BLOOD THINNING MEDICATION’S PART 3: STATINS: WHAT ARE THEY AND HOW ARE THEY USED?

Over the past two weeks, I have described the blood thinning medications that vascular surgeons use to treat patients: Anticoagulant and Antiplatelet medications. This week, I want to spend time talking about another important medication that primary care physicians and vascular surgeons both agree helps to improve patient outcomes: Statins.

Statins refer to a general class of drugs that inhibit a special enzyme involved in the production of cholesterol within the body: 3-hydroxy-3-methylglutaryl-Coenzyme A, otherwise known as HMG-CoA.  HMG-CoA catalyzes the first reaction in a series of almost 30 individual reactions to create molecules of cholesterol!  As a vascular surgeon I sometimes prescribe Statins to my patients with high cholesterol to help my patients manage their cholesterol levels.

Cholesterol:

A high cholesterol level is one of the most common medical problems that patients I see have.  As a vascular surgeon it is important for me to understand when a patient has high cholesterol because of the following fact:

A high cholesterol level in the blood may result in a narrowing within the blood vessels of the heart, legs, and neck.  When these narrowing’s form they can cause heart attacks, ulcers and pain in the feet, and strokes, respectively.

In numerous clinical trials, the administration of statins has been shown to decrease the rate of death, heart attack, and stroke in patients at elevated risk of these medical problems due to high blood pressure, history of smoking, and diabetes.  The general group of statins includes medications like atorvastatin, simvastatin, and rosuvastatin.

At every office visit, I check my patients’ medical history to make sure that their cholesterol levels are being properly managed to ensure the best possible outcomes. Typically, when a patient presents in my office with a history of the following medical conditions, I will often prescribe statins as part of a larger approach to managing their cardiovascular disease:

  • History of heart attack, peripheral vascular disease, or stroke
  • History of diabetes mellitus over the age of 45

Vascular disease is both complex and difficult to manage. At South Bay Vascular Center and Vein Institute our physicians have been specially trained to understand “WHY” a problem exists so that our patients have real solutions to living a healthy life. Proper medical and surgical management of our patient involves a deep understanding of our patient’s medical history of which statins may play an important part. If you are currently on a statin or your referring physician believes a statin may be part of a larger approach to your circulatory health, please feel free to schedule an appointment with our office so that we can help you to evaluate this important decision with the context of your overall vascular health. Moreover, if you have a history of ulcers or pain in your feet or stroke, please do not hesitate to call my office today to schedule a consultation to determine if statins can be prescribed as part of your overall care and treatment!

Dr. Ignatius H. Lau: Vascular Surgeon

Dr. Ignatius Lau grew up in Portland, Oregon. He attended the University of Washington in Seattle for college and Stony Brook University in Long Island for medical school. He then went on to train in vascular surgery at Mount Sinai Hospital in New York City. During his time in New York, he performed over 1600 cases involving aortic, peripheral, venous, and carotid surgery. He has a special interest in limb salvage and treating patients with peripheral arterial disease and has extensive training and experience in treating the full spectrum of vascular diseases. Dr Lau was also very active in medical research during his training, ultimately finishing with twelve peer reviewed manuscripts. During his training in New York he met his wife, Lisa, who is a practicing endodontist. Together they love to hike, try new restaurants, and travel.

To see what our patients are saying about us, follow the link below to read our reviews.

https://www.google.com/search?q=south+bay+vasculr&rlz=1C1CHBD_enUS878US878&oq=&aqs=chrome.0.69i59i450l8.2997409j0j7&sourceid=chrome&ie=UTF-8#lrd=0x808e34eecfbc0653:0xb9aa2de7f50ba6a5,1,,,

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.

BLOOD THINNING MEDICATIONS PART 2: ANTIPLATELETS: PLAVIX AND ASPIRIN. WHAT ARE THEY AND HOW ARE THEY USED?

