Author: Western Vascular Institute

Unveiling the Hidden Risks of Varicose Veins

The featured content from Western Vascular Institute, as seen on KTAR News, sheds light on the significant health implications of varicose veins beyond mere cosmetic concerns. Dr. Mitar Vranic, Vascular Surgeon and CEO of Western Vascular Institute, underscores the multifaceted problems associated with varicose veins, including pain, blood clots, and skin ulcers.

Understanding the physiological role of veins in facilitating blood flow, the content explains how weakened or damaged valves can lead to venous insufficiency, causing blood to pool in the veins and resulting in the characteristic bulging appearance of varicose veins.

Various risk factors predispose individuals to varicose veins, such as pregnancy, menopause, age over 50, sedentary lifestyle, obesity, and prolonged periods of sitting or standing. Recognizing symptoms like leg pain, itching, swelling, and skin discoloration is crucial, especially as symptoms worsen in hot weather.

The content emphasizes preventive measures, including weight loss, leg elevation, avoidance of prolonged sitting or standing, and wearing compression stockings. Additionally, it outlines treatment options, ranging from minimally invasive procedures like sclerotherapy and RF ablation to surgical interventions like phlebectomy, all aimed at alleviating symptoms and improving vascular health.

Western Vascular Institute, with its team of Vascular Specialists, offers comprehensive support from diagnosis to treatment selection, ensuring personalized care for individuals experiencing varicose vein symptoms or other vascular issues. Readers are encouraged to seek expert guidance and make appointments for further evaluation and treatment at Western Vascular Institute.

Preventing Deep Vein Thrombosis: Expert Insights from Western Vascular Institute

Western Vascular Institute was featured on KTAR News highlighting the importance of movement to prevent deep vein thrombosis (DVT), a serious medical condition where blood clots form in deep veins, often in the legs. Dr. Henry Tarlian, a Vascular Surgeon at Western Vascular Institute, emphasizes the life-threatening nature of DVT and the necessity of medication to dissolve clots and prevent their migration to the lungs.

Various factors contribute to the risk of DVT, including lifestyle choices like smoking, obesity, sedentary jobs, leg crossing, and extended periods of immobility. Additionally, hormonal changes from pregnancy or birth control pills, advancing age, and genetic predisposition also increase susceptibility to DVT.

Symptoms of DVT may include pain, swelling, redness, or tenderness in the leg or arm, although half of those affected may not display symptoms. Furthermore, if a clot reaches the lungs, it can lead to a pulmonary embolism, presenting symptoms like chest pain, difficulty breathing, or coughing up blood.

Western Vascular Institute offers information and appointments for individuals concerned about DVT, underscoring the importance of seeking professional guidance for this potentially life-threatening condition.

How to Know It’s Deep Vein Thrombosis

Deep Vein Thrombosis occurs when a blood clot forms in a deep vein usually in the leg or thigh. It is essential to recognize the signs of DVT since the clot can break away and become lodged in the lungs. What may follow is PE, or a Pulmonary Embolism, which can be life-threatening.

Here are a few of the risk factors for DVT and how to know it’s Deep Vein Thrombosis.

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Is My Leg Pain Caused By Peripheral Artery Disease (PAD)?

If you have unexplainable leg pain, especially after walking or exercising, it could be due to peripheral artery disease, or PAD. This condition is often under-diagnosed and untreated, which is a serious problem due to the danger that it can pose to your health and well-being.

What is PAD?

Peripheral artery disease is the narrowing of the peripheral arteries, which are responsible for bringing blood away from the heart and to other areas of the body. While it most commonly affectsperipheral artery disease. the legs and feet, it can also be found in other parts of the body, including upper extremities.

PAD occurs when arteries begin to narrow or become blocked when plaque, which consists of cholesterol, calcium, and fibrous tissue, builds on the walls of the artery. This can cause pain in legs while walking and exercising.

In severe cases, a blood clot can form and completely stop blood flow, which can result in a stroke or heart attack.

Risks & Symptoms of PAD

Many people who have PAD may not have symptoms, or they may mistake their symptoms for another condition. Most commonly observed symptoms of PAD include:

  • Leg pain during exercise, and also at rest
  • Leg numbness or weakness
  • Wounds of the legs, foot, or toes that do not heal easily
  • Decreased temperature of the leg or foot
  • Slow nail growth on toes or hair growth on the leg
  • Some men experience erectile dysfunction

Patients are more at risk for peripheral artery disease when they:

  • Smoke cigarettes
  • Have type 2 diabetes
  • Are obese
  • Have high blood pressure or high cholesterol
  • Are over 50 years of age
  • Have a family history of heart issues or strokes

PAD Treatment Options

There are lifestyle changes individuals with PAD can take to reduce the progression and relieve symptoms. These include: quitting smoking, regular physical activity, consuming a diet low in saturated and trans fat, and taking steps to manage your diabetes.

