BLOOD CLOTS (DEEP VENOUS THROMBOSIS‐DVT) A SILENT KILLER

Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in your legs. Deep vein thrombosis can cause leg pain or swelling, but may occur without any symptoms. DVT is a very feared complication of venous disease because it can lead to a pulmonary embolus, a clot in the lung that can be deadly.

There are several symptoms to DVT but the most common are the sudden onset of pain and swelling in your leg. This does not happen in your foot, but happens, most commonly in the back of your calf or your entire thigh. Usually, the painful part of your leg is also swollen. This comes on abruptly and generally does not go away even after a few days. It is very important to go to your regular doctor and get an ultrasound of your leg. If this is “normal” but the swelling or pain persists, then you should go see a vascular surgeon as more testing (such as CT scan or specialized ultrasound) may need to be done. This is quite important to do quickly as some treatments only work if they are done within a week of the development of symptoms.

If you are diagnosed with a DVT, you should be treated with blood thinners immediately. The role of blood thinners is not to actually “dissolve” the clot in your leg, but rather to prevent it from travelling to your lung and causing a Pulmonary Embolus. The blood thinners also work to prevent the clot from becoming more extensive. If this is your first blood clot, you should be treated for 6 weeks to 3 months with blood thinners depending on why the blood clot occurred. The risk factors for developing blood clots include long plane or car rides, immobility (after an operation or injury), obesity, being very sedentary, pregnancy, having had an orthopedic or gynecologic procedure, some genetic factors (hypercoagulable syndromes), dehydration, and cancer. It is important if there if there is not a clear reason for the blood clot, that a search for a hidden cause be done.

Dr. Kokinos and the staff at South Bay Vascular Center and Vein Institute are experts in the identification of and treatment of blood clots. If you or anyone you know suffers from the rapid onset of pain and or swelling following a medical procedure and or long trip (most common on long airplane flights) please contact your primary physician immediately or call us at 408-376-3626 to discuss your treatment options.

SWOLLEN LEG?

It is amazing to me how many patients we see who have suffered with leg swelling or wounds for months or years. They believe that it will just go away, or that the wound will just heal. Sometimes, they have even gone to their doctor, who usually does not even look at their leg. Although mild ankle swelling can sometimes occur just because the weather has been hot, or you have been sitting for a long time, or you had a lot of salt in your diet, the vast majority of the time, there is actually an underlying reason for the leg swelling. This can include such “big” problems such as a heart or kidney problem, a blood clot that has not been diagnosed (especially after an orthopedic procedure or a long car or plane trip), a tumor that is compressing your abdominal or pelvic vessels, or leaky valves in your veins. It is truly important to seek expert help from a vascular surgeon if your leg swelling extends up into your calf, or if it lasts more than a couple of days. This is especially true if it is painful. That is most commonly the sign of a deep venous thrombosis (DVT) and those must be treated immediately to prevent the blood clot from going to your lung and potentially killing you. Pulmonary embolus, when the clot travels to your lung and blocks a main artery there, is the number three cause of death in the United States that nobody talks about.

The work-up for leg swelling almost always will involve a leg ultrasound. This is a painless, quick, and inexpensive test that is diagnostic both for blood clots and leaky valves in the veins. Sometimes, if the problem is in the abdomen or pelvis, an ultrasound or CT scan there may be necessary. If the problems relates to a kidney or heart issue, blood work may be in order. In any case, sometimes, the treatment of the underlying problems that cause leg swelling need to be begun within a few days of its occuring so that one can have the best outcome possible.

If you have a swollen leg, whether it is for a few days or several months, come see the experts at South Bay Vascular Center to help diagnose and treat its cause.

SWOLLEN LEGS? YOU MAY HAVE ILIAC VEIN COMPRESSION

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 any kind of cosmetic or other surgical procedure done on your leg 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 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 are now able to diagnose and successfully treat iliac vein compression using state of the art ultrasonic imaging technology. 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. All of these procedures can be performed in our state-of-art angiography suite right at our office meaning that you can avoid going to the hospital to get this done. To date, Dr. Kokinos has successfully performed over 100 of these iliac vein stent procedures in her out-patient angiography suite and will be the featured speaker at a national convention in April 2016 to share her success stories helping patients reduce leg swelling and to increase the rate of wound healing.

During the months of April and May, Dr. Kokinos is offering a FREE, limited number of iliac vein screenings to patients with a history of venous reflux or DVT (blood clots) to screen for this possible compression problem. 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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