Last week I began a description of the medications that vascular surgeons use with a blog post on drugs used for anticoagulation.  This week, I want to describe a group of medications that also thin the blood, albeit through a different mechanism.  As discussed last week, the coagulation cascade works to turn the blood from a liquid to a solid.  A special group of cells in the blood mixed with red blood cells called platelets works simultaneously with the coagulation cascade to serve as the glue so to speak between clumps of red blood cells.  This bond that platelets facilitate with clotted blood helps clot to attach and build upon other collections of clot, thereby facilitating the control of bleeding that the clotting system was designed for.

Obviously, in the case of vascular surgery we often times want to prevent blood clotting from occurring.  The main agents we use are aspirin and plavix (clopidogrel).  In the early 2000s literature from interventional cardiology for minimally invasive heart procedures found that placing patients on aspirin and plavix together reduced the incidence of recurrent heart attacks as well as death.  This literature from cardiology has been extrapolated to the lower extremity circulation and allows the interventions we perform in the lower extremities to fix blood flow to stay open for a long period of time.  In addition to the use of aspirin and plavix for lower extremity arterial blockages, we also use it in patients who have had a stroke in order to help prevent them from having another stroke.

Aspirin is a low strength blood thinner that patients can take orally as an 81 mg tablet once a day.  In the body aspirin blocks a specific enzyme called cyclooxygenase.  When cyclooxygenase is inhibited, the enzyme cannot help to produce chemicals in the blood called prostaglandins.  Prostaglandins are normally responsible for creating an environment that stimulates the clotting of blood via complex but mild mechanisms.  Studies have shown generally that patients with cardiovascular disease have a lower incidence of death, stroke, and heart attack over time than patients who do not take aspirin.  In general, I tend to make sure that all my patients who have peripheral vascular disease take aspirin as a general preventative measure.

Plavix is a much higher strength blood thinner that binds directly to platelets and completely inhibits their function.  When used in concert with aspirin, the blood becomes thin enough to prevent the recurrent blockage of vessels that we have opened up.

Overall the large majority of my patients who receive procedures to fix blood flow to the foot are placed on aspirin and plavix.  If you think you might benefit from these medications or are in need of a procedure to fix the blood flow to your feet or brain, please do not hesitate to call my office to schedule an appointment!

 

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.

CLICK ON THE LINK BELOW TO READ HOW OUR PATIENTS DESCRIBE THEIR EXPERIENCE AT SOUTH BAY VASCULAR.

https://www.google.com/search?q=south+bay+vascular+center&rlz=1C1GGRV_enUS748US759&oq=&aqs=chrome.0.69i59i450.91302019j0j7&sourceid=chrome&ie=UTF-8#lrd=0x808e34eecfbc0653:0xb9aa2de7f50ba6a5,1,,,

 

PART 4: WHY DO MY TOES, ANKLES AND FEET HURT AT NIGHT? DIABETIC FOOT DISEASE

Over the past month, I have discussed why venous and arterial disease as well as Raynaud’s Syndrome may cause pain in the feet and toes at night. Today, I want to discuss another one of the most common causes I see in my clinic for pain in the feet at night: Diabetic foot disease.

Interestingly, diabetes mellitus has Greek etiology and literally means sweet (mellitus) urine (diabetes).  Diabetes is a condition in which the body loses its ability to limit the amount of sugar in the blood.  The high concentrations of sugar result in the formation of harmful chemicals that can hurt the eyes, kidneys, and nerves all around the body, especially in the feet.  Once the sugar levels become high enough, they overload the kidneys—the organ that creates urine—and sugar overflows into the urine, hence the Greek etiology of diabetes mellitus.

Diabetes causes pain in the feet via two main pathways: Neuropathic pain and pain from ulcers. 

Neuropathic Pain:

For neuropathic pain, the high blood sugar levels damage the small nerves in the feet responsible for sensation.  As a result, patients often complain of burning, cramping, tingling, and at the very worst end of the spectrum, numbness.  Sometimes only the toes have these symptoms, but often times the symptoms can encompass the entire foot!

