Leg pain with Peripheral Vascular Disease before treatment and after treatment.  Patients are pain free after Dr Imtihan Jawdat procedure.


Peripheral vascular disease is a very serious illness, sometimes it can lead to amputation.  Early detection and testing can prevent loss of a limb. This is an example  of a patient X-ray with severe peripheral vascular disease before and after treatment with resolution of symptoms and saving the leg.



Enhanced External counter pulsation

(Also Called ‘EECP’)
What is external counter pulsation?

This is a noninvasive technique to increase oxygen-rich blood flow to the heart and to reduce the heart’s workload. It’s performed over a series of several weeks, with each session lasting from one to two hours. Pressure cuffs on the legs are inflated in sequences. As a result, the blood vessels in the legs are gently compressed and the blood is forced back to the heart. External counter pulsation improves the balance
between the amount of oxygen the heart needs and the amount it gets. Both these changes reduce the pain of angina, increase level of exercise and decrease the need for medication.
This technique

  • lowers the pressure the heart must pump against
  • increases the rate of return of blood to the heart
  • increases blood pressure while the heart is resting

Who is a candidate for EECP?

You may be a candidate if you:

  • Have chronic stable angina
  • Are not receiving adequate relief from angina by taking nitrates
  • Do not qualify as a candidate for invasive procedures (bypass surgery, angioplasty, or stenting)

What happens during EECP treatment?

EECP is a non-invasive, outpatient therapy. During treatment:

  • Patients lie down on a padded table in a treatment room
  • Three electrodes are applied to the skin of the chest and connected to an electrocardiograph (ECG) machine. The ECG will display the heart’s rhythm during treatment. Blood pressure is also monitored.
  • A set of cuffs is wrapped around the calves, thighs and buttocks. These cuffs attach to air hoses that connect to valves that inflate and deflate the cuffs. Patients experience a sensation of a strong “hug” moving upward from calves to thighs to buttocks during inflation followed by the rapid release of pressure on deflation. Inflation and deflation are electronically synchronized with the heartbeat and blood pressure using the ECG and blood pressure monitors.

How does EECP work?

  • The EECP treatment gently but firmly compresses the blood vessels in the lower limbs to increase blood flow to your heart. Each wave of pressure is electronically timed to the heartbeat, so that theincreased blood flow is delivered to your heart at the precise moment it is relaxing. When the heart pumps again, pressure is released instantaneously. This lowers resistance in the blood vessels in the legs so that blood may be pumped more easily from your heart.
  • EECP may encourage blood vessels to open small channels that become extra branches. These channels or collaterals may eventually become “natural bypass” vessels to provide blood flow to heart muscle. This contributes to the relief of angina symptoms.

How often are patients treated?

Patients who are accepted for treatment must undergo 35 hours of EECP therapy. Treatment is administered 1-2 hours a day, five days a week, for 7 weeks. Published studies conducted at numerous medical centers have demonstrated benefits for most patients

  • Less need for anti-anginal medication
  • Decrease in symptoms of angina
  • Increased ability to do activities without onset of symptoms
  • Ability to return to enjoyable activities

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