What is Vascular Medicine? Vascular Medicine is a relatively new but rapidly expanding subspecialty of internal medicine. The Society for Vascular Medicine and Biology was founded in 1989. The field of vascular medicine was first recognized by the American Medical Association in 1998, and the American Board of Vascular Medicine was established in 2004. Vascular medicine focuses on the non-invasive diagnosis and treatment of all problems involving the circulatory system outside of the heart. These problems may involve arteries, which deliver blood from the heart to the tissues; veins, which deliver blood back to the heart; or the lymphatic system, which transports lymph fluid back to the circulation. Commonly encountered conditions in the field of Vascular Medicine include: - peripheral arterial disease / claudication - blockages in the leg arteries; may cause pain with walking
- carotid artery stenosis - blockages in the neck arteries; may lead to a stroke
- renal artery stenosis - blockages in the kidney arteries; may contribute to high blood pressure and/or chronic kidney disease
- abdominal aortic aneurysms (AAAs) - a bulging of the aorta that may cause it to rupture
- venous problems such as deep venous thrombosis (DVT) and chronic venous insufficiency
- Raynaud’s, vasculitis, lymphedema, and other less common vascular conditions
History of Vascular Medicine at Johns Hopkins Exciting and cutting-edge research in the field of vascular biology, the “science” of vascular medicine, has been underway for decades at Johns Hopkins. The Clinical Vascular Medicine Program in the Division of Cardiology was started in 2007. The Division recognizes the importance of early diagnosis and treatment of vascular disease, particularly because it is so often associated with heart disease and cerebrovascular disease. In 2007, Dr. Matthews Chacko became the Director of Peripheral Interventions, and Dr. Elizabeth Ratchford became the Director of Clinical Vascular Medicine. Non-Invasive Diagnosis: Vascular Imaging Vascular ultrasound remains the cornerstone for the non-invasive diagnosis of vascular disease. Dr. Ratchford (Medical Director) supervises the non-invasive vascular ultrasound laboratory, which offers a comprehensive range of vascular ultrasound services including: Non-invasive vascular evaluations are available at Johns Hopkins Cardiology locations throughout the metropolitan Baltimore area including Green Spring Station, Timonium, Columbia, and Odenton. Medical Management Dr. Ratchford has an active clinical practice that focuses on the non-invasive diagnosis and medical management of vascular conditions such as those described above. As a vascular medicine specialist and an internist, Dr. Ratchford’s goals of treatment include aggressive risk factor modification, lifestyle changes, and often a formal exercise program. She treats vascular risk factors such as diabetes, hypertension, and high cholesterol with additional focus on smoking cessation, exercise, and weight loss. She works 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. Endovascular Approach Dr. Chacko specializes in the endovascular (minimally-invasive) treatment of vascular diseases. In some cases, medical therapy may be inadequate and the patient may benefit from an endovascular procedure such as angioplasty and stenting. Additional imaging tests such as magnetic resonance angiography (MRA), computed tomography angiography (CTA) or an additional ultrasound may help guide this decision. Dr. Chacko will discuss all available options with the patient and will help coordinate care, for example in the Cardiovascular Interventional Laboratory (CVIL), or in some cases with a vascular surgeon. In addition to being a vascular specialist, Dr. Chacko is also a cardiologist and treats a wide-range of cardiovascular conditions. Making an Appointment To make an appointment to see a Vascular Medicine specialist at Johns Hopkins, please contact the CAL line. | 