Ulcerative Pain:

The way diabetes results in the formation of ulcers is multifactorial.

  • First, the damage to the nerves can result in numbness or lack of sensation.  Thus, when a person injures their foot, that person does not feel it and protects it from further injury.
  • Second, in addition to damaging the nerves responsible for sensation, diabetes also damages the nerves that innervate muscles responsible for moving.  The damage to the muscle nerves occurs in such a way that irregular contractions of muscles within the foot push the bones of the foot outward creating pressure points that ulcerate easily.  Once the ulcer is formed, infection of the ulcer or exposure of the raw tissues beneath the skin can cause pain.  In patients who otherwise have numb feet, an infection can spread to an area that does have sensation and cause pain there.

Given that diabetes is so common, patient education is vitally important to those impacted by this disease.  If you or anyone you love suffers from diabetes, my hope is that this blog will help you to better understand some of the underlying factors that may be contributing to your foot pain at night.  As a rule of thumb, always remember to share with your primary care physicians all symptoms of pain that you experience during your regularly scheduled appointments and if you think your condition may be getting worse, please do not hesitate to call my office to schedule an appointment for a second opinion! We can help.

408-376-3626

Dr. Ignatius H. Lau

Vascular Surgeon

Dr. Ignatius Lau grew up in Portland, Oregon. He attended the University of Washington in Seattle for college and Stony Brook University in Long Island for medical school. He then went on to train in vascular surgery at Mount Sinai Hospital in New York City. During his time in New York, he performed over 1600 cases involving aortic, peripheral, venous, and carotid surgery. He has a special interest in limb salvage and treating patients with peripheral arterial disease and has extensive training and experience in treating the full spectrum of vascular diseases. Dr Lau was also very active in medical research during his training, ultimately finishing with twelve peer reviewed manuscripts. During his training in New York he met his wife, Lisa, who is a practicing endodontist. Together they love to hike, try new restaurants, and travel.

To see what our patients are saying about us, follow the link below to read our reviews.

https://www.google.com/search?q=south+bay+vasculr&rlz=1C1CHBD_enUS878US878&oq=&aqs=chrome.0.69i59i450l8.2997409j0j7&sourceid=chrome&ie=UTF-8#lrd=0x808e34eecfbc0653:0xb9aa2de7f50ba6a5,1,,,

 

PART 3: WHY DO MY TOES, ANKLES AND FEET HURT AT NIGHT? PERIPHERAL ARTERIAL DISEASE

In part one- and two of our four-part series on “Why do my feet hurt at night”, I discussed Venous disease and Raynaud’s Syndrome. In today’s discussion I want to focus on an even more common reason for why patients may suffer from leg pain at night: Peripheral arterial disease (otherwise known as PAD.)

As we’ve discussed in our earlier blogs, there are two kinds of blood vessels: Arteries and veins.

  • Arteries bring blood from the heart to the foot and toes under high pressure while
  • Veins bring the blood back from the foot to the heart under low pressure.

Over the course of anyone’s lifetime, blockages may build up in the arteries between the heart and the feet, especially in the pelvis and the legs.  Risk factors that increase the risk of formation of these blockages include:

  • Obesity
  • High blood pressure
  • High cholesterol
  • Diabetes
  • History of smoking tobacco.

As you may imagine, the tissue within the foot needs a certain amount of blood to supply the nutrients and oxygen necessary to keep the cells within the foot living.  Though a single, short segment blockage of the arteries in the leg may not result in any problems, multiple blockages from the pelvis to the foot may can make it difficult or even impossible for the cells within the foot to survive this lack of nutrients and oxygen.

What Does PAD Feel Like?

