Tag: BLOOD CLOTS

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

Posted on by Michael Kokinos

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?

Posted on by Michael Kokinos

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,,,

 

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.

PART 2: WHY DO MY TOES, ANKLES, AND FEET HURT AT NIGHT? RAYNAUD’S SYNDROME

Posted on by Michael Kokinos

Last week I wrote the first part of a four-part series about foot pain at night.  Specifically, I talked about venous disease as a cause of foot pain.

Today, I want to talk about another common cause of foot pain at night: Raynaud’s Syndrome. 

As a quick review, last week we talked about the two main types of blood vessels in our bodies: arteries and veins.  Arteries bring blood from the heart to the feet under high pressure.  Veins bring blood back from the foot to the heart under low pressure.

Raynaud’s Syndrome is a disease of the arteries, particularly the small arteries, in the feet.

(Though Raynaud’s can also affect the hands as well). 

Before we dive into Raynaud’s Syndrome though, I need to briefly review another anatomical system in our bodies that is involved in Raynaud’s Syndrome: The nervous system.

In general, we have two broad types of nerves.

  1. There are nerves that are responsible for sensation and for moving muscle and
  2. There are nerves that are responsible for regulation of bodily function.

Diving a little bit deeper into the kinds of nerves that regulate bodily function, there are the

  • Sympathetic nervous system: The sympathetic nervous system, amongst other things, is responsible for opening blood vessels in the legs and arms and increasing blood flow when exercise is necessary
  • Parasympathetic nervous system: The parasympathetic nervous system in similar fashion opens the blood vessels leading to the intestines to allow for the digestion of food.

In patients with Raynaud’s Syndrome, sometimes their sympathetic nervous system does not function properly resulting in the constriction of blood vessels that lead to the hands, fingers, feet, and toes.  When it happens, blood vessels in the fingers and toes typically first turn blue because of the lack of oxygen; then white because of the lack of blood flow; and finally red, once the constriction ends and the blood flow returns to the fingers and toes.  During this constriction of the blood vessels, patients can have significant pain, numbness, tingling, and, in very severe cases, ulcers (defects in the skin with exposure of underlying fat and muscle) and gangrene (black and dead tissue).

Interestingly, environmental and social triggers play a significant role in Raynaud’s Syndrome episodes of vessel constriction.  Factors including stress, caffeine, alcohol or other drugs, and cold temperature can all induce a painful episode with lack of blood flow to the hands and feet.

Not much is known about the cause of Raynaud’s Syndrome or specifically why it happens.  Sometimes, Raynaud’s Syndrome can occur on its own without any other related disease.  In other cases, the patient has another inflammatory disorder like lupus or Sjogren’s Syndrome that is known to be highly associated with Raynaud’s Syndrome.

Though we do not fully understand the causes of Raynaud’s Syndrome there are many treatment strategies that can help.  Starting with behavioral modifications and certain blood pressure medications that can reduce spasm to specific procedures aimed to reduce the spasm of the vessels induced by the sympathetic nervous system, there is so much that I as a vascular surgeon can do to help patients with Raynaud’s Syndrome.  If you think that you might suffer from Raynaud’s Syndrome, please do not hesitate to call our office on 408-376-3626 to schedule an appointment. 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.

BLOOD CLOTS

Posted on by Michael Kokinos

Today, I want to give insight into one of the more common questions I receive as a vascular surgeon: How do I know if I have a blood clot?

Why is this important? Here are a few facts directly from the US Center for Disease Control and Prevention (CDC).

  • Anyone can develop a blood clot.
  • In the United States, as many as 900,000 people are affected by DVT’s each year and
  • About 100,000 people die of PE annually.

Many factors can put you at risk for a blood clot. These include:

  1. Major trauma
  2. Cancer
  3. Being 55 and older
  4. Having a personal or family history of blood clots
  5. Immobility (such as being on bed rest or difficulty with walking)
  6. Pregnancy, or using estrogen containing medications such as birth
    control pills, patches, and hormone replacement therapy
  7. Obesity
  8. Smoking

Almost half of all blood clots occur either during or soon after discharge from a hospital stay or following surgery. The more risk factors you have, the greater your risk of developing a blood clot will be.