You may have a medication prescribed to you to help reduce your risk for PAD or worsening the condition.

When lifestyle changes or medications are not suitable, minimally invasive procedures are typically the next option. Western Vascular Institute provides revascularization procedures as an effective PAD treatment option. Balloon angioplasty and stent placement opens the narrowed/blocked artery and a stent is placed to keep the artery open.

Western Vascular Institute works with each patient to provide a thorough diagnosis and personalized treatment plan.

Contact Western Vascular Institute at (480) 668-5000 to schedule your peripheral artery disease consultation today.

Carotid Artery Disease: How to Lower Your Risk of Stroke

Are you aware that a stroke is the leading cause of long-term disability in adults in the United States? More specifically, one third of all strokes are due to carotid artery disease. Your two carotid arteries are located on either side of your neck, and their main purpose is to deliver blood and oxygen to your brain. A stroke occurs when blood is interrupted or something slows down the flow of blood. Let’s understand more about carotid artery disease and how to lower your risk of stroke.

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Carotid Endarterectomy

Carotid endarterectomy is a surgical procedure that involves removing plaque buildup from the carotid arteries, which are located in the neck and supply blood to the brain. This blog post aims to provide you with a comprehensive understanding of carotid endarterectomy, including its purpose, procedure, and why you might need one.

What is Carotid Artery Disease?

Before delving into carotid endarterectomy, it’s essential to grasp the concept of carotid artery disease. Over time, the carotid arteries can become narrowed due to the accumulation of fatty deposits called plaques. This condition, known as atherosclerosis, restricts blood flow to the brain, potentially leading to a stroke or transient ischemic attack (TIA), often referred to as a mini-stroke.

Purpose of Carotid Endarterectomy:

Carotid endarterectomy aims to reduce the risk of stroke by removing the plaque buildup from the carotid arteries. By restoring normal blood flow, the procedure helps prevent the development of vascular surgeon in the or.a full-blown stroke or TIA.

Indications for Carotid Endarterectomy:

Significant carotid artery narrowing: Typically, a stenosis of 70% or more is considered significant, but the decision to undergo surgery depends on several factors, including your overall health and the presence of symptoms.
Experienced a recent TIA or minor stroke: If you’ve had a transient ischemic attack or a minor stroke, carotid endarterectomy may be recommended to prevent further, more severe strokes.
Asymptomatic with high-grade stenosis: In some cases, carotid endarterectomy may be considered for individuals without symptoms but with high-grade carotid stenosis (greater than 80%) due to the increased risk of future strokes.

The Carotid Endarterectomy Procedure:

Here’s a general overview of what you can expect during a carotid endarterectomy procedure:

Anesthesia: You will be given either general anesthesia (where you’re asleep) or local anesthesia (where only the neck is numbed).

Incision: A small incision is made in the neck over the affected carotid artery.

Artery Access: The vascular surgeon carefully opens the carotid artery to access the plaque inside.

Plaque Removal: The plaque is removed from the artery, aiming to restore normal blood flow.

Closure: The artery is then closed, and the incision in the neck is stitched or stapled.

Recovery: After the procedure, you will be closely monitored in the hospital for a day or two before being discharged. The recovery period may vary, but most individuals can resume their normal activities within a few weeks.

Carotid endarterectomy is a well-established procedure aimed at reducing the risk of stroke in individuals with significant carotid artery disease. By removing plaque buildup from the carotid arteries, the procedure helps restore normal blood flow to the brain, potentially preventing future strokes. If you’ve been recommended to undergo carotid endarterectomy, it’s crucial to discuss any concerns or questions you may have with your healthcare provider. Remember, the decision to undergo the procedure should be made based on a careful assessment of your individual medical condition and the risks and benefits involved.

The “Five P’s” of Peripheral Vascular Disease

The “Five P’s” of Peripheral Vascular Disease

The “Five P’s” of Peripheral Vascular Disease (PVD) are a set of clinical signs and symptoms used to assess and diagnose vascular compromise in the extremities. These indicators help healthcare professionals evaluate the severity and progression of PVD. The Five P’s include:


Patients with PVD may experience pain in the affected limb, typically described as cramping, aching, or sharp discomfort. The pain may occur during physical activity (intermittent claudication) and subside with rest. In advanced cases, pain may persist even at rest or during the night.


Pallor refers to the pale appearance of the skin in the affected limb. Reduced blood flow due to narrowed or blocked arteries can result in decreased oxygen supply to the tissues, leading to paleness.


Pulselessness indicates the absence or diminished quality of the peripheral pulses in the affected limb. A weak or absent pulse may suggest arterial insufficiency due to PVD.