Typically, patients notice a gradual onset of pain in the forefoot and toes over the course of a few weeks to months.  As their blockages worsen, their pain becomes more severe.  Pain from PAD occurs in the forefoot and toes because those parts of the body are the furthest away from the heart and thus any blockage along the way from the heart to the toes can contribute to the lack of blood flow. One classic symptom of PAD pain is a burning, tingling, or numb sensation that can be partially relieved by hanging your foot off the bed or a chair.  In this position with the foot hanging down, gravity assists the flow of blood to the foot and toes and relieves the pain.  Typically, patients complain that when they lay flat at night, the pain in the forefoot and toes or just the foot in general will wake them up.  I always specifically ask patients if they are woken up at night by the pain.  If they are woken up by the pain, then I know the PAD must be very severe.

In some patients, the lack of blood flow is so diminished that there is also the development of ulcers, or defects in the skin with exposure of underlying fatty tissue, bone, and muscle or gangrene, the death of the tissue itself.

Even though PAD is a very severe and life limiting disease, specially trained vascular surgeons have many tools to combat it!  We can do a minimally invasive procedure called an angiogram that I described in an earlier blog post that you can access here!  Essentially, I access the diseased blood vessel with a needle and through that needle use contrast and x-ray to see where the blockages are.  Then, using balloons, stents, or self-expanding metal tubes, it is possible to re-open the blockages to re-establish blood flow to the impacted area.  For severe blockages, I also use a device called atherectomy that allows me to cut through and to remove the plaque responsible for blocking this vessel.  The procedure on average takes 1.5 to 2.5 hours and most patients can go home the same day.

Does foot pain wake you up at night? If you are experiencing pain in your foot or toes, please do not hesitate to contact my office at 408-376-3626 to schedule a clinic appointment today!

We Can Help!

Dr. Ignatius H. Lau

Vascular Surgeon

Dr. Ignatius Lau grew up in Portland, Oregon. He attended the University of Washington in Seattle for college and Stony Brook University in Long Island for medical school. He then went on to train in vascular surgery at Mount Sinai Hospital in New York City. During his time in New York, he performed over 1600 cases involving aortic, peripheral, venous, and carotid surgery. He has a special interest in limb salvage and treating patients with peripheral arterial disease and has extensive training and experience in treating the full spectrum of vascular diseases. Dr Lau was also very active in medical research during his training, ultimately finishing with twelve peer reviewed manuscripts. During his training in New York he met his wife, Lisa, who is a practicing endodontist. Together they love to hike, try new restaurants, and travel.

TRANSCAROTID ARTERY REVASCULARIZATION: THE FUTURE OF CAROTID SURGERY

One of the most gratifying problems we help treat for patients is carotid artery disease.  The carotid arteries supply the brain with blood.  In patients with high blood pressure, high cholesterol, diabetes, and a history of smoking, the carotid arteries can become narrowed and form blood clots that then go into the brain and cause strokes.  Traditionally, vascular surgeons have fixed this carotid artery narrowing’s with a surgery called a carotid endarterectomy.  The carotid artery is dissected out and cut open.  The plaque is then removed, and the carotid artery is sewn back together.

Over the past five years, however, I have had the opportunity to perform a new technique involving carotid stenting called trans carotid artery revascularization or TCAR.  Stents are self-expanding metal tubes that we can use in the carotid artery to stop clots from forming in narrowed areas.  TCAR uses a suction machine to reverse flow in the carotid artery during the placement of a stent to minimize the risk of inadvertent stroke during the procedure itself.  After having performed over 20 of these procedures in the past two years, I can say with confidence that the flow reversal and stenting that TCAR provides is a highly safe and successful way to treat carotid artery disease.  Furthermore, the length of the incision, postoperative pain, and risk of nerve damage and bleeding are all much less with TCAR than with CEA.

