bariatric and breast surgery. Recently, locally renowned surgeon and practice partner Dr. Douglas Wilhite discussed some aspects of modern vascular surgery that are especially relevant to residents of the Eastern Shore.
“It’s an exciting time in vascular medicine these days,” said Dr. Wilhite. “The last 10 to 15 years have seen dramatic advances in vascular procedures, specifically endovascular and other minimally invasive procedures. It’s especially 
exciting for us because, as a practice, we always try to stay at, if not one step ahead of, the curve in terms of the clinically tested and sanctioned procedures we perform.”
Currently, Dr. Wilhite said 70%-75% of the surgery he performs involves endovascular procedures, including x-ray-guided procedures, catheterization, balloon angioplasty, stents and other devices that work inside arteries or veins. This is an encouraging trend because it means more and more people can be treated with techniques that involve less trauma to the body and faster convalescence, for a more complete recovery overall.
Though vascular disease and its symptoms can occur at any time of life, they manifest much more often in people of middle age and older, especially if genetic and lifestyle factors predispose them to it. What follows is a discussion of the most common vascular conditions that face that demographic and the minimally invasive corrective procedures available to them.
One of the body’s most important vessels, there are actually two carotid arteries, the left and right, referred to collectively as the common carotid arteries. These arteries supply essential oxygenated blood through the neck to the face and brain. Because this vascular structure branches off to different areas of the head, it has at its base what amounts to a vascular delta, where the reduced flow of blood sets the stage for the deposit of material that can result in the formation of plaque against the arterial wall. If a piece of that plaque were to break off and clog or block an artery, a massive stroke can occur. Stroke is the fourth leading cause of death in the America and a leading cause of adult disability. The good news is that 80% of strokes can be avoided.
Carotid endarterectomies are a comparatively safe, effective and routinely performed procedure at Mid-Atlantic Surgical, and they can permanently diffuse the time bomb that may be ticking within you. Dr. Wilhite says that people 50 and older are at greater risk, especially if they are diabetic, smoke, have hypertension or hereditary factors that predispose them to arterial plaque formation. He added that early detection is the key and that PRMC offers free screenings on a monthly basis.
Occasionally, the wall of an artery will weaken at a 
specific location, allowing for the formation of a “balloon” or bulge in the arterial wall at the weakened spot. That bulge is known as an aneurysm. Once the aneurysm grows large enough, it can rupture or split (known as a dissection), 
triggering dangerous bleeding within the body that is often fatal. Usually stemming from the aorta, the body’s main 
artery, aneurysms are most commonly found in the thoracic (chest) cavity or the abdomen, with abdominal aortic aneurysms (AAAs) accounting for about 95% of the aneurysms Mid-Atlantic Surgical treats. They can repair the aneurysm with a simple stent procedure, which will prevent blood from accumulating in, and therefore rupturing, the affected artery.
Dr. Wilhite — who since 2006 is the chief of vascular surgery at Peninsula Regional Medical Center — emphasizes that everyone over 60 who is a regular smoker especially needs to be evaluated for aortic aneurysms and that a quick, safe and painless ultrasound screening is all that’s required to identify a risk. He added that congress’ passage of the SAAVE Act of 2009 mandates that Medicare provide a one-time AAA ultrasound screening for at-risk beneficiaries.
It seems more people than ever are being diagnosed with what’s called Peripheral Artery Disease (PAD) these days. PAD is a condition that involves reduced or abnormal blood flow to the extremities, particularly the legs. It is characterized by severe muscle cramps and chronic pain after walking a certain minimum distance, such as the length of one city block. Most common in people over 50 who have diabetes and/or smoke, Mid-Atlantic Surgical performs safe and effective limb salvage procedures to restore normal blood flow to these areas.
Whether it involves discomfort due to ulceration or is only for cosmetic purposes, which includes lower-extremity discoloration, varicose disease (known colloquially as varicose veins) is a very common condition in people of middle age and older and the most common venous disorder overall. Left untreated, risk factors may eventually emerge, but Mid-Atlantic Surgical Group can resolve this condition with endovascular procedures that about 85% of the time can be done on an outpatient basis or have you out and about the next day. In fact, most of the vein-related procedures the practice performs can be done by laser techniques within the comfort and privacy of its own offices.
Dr. Wilhite concluded by pointing out that for the conditions described above and others, regular visits and checkups are an essential part of remaining free of disease and dysfunction, which is why his practice maintains lifelong relationships with the majority of its patients. More than just alleviate your symptoms, Mid-Atlantic Surgical Group will work with you on things like smoking cessation, diabetes control and dietary modification or restructuring so that further vascular disease or compromise may be avoided.

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