Tag: PERIPHERAL ARTERIAL DISEASE

MILLIONS WITH LEG PAIN HAVE PERIPHERAL ARTERIAL DISEASE

Posted on by Angelica Rodezno

A NY Times Health Care blog published in April of 2016 screamed out with the title “Millions With Leg Pain Have Peripheral Arterial Disease”.”More than eight million older Americans have a condition that can cause leg pain when they walk even short distances. Yet half of those who have the condition don’t know it and consequently don’t get treated for it, putting themselves at risk for a heart attack, stroke or worse.The condition, called peripheral artery disease, or P.A.D., is marked by diseased or blocked arteries in the legs. More than half of those with such circulatory problems in the extremities also have coronary or cerebral artery disease, noted Dr. Iftikhar J. Kullo, a cardiovascular specialist at the Mayo Clinic, in The New England Journal of Medicine in March. Failure to diagnose and treat blocked arteries elsewhere in the body can result in more serious, or even fatal, problems if they affect the heart or brain.It may seem odd that people who have serious difficulty walking normal distances would not know something is wrong and get checked out. Yet, as Dr. Kullo noted, P.A.D. is both underdiagnosed and undertreated. And the number of cases of P.A.D. is only likely to rise as the population ages, he said.”The article in its entirety can be read by clicking on the link below

https://well.blogs.nytimes.com/2016/04/11/millions-with-leg-pain-have-peripheral-artery-disease/

San Jose’s South Bay Vascular Center surgeons specialize in the care and treatment of patients suffering from PAD. Recognized as one of California’s leading Vascular Surgeons, Dr Kokinos has a special interest in peripheral re-vascularization procedures. Essential to her success in treating PAD is her ability to perform these re-vascularization procedures in her nationally accredited, custom built, state of the art peripheral arterial disease (PAD) treatment center. This facility, located in Campbell, CA., was specifically designed as a PAD treatment facility and is where South Bay Vascular Center physicians leverage advanced imaging systems (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. This advanced technology, together with a vast inventory of specialized medical devices not found in traditional operating rooms allows our surgeons to perform advanced, minimally invasive surgical procedures in their efforts to provide the best possible outcomes in the most difficult circumstances.Diagnosis
Many types of health care providers can diagnose and treat PAD. Family physicians, internists, physician assistants, nurse practitioners and vascular specialists can all diagnose PAD by examining a patient’s medical and family history, performing a physical exam, and conducting diagnostic tests. PAD can be diagnosed through a variety of diagnostic procedures including:

  • Ankle-brachial index (ABI):A common test used to measures the difference between blood pressure at the arm and at the ankle. A difference in the two areas indicates restricted blood flow.
  • Ultrasound
  • CT and MR angiograms
  • Angiography
  • Blood tests

Treatment
Over the past 15 years the interventional treatment of peripheral arterial disease (PAD) has changed significantly. Endovascular techniques have replaced many traditional open surgically invasive procedures as the dominant intervention. More recently, pedal access techniques, accessing the blocked area from the toe versus a traditional access point in the patients groin, has shown, in certain instances, to be significantly more successful that earlier methods of revascularizing the impacted area. Dr. Kokinos has performed more pedal access approach procedures that anyone in Northern California and because of this she able to provide patients with more options for treating their disease than many other surgeons.There are multiple options for treatment of PAD, ranging from medical interventions, surgical revascularization, and endovascular therapy. Vascular Surgeons are uniquely qualified and trained to treat patients diagnosed with PAD. Approaches to treatment include:

  • Minimally invasive endovascular procedures
  • Medical management
  • Exercise and lifestyle modifications
  • Surgical bypass Amputation

Early detection and treatment are important to control the disease and to allow patients a full selection of treatment options. If you suffer from non-healing leg wounds and or have difficulty walking short distances, ask your physician if you can have a vascular ultrasound study to evaluate your risk of PAD.

South Bay Vascular Center and Vein Institute is the recognized as the regional treatment center for the treatment and care of patients suffering from Peripheral Arterial Disease. Dr.’s Kokinos’ specialized training and state of the art interventional facility offers patients a unique alternative to a hospital setting and provides the highest level of care for the treatment of PAD as an alternative to limb amputation.

If you or a loved ones suffers from PAD, call our office today at 408-376-3626 to schedule a visit.