I am so happy to be able to offer this revolutionary, safe, and effective therapy to all my patients at South Bay Vascular Center.  Should you or anyone you know have any problems with your carotid arteries or a stroke, please do not hesitate to call us today at 408-376-3626 to schedule a consultation.

https://youtu.be/O32nDoovMPY]

DOES YOUR PATIENT HAVE PAD? A REFERENCE GUIDE FOR PHYSICIANS

Does Your Patient Have PAD? A Reference Guide for Physicians

Know the Facts about 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 Arterial Disease (PAD), a common circulatory problem in which narrowed arteries reduce blood flow to the limbs. Although estimates suggest that anywhere from 12 to 20 percent of individuals over the age of 60 are living with PAD, most Americans remain unaware of PAD symptoms.

Unfortunately, as many as 180,000 Americans will undergo a limb amputation as result of PAD-related condition this year. But amputation is not the only answer! Identifying arterial disease early may improve a patient’s quality of life and allow early medical and surgical interventions to lower the risk of critical limb ischemia and amputation.

As a physician, you are your patients’ first line of defense. So it is critically important to be on the lookout for typical symptoms of Peripheral Arterial Disease, which can include:

  • Leg pain with walking
  • Numbness in the toes
  • Wounds on the toes or feet
  • Gangrene

Individuals with high cholesterol, high blood pressure, or diabetes are at greatest risk for PAD. Anyone who has suffered from diabetes for over 15 years should be evaluated by a vascular surgeon.

The Importance of Early Detection and Proper Diagnosis

Dr. Polly G. Kokinos, a board-certified Vascular and General Surgeon in Campbell, CA, is recognized as one of the region’s foremost authorities in the diagnosis and treatment of PAD. Dr. Kokinos has dedicated her entire career to serving the South Bay community as an independent physician and a pioneer in the treatment of patients suffering from Peripheral Arterial Disease.

Early detection and treatment are critical to controlling the disease and allowing patients a full selection of treatment options. In an effort to help front line doctors better evaluate and diagnose PAD, Dr. Kokinos has given many lectures to primary care physicians, internists, podiatrists, and orthopedic surgeons about the management of lower extremity arterial and venous disease and the signs and symptoms to look for.

Due to the complex nature of vascular disease, an evidence-based multidisciplinary approach is essential to early assessment, proper diagnosis, and optimal treatment.

How Treatment for PAD Has Changed

Over the past 15 years, the interventional treatment of peripheral arterial disease (PAD) has changed significantly. Minimally invasive endovascular procedures have replaced many traditional surgical procedures as the dominant intervention.

More recently, pedal access techniques, which access the blocked area from the toe instead of a traditional access point in the patient’s groin, have shown, in certain instances, to be significantly more successful than earlier methods of revascularizing the impacted area. Because Dr. Kokinos has performed more pedal access approach procedures than anyone in Northern California, she can provide patients with more options for treating their disease.

Other treatment options for PAD include medical management, exercise and lifestyle modifications, and surgical bypass amputation (when absolutely necessary).

South Bay Vascular Center & Vein Institute: Designed for PAD Treatment

Founded by Dr. Polly Kokinos, South Bay Vascular Center & Vein Institute is a nationally accredited Vascular Surgery Center of Excellence. Unlike traditional hospital operating rooms, this state-of-the-art facility in Campbell, CA was specifically designed as a PAD intervention and treatment facility.

At South Bay Vascular, physicians leverage advanced technology (including Ziehm C-Arms with Flat Panel Detectors and Phillips Intra Vascular Ultrasound imaging systems) to provide the most advanced surgical techniques available in this area.

With a vast inventory of specialized medical devices not found in traditional operating rooms, South Bay Vascular’s surgeons can perform advanced, minimally invasive surgical procedures to provide the best possible outcomes in the most difficult circumstances.

If you suspect any of your patients may have symptoms of Peripheral Arterial Disease or other complex vascular or arterial issues, we would be honored to meet with them to discuss their symptoms. Please refer them to South Bay Vascular Center & Vein Institute (with offices in Campbell and Gilroy, CA) or call 408-376-3626 to schedule an appointment.

