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Dr. Raul Guzman Hopes to Bring a Unique Patient Care Experience to New Vascular Clinic

Tuesday, October 08, 2013

Raul Guzman, M.D., vascular surgeon at Beth Israel Deaconess Medical Center and Visiting Associate Professor of Surgery at Harvard Medical School, joined Joslin Diabetes Center at the end of August to address one of the most significant diabetes issues – peripheral arterial disease (PAD).  Dr. Guzman initiated a weekly clinic that treats diabetes-related vascular complications and explores innovative therapies to prevent them. 

People with diabetes have too much glucose, or sugar, in their blood stream and over a long period of time this can lead to damage in the blood vessels.  This damage can result in the development of blockages of the arteries in the legs.  In the vascular clinic, Dr. Guzman treats patients with a variety of problems that result from diabetic vascular disease including claudication and critical limb ischemia.

Critical limb ischemia is the worst form of vascular disease affecting the legs and feet; it occurs when the blood flow to the legs is severely decreased.  Another unfortunate and common complication of diabetic vascular disease is diabetic foot ulcers, which happens when blisters or sores appear on the feet due to nerve damage and poor circulation. Dr. Guzman also addresses claudication, otherwise known as a cramping pain in the calf muscles that is caused by insufficient blood flow when someone is walking.

In conjunction with other Joslin physicians, Dr. Guzman seeks to deliver high quality and comprehensive vascular care in a timely manner.  

“One of our main goals is to develop a system that can provide a complete foot evaluation for our patients within 24 hours of their presentation,” said Dr. Guzman. “By that, I mean that a patient who comes to see us at Joslin should be able to undergo vascular, wound care and podiatry assessment in standardized and efficient manner.”

He continued, “What we really want to do is decrease the length of time it takes to get a patient from the initial visit to definitive treatment.  And we think that by doing this, we can improve outcomes and get patients back to their usual activity level as quickly as is possible.”

One significant vascular problem for patients with diabetes and renal failure – as well as Dr. Guzman’s main area of interest – is arterial calcification, which is the hardening of arteries that happens when calcium deposits form in the arterial wall and in the plaque inside arteries.  When calcification occurs, it contributes to stiffness in the arteries that can result in severe blood flow impairment. Dr. Guzman plans to work in the clinic to develop new treatments for patients with severe arterial calcification.

“One of things we can do as a team is engage in clinical research that provides cutting edge therapies to our patients with the most difficult vascular problems,” explained Dr. Guzman. 

Dr. Guzman is currently investigating a potential group of chemical agents that may work to inhibit proteins involved in vascular calcification. Recent research performed using rodent models suggests that they may be able to slow the progression of arterial calcification in patients with diabetes. If these new inhibitors become available for treatment, they may offer an alternative to surgery for some of the most severely affected patients.

“We hope to be able to help patients who do not have a surgical option by offering them a treatment that will improve their chances of healing and decrease their risk of amputation,” commented Dr. Guzman.

This intersection between high quality clinical care and innovative research is an essential part of the multidisciplinary approach that Joslin thrives on.  Expanding this model into peripheral vascular disease will be the main focus of the new clinic.

“Joslin offers a multidisciplinary approach to diabetes care and many people may not realize what multidisciplinary care is, or that care at Joslin involves a team of experts in the field who are focused on each patient’s care,” said Bridget Stewart, LPD, MBA and Vice President, of Clinical Operations at Joslin.  “The addition of Dr. Guzman to the clinical team adds yet another level of specialty expertise, specifically to protect and reduce the risk of lower extremity complications.”

Dr. Guzman shares Stewart’s excitement and vision for implementing and building the vascular clinic at Joslin. 

“I am thrilled to be joining the staff at Joslin and think the opportunity to develop the vascular clinic here is an exciting one,” said Dr. Guzman. “I hope to be able to build a premiere outpatient experience for our patients with diabetic vascular disease. Ultimately, our goal is to be patient centered with a focus on quality care and excellent outcomes.”

To schedule an appointment with Dr. Guzman call 617-309-2440 or visit www.joslin.org/care/appointments.html.

Page last updated: April 18, 2014