The medical term for blood clot is Deep Vein Thrombosis. (DVT) Veins at their most fundamental level are blood vessels that return blood from the body (e.g. feet, hands, intestines, kidney, etc.) back to the heart.  In the legs, there are two main sets of veins: superficial and deep.  Deep veins are very close to the muscle and bones.  Superficial veins are very close to the skin, hence the name superficial.  The word thrombosis derives from the Greek word of the same spelling, thrombosis, which means curdling.  In contemporary medicine thrombosis refers to the blood’s transition from liquid to solid.  With all these words explained, we can see that a deep vein thrombosis refers to blood clots that are in the deep system of veins in the legs.  Though superficial veins can become clotted as well, the symptoms that result are usually not as severe as a deep vein thrombosis.

Once the deep veins of the legs are blocked, blood becomes trapped in the veins below and the blood pressure in the veins increases.  Consequently, the leg and foot will become swollen, blue, and tender.  Patients often complain of a “tension” or “pulling” sensation in the groin, thigh, and behind the knee.  These feelings of tension and pulling are often also considered as very painful.  Because of the swelling there may be severe difficulty with tasks as simple as walking to the bathroom or a few feet.

PE’s: A Silent Killer

Sometimes, a piece of clot can break off from the legs and travel to the lungs.  This is called pulmonary embolism or PE.  Pulmonary refers to lungs and embolism refers to something that breaks off from one place and travels to another.  When patients have a blood clot associated with a pulmonary embolism, they will experience:

  • Shortness of breath
  • Palpitations/fast heart rate, and
  • In very severe cases, dizziness associated with fainting.

Recognize The Signs and Symptoms of a Blood Clot

DVT (Arm or Leg) – if you experience any of these, call your doctor as soon as possible.

  • Swelling of your leg or arm
  • Pain or tenderness not caused by an injury
  • Skin that is warm to the touch, with swelling or pain
  • Redness of the skin, with swelling or pain

PE (Lung) – if you experience any of these, seek medical attention immediately.

  • Difficulty breathing
  • Chest pain that worsens with a deep breath
  • Coughing up blood
  • Faster than normal or irregular heartbeat

Blood Clots Can Be Prevented

  • Know your risks and recognize signs and symptoms.
  • Tell your doctor if you have risk factors for blood clots.
  • Before any surgery, talk with your doctor about blood clots.
  • See your doctor as soon as you can if you do have any symptoms.

    I hope this blog post can shed some light on blood clots.  If you or someone you know are experiencing these types of symptoms, please do not hesitate to visit our website at www.southbayvascular.com to call our office at 408 376 3626 to schedule an appointment today!

    ONE PATIENT, ONE DOCTOR, ONE NURSE; SOUTH BAY VASCULAR CENTER’S COMMITMENT TO PERSONALIZED CARE

    Posted on by Michael Kokinos

    Unlike so many big box medical centers (Kaiser, Sutter, PAMF, Stanford) where patients are often “overwhelmed” as soon as they get to the parking lot, South Bay Vascular Center and Vein Institute offers world class, cutting edge vascular surgical care in a kinder, gentler environment.  Individualized patient care, although talked about and marketed heavily by these corporate health systems, more often than not falls far short of patient expectations as higher order operational efficiencies and profitability concerns impact the kind of care patients actually experience in these larger health care systems.

    ONE PATIENT; ONE DOCTOR; ONE NURSE. 

    Putting patients at the center of everything that a physician does is a philosophy that sounds obvious…but is that always the case? At South Bay Vascular Center we are honored by the chance to earn your trust and to serve as your physicians; BUT, we also know that we must EARN the trust of every patient that we see.  That’s why our CREDENTIALS are NOT Enough…That’s why our REPUTATION is NOT enough. That’s why unmatched patient care is at the center of everything that we do. That’s why when patients come to our facility for a procedure each patient has their own nurse from start to finish to ensure the greatest patient care experience from start to finish. 

    We know patients have options for their vascular care and that’s why we work hard to ensure that any patient referred to us by another doctor or that comes to us on their own has the confidence to know they’ve made the right choice of doctor to help them with their vascular related illnesses. ONE PATIENT; ONE DOCTOR; ONE NURSE is just one of the many ways that South Bay Vascular Center demonstrates our commitment to our patients in our efforts to provide the most advanced vascular care options offered anywhere in the world.

