Tag: advanced vein care

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.

SOUTH BAY VASCULAR CENTER: SIMPLY THE BEST VARICOSE VEIN TREATMENT CENTER IN SAN JOSE

Posted on by Angelica Rodezno

Millions of Americans suffer from varicose veins. In adult western populations it is estimated that visible varicose veins are present in 20 to 25% of women and 10 to 15% of men.

Both invasive and non-invasive (i.e surgical and non-surgical) methods are available to treat varicose veins. Non-invasive methods include wearing compression stockings, exercising, leg elevation, losing weight, not wearing tight clothes, avoiding long periods of standing or sitting and not crossing your legs while seated. Invasive treatments include endovenous therapy, ligation, and phlebectomy.

Endovenous therapy is a treatment from inside the vein using heat generated by lasers, radiofrequency devices or chemicals to irritate the vein walls causing the vein to close and then be reabsorbed by the body. Ligation is tying off a vein to cause it to shrink. Phlebectomy is REMOVAL of varicose veins, NOT the closing of a vein. Only after your physician evaluates a patients vascular ultrasound study are they in a position to discuss the best treatment option for their patients.

Recognized by her peers as one of the pre-eminent vascular surgeons in the region, Dr. Kokinos serves as Chair of the Cardiovascular department at Good Samaritan Hospital in San Jose, CA. and was recently appointed as the Medical Director of both the O’Connor and St. Louise wound care centers. Dr. Kokinos has performed over 10,000 vein procedures over the past 20 years and brings this experience to all of her patients.

Lots of centers treat venus reflux or “leaky valves” when they show up as painful and unsightly varicose and spider veins. Fast cosmetic fixes, however, can often mask more serious underlying circulation issues that only a vascular surgeon is trained to address. For this reason, it is vitally important that patients understand their options for treatment as well as the credentials of their treating physician.

NO PATIENT SHOULD UNDERGO A VARICOSE VEIN TREATMENT PROCEDURE WITHOUT FIRST HAVING HAD A DETAILED VASCULAR ULTRASOUND STUDY BY A REGISTERED VASCULAR ULTRASONOGRAPHER FOLLOWED BY A RPVI READ OF THIS STUDY.

At South Bay Vascular Center and Vein Institute we are Board Certified Vascular Surgeons. We are NOT phlebology doctors nor cardiologists who have learned how to treat cosmetic veins or Peripheral Vascular Disease (PAD) at a weekend course or seminar and who treat varicose and spider veins as a means to supplement their primary practice.

Vascular Surgeons have completed an accredited 5-7 general surgery residency program followed by an additional 2 years in an accredited vascular surgery fellowship program specifically focused on the treatment of arterial and venous disease…. and that’s after spending 4 years in medical school and 4 years in college. Treating diseases of the circulatory system IS our primary practice and it is what we have been trained to do.

Unlike many other cosmetic vein centers, every South Bay Vascular surgeon is either ABMS board certified or board eligible. Established as the Gold Standard in medicine, board certification is only awarded to a select few physicians following their completion of a rigorous training in a board eligible fellowship program. Even after completing fellowship training, board certification is not granted until after the physician has passed a series of exhaustive clinical and written examinations and must be renewed every 10 years.

“Phlebologists” on the other hand sometimes refer to themselves as being “Board Certified” in Phlebology. In actual fact there is no such ABMS designation. Instead, board certification in “Phlebology” is granted by an association of Phlebologists and not by the American Board of Medical Specialties. A Phlebology board is received simply by taking a written exam , without having completed a rigorous and specialized clinical fellowship.

Dr.’s Kokinos and Pineda provide an unmatched level of varicose vein care and treatment in the greater San Jose area. Compassionate care in a personalized setting using the most advanced Varicose Vein Treatment options sets them apart as the regions foremost varicose vein care experts. We are proud to bring the highest level of vascular care to our patients and would be honored to work alongside you, our patient, in your ongoing efforts to live a healthy and productive life.

We look forward to meeting you at our office. Call our office today to schedule an appointment at 408-376-3626.