We offer hope when others say there is none.

www.southbayvascular.com

TREATING DIABETIC FOOT ULCERS

Posted on by Angelica Rodezno

Millions of patients every year are seen in wound care centers for the treatment of their foot and leg ulcers. This is absolutely the correct place for anyone who has had a wound that is “non-healing” or “chronic”. That is, a wound that is still there after four weeks. Unfortunately, sometimes the physicians in these wound care centers are quick to put on expensive savs or other advanced treatment options. After all, isn’t that why the patients go to the wound care center instead of just their physician’s office? Partially. Good wound care centers treat by guidelines.

Guidelines are a scientifically proven set of steps that have been shown to help wounds heal faster. For EVERY wound on the leg or foot, the very first step is to assess BLOOD FLOW. This means that every patient with a leg or foot wound that hasn’t healed in four weeks MUST be seen by both a vascular surgeon AND a podiatrist (foot specialist).

The vascular surgeon will assess the circulation and order appropriate diagnostic tests, such as vascular ultrasounds to look at the blood flow. This is important to examine, as a large number of the patients who have ulcers, have not previously been diagnosed with an arterial or venous problem. Without fixing the underlying cause of the ulcer, even if it does heal initially, it will soon recur, and cause further problems. It is important for patients to take an active role in asking for these referrals so that the problem does not progress and become a wound that can lead to an amputation.

If you or anyone you know is diabetic and suffers from non-healing leg wounds call today to schedule an appointment at our office. South Bay Vascular Center and Vein Institute Surgeons are recognized as the regional experts in wound care healing and amputation prevention. Our Vascular Surgeons have performed more lower extremity re-vascularizations than any other surgeons in the region and offer hope when others say there is none.

Call today at 408-376-3626

PERIPHERAL ARTERIAL DISEASE (PAD) INTERVENTION AND TREATMENT

Posted on by Angelica Rodezno

Over the past 15 years the interventional treatment for peripheral arterial disease (PAD) has changed significantly with endovascular revascularization replacing surgically invasive procedures as the dominant intervention. Early detection and treatment are important to control the disease and to allow patients a full selection of treatment options.

Diagnosis
Many types of health care providers can diagnose and treat PAD. Family physicians, internists, physician assistants, nurse practitioners and vascular specialists can all diagnose PAD by examining a patient’s medical and family history, performing a physical exam, and conducting diagnostic tests. PAD can be diagnosed through a variety of diagnostic procedures including:

  • Ankle-brachial index (ABI):A common test used to measures the difference between blood pressure at the arm and at the ankle. A difference in the two areas indicates restricted blood flow.
  • Ultrasound
  • CT and MR angiograms
  • Angiography
  • Blood tests

Treatment
There are multiple options for treatment of PAD, ranging from medical interventions, surgical revascularization, and endovascular therapy. Vascular Surgeons are uniquely qualified and trained to treat patients diagnosed with PAD. Approaches to treatment include:

  • Minimally invasive endovascular procedures
  • Medical management
  • Exercise and lifestyle modifications
  • Surgical bypass Amputation

South Bay Vascular Center and Vein Institute is the recognized as the regional treatment center for the treatment and care of patients suffering from Peripheral Arterial Disease. Dr.’s Kokinos and Pineda specialized training and state of the art interventional facility offers patients a unique alternative to a hospital setting and provides the highest level of care for the treatment of PAD as an alternative to limb amputation.

If you or a loved ones suffers from PAD, call our office today at 408-376-3626 to schedule a visit.

We offer hope when others say there is none.

