Category: Blog

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

PERIPHERAL ARTERIAL DISEASE (PAD)

Posted on by Angelica Rodezno

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

Posted on by Angelica Rodezno
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?

Posted on by Angelica Rodezno

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!!

Posted on by Angelica Rodezno

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

Posted on by Angelica Rodezno

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

VEINS, VEINS, VEINS…VARICOSE VEIN TREATMENT IN SAN JOSE

Posted on by admin

South Bay Vascular Center and Vein Institute is Northern California’s #1 varicose vein treatment center and vein repair clinic. Our ABMS board certified vascular surgeons have performed more successful varicose vein procedures than any other physicians in the region and are the best trained vein specialists in the area. Every vascular surgeon at South Bay Vascular Center and Vein Institute has completed a board eligible fellowship training program in both general as well as vascular surgery and has been trained to both identify and to treat any level of venous disease.

Unlike interventional radiologists, interventional cardiologists, phlebologist’s and dermatologists who perform varicose vein procedures to supplement the income from their primary speciality, VASCULAR SURGEONS have spent their entire careers treating diseases of the circulatory system. They spend all their time diagnosing and treating any venous and/or arterial abnormalities. More importantly, when the problem is more than a simple cosmetic issue (most commonly experienced as leg swelling or aching) the vascular surgeons of South Bay Vascular Center are the ones to take care of it. They have the most advanced ultrasound testing facility, angiography suite and screening protocols in the entire region to help diagnose deeper systemic circulatory diseases such as DVT’s (blood clots) and iliac vein compression.

Many of the patients who visit our clinic find us after their vein treatments at other “Vein Speciality” clinics fail to help them achieve their desired outcomes. Unfortunately, many of these same patients tell us they were led to believe that varicose vein surgery is a relatively easy procedure and can be performed by any level of licensed physician after a basic course in cosmetic vein treatment modalities.

Having served the South Bay for over 20 years, Dr. Kokinos and the staff of South Bay Vascular Center and Vein Institute have performed over 20,000 successful Varicose vein procedures. In addition to her clinical practice, Dr. Kokinos is recognized nationally as an expert in the treatment of varicose veins, peripheral arterial disease, chronic limb ischemia and iliac vein compression. Together with her partner, Dr. Carlos E Pineda, Dr. Kokinos is proud to bring this level of care and experience to every one of her patients and is honored to be entrusted with the care and treatment of them.

Understand your treatment options. Ask your “Vein Specialist” about what happens if you have a complication with your procedure. Ask your provider if they have “Admitting privileges” at the local hospital in the event something goes wrong during the procedure and what their plan is if their procedure fails. Most importantly, check the primary board speciality of your varicose vein “specialist”. If it isn’t vascular surgery, there is someone more qualified and better trained to perform the procedure.

Remember, these are your legs. You deserve the best..and you deserve to “Love Your Legs Again”.

CALL US AT SOUTH BAY VASCULAR CENTER AND VEIN INSTITUTE.

408-376-3626

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

Posted on by Angelica Rodezno

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.