PERIPHERAL ARTERIAL DISEASE (PAD)

According to the U.S. Centers for Disease Control and Prevention (CDC), approximately 18 million people in the United States suffer from Peripheral Artery Disease (PAD), a common circulatory problem in which narrowed arteries reduce blood flow to the limbs. Estimates suggest that anywhere from 12 to 20 percent of individuals over the age of 60 are living with PAD. Approximately 160,000 to 180,000 of the estimated 18 million Americans with PAD will undergo a limb amputation as result of PAD-related condition this year, resulting in lower quality of life, high medical costs, and shorter life expectancy.

But even with these alarming numbers, general population awareness of PAD is estimated at only 25 percent. Symptoms of severe PAD include leg pain, wounds on the toes or feet, gangrene and a loss of leg mass compared to the rest of the body. Individuals are at greatest risk for PAD if you have high cholesterol, high blood pressure, or diabetes. African American and Hispanic populations are also at higher risk as are individuals with a history of smoking. Improvements in technology have allowed for the migration of interventional services from hospitals to same-day interventions at a physician’s office, which offers a more cost-efficient and patient-preferred alternative to inpatient care.

It is crucial for patients to have access to PAD screenings in the community setting to ensure the appropriate treatments are performed before undergoing an amputation. South Bay Vascular Center and Vein Institute is the leading center for the treatment of PAD in San Jose, Santa Clara County, and Silicon Valley.

If you or a loved one is facing a possible lower limb amputation, call our office to schedule a secondary consultation before agreeing to an amputation.

We offer hope when others say there is none.

408-376-3626

www.southbayvascular.com

SEPTEMBER IS PAD AWARENESS MONTH

What is Peripheral Arterial Disease?
Peripheral artery disease (PAD), also known as claudication, poor circulation, vascular disease, or hardening of arteries, is a chronic, life-threatening circulatory condition. PAD causes narrowing or blockage of the vessels that carry blood from the heart to the legs. The primary cause of PAD is atherosclerosis, or the buildup of plaque in the arteries. This occurs when arterial inflammation, cholesterol, calcium and scar tissue build up, forming plaque that clogs the arteries and slows blood flow to the legs. The more plaque that builds up on the inside walls of the blood vessels carrying blood from the heart to legs and arms, the more the arteries lose flexibility and narrow, putting patients at greater risk.
Risk factors for PAD
Smoking
High blood pressure
Diabetes,
High cholesterol
60+ years old.
PAD patients are at high risk of developing critical limb ischemia (CLI), a chronic condition that results in severe pain in the feet or toes, even while resting. Complications of poor circulation can include sores and wounds that won’t heal in the legs and feet. Left untreated, the complications of CLI could result in amputation of the affected limb. PAD patients are also at greater risk for heart attack and stroke. Studies have found that the total annual US costs for patients with PAD exceed $21 billion, including nearly $10 billion for hospitalizations. In Medicare alone, one study estimated spending on PAD accounted for more than 2% of all Medicare spending. PAD has been identified by the Institute of Medicine (IOM) as a priority area for comparative effectiveness research. One study suggested that endovascular therapy appears to be the least costly option in the short-run for patients with PAD.
Symptoms Blockages can restrict blood flow to the muscles, causing muscle cramps, tightness or weakness, especially during activity. In the early stages of PAD, patients may not experience any symptoms. If PAD is not treated, though, blockages may continue to grow and restrict, or even completely block, blood flow.
Common symptoms include:
Leg pain when walking
Muscle pain or cramping in legs and calf triggered by activity
Leg numbness or weakness
Coldness on lower leg or foot
Sores on toes, legs or feet that won’t heal
Change in color of legs
IF YOU OR ANYONE YOU KNOW SUFFERS FROM ANY OF THESE CONDITIONS WE CAN HELP! CALL US TODAY AT
408-376-3626 TO SCHEDULE AN APPOINTMENT.

HOW CAN A SWOLLEN LEG BE RELATED TO CANCER?

How Can A Swollen Leg Be Related To Cancer? Many people know that leg swelling is a normal part of pregnancy. Or that if your heart or kidneys are not working properly, then fluid can “back up “ into your legs and cause swelling. Unfortunately, one problem that most people do not associate with leg swelling is cancer. This is unfortunate, because many people have leg swelling, most specifically an unprovoked deep venous thrombosis causing that swelling, as the first sign of their cancer. What does that mean?

Deep venous thrombosis (DVT), or a blood clot in one of the deep veins in the leg, is very common in the United States. This usually presents as unilateral leg (when only one leg swells) swelling, especially of the calf and ankle. As many as 900,000 people a year are diagnosed with a DVT and about 100,000 of them DIE of either the DVT or a pulmonary embolus (PE). A pulmonary embolus is when the blood clot travels to the lung and causes the death of a part of the lung. Most of the time, a DVT is provoked, or has a cause. Common reasons for a DVT include long car or plane rides, having orthopedic or other surgery, being on bedrest or being very sedentary, being on birth control pills, or having unusual proteins in the blood that cause one to clot more easily.

Sometimes, however, a patient develops a blood clot without having a history of one of these things. When that happens, it is VERY important to be worked up for the possibility of a hidden cancer. This is because studies have shown that if someone develops a DVT with none of the “normal” risk factors, the chance of diagnosing cancer in that patient is one in ten in the first year after the DVT.