www.southbayvascular.com

SEPTEMBER IS PAD AWARENESS MONTH

Posted on by Angelica Rodezno
What is Peripheral Arterial Disease?
Peripheral artery disease (PAD), also known as claudication, poor circulation, vascular disease, or hardening of arteries, is a chronic, life-threatening circulatory condition. PAD causes narrowing or blockage of the vessels that carry blood from the heart to the legs. The primary cause of PAD is atherosclerosis, or the buildup of plaque in the arteries. This occurs when arterial inflammation, cholesterol, calcium and scar tissue build up, forming plaque that clogs the arteries and slows blood flow to the legs. The more plaque that builds up on the inside walls of the blood vessels carrying blood from the heart to legs and arms, the more the arteries lose flexibility and narrow, putting patients at greater risk.
Risk factors for PAD
Smoking
High blood pressure
Diabetes,
High cholesterol
60+ years old.
PAD patients are at high risk of developing critical limb ischemia (CLI), a chronic condition that results in severe pain in the feet or toes, even while resting. Complications of poor circulation can include sores and wounds that won’t heal in the legs and feet. Left untreated, the complications of CLI could result in amputation of the affected limb. PAD patients are also at greater risk for heart attack and stroke. Studies have found that the total annual US costs for patients with PAD exceed $21 billion, including nearly $10 billion for hospitalizations. In Medicare alone, one study estimated spending on PAD accounted for more than 2% of all Medicare spending. PAD has been identified by the Institute of Medicine (IOM) as a priority area for comparative effectiveness research. One study suggested that endovascular therapy appears to be the least costly option in the short-run for patients with PAD.
Symptoms Blockages can restrict blood flow to the muscles, causing muscle cramps, tightness or weakness, especially during activity. In the early stages of PAD, patients may not experience any symptoms. If PAD is not treated, though, blockages may continue to grow and restrict, or even completely block, blood flow.
Common symptoms include:
Leg pain when walking
Muscle pain or cramping in legs and calf triggered by activity
Leg numbness or weakness
Coldness on lower leg or foot
Sores on toes, legs or feet that won’t heal
Change in color of legs
IF YOU OR ANYONE YOU KNOW SUFFERS FROM ANY OF THESE CONDITIONS WE CAN HELP! CALL US TODAY AT
408-376-3626 TO SCHEDULE AN APPOINTMENT.

ACHING TIRED OR HEAVY LEGS?

Posted on by Angelica Rodezno

DR. KOKINOS SELECTED TO PRESENT AT THE AMERICAN VENOUS FORUM

Posted on by Angelica Rodezno

Dr. Kokinos will be presenting an abstract on her clinical research regarding iliac vein compression at the national American Venous Forum in New Orleans early next year. This meeting is the largest venous meeting of the year, and is sponsored by the Society for Vascular Surgery.

Dr. Kokinos has been recognized nationally as an expert on May-Thurner’s Syndrome, or iliac vein compession. This problem can cause symptoms of (predominantly) left leg swelling, heaviness, aching, deep venous clots, and non-healing ankle or leg wounds. She has performed more intravascular ultrasound exams and stents of the deep venous system than any other doctor on the West Coast in the last year. She will be presenting her clinical research on using regular ultrasound, done by the specially trained registered vascular technologists in the ICAVL accredited Institute for Vascular Testing to diagnose this fairly common but widely underdiagnosed issue. Previously, patients needed to get CT scans which used significant amounts of radiation and contrast for the diagnosis. This problem is not only seen because of a common anatomic situation, but also often as a result of an undiagnosed blood clot (DVT) in the iliac or femoral vein after orthopedic, back, or gynecologic surgery.

If you have one leg that is more swollen or painful than then other, or have had a leg blood clot in the past, please call us at 408-376-3626 or visit us at www.southbayvascular.com.

SOUTH BAY VASCULAR CENTER IS “TAKING A STAND AGAINST AMPUTATION”

Posted on by Angelica Rodezno

18 Million Americans Suffer from Peripheral Arterial Disease (PAD). Left untreated, PAD can lead to amputation. Each year 160,000 amputations are performed as a result of peripheral arterial disease.

South Bay Vascular Center and Vein Institute is Taking A Stand Against Amputation. Dr. Pineda and Dr. Kokinos recently attended the “Advanced Orbital Atherectomy Course in the Treatment of Complex PAD Below the Knee” at Metro Health Hospital, in Grand Rapids, Michigan. This course was led by Dr. Jihad Mustapha, a thought leader in the field of critical limb ischemia. The techniques included using alternate access sites (using the arteries at the ankle and foot for access), instead of using the traditional groin site. The course also included treatment of arteries in the foot, with the main goal being on limb preservation and amputation prevention. To date, Dr.’s Kokinos and Pineda have performed more procedures using pedal access than any other surgeons in the greater San Francisco Bay Area, and are recognized as leaders in this area.

The practices expounded by Dr. Mustapha and his team are the same techniques and principles the vascular surgeons at South Bay Vascular use in their care and treatment of PAD. These include: identification and aggressive medical management of risk factors, minimally invasive interventions when indicated, and continued surveillance to detect issues before they become clinically apparent.

At South Bay Vascular, we do use alternate sites frequently, and by using this approach, decrease the rate of groin complications and the length of time that the patient has to remain flat after a procedure. Furthermore, with our growing population of diabetics and patients with kidney disease, we are better equipped to manage critical limb ischemia and prevent amputations. This course is in support of our focus on taking care of patients at risk of losing a limb.

If you or a loved one is diabetic, has kidney disease (is on dialysis), or has been told they need an amputation, please contact us for a consultation with one of our surgeons and together we will Take A Stand Against Amputation.