Peripheral Arterial Disease (PAD) continues to pose a serious and often underestimated threat to patients across the United States. What may begin as leg discomfort or slow-healing wounds can escalate into chronic limb-threatening ischemia (CLTI), infection, and life-altering amputations when vascular disease goes undiagnosed or untreated. In a region as large and medically complex as North Texas, access, speed, and coordination of care can determine outcomes. This is precisely where PADS DFW has emerged as a vital force — and where the leadership vision of Dr. Andrew Gomes is reshaping how outpatient limb-salvage care is delivered at scale.
Opened on April 1, 2022, PADS DFW has quickly established itself as a high-impact outpatient vascular center, completing 1,919 consults and 1,413 procedures in just over two years. But beyond the numbers, the facility reflects a broader philosophy championed by Dr. Gomes: that limb preservation succeeds when advanced technology, multidisciplinary expertise, and human-centered care operate as one system.
Building a Regional Access Point for Limb Salvage
The Dallas–Fort Worth metroplex is home to millions of residents spread across urban, suburban, and semi-rural communities. Despite its size, gaps in specialized PAD care persist, particularly for seniors, nursing home residents, and patients with mobility or transportation challenges. Delays in evaluation often result in patients presenting only when disease has progressed to its most severe stages.
PADS DFW was designed to confront this challenge directly. With an average appointment wait time of less than one week, the clinic prioritizes speed without sacrificing clinical rigor. Referring podiatrists, wound-care teams, and primary providers consistently note the center’s rapid responsiveness and clear communication — a hallmark of the operational systems Dr. Andrew Gomes has spent more than 15 years refining across outpatient vascular programs.
One recent case illustrates this impact vividly. A patient referred by a podiatrist arrived after being told by two separate physicians that a below-knee amputation was unavoidable. The PADS DFW team evaluated the patient the very next day, performed a complete revascularization, and ultimately preserved the limb. What had been labeled “inevitable” was avoided through timely access, advanced techniques, and coordinated care.
What Sets PADS DFW Apart in a Competitive Market
North Texas is home to numerous healthcare facilities, yet PADS DFW distinguishes itself through a combination of technical capability, patient support, and culture.
Clinically, the facility is one of the few in the DFW area capable of performing pedal loop access — a highly specialized endovascular technique that allows revascularization of complex below-the-knee and foot vessels. Referring physicians frequently cite this capability as a decisive factor when sending high-risk cases to PADS DFW.
Operationally, the clinic removes barriers that often prevent patients from following through with care. Transportation assistance ensures patients can attend appointments, while free meals at every visit address a practical but often overlooked need among seniors. Staff members routinely hear that these meals — paired with kindness and familiarity — play a meaningful role in keeping patients engaged in their treatment plans.
Community involvement further strengthens the clinic’s role beyond its walls. PADS DFW sponsors local events, participates in health fairs, and regularly educates seniors about vascular disease and limb-saving options. This outreach reflects Dr. Gomes’ belief that improving PAD outcomes requires education and early engagement, not just procedural excellence.
Inside the Outpatient Limb-Salvage Framework
At PADS DFW, limb preservation follows a structured, multidisciplinary pathway optimized for the outpatient setting:
- Comprehensive Diagnostics
Patients undergo targeted vascular testing, including ABI/TBI, duplex ultrasound, toe pressures, and advanced imaging when needed. Early vascular assessment ensures wounds are not treated in isolation. - Advanced Revascularization
Most interventions are minimally invasive endovascular procedures performed under local anesthesia, including angioplasty, atherectomy, stenting, and complex below-the-knee work such as pedal loop access. These techniques minimize recovery time while maximizing perfusion. - Integrated Wound and Referral Coordination
The clinic works closely with podiatrists, wound-care specialists, and nursing facilities to align treatment plans, monitor healing, and prevent recurrence. - Ongoing Follow-Up and Education
Patients receive consistent follow-up and education to reinforce the importance of vascular health, adherence to appointments, and lifestyle management — a core component of sustained limb preservation.
Culture as a Clinical Advantage
While technology and technique matter, PADS DFW’s leadership emphasizes that culture is equally critical. The clinic operates as a small, tightly knit team where accountability and compassion coexist. Staff members personally reach out to patients, explain the urgency of care, and ensure no referral is lost in the shuffle.
This environment is embodied by Emma Balcarcel, the facility’s Employee of the Year. Serving as a CS1/2, Emma is recognized not only for her clinical excellence but for her rapport with patients and unwavering commitment to the team. Known for her willingness to travel, support colleagues, and step in wherever needed, she has become a cornerstone of daily operations. Patients consistently mention her warmth and professionalism, while coworkers describe her as a true rockstar teammate. Outside the clinic, Emma brings the same energy to her personal interests, balancing work with hobbies that reflect her driven and positive nature.
Dr. Andrew Gomes’ Vision in Action
For Dr. Andrew Gomes, PADS DFW represents more than another outpatient facility — it is a living example of how thoughtful system design can change outcomes across an entire region. His background spanning diagnostic radiology, outpatient procedural leadership, and healthcare operations has shaped a model where efficiency supports — rather than compromises — patient care.
Low complication rates, fast access, and strong referral relationships are not accidental. They are the result of deliberate integration between clinical expertise and operational clarity. In a healthcare landscape often strained by delays and fragmentation, PADS DFW demonstrates what is possible when outpatient vascular care is built with intention.
Looking Ahead: A Scalable Model for North Texas
As PAD prevalence continues to rise with aging populations and increasing rates of diabetes, the need for accessible limb-salvage care will only grow. PADS DFW offers a blueprint for how outpatient centers can meet this demand — blending advanced techniques, community engagement, and genuine compassion.
For patients across the DFW metroplex, the message is clear: limb loss does not have to be the default outcome. With leaders like Dr. Andrew Gomes and facilities like PADS DFW, the future of limb preservation in North Texas is faster, more humane, and measurably more effective.