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

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.

WHY DON’T THE WOUNDS ON MY LEGS AND FEET HEAL ANYMORE?

Hi! Dr. Lau here again with South Bay Vascular. Today, I wanted to shed some light on one of the most common issues that we see in vascular surgery, non-healing wounds of the feet and toes. My hope is that after reading this blog you will have a better understanding of what causes leg wounds and ulcers; why sometimes they won’t heal on their own, and what we in vascular surgery can do to help them heal.

Ulcers, generally speaking, develop because of TWO main causes: nerve damage induced by diabetes and lack of blood flow. When patients have elevated levels of sugar in their blood with diabetes, the sugar forms toxic compounds that damage nerves in the foot. Consequently, the patient cannot feel injuries that would otherwise cause a normal patient to adjust position to stop the injury. With this loss of sensation ulcers form at the point of repeated injury that the patient cannot feel.

The second cause, a lack of blood flow, develops over decades in patients who smoke and who have high blood pressure and high cholesterol. These medical problems cause hardening and narrowing of the blood vessels, otherwise known as atherosclerosis.

In patients with diabetes, I coordinate carefully with my podiatrist colleagues who are experts in specialized footwear and surgical interventions that alleviate common areas of trauma. In patients with poor blood flow, I, as a vascular surgeon, can perform minimally invasive surgery to restore blood flow to the affected area. We use wires and specialized tubes to gain access to the blood vessels and then use balloons to break open the narrowing’s and self-expanding tubes called stents to keep the vessels open. Afterwards, we use a specialized x-ray machine called fluoroscopy to see that the narrowing’s have opened again to allow blood to flow back to the area. Patients usually leave to go home the same day with only a 2-millimeter puncture in their groin and are back to normal activity the day after surgery!

If you or anyone you know has a wound on their leg, foot or toe that hasn’t healed in more than two weeks, please call our office at 408 376 3626 to schedule an appointment.

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

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

THE “RIGHT” EXPERIENCE COUNTS WHEN IT COMES TO YOUR HEALTH

The “RIGHT” Experience Counts When It Comes to Your Health! South Bay Vascular Center and Vein Institute is the Bay Area’s Most Trusted Varicose Vein Clinic and Treatment Center.

Having performed over 20,000 vein procedures in the past 24 years, more independent doctors refer their vein patients to Dr. Polyxene (Polly) Kokinos than to any other vascular surgeon in the greater Silicon Valley region. Recognized as San Jose’s most experienced Vascular Surgeon and Varicose Vein Expert, Dr Kokinos offers cutting edge care to patients suffering from all forms of both arterial and venous disease.

Here’s why more local doctors refer to South Bay Vascular than to any other Vascular Surgery Center in the Valley:

  • The “RIGHT” Experience Counts When it Comes to your Health: South Bay Vascular center has been treating vein patients in a private practice setting for over 24 years.
  • Cutting edge vascular care in a fully accredited, state of the art, and private out-patient surgery center dedicated entirely to the practice of vascular surgery.
  • Access to the most Advanced Imaging and Device technologies found anywhere in the world.
  • On-site fully staffed IAC accredited Vascular Ultrasound Clinic that is operated full time by Registered Vascular Technologists (RVT).
  • Vascular Studies ready by RPVI certified Vascular Surgeons.
  • Same day availability for Hemodialysis Access de-clots.
  • “One-Doctor, One Patient, One Nurse” practice philosophy means we put the patients first.
  • Full time access to practice physicians
  • Easy access to care: No admissions departments.
  • RESULTS:   We are MORE than just a colorful website and a Google Adwords campaign. Remember, all that glitters is NOT Gold!  https://www.southbayvascular.com/blog/varicose-vein-doctors/

 Trust the doctor your physician does.

 Remember, Its Not Just Experience That Counts.

When It Comes to Your Health, It’s The “RIGHT” Experience that Matters!

Dr Polyxene Kokinos, Silicon Valley’s Vascular Surgeon.

Call us today at 408-376-3626 to schedule your vein consultation.

Click here to learn more about Dr Kokinos  NOT JUST VASCULAR CARE, EXCEPTIONAL VASCULAR CARE

VARICOSE VEIN DOCTORS

Type “Varicose Vein Doctor” into your Google search and in seconds, you’re overwhelmed by results.

