Specialty
Vein & Vascular
Severe pain at rest, non-healing ulcers, blackened tissue. CLTI is a medical emergency for the leg — and we treat it the same week, often the same day.
Chronic Limb-Threatening Ischemia (CLTI) is the most severe stage of peripheral artery disease — when blood flow drops so low that tissue starts dying. The give-away signs are constant pain at rest (especially at night, often relieved by hanging the foot off the bed), non-healing ulcers, and black or gangrenous patches on toes or heels.
CLTI is genuinely a race against time: every week of delay raises the chance of amputation. The standard of care today is urgent revascularization — opening the blocked arteries with angioplasty, stents, atherectomy or surgical bypass — combined with infection control and aggressive wound care. With early treatment, the limb-salvage rate exceeds 90%.
Book a Consulting →Minimally invasive, in-office diagnostics and procedures — no hospital stay.
Care led by a board-certified interventional cardiologist, not a generalist.
Endocrinology, vascular and wound care under one roof — one plan, not five referrals.
Same-week new-patient appointments across five Hudson County locations.
Insurance verified before your visit — no billing surprises.
A small, senior team — board-certified cardiology, vascular, podiatry and endocrinology — sharing one chart and one plan.
Dr. Merwin Richard, MDInterventional Cardiologist
Dr. Bakul Desai, MDBoard-Certified Cardiologist
Margaret M. Ciechanowska, MDEndocrinologist
Dr. Maher BadriInternal Medicine
Christopher Samaniego, DPMPodiatrist
We coordinate evaluation, angiogram and treatment in the shortest possible window — same week for most patients, same day for emergencies.
Same-week imaging to map and grade the blockage.
Learn more →
Open the blocked artery to restore flow to the foot.
Learn more →
Carefully remove plaque to re-establish a durable channel.
Learn more →Specialized small-vessel techniques for diabetic CLTI.
Learn more →
Coordinated debridement, dressings and antibiotics.
Learn more →Coordinated, specialist-led vascular care — in five Hudson County locations, close to home.
Specialist-led care
In-office OBL
Same-week appointments
Coordinated care team
Minimally invasive
Insurance conciergeIf two or more of these apply to you, a baseline vascular evaluation is one of the highest-yield prevention steps you can take.
A predictable four-step path — no guesswork, no months of waiting between appointments.
Vascular exam, ABI and on-site imaging — usually completed in one visit.
A coordinated written plan tailored to your anatomy and goals.
Minimally invasive treatment in our OBL, under local anesthesia.
Structured follow-ups, surveillance imaging and risk-factor coaching.
Real, specific answers from our team. If your question is not here, our front desk can usually answer it in a 5-minute phone call.
CLTI is an urgent condition. New rest pain or a non-healing ulcer with PAD should be evaluated within a week — sooner if there is active infection or tissue loss. We hold same-week and same-day urgent slots.
With timely revascularization plus modern wound and infection care, limb salvage exceeds 90%. Delay is the single biggest enemy.
No. Most CLTI today is treated through a tiny catheter — angioplasty, stents and atherectomy — in our office under local anesthesia. Open bypass is reserved for the few cases that need it, and we coordinate that referral.
Below-the-knee arteries can be challenging, but modern small-vessel devices and pedal-loop techniques succeed in the great majority of cases. We do these every week.
Many do for years. Some need re-intervention. We do scheduled ultrasound surveillance at 1, 6 and 12 months and act early on any narrowing before it becomes a problem.
Yes — Medicare and all commercial plans cover urgent vascular evaluation and treatment of CLTI. Our concierge can verify in hours, not days.
Names changed where requested. Every quote below comes from a patient seen at one of our Hudson County locations.
“I was told I’d lose the toe within a month. Three weeks after the angioplasty it was healing. I still have all ten.”
“They saw me within 48 hours. No waiting list, no delays, no excuses. That speed saved my foot.”
“The pain at night was unbearable. After the procedure I slept through the first night in weeks.”
If you have rest pain or a non-healing ulcer, please don’t wait. Our urgent vascular team holds same-week and same-day slots for CLTI evaluation.
Patient Login
(201) 581-6100