It is therefore very important that if you are told you have a DVT, that you be screened for cancer. This can be done simply with a thorough history and physical, some lab work, and possibly some Xrays, depending on your history. It is important NOT to just go to the urgent care, be told you have a blood clot, and just take your blood thinners. Please go see a vascular surgeon who can both manage the medication for you blood clot, follow it up with ultrasounds, and do the proper work-up to ensure that it is not the sign of something bad.
South Bay Vascular Center and Vein Center specializes in the treatment of DVT and Swollen Legs. If you or anyone you know suffers from blood clots (DVT’s) or swollen legs, please call our office to schedule a consultation at 408-376-3626

DON’T SUFFER FROM SWOLLEN LEGS OR NON-HEALING LEG ULCERS ANY LONGER. WE CAN HELP!!

The sequence of photos below shows the before and after pictures of an 87 year old man who had seen multiple doctors over a 3-4 months period of time for his severe right leg swelling. This was not only causing him discomfort, but caused him to fall because of the imbalance it led to. He was found on a regular venous ultrasound in our accredited vascular lab to have abnormal flow in his right iliac vein.

The next day, we took him to our Campbell angiography suite for a 45 minute outpatient procedure. There, using both venography (injection of contrast into the vein through a small straw like catheter in the groin) and IVUS (intra-vascular ultrasound) we diagnosed a scarred and blocked right iliac vein system. This was easily treated with a stent and balloon.

Unfortunately, this was found to be a result of a combination of radiation treatment the patient had received 20 years before for his prostate cancer as well as because of a return of his cancer. This tumor (seen on CT scan) was surrounding his vein. When he came back five days later for a check, his right leg swelling was gone as was his leg heaviness and aching.

Please note, compression of the iliac vein usually (80%) occurs on the left. Often, if leg swelling occurs on the right, it may be a sign of a tumor or mass pushing on the vein in the abdomen.

Patient with right lower leg swelling before procedure

Inserting a wire into the diseased vessel. Notice the light colored area where no blood was flowing.

Opening the diseased vessel using a “balloon”.

Placing a stent in to the opened vessel to maintain blood flow. Notice how even blood flows through the opened vessel

Patient 5 days after surgery with leg swelling almost completely resolved

If you or anyone you know suffers from lower leg swelling, call us today to set up a consultation to evaluate your treatment options.

408-376-3626

South Bay Vascular Center and Vein Institute

SAN JOSE’S BEST VARICOSE VEIN DOCTOR

San Jose’s most advanced vein treatment center, South Bay Vascular Center and Vein Institute invites you to

Love Your Legs Again

If you suffer from painful and unsightly varicose veins WE CAN HELP! Silicon Valley’s most trusted varicose vein clinic and treatment center.

CALL US AT 408-376-3626 TO LEARN HOW WE CAN HELP YOU GET BACK YOUR LIFE.

Actual patients from our practice.

Before After

Before After

Before After

Before After

LEG SWELLING: BEFORE AND AFTER PHOTOS FOLLOWING THE PLACEMENT OF AN ILIAC VEIN STENT

Photos of patient who had suffered with right leg swelling for three months before coming to see us. The patient was found to have a problem with their right iliac vein (in the pelvis) that we easily treated with a 45 minute outpatient procedure placing a stent in the vein through a small puncture in their groin. Five days later, his swelling was almost completely gone.

If you have had painful or annoying one-sided leg swelling we may be able to help. Call us today for a consultation at 408-376-3626. South Bay Vascular Center and Vein Institute is the regional leader in treating leg swelling due to iliac vein compression.

DR. KOKINOS CHOSEN TO PRESENT AT 2017 OEIS MEETING

Dr. Kokinos was selected as a speaker at this years OEIS (Outpatient Endovascular and Interventional Society)meeting that will be held March 31- April 2 in San Diego California. Dr Kokinos will be presenting her expertise in the establishment and operation of cutting edge outpatient treatment facilities.

Congratulations Dr. Kokinos on this honor.

Dr. Polyxene Kokinos and her partner, Dr. Carlos E Pineda of South Bay Vascular Center and Vein Institute, operate San Jose’s leading center for the treatment of Varicose Veins. As a Board Certified Vascular and General Surgeon, Dr. Kokinos is recognized by her peers as the one of the countries leading experts on the treatment of deep venous disease and is frequently sought out as a speaker. South Bay Vascular specializes in treating peripheral arterial disease (PAD) and is the regional center of excellence for amputation prevention.

If you or anyone you know suffers from unsightly and painful varicose veins, peripheral arterial disease, non-healing wounds or is facing a diabetic amputation, please call our office at 408-376-3626 to schedule a consultation. WE CAN HELP!

DR. KOKINOS SELECTED TO SPEAK AT 2017 UCSF VASCULAR SYMPOSIUM

Dr. Kokinos is honored to be a featured speaker at this years world renown UCSF Vascular Symposium. Dr. Kokinos will present her on-going research on the treatment of venous ulcers. This years session will be presented on April 6, 2017 in San Francisco, CA. Congratulation’s Dr. Kokinos on your selection as a speaker.

Dr. Kokinos is a Board Certified Vascular and General Surgeon and is the medical director of the wound care clinics at Verity’s O’Connor Hospital in San Jose and St. Louise Hospital in San Martin Ca. Together with her partner, Dr. Carlos Pineda, Dr. Kokinos operates the leading varicose vein treatment center in Northern California and has provided specialized vein care treatment and repair for over 20 years. Recognized as the leading Vein Specialist and Varicose Vein Doctor in Northern California, Dr. Kokinos is known as the Doctor’s Doctor and is honored to work alongside her patients to help them return to a healthy and normal lifestyle.