Prompt Response to Arteriosclerosis in the Legs

Providing Accurate Diagnosis and Treatment

Lower limb obstructive arteriosclerosis (PAD) carries a risk of gangrene or limb amputation if early symptoms are overlooked. Our hospital has established a system for same-day diagnosis and is nationally recognized for its achievements in catheter-based treatment.

Providing Medical Institution

Kishiwada Tokushukai Hospital

〒596-0042
4-27-1 Kamoricho, Kishiwada City

https://kishiwada.tokushukai.or.jp/en/

Specialty

**Cardiovascular Surgery:**
1. Coronary Artery Disease
2. Heart Valve Disease
3. Aortic Aneurysm
4. Aortic Dissection
5. Arteriosclerosis Obliterans
6. Arterial Thrombosis
7. Complications of Myocardial Infarction
- Ischemic Cardiomyopathy
- Left Ventricular Rupture
- Left Ventricular Aneurysm
- Ventricular Septal Rupture
- Papillary Muscle Dysfunction (Mitral Regurgitation)
8. Infective Endocarditis
9. Intracardiac Tumors

**Cardiology:**
1. Ischemic Heart Disease (e.g., Angina, Myocardial Infarction)
2. Lower Limb Arteriosclerosis Obliterans
3. Arrhythmia
4. Heart Valve Disease
5. Aortic Stenosis
6. Mitral Regurgitation

**Lower Gastrointestinal Surgery**
*Da Vinci Si - Robot-Assisted Surgery*
1. Malignant Diseases
2. Surgical Treatment of Small and Large Intestine Diseases
3. Primarily Surgical and Medical Treatments for Colon and Rectal Cancer
4. Robot-Assisted Surgery
5. Laparoscopic Surgery
6. Multimodal Therapy Combining Surgery, Chemotherapy, and Radiation Therapy
7. Systemic Chemotherapy for Unresectable Colorectal Cancer

**Breast Surgery:**
1. Breast-Conserving Surgery
2. Mastectomy
3. Sentinel Lymph Node Biopsy
4. Lymph Node Dissection
5. Breast Reconstruction Using Autologous Tissue

**Neurosurgery:**
1. Stroke
2. Cerebral Hemorrhage
3. Subarachnoid Hemorrhage
4. Cerebral Infarction
5. Head Trauma
6. Traumatic Intracranial Hematoma
7. Skull Fracture
8. Chronic Subdural Hematoma
9. Brain and Spinal Cord Tumors
10. Acoustic Neuroma
11. Pituitary Tumor
12. Meningioma
13. Metastatic Brain Tumors
14. Functional Neurological Disorders
15. Facial Spasm
16. Trigeminal Neuralgia
17. Epilepsy
18. Normal Pressure Hydrocephalus

**Urology**
*Da Vinci Si - Robot-Assisted Surgery*
1. Robot-Assisted Laparoscopic Radical Prostatectomy
2. Prostate Cancer
3. Renal Cancer
4. Upper Urinary Tract Cancer
5. Urolithiasis (Urinary Stones)

**Radiology:**
1. Comprehensive Imaging Diagnosis (X-ray, Ultrasound, CT, MRI, Angiography, PET)
2. Liver Tumors
3. Gastrointestinal Hemorrhage
4. Arterial Embolization for Hemoptysis and Traumatic Hemorrhage
5. Transcatheter Venous Embolization for Gastric Varices
6. Intra-Arterial Chemotherapy for Cancer
7. Reservoir Placement
8. CT-Guided Biopsy (Interventional Radiology - IVR)
9. TomoTherapy - Radixact

**Dialysis**
*Travel Hemodialysis* (Available for Individual Travelers Only, Not for Groups)

**Other**
*Second Opinion* (In-person Only, Online Not Available)

Eligibility Criteria/Exclusions for Treatment

1. Medical Information: - Diagnosis - Details of symptoms - Onset date and progression - History of treatment at other facilities and availability of referral letters 2. History of Treatment: - Past treatments (e.g., surgery, medication, rehabilitation) - Effectiveness of treatment and presence of side effects - Current medications and presence of allergies 3. Age: - Age restrictions for patients (e.g., suitability for pediatric or elderly care) 4. Treatment Duration, Days, and Time: - Estimated hospitalization period - Time required for treatment or examinations - Frequency of outpatient visits and availability of emergency care Based on the above information, we determine the acceptability of the patient and develop an appropriate treatment plan.

Precautions / Contraindications

[Precautions and Contraindications]

1. Cases Not Suitable for Surgery or Treatment:
- Patients with severe comorbidities (e.g., heart failure, untreated infections, advanced renal failure) may face significant risks for surgery or catheter-based treatments, requiring careful consideration.
- In cases of terminal atherosclerosis or extensive vascular occlusions, catheter-based treatments may be difficult.
- For patients with advanced gangrene caused by diabetes, urgent intervention is necessary, but some cases may be challenging to treat.

2. Precautions Related to Medication Therapy:
- Patients taking anticoagulants or antiplatelet drugs must discontinue them before treatment, following prescribed instructions carefully.
- If there is a history of allergies or adverse reactions to medications, special caution is required in drug selection.

3. Risks of Post-Treatment Complications:
- Risks such as thrombosis, bleeding, and infection necessitate postoperative care and regular follow-ups.
- Since there is a risk of restenosis, lifestyle modifications and periodic monitoring after treatment are essential.

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[Important Pre-Treatment Information]

1. Preoperative Preparation:
- Preoperative tests (e.g., blood tests, vascular ultrasound, ABI measurements) are critical for accurate diagnosis and treatment planning and must be completed.
- Follow instructions on the discontinuation period for anticoagulants or antiplatelet drugs and alternative therapies, if required.

2. Postoperative Complications and Care:
- Risks such as wound infections, thrombosis, and bleeding require adherence to the physician’s instructions and immediate reporting of any abnormalities.
- Regular follow-ups and monitoring are necessary to address risks of restenosis or recurrence.

3. Lifestyle Modifications:
- After treatment, lifestyle changes such as smoking cessation, exercise, and dietary management are crucial to prevent the progression of atherosclerosis.

4. Hospitalization and Postoperative Schedule:
- The duration of hospitalization and postoperative observation varies depending on the patient’s condition, and the schedule should be confirmed in advance.
- Adhere to instructions regarding limitations on activities and daily life after discharge.

5. Emergency Response:
- If symptoms such as leg pain, fever, or discoloration of toes occur after discharge, contact a medical facility immediately.
- Confirm emergency contact information and the availability of medical facilities capable of responding to urgent cases in advance.