Author: Angelica Rodezno

TREATING DIABETIC FOOT ULCERS

Posted on by Angelica Rodezno

Millions of patients every year are seen in wound care centers for the treatment of their foot and leg ulcers. This is absolutely the correct place for anyone who has had a wound that is “non-healing” or “chronic”. That is, a wound that is still there after four weeks. Unfortunately, sometimes the physicians in these wound care centers are quick to put on expensive savs or other advanced treatment options. After all, isn’t that why the patients go to the wound care center instead of just their physician’s office? Partially. Good wound care centers treat by guidelines.

Guidelines are a scientifically proven set of steps that have been shown to help wounds heal faster. For EVERY wound on the leg or foot, the very first step is to assess BLOOD FLOW. This means that every patient with a leg or foot wound that hasn’t healed in four weeks MUST be seen by both a vascular surgeon AND a podiatrist (foot specialist).

The vascular surgeon will assess the circulation and order appropriate diagnostic tests, such as vascular ultrasounds to look at the blood flow. This is important to examine, as a large number of the patients who have ulcers, have not previously been diagnosed with an arterial or venous problem. Without fixing the underlying cause of the ulcer, even if it does heal initially, it will soon recur, and cause further problems. It is important for patients to take an active role in asking for these referrals so that the problem does not progress and become a wound that can lead to an amputation.

If you or anyone you know is diabetic and suffers from non-healing leg wounds call today to schedule an appointment at our office. South Bay Vascular Center and Vein Institute Surgeons are recognized as the regional experts in wound care healing and amputation prevention. Our Vascular Surgeons have performed more lower extremity re-vascularizations than any other surgeons in the region and offer hope when others say there is none.

Call today at 408-376-3626

USE IT OR LOSE IT!

Posted on by Angelica Rodezno

Now may be the best time to ” Love Your Legs Again”. Many corporate flexible health spending accounts create an ideal opportunity to give yourself that special gift of being able show off your legs again. Call today. Time is limited. If you’ve met your 2017 deductible getting back your beautiful might be a whole lot easier that you thought.

We can help!

408-376-3626

South Bay Vascular Center and Vein Institute: Northern California’s most experienced varicose vein doctors and treatment centers.

A MULTI-CULTURAL APPROACH TO VASCULAR CARE

Posted on by Angelica Rodezno

South Bay Vascular Center and Vein Institute, with offices in Campbell and Gilroy CA., is recognized as one of the leading vascular surgery practices in Northern California. In addition to their cutting edge work in amputation prevention, South Bay Vascular Center is widely recognized as the leading center for the diagnosis and treatment of iliac-vein compression, medically know as May-Thurners disease, in the whole of the Western United States. Using the most advanced diagnostic imagining technology, Intra Vascular Ultrasound (IVUS), Dr’s Kokinos and Pineda have treated more patients for this mostly undiagnosed cause of leg swelling….a condition which often presents in patients as left leg swelling, than any other medical practice in the region.

Delivering exceptional care, however, involves much more than simply being the best practitioner. Exceptional patient care demands compassionate care. Exceptional patient care is born of a philosophy that understands the patient apart from their disease….it requires an understanding of how disease impacts every part of a patients life…their lifestyle, their family, their friends and most importantly, their future. Communicating this understanding to patients is difficult in the best of circumstances and when patients come from a different cultural system, communication becomes even more difficult.

At South Bay Vascular Center and Vein Institute, we pride ourselves in being able to communicate with our patients across multiple cultural and language barriers. To this point, our physicians and staff speak many different languages and represent a diversity of cultural and faith traditions. As native speakers South Bay Vascular Staff can communicate with our patients in the following languages:

  • Spanish
  • Greek
  • German
  • Hindi
  • Farsi
  • Russian
  • English
  • Tagalog
  • French
  • Turkish

Additionally, our staff is sensitive to many diverse cultural traditions, faith based gender sensitivities and ethnic differences.

South Bay Vascular Center is a community based surgical practice operating at the forefront of vascular medicine. Our physicians provide unmatched medical care by providing the best possible outcomes in the most difficult of circumstances. In our private, nationally accredited state of the art ambulatory surgery center and vascular ultrasonography laboratory we treat each and every patient with the utmost of respect allowing them to maintain their dignity in difficult times

Large medical systems, often referred to as “Big Box” medicine, are an operationally efficient and a very profitable way to practice medicine but delivering exceptional care is difficult as the underlying drivers are often constrained by larger “business” decisions instead of what’s in the best interest of the patient. At South Bay Vascular, we operate with a care philosophy wholly different than big box medicine and as such, provide an unmatched level of care not found anywhere else in the region.