    OUR TEAM

    Together with her full time, highly skilled team of critical care and surgical nurses, radiological technicians, RVT certified Ultrasound Technologists and scrub assistants, Dr Kokinos provides unmatched peripheral vascular surgical care in her Nationally Accredited Surgical Facility. As diverse as Silicon Valley is, our staff reflects this same diversity as we have native speaking staff fluent in over 10 different languages. Be it Vietnamese, Mandarin, Korean, Russian, Tagalog, Hindi, Spanish, French, Greek or English, we have staff to make our patients comfortable in their native tongue.

    OUR FACILITY

    The South Bay Vascular Ambulatory Surgery facility is one dedicated entirely to the practice of Vascular Surgery and houses a specialized inventory of vascular medical devices and imaging equipment that surpasses the number of vascular medical devices and imaging equipment at Good Samaritan and O’Connor Hospitals combined. Together with her highly trained and specialized team, Dr Kokinos brings over 30 years of surgical experience and 7 years of specialized surgical experience operating in a specially built vascular surgery outpatient facility to her patients.  Other physicians may claim to have the kind of training and experience that Dr Kokinos has in the outpatient environment, but NO other Vascular Surgeon in Silicon Valley comes anywhere close to having the kind of experience and outcomes Dr Kokinos does when it comes to providing care to the patients who come to her for the treatments and care of their vascular disease.

    Put another way, for 25 years Dr Kokinos and her team at South Bay Vascular Center and Vein Institute have provided unmatched, compassionate and individualized vascular surgical care to South Bay communities. It is why more independent physicians refer their vascular patients to Dr Kokinos than to all the other Silicon Valley vascular surgeons combined. When it comes to your health, we know that it’s not just our credentials and our experience that count.  It’s not about just having an accredited facility or a staff of travelling specialists to help when needed…   It’s about the RIGHT KIND OF EXPERIENCE EVERY TIME YOU NEED IT.

    RESULTS matter when it comes to your health because sometimes you don’t get a second chance.

    South Bay Vascular Center and Vein Institute: We Offer Hope When Others Say there Is None.

    Call us at 408-376-3626. We Can Help

    FOOT PAIN AT NIGHT: IT MIGHT BE MORE SERIOUS THAN YOU THINK

    Posted on by Michael Kokinos

    Many patients over the age of 65 who have a history of smoking, diabetes, high blood pressure, and/or high cholesterol wake up at night with pain in their foot or toes. Some believe this is arthritis or gout; others think it is the result of just spending too much time on their feet during the day.  Patients often self-adapt to this problem, as it usually develops slowly over time, but when questioned about their sleep habits, they will sometimes tell you that they sleep in a recliner or they sleep with their leg hanging over the side of the bed to make their pain go away.

    It is very common for elderly patients to get up at night to go to the bathroom. Sometimes, however, it’s actually foot pain that wakes them up.  Once up, they get out of bed because that makes their feet feel better (again due to gravity) and after walking to the bathroom they can go back to sleep, pain -free for a couple of hours.  Even that small amount of walking helps to get their blood flowing again and makes it easier for them to go back to sleep.

    Sometimes, foot pain at night is the sign of a more serious condition.

    • Foot pain at night may be related to having poor circulation in the foot. The name for this in medical terms is “rest pain”. This is not “pain at rest” but rather pain that happens because the circulation cannot support the tissues even when they are at rest.

    Foot pain at night may be an early warning sign of critical limb ischemia.

    • Chronic Limb Ischemia is another term for lack of blood flow;  if you experience this rest pain at night and it goes away after hanging your foot over the side of the bed or chair you are sleeping in, immediately call and speak with your doctor to set up an appointment for them to evaluate your symptoms. Although it may come on slowly, the arteries in your feet may be so blocked that they cannot even deliver the minimal amount of oxygen the tissues in the foot and toes need to keep them nourished. Left untreated, this blockage can lead to a more serious problem, amputation or even death.

