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West Maui doctor develops new vascular screening program

By Staff | Aug 20, 2009

Dr. George S. Lavenson Jr. uses a Doppler to check blood flow in a wounded U.S. soldier at Landstuhl Air Base in Germany in 2008. The same noninvasive tool is used to screen for Peripheral Arterial Disease.

LAHAINA — Dr. George S. Lavenson Jr. is advocating a new medical screening program that can help prevent deadly heart attacks and strokes.

“It is my hope that when I give a presentation on screening at the Max Gaspar Vascular Symposium at USC (University of Southern California) in September, it will help to jump-start acceptance of the concept and program,” he said.

While “retired,” Lavenson, a leading vascular surgeon, is traveling the world this year to present scientific papers and substitute for doctors taking a break from their surgery practices.

He is suggesting a screening program that involves a quick ultrasound scan of the carotid arteries in the neck for cholesterol blockage, the leading cause of strokes; the abdominal aorta for aneurysms; and the femoral arteries in the legs, a potent indicator of cholesterol blockage of the coronary arteries — the leading cause of heart attacks.    

“Abnormality of any of these scans is the indication to do testing for blockage of the coronary arteries and for high cholesterol,” he explained.

Lavenson won two awards from the Society of Vascular Ultrasound for his paper on this screening program at its annual convention held recently in Denver.

He also detailed the program in “Vascular Ultrasound Today,” and he has a manuscript under consideration for publication in the Journal of Vascular Ultrasound.

He hopes this screening method will become common and widespread.

“Some are doing elements of our screening program in Oregon, Florida and elsewhere, but we need to have it become widely employed, such as with Pap smears for cancer of the cervix, mammography for cancer of the breast, colonoscopy for cancer of the colon and the PSA for cancer of the prostate,” he said.

Lavenson noted that heart attacks and strokes are our leading health care problems.

Heart attacks represent the leading cause of death — more than 600,000 per year in the United States — and strokes represent the leading cause of disability.

Americans suffer more than 200,000 strokes each year, which are responsible for half of all nursing home admissions and Medicare expenditures of more than $60 billion annually.

“Over 50 percent of heart attacks come without warning in people with no prior symptoms, and 80 percent of strokes occur without warning. And yet screening of seniors with a simple, rapid, noninvasive and inexpensive ultrasound examination can lead to the discovery of the immediate causes of heart attacks and strokes, as well aneurysmal enlargement of the abdominal aorta that can burst and be fatal,” Lavenson said.

“Once discovered, there is excellent and effective management for these immediate causes of heart attacks, strokes and aortic aneurysms before the disasters occur.”

Blocks of the carotid arteries can be treated with surgery or stents to prevent strokes.

Disease of the coronary arteries can be treated with medicine, stents or surgery to prevent heart attacks.    

Aneurysmal enlargement of the abdominal aorta can be treated with stents or surgery.

Medical management to lower cholesterol would accompany all of these options.

Lavenson said the ultrasound equipment is available on Maui, and Maui Memorial Medical Center has scheduled a screening program on Aug. 29 to check blood pressure in seniors’ legs. These checks can help indicate possible blockage in more serious areas, he noted, “and is very worthwhile and a good start.”

Lavenson believes Maui could serve as a research model for ultrasound screening.

“Maui is a great place to start, as we know the incidence of our heart attacks and strokes on this rather defined island and could see if the program reduced these as a model for elsewhere, really in synch with the new emphasis on prevention. The discovery of coronary artery disease also has good timing with our new cardiac surgery capability here on Maui,” he said.

Health Grades, a firm contracted by Medicare, listed Lavenson among the nation’s leading vascular surgeons, and this was published in Money Magazine.

Trained at the University of Washington Medical School, Lavenson served as an Army surgeon for 20 years, then had a surgical practice for another 30 years in Visalia,  California, before retiring in 2005.

Lavenson has treated U.S. soldiers in three wars: Vietnam and the first Gulf War in Kuwait on active duty, and during the 2008 holiday season at Landstuhl Air Base in Germany — one of the world’s most advanced hospitals — to help care for U.S. soldiers flown in from Iraq and Afghanistan.