A multi-cultural approach to providing exceptional vascular care is just one of the many ways that the physicians and staff at South Bay Vascular Center and Vein Institute strive to be the best at what we do. Together with providing the most sophisticated medical care we deliver exceptional patient care in the most difficult of circumstances.

If you our anyone else that you know suffers from problems in any part of their circulatory system, call us today to learn how we can help.

DR. KOKINOS RECOGNIZED AS A THOUGHT LEADER AT ANNUAL DIALYSIS ACCESS CONFERENCE

Posted on by Angelica Rodezno

Dr. Kokinos speaks on complex dialysis access issues at the annual CIDA conference (Controversies in Dialysis Access) in San Diego, California. CiDA’s accredited scientific program provides the highest quality of comprehensive, interactive education for all clinicians involved in the care and treatment of dialysis patients. Recognized as a thought leader in Dialysis Access, Dr. Kokinos is proud to be on the forefront of advances in dialysis access. Together with her partner Dr. Carlos Pineda, South Bay Vascular Center and Vein Institute physicians brings their patients the highest level of clinical training and surgical expertise.

South Bay Vascular Center and Vein Institute is recognized the premiere dialysis access center in the Silicon Valley. As the only dialysis access center staffed by local, full time vascular surgeons in the greater San Francisco Bay Area, South Bay Vascular offers dialysis access patients immediate access to care in their nationally accredited ambulatory surgery center. Supported by an on-site ICAVL accredited Vascular Ultrasound Lab and full time RVT’s (Registered Vascular Ultrasound Technicians). South Bay Vascular Center provides cutting edge care by community doctors dedicated to the long term health of their patients and who are locally based to ensure their patients are treated with dignity and respect.

Physicians and patient families can reach our Dialysis Access Facility by calling

1-855-WE-D-CLOT to schedule an appointment.

WOUND CARE AND HYPERBARIC OXYGEN

Posted on by Angelica Rodezno

Over the last few decades the treatment of chronic wounds (wounds that haven’t healed in 4 weeks) has become increasingly complicated and expensive. Thousands of specialized “Wound Care Centers” have cropped up across the country. The idea behind these is founded on the fact that getting these types of wounds to heal often requires physicians and nurses of different backgrounds and with special training. These centers are often made up of physicians such as podiatrists, general surgeons, orthopedic surgeons, vascular surgeons, plastic surgeons, infectious disease doctors, diabetic specialists, etc. The reason for that is that it is often the underlying medical issues such as diabetes, poor nutrition, the presence of infections, the use of drugs to treat diseases such as Lupus or Rheumatoid arthritis, that contribute to the poor healing of wounds. In addition, multiple products, surgical and nonsurgical techniques, and “advanced wound care therapies” are used when wounds just won’t heal.

Silicon Valley’s South Bay Vascular Center and Vein Institute doctors are recognized as the leading wound care doctors in the greater San Francisco Bay Area. Recognized as the one of the leading wound care doctors in the country, Dr. Kokinos serves as the medical director of both the Verity/O’Connor Wound Care Center in San Jose and the St Louise Hospital Wound Care Center in Morgan Hill, CA. Dr. Kokinos brings her cutting edge expertise in wound care to patients from all over California who come for treatment at these facilities.

One of the most “hyped” of these treatments is the use of Hyperbaric Oxygen. This is 100% oxygen (normal air is about 21%) that is pressurized in a special tank and breathed by the patient over a period of about 90-120 minutes. This is done daily for thirty to forty treatments. It has been shown that this increases oxygen delivery to the tissues around the wound, and thus increases healing. Originally used to treat “the bends” after a scuba diving accident, today, most “dives” in the hyperbaric chamber are done for wound healing. Many insurers pay for this IF

  • The treatment is used to treat certain classes of wounds and
  • The wound has failed to improve after four weeks of standard therapy.

It is critically important that those two conditions are met, as hyperbaric treatment is not only quite expensive, but does have some significant side effects associated with it.

BE ADVISED: Often times wound care centers will promote this type of advanced therapy before adequately evaluating/treating the patient for the underlying factors that can contribute to non-healing. This is particularly true for vascular causes and is why before beginning any hyperbaric oxygen treatments patients must be seen and evaluated by a Vascular Surgeon. Vascular Surgeons are uniquely trained and qualified to evaluate the state of a patient’s underlying circulatory issues and patients should only agree to this kind of therapy only after speaking with their vascular surgeon.