    What’s important for the patient to realize is that chronic limb ischemia causes the foot and leg to get swollen, so the patient is often MIS-DIAGNOSED with a vein problem, not an arterial problem

    If this sounds like something you or someone you love is experiencing, it is important to tell your primary care doctor OR schedule an appointment DIRECTLY with a vascular surgeon. These symptoms are a sign that your body is giving you that you may need immediate help. This truly is a sign that your foot is starving for oxygen and blood and that if left untreated, might lead to an unnecessary amputation. Help is possible, however and if treated early enough, those suffering from these symptoms can be helped significantly.

    If you suffer from painful feet in the middle of the night, WE CAN HELP

    contact us today  at 408-376-3626 to learn more about PAD and how Dr. Kokinos can help, click here.

    South Bay Vascular Center and Vein Institute: We Offer Hope When Others Say There Is None.

     

     

    NOT JUST VASCULAR CARE, EXCEPTIONAL VASCULAR CARE

    Posted on by Angelica Rodezno

    Your health care is complicated enough… finding the right Vascular Surgeon shouldn’t be!

    Experience counts when it comes to your health

    Polyxene (Polly) Kokinos MD. RPVI. Board Certified in Vascular and General Surgery

    Silicon Valley’s Most Trusted Vascular Surgeon.

    Dr Kokinos…The Confidence of knowing you made the Right choice for your Vascular care.

    • The confidence of knowing that your vascular surgeon has been taking care of South Bay patients with vascular disease for almost 30 years.
    • The confidence of knowing that your surgeon built her private practice one patient at a time for almost a quarter of a century…BECAUSE referring PHYSICIANS TRUST Dr Kokinos to deliver the best possible outcomes for their patients: even in the most difficult of circumstances.
    • The confidence of knowing that your surgeon delivers both world class and compassionate care. That Dr Kokinos is the only Vascular surgeon in the South Bay who has built an independent, nationally accredited, state of the art Vascular Surgery Center of Excellence where SHE takes care of her patients…where cutting edge care is at the heart of everything that she does.
    • The confidence of knowing that your surgeon has earned the trust of local physicians. More independent local physicians refer their vascular patients to Dr Kokinos than to any other vascular surgeon in Silicon Valley.
    • The confidence of knowing you will receive the most Advanced and Innovative Care found anywhere in the world…No other vascular surgery practice in Silicon Valley offers a combination of the imaging, device and care options that South Bay Vascular Center can offer to their patients in their private, AAAASF nationally accredited ambulatory surgery center dedicated entirely to the treatment of complex vascular disease. “We offer hope when others say there is none”
    • The confidence of knowing you will receive Personalized Care…” One Doctor, One Patient, One Nurse” …We’re NOT a hospital; we are more. That’s why we provide individualized care. At South Bay Vascular Center, we care for you as a person, not just as another patient. Our job is to understand the “why” so that you have real solutions to living a healthy life.
    • The confidence of knowing you will receive Simplified Care: ALL your vascular care under one roof. Clinical care, Vascular Ultrasound care, and Surgical care. All your care in a single facility.

    South Bay Vascular Center and Vein Institute. Silicon Valley’s Vascular Surgeon.

    A SWOLLEN LEG IS NOT NORMAL

    Posted on by Angelica Rodezno

    Leg Swelling: Iliac Vein Compression
    Chronic pain and swelling in one leg, (especially the left side) may be caused by iliac Vein Compression. This is a little-known but fairly common condition that can greatly impact your quality of life – and may lead to more serious complications. Leg swelling is NOT a normal part of aging or weight gain. And it’s NOT something you have to “just live with.”

    Leg swelling is a special area of interest of Dr. Polly Kokinos, and she has been active in doing clinical research to find better ways to diagnose and to treat this condition. South Bay Vascular Center and Vein Institute is recognized as the leading treatment center for evaluating and treating left leg swelling. If you have been told there is nothing to do for your leg swelling, call us at 408-376-3626 for an evaluation. We offer hope when others say there is none!

