Tag: accredited vascular ultrasound lab

BLOOD THINNING MEDICATIONS PART 1: ANTICOAGULANTS: WHAT ARE THEY AND HOW ARE THEY USED?

Posted on by Michael Kokinos

Over the next few weeks, I want to discuss the medications that vascular surgeons may prescribe.  These medications include anticoagulants, antiplatelets, statins, and other miscellaneous agents.  This week I will discuss anticoagulants!

Anticoagulation refers to agents that STOP the clotting of blood.  The clotting of blood starts with what is known as the coagulation cascade.  The cascade refers to a series of consecutive events each involving special proteins that are needed to occur for blood to form a clot.  Different anticoagulants block specific parts of the cascade.  The main reason we usually see patients with anticoagulants are for hypercoagulable states, certain heart arrhythmias like atrial fibrillation, and deep vein thromboses otherwise known as blood clots.  Hypercoagulable states are specific genetically inherited disorders that result in the blood being more likely to clot.  Atrial fibrillation and other arrhythmias can cause blood clots to form in the heart.

 

Anticoagulant agents are given to prevent the formation of clots in the heart that can then break off and go to the brain, hands, feet, kidneys, or any other part of the body and cause problems. 

 

Deep vein thrombosis or blood clots mandate the prescription of anticoagulant therapy to ensure that more blood clot does not form.

 

Anticoagulants can be broken up by many different classification schemes.  For the purposes of this blog, I will limit our discussion here to agents that are appropriate for the OUTPATIENT (Outside of the hospital) setting.  Please speak with you private physician to answer any additional questions you may have regarding Anticoagulation medication of feel free to reach out to me directions for more information on how anticoagulation is used. Anticoagulation agents that are used during hospitalization or in the IN-PATIENT setting in patients are outside the scope of this article.

 

Up until the 2010’s the mainstay of anticoagulation therapy was with a drug called warfarin (Trade name: Coumadin).  Warfarin, though effective, requires the weekly or biweekly measurement of a specific lab for the blood called the prothrombin time.  The active monitoring of the prothrombin time facilitates modulation of dosing to always allow for safe levels of effective therapeutic anticoagulation.  Since the beginning of the 21st century new agents have come to market that require only taking one or two pills a day.  They include Xarelto or Rivaroxaban and Eliquis or apixaban.

If you have a question about how your medications may be affecting your vascular disease, please do not hesitate to call and schedule an appointment today!

South Bay Vascular Center and Vein Institute is Silicon Valley’s largest and most trusted Vascular Surgery practice.  Serving South Bay communities for over 26 years, Dr Kokinos and her Colleague, Dr Ignatius Lau are the region’s foremost experts in advanced vascular care and provide innovative care for patients suffering from circulation relation problems. At South Bay Vascular Center and Vein Institute our job is to understand the “Why” so that you have real solutions to living a healthy life. Call us today at 408-376-3626 or visit our website at www.southbayvascular.com to learn about what makes us the most referred to vascular surgery clinic in Silicon Valley.

WHAT IS VASCULAR ULTRASOUND*

Posted on by Angelica Rodezno

The medical specialty of vascular technology utilizes diagnostic ultrasound to generate images of blood flow within the veins and arteries. Ultrasound uses high frequency sound waves, similar to the sonar that a ship uses to detect structures beneath the surface of the water. Vascular ultrasound can also be known as a Doppler or duplex study. For example, if your physician wants to make sure that you do not have a blood clot in your leg, he or she might order a venous duplex or venous Doppler examination.

Vascular ultrasound procedures are noninvasive, meaning they do not require the use of needles, dyes, radiation or anesthesia and are, therefore, relatively painless and harmless.

The information obtained through vascular ultrasound examinations is extremely helpful to physicians in diagnosing a variety of conditions related to cardiovascular disease, disorders of the heart and blood vessels. Early detection of life-threatening vascular diseases is possible through the use of noninvasive vascular testing techniques performed within vascular facilities.