For more information, go to southbayvascular.com.

PERIPHERAL ARTERIAL DISEASE (PAD); EARLY RECOGNITION AND REFERRAL TO A VASCULAR SURGEON

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, APPROXIMATELY 3 OUT OF 4 AMERICANS are unaware of PAD Symptoms.

Severe PAD symptoms 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.

Dr. Polly G Kokinos, a board certified Vascular and General Surgeon in Campbell, CA. is recognized as one of the regions foremost authorities in the diagnosis and treatment of PAD. With offices in both Campbell and Gilroy, CA. Dr Kokinos has dedicated her entire career to serving the South County community as an independent physician and as a pioneer in the evaluation and treatment of patients suffering from Peripheral Arterial Disease.

Unburdened by the productivity metrics, financial benchmarks and administrative red tape commonly found in Big Box Medical Systems, Dr. Kokinos has focused her entire career on providing exceptional vascular care building her practice one patient at a time. Her Campbell Surgery center, a nationally accredited Vascular Surgery Center of Excellence, is entirely dedicated to treating patients suffering from complex vascular surgical disorders. Unlike a traditional hospital or university operating room, Dr. Kokinos’ surgery center is entirely dedicated to addressing vascular issues ensuring that she has the most advanced imaging and device technology available anywhere in the world.

Unfortunately, even with all of her skill experience and technology, many patients don’t find Dr. Kokinos until its too late. Many patients go under diagnosed or undiagnosed until it is too late and their medical condition has declined to the point where no one can help. In this circumstance patients lose limbs, suffer unnecessarily and become an incredible burden on their family and loved ones. In the worst cases, patients can die if their leg wounds are left untreated.

In an effort to help front line medical doctors better evaluate and diagnose peripheral arterial disease Dr. Kokinos has spoken extensively to the Primary Community Care Team (Internists, Podiatrists, Orthopaedic Surgeons) in the management of lower extremity arterial and venous disease. As is the case in most instances, early detection of peripheral arterial disease has a dramatic impact on the success of any future treatments.

Bridging this educational gap was the topic of a recent talk Dr. Kokinos was honored to give in March of 2020 to a group of Northern California primary care physicians. The focus of this talk was to help primary care and referring physicians better understand the etiology (the cause of a disease or condition) its diagnosis, management, and referral strategies for peripheral arterial and venous disease.

The key takeaways from her talk are outlined below:

  • Prevalence of PAD and Venous Disease have reached epidemic proportions.
  • Peripheral Arterial and Venous Disease are both associated with high rates of disability and death.
  • Identifying arterial disease early may improve a patients quality of life and allow early medical and surgical interventions to lower the risk of critical limb ischemia and amputation.
  • Identifying venous disease can greatly improve a patients quality of live and lower their risk of dying from this disease.
  • Despite greater awareness, PAD and Venous disease are still under-recognized and under treated.
  • Due to the complex nature of vascular disease, an evidence-based multidisciplinary approach is essential to early assessment, proper diagnosis and optimal treatment
  • Minimally invasive endovascular techniques now enable vascular surgeons to treat significantly higher numbers of patients with a lower complication and death rate
  • Appropriate referrals to specialists must be emphasized if physicians are to continue to improve the lives of patients with PAD

Her underlying message to the audience was that primary care physicians are a patients first line of defense. Helping patients achieve better outcomes requires early recognition and management on the part of the primary care physician and that early referral to a vascular surgeon is essential to the successful outcome of advanced treatments.

If you or anyone you love suffers from any of the symptoms outlined in this blog, we would be honored to speak with them to discuss their symptoms. Call Dr. Kokinos’ office at South Bay Vascular Center to schedule an appointment at 408-376-3626.