Each link points to a different website.  Each site claims their “Vein Doctor” is the “best” and every practitioner claims to have the “bona-fides” to back-up these claims. Credentials span the continuum from Academic Institution Affiliations, (claiming to be X, Y or Z University Affiliated); to Chair-Personships (they “chaired’ this or that medical departments in the “Big Box” health care systems they came from (i.e. Kaiser, PAMF, or Sutter) to Medical Journal Publications…all this in an apparent attempt to equate administrative responsibilities with clinical excellence. Some of the bolder in the group even claim they trained at the best medical schools hoping to convince potential patients that by attending a great medical school they are the best physician for the procedure.

 

AN ESPECIALLY CONCERNING TREND IS A PHYSICIAN’S USE OF GOOGLE ADWORDS TO ADVANCE THEIR MESSAGE

 

If a vein doctor’s website shows up in your Google Search and you see that the listing starts with the word “AD” …be careful. It means that the owner of this practice is paying Google a special Advertising fee to get their name to the top of the search results. This is an attempt by this physician to “BUY LEGITIMACY”.  Businesses PAYING google to display their ads above the practitioners who have EARNED this privilege is a great way for Google to make money. Unfortunately, it can be deceiving to people who think that because a doctor’s website pops up at the top of the search results that they must be the best. (On a separate note…If a physician’s website DOES show up at the top of the search results and DOES NOT have the word “AD” in front of it, IT IS a sign that this physician has many website visitors and that they have been around for a long time…Especially if this listing is followed by a large number of Google Reviews.)  It also means that this physician has EARNED their reputation, and NOT purchased their website ranking. A word of warning to patients searching for an experienced vein care professionals. Anyone can pay to elevate their search rankings on Google; regardless of their experience.

 

IGNORE websites with paid “AD’s”, especially if they don’t have any verified Google reviews. 

 

To make things even more difficult, it can be very confusing just trying to figure out what kind of doctor actually does varicose vein procedures. Some doctors call themselves “Vein Specialists”. Others call themselves “Vein Experts”. You’ll also see the labels “Phlebologist” and “Vascular Expert”. Finally, there is the “Vascular Surgeon”. You ask yourself, do all of these physicians fix varicose veins? If so, what’s the difference? (Learn more by clicking on the following link). https://www.southbayvascular.com/blog/vascular-surgeon-vs-phlebologist-vs-vein-specialist/ Every one of these “Vein Doctors” promises to rid you of your ugly, painful veins, leg swelling and non-healing ulcers. Every one of them posts photos showing off their work to prove their point.

Let’s face it, it’s confusing. All you really want is to get your veins “fixed” so that next time you get invited to a pool party you can wear shorts or a skirt again without being “mortified” by how bad your legs look. So, what’s next?

Lost in this hype, finding the right doctor to treat your varicose veins might seem impossible. Choosing the best doctor for your specific vein condition is a difficult decision and not one that you should take lightly.  Only after serious consideration of the available options should this decision be made and in the best of all worlds, it should be made in consultation with your primary care physician…and this is the probably the most important message in this post.

LISTEN TO YOUR PRIMARY CARE DOCTOR

They’ve been in this community a long time and they know who is good and who is not. Their referral should be your number one reason to make an appointment with a Varicose Vein Doctor.

In the best of scenarios, patients should visit as many doctors as they can; interview them and question them about everything relating to their condition and their ability to help you…but remember, your primary care doctor has been doing this for a long time. They’ve got the benefit of having seen the results from different doctors and on the strength of their recommendation, you should have the confidence to know that you are making the right choice.

Here are a few things varicose vein patients should keep in mind:

  1. Remember, these are your legs. You deserve the best and you deserve to “Love Your Legs Again”.
  2. Don’t be frightened to ask your doctor tough questions.
    • Don’t just ask your vein doctor how long they have been in practice, ask them how long they have been doing these specific kinds of vein procedures. Ask them how many of these procedures they’ve done.
    • If your doctor is in private practice, ask them how long they have owned their own practice. This is important because getting things done right in a private practice is significantly more difficult than getting work done in a University Hospital or Big Box Medical System.
    • How many of these procedures have you done RECENTLY….if they do less than 25-30/ month, you might want to seriously consider finding another option
    • What kind of complications might you expect…every person is different and if your doctor says your legs will look as good as they did when you were 20, you might want to consider seeing someone else.
    • Who does your ultrasounds…are your ultrasound techs RVT’s (Registered Vascular Technologists?) Are they done “in-house” by full time Vascular ultrasonographers or are they done by “travelling” ultrasonographers who just work in their office a few times a week and who are not full time employees of the medical office.
    • Most importantly, is your Vascular lab IAC Accredited? This is especially important as your doctor will make their diagnosis on the basis of your ultrasound report and an IAC accreditation guarantees the best of the best studies are being done at that particular lab.
    • Who reads the ultrasounds….is it an RPVI registered physician, not simply a radiologist… as the two physicians will look for vastly different signs relating to vascular disease and health. Keep in mind if the study isn’t read correctly, the procedure can go poorly.
  3. Finally, ask your “Vein Specialist” about what happens if you have a complication 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.

