2016 Top Doctor: Alessandra Puggioni, M.D.

Written by Editorial Staff Category: Profiles Issue: April 2016
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Vascular surgery  
Med School/Year Graduated: La Sapienza University of Rome, 1994

Years in Practice: 21

photography by Steve Craft; Alessandra Puggioni, M.D.You studied medicine in both Rome and Hawaii. What’s your favorite thing about each place?
In Rome, there is so much history, culture and an emphasis on a healthy lifestyle. In Hawaii, the weather, people’s warmth and island lifestyle are unique.

How do Italians compare to Americans in vascular health?
Vascular disease is certainly more prevalent in America. I believe what makes Italians more immune to cardiovascular disease and promotes longevity is the use of feet as a method of transportation, olive oil, tomato sauce and the afternoon nap, which in Rome we call “pennichella.”

Does modest red wine consumption limit heart disease?
That is scientifically proven, and it is due to antioxidants and vasodilation. If you drink red wine, you should do it in moderation. Two glasses a day for men and one for women. I recommend a nice Barolo. If you add laughter here and there, that does not hurt either. A low-stress lifestyle definitely helps.

At what point does cardiovascular surgery end, and vascular surgery begin?
Cardiovascular surgery focuses on the heart and the vessels that come off the heart. Peripheral vascular surgery pertains to the arteries and veins in the rest of the body. Given the high prevalence of cardiovascular disease, often the two specialties overlap.

What inspired you to specialize in venous disease?
I wanted to focus on the medical and surgical treatment of peripheral arterial and venous disorders. I had the opportunity to train with and to be mentored by some of the pioneers in the field. I had exceptional mentors and feel truly blessed to this day [that] I could work with the best of the best in this field.  

What are some of the cutting-edge endovascular procedures in use today?
I routinely use endovascular, minimally invasive techniques for most vascular problems. Instead of performing a surgery I use metal wires and small plastic tubes called catheters with modern vascular devices that allow me to treat my patients with minimal surgical trauma. I am a huge promoter of the motto “First, do no harm.” I also use ultrasound instead of X-rays whenever possible.  This drastically reduces the risk of side effects to the patients.

Do you also treat cosmetic maladies like varicose veins?
Varicose veins are a part of my practice, but it is a misconception that varicose veins are merely cosmetic. Often they are a manifestation of more complex vascular disease or other medical issues. They can cause severe pain, leg swelling and sometimes sores, which are called venous ulcers. Venous issues affect millions of Americans. Millions of days of work are lost due to complications of venous disorders, such as venous ulcers and blood clots, which are potentially life-threatening. Prevention of varicose veins is unlikely, as they often run in the family, but early treatment of complications is important.

What do you like to do in your free time?
I love to swim, travel and to cook.

If I wasn’t a doctor, I’d be...
A chef.