    About Iliac Vein Compression:
    Iliac vein compression (also known as May-Thurner Symptom) is an anatomic condition that occurs when the left iliac vein gets squeezed and compressed between the lumbar spine and the right iliac artery. This compression prevents the adequate drainage of blood from the leg, which can cause serious problems such as swelling, aching, blood clots, and non-healihg ulcerations. (See Diagram)

    Symptoms:

    • Swelling, heaviness and aching in one leg, especially the left leg
    • Recurrent blood clots, especially in the left leg
    • Non healing wounds or dark dry skin in the ankle or shin

    Solutions
    South Bay Vascular Center and Vein Institute is the leading leg swelling clininc in Northern California offering cutting-edge treatment options that very few other facilities can deliver. We are at the forefront of diagnosing Iliac Vein Compression using regular vascular ultrasound and in treating it with the newest endovascuar techniques using IVUS (intravascular ultrasound) and stents in an outpationt office setting.

    If you or a loved one are suffering from leg swelling or any other vascular problems, please call our office today at 408-376-3626 to schedule an appointment. Our offices in Campbell and Gilroy remain open to safely treat patients even during the COVID-19 crisis.

    DO YOU SUFFER FROM SWOLLEN LEGS? WE CAN HELP!

    Posted on by Angelica Rodezno

    Do you Suffer From Iliac Vein Compression?

    To answer that question, take a few seconds to consider the following:

    ▪ Are your legs swollen? Is your left leg larger than your right?
    ▪ Is it harder to slip one shoe on in the morning than the other?
    ▪ Have you had cosmetic or other surgical procedure done and not gotten the outcome you wanted?
    ▪ Are you a cancer patient undergoing treatment or procedures?
    ▪ Have you ever suffered from a blood clot or (DVT) in your leg
    ▪ Do you visit a wound care clinic with little to no success?

    If you’ve answered yes to any of these questions, you MAY be suffering from a well known, but previously difficult to diagnose problem called May-Thurner’s Syndrome.

    May Thurner’s Syndrome, also known as iliac Vein Compression, is a condition where the main artery supplying blood to the leg pushes down or compresses the main vein taking blood back to your heart. Previously undiagnosed, major advances in medical imaging technology have given vascular surgeons the tools needed to demonstrate that May Thurner’s syndrome is directly responsible for the slowing of blood going back to ones heart resulting in the swelling and or edema of the leg. These same studies have shown that in a full 30% of all people, the left iliac vein can be significantly compressed by the right iliac artery resulting in some kind of leg symptom….aching, heaviness, and most commonly, swelling or non-healing of wounds in the leg veins.

    The Physicians and Surgeons at South Bay Vascular Center and Vein Institute specialize in treating Iliac Vein Compression. To diagnose and to treat this condition and the potentially deadly side effects caused by it (Blood Clots or Deep Venous Thrombosis) Dr. Kokinos has assembled a highly skilled team of vascular ultrasonographer’s who have developed a specialized screening protocol to evaluate for Iliac Vein Compression. Using state of the art ultrasonic imaging technology Registered Vascular Ultrasonographer’s use this new protocol and ultrasonic sound waves to scan up into the abdomen of their patients to examine the physics of the blood flow in this area. If a patient is found to have iliac vein compression, and is symptomatic for this condition, we then recommend IVUS–intravascular ultrasound and iliac vein stenting to re-establish blood flow in this area by opening up the compressed blood vessel in this area.

    South Bay Vascular Center is a specialized vascular surgical facility dedicated entirely to treating vascular related illnesses. Unlike in a traditional hospital operating room, South Bay Vascular’s nationally accredited ambulatory surgery center is designed specifically to treat this kind of circulatory disease. Using advanced imaging equipment and device technology designed specifically for vascular related illnesses Dr. Kokinos is able to treat IVC disease in her outpatient surgery center setting in Campbell, CA. Treating her patients in this kinder and gentler environment Dr. Kokinos simplifies what has traditionally been the difficult, unfriendly and often times complicated admissions process of a traditional hospital. To date, Dr. Kokinos has successfully performed over 200 of these iliac vein stent procedures in her out-patient angiography suite and has lectured extensively at major vascular surgery meetings on her approach and success helping patients reduce leg swelling, increase the rate of wound healing and return to a normal way of living.

    If you are currently experiencing a swollen leg, have a non healing leg, foot,or ankle wounds or have ever suffered a blood clot (DVT) please contact our office at 408-376-3626 to schedule an appointment.

    Don’t suffer from swollen legs or non-healing leg ulcers any longer.

    We can help!

    408-376-3626

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