DR. POLYXENE KOKINOS…AN INDEPENDENT COMMUNITY VASCULAR SURGEON SERVING SOUTH BAY RESIDENTS FOR 24 YEARS

For 24 years, Dr. Polyxene (Polly) Kokinos has worked in the greater San Francisco Bay Area community as an independent vascular surgeon, dedicating her time to serving patients suffering from vascular disease.

With offices in both Campbell, CA and Gilroy, CA Dr. Kokinos has worked with over 25,000 patients helping them as they suffer from circulatory illnesses and the impact of their disease. From the most delicate to the most complex surgical care, Dr. Kokinos’ and her staff have remained independent community physicians, offering patients an alternative to the “Big Box” medical systems of Santa Clara, San Mateo and Alameda Counties (Kaiser, PAMF, Sutter, Stanford) by offering unmatched personalized care and innovative surgical techniques to advance the care and treatment of her patients.

“We offer hope when others say there is none” is more than a simple message crafted by a marketing agent. It is at the core of everything we do and is the reason why we our facility operates in the most personal way available…

One Patient, One Doctor, One Nurse

South Bay Vascular Center and Vein Institute, located in Campbell, CA is the only fully accredited privately owned state of surgery center in the South Bay dedicated entirely to the practice of Vascular Surgery. Here, Dr. Kokinos provides unmatched vascular surgical care using cutting edge imaging and device technology that no other vascular surgeon or institution in the area can offer as she continues her pioneering work in the treatment of vascular disease.

Recognized by her peers as a national expert in the care of complex vascular disease, Dr. Kokinos is highly sought after as a speaker at national and international vascular surgical conferences and educational symposia. On March 4 2020 as part of her ongoing commitment to her community, Dr. Kokinos spoke in San Mateo, CA. addressing a large group of her peers as an invited guest of Global Education Group and Educational Awareness Solutions under a grant from Philips Image Guided Therapy. Her topic was “The Essential Role of the Primary Community Care Team in the Management of Lower Extremity Arterial and Venous Disease”

Her talk focused on Vascular diseases, “Including peripheral arterial disease (PAD) and venous thromboembolism and their prevalence in the US. When unrecognized or inadequately treated, these disorders may be life threatening and disabling. The therapeutic an diagnostic landscape for vascular conditions is rapidly evolving; yet there remains an unmet need for more awareness among healthcare professionals and patients.” As a recognized expert in her field, Dr. Kokinos was asked to address these topics with her peers, offering solutions and answering questions and was honored to present at this event.

As an independent community surgeon, Dr Kokinos isn’t forced to achieve the “productivity” targets or revenue targets that are by design a part of “Big Box” Medicine. Her practice has always been one of service to her community and as such continues taking emergency vascular call at Good Samaritan Hospital, O’Connor and El Camino Hospital’s in the Silicon Valley. She has served as the chair of vascular surgery at Good Samaritan Hospital in San Jose, Headed the wound care clinic at Good Samaritan, O’Connor and St Louis hospitals and continues to treat patients at the O’Connor Wound Care Clinic.

As an independent community physician Dr. Kokinos focuses her work on providing cutting edge care in the treatment of the most difficult vascular problems. Free from “corporate” medicine Dr Kokinos’ practice is dedicated to finding the “Why” you are suffering so that you have “real” solutions to living a healthy life. At South Bay Vascular, our first job is to listen. We take the time to fully understand your symptoms so that we can provide the best possible solutions to get your legs and your life back…and that’s what she has been doing for over 24 years.

Unlike Big Box medical practices where doctors see the patients on their “list” every morning, Dr. Kokinos must earn the trust and respect of everyone she sees. She’s knows each and every one of her patients by name and everyone who comes in to see Dr. Kokinos gets her cell phone to call if they ever have a problem. It’s what she does and what she’s always done, building her practice patient by patient, referring physician by referring physician for the past 24 years.

If you or anyone you love suffers from vascular disease, we would be honored to meet with you to discuss your symptoms. Please call our office at 408-376-3626 to schedule an appointment.