Vascular ultrasound’s reliability in diagnosing conditions related to heart disease and stroke is encouraging as we strive for ways to reduce the more than 500,000 lives lost in the United States each year to these disorders. However, it is critical that the public realizes there are many facets that contribute to an accurate diagnosis based on vascular ultrasound examinations. These factors include the skill of the technologist/sonographer performing the examination, the type of equipment used, the background and knowledge of the interpreting physician and quality assurance measures. In fact, poor ultrasound examinations often lead to inconvenient, redundant studies, misdiagnosis and even unnecessary tests or surgery.

*Taken from the Intersocietal Accreditation Commission Website

VASCULAR ULTRASOUND LAB ACCREDITATION: WHY IT’S IMPORTANT

Posted on by Angelica Rodezno

Taken from the IAC Vascular Testing Accreditaton Website

IAC accreditation demonstrates a commitment to quality care.

The purpose of the IAC Vascular Testing accreditation program is “to ensure high quality patient care and to promote health care by providing a mechanism to encourage and recognize the provision of quality vascular diagnostic evaluations by a process of accreditation.” Through the accreditation process, facilities assess every aspect of daily operation and its impact on the quality of health care provided to patients. While completing the accreditation application, facilities often identify and correct potential problems, revise protocols and validate quality improvement programs. Because accreditation is renewed every three years, a long-term commitment to quality and self-assessment is developed and maintained. Facilities may use IAC accreditation as the foundation to create and achieve realistic quality care goals.

IAC accreditation provides a confidential peer-review.

Designed to serve facilities as an educational tool, IAC accreditation is made up of two crucial steps. First, facilities conduct a detailed self-evaluation using the IAC Standards and Guidelines for Vascular Testing Accreditation and the Online Accreditation application. Completion of the application requires detailed information on all aspects of facility operation as well as the submission of actual case studies for review. The case studies are crucial in determining the facility’s compliance with the IAC Standards, and are the basis for judgment of the quality of work that facilities perform. Once the self-evaluation is completed, the documents and case studies are reviewed by the IAC Vascular Testing Board of Directors. All aspects of the review are confidential.

IAC accreditation is a recruiting tool.

Accredited facilities can use their accreditation as a recruiting tool to attract the best and brightest physicians, sonographers and technologists. Talented professionals look for high-quality programs, and accreditation assures potential employees that a facility is dedicated to achieving the highest standards for patient care.

IAC accreditation is intersocietal.

The intersocietal, multi-specialty approach is the foundation of the accrediting divisions under the IAC umbrella. IAC Vascular Testing is a nonprofit organization established with the support of the sponsoring organizations. Representatives from these sponsoring organizations, including physicians, sonographers and technologists, serve on the IAC Vascular Testing Board of Directors. All areas of vascular testing were represented on the Board during the creation of the Standards for accreditation, and all areas continue to steer the accreditation process.

IAC accreditation is proven successful.

Offering accreditation for more than 20 years, the IAC Vascular Testing (formerly ICAVL) pioneered the intersocietal approach to imaging accreditation in 1990, as the first of the Intersocietal Accreditation Commission (IAC) divisions to be developed. Today, reimbursement in more than 30 states hinges on either facility accreditation or technologist certification. The number of IAC Vascular Testing accredited facilities in the U.S., Canada and Puerto Rico continues to grow, with more than 2,600 sites currently holding the accreditation. The IAC offers multi-modality accreditation through its programs dedicated to Vascular Testing, Echocardiography, Nuclear/PET, MRI, CT / Dental CT, Carotid Stenting, Vein Center and Cardiac Electrophysiology.

IAC accreditation demonstrates accountability.

Health care organizations are held to very high levels of accountability, by peers and by the general public. In numerous states, reimbursement directives that require accreditation of the facility have been instituted by Medicare carriers as well as private, third-party insurers (please visit Payment Policies section for the current list). Similar draft payment policies are pending throughout the United States. Facilities attaining accreditation before it is required for reimbursement demonstrate a willingness to surpass current expectations. The general public and members of the vascular testing community will recognize an unmatched commitment to providing quality health care by facilities that achieve IAC accreditation.