Previously, vascular therapies often entailed long, dangerous operations to open blocked arteries. However, now, most of these treatments are minimally invasive (done through a poke in the groin or foot) and are often done in the office. Almost all patients, no matter how old nor what other medical conditions they may have, are candidates for these safe procedures.

Hyperbaric oxygen is also used for wounds in areas that have been radiated or that are the result of diabetes. Again, it is critical to optimize all other factors before progressing to “diving” or hyperbaric treatments.

WOUND CARE

Posted on by Angelica Rodezno

Millions of Americans suffer from wounds that don’t heal. It’s a problem most don’t even think about until they or a loved one develops this type of wound. After all, every one of us has fallen or hurt ourselves with a resulting wound. It generally hurts for a little, we put a little Neosporin or a band-aid on it, and forget about it. Pretty soon, it is gone, and there is a little or big scar in its place. However, as we get older, and develop medical issues, this healing may not happen. A wound that has been “open” for more than four weeks, is called a chronic wound, and often needs the special attention of a wound care center. In these centers, team of specially trained nurses and doctors use a variety of diagnostic and therapeutic tools to help promote healing.

Several different problems can contribute to wound healing. The most common of these is a circulation issue. Either the arteries are blocked that supply oxygen and nutrients to help heal the wound, or the veins that promote drainage of toxins and fluids are not functioning properly. This can occur either because they have leaky valves, or because they too are blocked. In general, it has been discovered that about 70% of wounds seen in wound care centers have an underlying vascular issue. This problem is most often an issue with leg or foot wounds. For this reason all of these should be consulted on by a vascular surgeon, a specialist in treating circulation problems. Simple tests, most of which are not invasive, can reveal problems in the arteries and veins. It is very important to do this, because treating these issues alone can greatly improve the wound healing rate.

Other issues that can contribute to wound healing problems include diabetes, poor nutrition, infection, pressure on the wound, and certain medications (such as steroid use). These can often be addressed by the wound care specialists and thus improving the ability of the wound to ultimately heal.

Silicon Valley’s South Bay Vascular Center and Vein Institute doctors are recognized as the leading wound care physicians in the greater San Francisco Bay Area. Dr. Kokinos is the medical director at both the Verity/O’Connor Wound Care Center in San Jose and St Louise Hospital Wound Care Center in Morgan Hill, CA. and is recognized as the regional expert in the greater San Francisco Bay Area.

VENOUS DISEASE AND WOUND HEALING

Posted on by Angelica Rodezno

One of the most common contributors to the development of leg wounds is venous disease. This can occur either because of venous insufficiency—leaky valves in the leg veins or because of issues stemming from a DVT (deep venous thrombosis). Both of these problems contribute by causing high pressure at the ankles that impair the healing of the wounds. Silicon Valley’s South Bay Vascular Center and Vein Institute doctors are recognized as the leading wound care physicians in the greater San Francisco Bay Area and Dr. Kokinos is the medical director at both the Verity/O’Connor Wound Care Center in San Jose and St Louise Hospital Wound Care Center in Morgan Hill, CA.

Venous wounds have a classic appearance. The wound is generally around the inner or outer ankle bone and the skin around the wound is often very dark (hyperpigmented). The skin can also be quite leathery. Not everyone with a venous wound has varicose (bulgy) veins, but many do. These can often be painful, and even with excellent care, can take many months to heal. Although the diagnosis can be made by simple examination, it is important to do an ultrasound to get a roadmap of the venous system so that any problems that can be fixed are addressed.

The specialists who deal with the venous system best are called vascular surgeons. These doctors can deal with both leaky valves as well as blockages in the system. It is felt to be very important not only in helping these wounds heal, but in preventing them from coming back, to treat the underlying venous issues. For the leaky valves, this is done by sealing the veins closed, often using the VNUS closure catheter or a laser fiber. For blocked veins, they can often be treated with stents that will hold them open. These procedures are all minimally invasive and can be done in the office setting. With all venous ulcers, compression using medical grade stockings is vitally important. In addition, there is evidence that using an old drug called Trental or a newer one called Vasculera can help heal these wounds faster.