 

EXPERIENCE COUNTS WHEN IT COMES TO YOUR HEALTH!

 

South Bay Vascular Center and Vein Institute brings 24 years and 20,000 vein procedures to you as our patients. As the leading independent Vascular Surgery practice in the San Francisco Bay Area, more local independent physicians refer their vein patients to Dr Kokinos than to any other vascular surgeon in the greater Silicon Valley Region.

WE OFFER HOPE WHEN OTHER SAYS THERE IS NONE!

Call us today at 408-376-3626 to schedule your vein consultation

AWARD WINNING WOUND CARE IN SAN JOSE

The O’Connor Wound Care Center, which celebrates it’s 25th Anniversary this year, was the site of a ceremony on Thursday, June 18th 2019 honoring it with a Commendation from the City of San Jose. The honorable Sam Liccardo as well as all the City Council Members were involved in recognizing the O’Connor Wound Care Center for distinguished service to the citizens of San Jose. The plaque was presented by Council Member Dev Davis to Dr. Polly Kokinos of South Bay Vascular Center, who is the Medical Director of the O’Connor Wound Care Center, as well as to the entire staff of the Wound Care Center.

Chronic wounds are a silent epidemic in the United States affecting almost 7 million people. If not healed in a timely fashion, they can lead to loss of limb and life. The wound care center was started 25 years by Drs. Bruce Lehrman, Peter Schubart, and Jude Roussere, who are still active in it today. It is a testament to their vision and understanding that chronic wounds are best treated by a multidisciplinary approach and by a team that focuses on them. Their are 10 physicians from 6 different specialties all of whom are have special training in wound care, advanced treatment modalities for wounds, and hyperbaric oxygen therapy. Our team of twelve nurses and five additional staff members are committed to these patients, and several of them have worked at the center for decades. We follow published clinical practice guidelines to ensure the best outcomes and our wound healing rates are over 98%.

We are the only JHACO accredited center in the Bay Area, and are proud to offer advanced therapies such as skin substitutes, the LUNA laser system, and Hyperbaric Oxygen treatment for difficult to heal chronic wounds. We have treated and healed over 15,000 patients.

Should your patient need our expert help, please call us at 408-947-2804 for an appointment.

PREVENTING DIABETIC AMPUTATIONS IN SAN JOSE

Every year over 160,000 amputations are performed in America. 60%-80% of Medicare patients who undergo amputation never walk again. Worse yet, there is a 30-50%, 2-year mortality rate following an amputation…meaning that between 30% and 50% of all patients undergoing an amputation die within 2 years of their procedure.

Recent advancements in both imaging and medical device technology have significantly improved a patients chances for a different outcome: avoiding amputation. Educating patients about these new procedures, however, is still very difficult because many of these new advances are known only to the surgeons and universities pioneering them. In fact, recent studies show that more than 54% of patients were not even assessed using diagnostic angiograms to determine if blood flow could be restored to their affected limbs prior to the amputation. Earlier this year, Medicare published figures showing that a full 67% of medicare patients who underwent a major amputation never even had a re-vascularization procedure in an attempt to save their limb.

Dr.’s Kokinos and Pineda are recognized as specialists in the field of lower limb re-vascularization and limb salvage. Having performed more pedal access re-vascularization cases (approaching the affected limb via the foot instead of the groin) than any other physicians in the region provides these South Bay Vascular surgeons with the experience and judgement to help patients avoid diabetic amputations and to treat patients with advanced cases of peripheral arterial disease (PAD) or what is otherwise known as Chronic Limb Ischemia (CLI).

If you or someone you know is facing the possibility of lower limb amputation, STOP! CALL US FOR A SECOND OPINION. South Bay Vascular is Taking a Stand Against Amputation and you should too. Call us at 408-376-3626 to schedule a thorough evaluation of your options. We are specialists in the area of lower limb re-vascularization and we provide hope when others say there is none.