Paralysis refers to the loss of motor function in the affected limb. Severe PVD, often associated with advanced stages or acute arterial occlusion, can cause muscle weakness or even complete paralysis.


Paresthesia refers to abnormal sensations in the affected limb, such as tingling, numbness, or a “pins and needles” sensation. Reduced blood flow and nerve damage associated with PVD can lead to altered or diminished sensation.

Assessing and documenting the presence of the Five P’s can aid in diagnosing PVD and determining the appropriate treatment course. However, it is important to note that not all individuals with PVD will exhibit all five signs, and the severity of each symptom can vary depending on the extent of the vascular compromise.

Prompt medical evaluation is crucial for individuals experiencing the Five P’s, as it may indicate significant vascular compromise requiring immediate intervention to restore blood flow and prevent potential complications, such as tissue damage or limb loss. Healthcare professionals, particularly those specializing in vascular medicine, use the Five P’s as part of a comprehensive assessment to guide diagnosis, treatment planning, and ongoing management of patients with suspected or confirmed PVD.

Intravascular Ultrasound (IVUS)

Intravascular Ultrasound

Intravascular ultrasound (IVUS) is a medical imaging technique that allows for the visualization of blood vessels from the inside. It involves the use of a tiny ultrasound probe that is threaded into the blood vessels through a catheter, providing detailed images of the vessel walls and structures.

Here’s how intravascular ultrasound works and why it is used in clinical practice:


Insertion of the Catheter:

A catheter, which has a small ultrasound probe at its tip, is inserted into a blood vessel, typically through the groin or the arm. The catheter is carefully guided through the blood vessels until it reaches the area of interest.

Ultrasound Imaging:

Once the catheter is in place, high-frequency sound waves are emitted from the ultrasound probe. These sound waves bounce off the vessel walls and other structures inside the blood vessel.

Image Capture:

The reflected sound waves are picked up by the probe and converted into real-time images. These images are then displayed on a monitor and can be recorded for further analysis.

Benefits and Applications of Intravascular Ultrasound:


Detailed Visualization:

IVUS provides high-resolution, cross-sectional images of blood vessels, allowing vascular surgeons to assess the vessel size, structure, and any abnormalities present. IVUS provides more detailed information compared to other imaging techniques.

Assessment of Atherosclerosis:

IVUS is commonly used in the evaluation of atherosclerosis, a condition characterized by the buildup of plaque inside the arteries. Intravascular ultrasound also helps determine the extent and composition of the plaque, identify areas of vessel narrowing or blockage, and guide treatment decisions.

Guidance for Interventions:

IVUS is often utilized during various vascular procedures, such as angioplasty or stent placement. IVUS provides real-time feedback to guide the placement of devices and assess their effectiveness in improving blood flow.

Assessment of Stent Deployment:

IVUS can evaluate the proper positioning and expansion of stents within the blood vessels. IVUS helps ensure that the stent is fully expanded and properly apposed to the vessel walls, reducing the risk of complications.

Research and Clinical Trials:

Intravascular ultrasound is also utilized in research studies and clinical trials to investigate new treatment approaches, assess the effectiveness of medications, and gather data on vascular conditions.

IVUS is a valuable tool in the field of vascular medicine. It helps vascular surgeons make accurate diagnoses, guide treatment decisions, and monitor the progress of interventions. The information obtained through IVUS enhances patient care by providing detailed insights into the condition of the blood vessels, allowing for personalized treatment plans and improved outcomes.

Transcatheter Deep Vein Arterialization

Transcatheter Deep Vein Arterialization

Transcatheter arterialization of the deep vein system is a minimally invasive procedure used to treat chronic limb-threatening ischemia (CLI). CLI is a condition in which the blood supply to the limbs is severely reduced, leading to pain, ulcers, gangrene, and possibly amputation.


In this procedure, a catheter is inserted into a blood vessel in the groin and threaded up to the deep veins in the leg. A small balloon is inflated at the tip of the catheter to create a new pathway for blood flow. A stent, a mesh tube, is then placed in the new pathway to keep it open.

Deep vein arterialization (DVA) is not a novel procedure;  Creating arterial-venous bypass, reverses venous flow, and limb perfusion can restore after the arterialization. It is however a new use of deep vein materialization in its treatment of Critical Limb Ischemia and its use for patients who are not eligible for other treatments such as angioplasty or surgery.

Deep vein arterialization is performed under general anesthesia. The procedure typically takes about two hours. Patients typically stay in the hospital for one to two days after the procedure.

Side Effects:

The most common side effects of Deep vein arterialization are pain, bruising, and swelling at the injection site. Other potential side effects include bleeding, infection, and blood clots.

Deep vein arterialization is a promising new treatment for CLI. It is a less invasive alternative to surgery and angioplasty, and it has been shown to be safe and effective in clinical trials.