WOUND CARE EXPERTS IN SAN JOSE

Posted on by Angelica Rodezno

Polyxene Kokinos MD, a Board Certified Vascular and General Surgeon of South Bay Vascular Center and Vein Institute was recently appointed as the new medical director of the O’Connor and St. Louise Hospital’s wound care clinics. Dr. Kokinos brings over 25 years of vascular surgery experience to her new position as medical director and is recognized as a national expert in the treatment of peripheral vascular and arterial disease. Dr. Kokinos has a special interest in the treatment of lower extremity and deep venous disease and is recognized as one of the country’s leading experts in this area. Working in partnership with the award winning Wound Care Center at O’Connor hospital, Dr. Kokinos was selected as the new medical director because of her cutting edge work in peripheral revascularication and ability to bring blood back into the lower leg and foot. Building upon the exceptional wound care services already in place at the O’Connor wound care center Dr. Kokinos will focus on providing state of the art minimally invasive (outpatient) procedures as the next breakthrough in wound care treatment.

Dr. Kokinos and her Partner Dr. Carlos Pineda, both board certified vascular surgeons are recognized as two of the leading wound care doctors in San Jose, Silicon Valley and all of Northern California. While podiatrists have always been the traditional starting point for the evaluation of and treatment of non-healing leg wounds, it is only the Vascular Surgeon who is fellowship trained to be able to evaluate and to treat the underlying cause of most non-healing wounds: poor circulation. Unfortunately, in many instances skin supplements, hyperbaric chambers and wound debridement are not enough to correct the underlying circulatory issues responsible for non-healing leg, foot and ankle wounds.

Dr. Kokinos is honored to be selected as the medical director at the O’Connor and St Louis Wound Care clinic’s and is excited to bring patients the most recent advances in wound care treatment to help keep Silicon Valley’s best wound care clinics at the forefront of patient care.

KPIX-TV CHANNEL 5 TO FEATURE SOUTH BAY VASCULAR CENTER ON SATURDAY OCTOBER 21, 2017 AT 7:00 PM

Posted on by Angelica Rodezno

KPIX- TV CBS Channel 5 will feature South Bay Vascular Center and Vein Institute as a Vascular Surgery Center of Excellence on Saturday October 21, 2017 at 7:00 PM.

Recognized as the premiere Vascular Surgery practice in the greater San Francisco Bay Area, Dr. Polyxene Kokinos and Dr. Carlos Pineda will discuss their cutting edge approach for preventing lower limb amputations. Additionally, the program will focus on advanced surgical techniques to re-establish blood flow to aid in diabetic wound healing and the resolution of asymmetrical leg swelling.

Produced by Medical Media Group, South Bay Vascular Center is honored to be featured in this special presentation.

Please join us by watching KPIX -TV Channel 5 on October 21st at 7:00 PM.

PERIPHERAL ARTERIAL DISEASE (PAD) INTERVENTION AND TREATMENT

Posted on by Angelica Rodezno

Over the past 15 years the interventional treatment for peripheral arterial disease (PAD) has changed significantly with endovascular revascularization replacing surgically invasive procedures as the dominant intervention. Early detection and treatment are important to control the disease and to allow patients a full selection of treatment options.

Diagnosis
Many types of health care providers can diagnose and treat PAD. Family physicians, internists, physician assistants, nurse practitioners and vascular specialists can all diagnose PAD by examining a patient’s medical and family history, performing a physical exam, and conducting diagnostic tests. PAD can be diagnosed through a variety of diagnostic procedures including:

  • Ankle-brachial index (ABI):A common test used to measures the difference between blood pressure at the arm and at the ankle. A difference in the two areas indicates restricted blood flow.
  • Ultrasound
  • CT and MR angiograms
  • Angiography
  • Blood tests

Treatment
There are multiple options for treatment of PAD, ranging from medical interventions, surgical revascularization, and endovascular therapy. Vascular Surgeons are uniquely qualified and trained to treat patients diagnosed with PAD. Approaches to treatment include:

  • Minimally invasive endovascular procedures
  • Medical management
  • Exercise and lifestyle modifications
  • Surgical bypass Amputation

South Bay Vascular Center and Vein Institute is the recognized as the regional treatment center for the treatment and care of patients suffering from Peripheral Arterial Disease. Dr.’s Kokinos and Pineda specialized training and state of the art interventional facility offers patients a unique alternative to a hospital setting and provides the highest level of care for the treatment of PAD as an alternative to limb amputation.

If you or a loved ones suffers from PAD, call our office today at 408-376-3626 to schedule a visit.

We offer hope when others say there is none.

www.southbayvascular.com