Author: Western Vascular Institute

Diabetes Awareness Month

November is Diabetes awareness month. The risk of dying from a vascular disease with diabetes is 3-4 times higher than those without diabetes. It is extremely important for individuals with diabetes to be seen by a vascular surgeon and get the care they need and deserve!

Schedule an Appointment for Diabetes Treatment in Phoenix, Arizona

If you currently suffer from diabetes and are in the Phoenix, Arizona area, call Western Vascular Institute today! Our highly-trained vascular surgeons will take the time to provide you with a comprehensive diagnosis and give you the tools needed to prevent vascular disease. For more information, contact our vascular clinic at (480) 668-5000 and schedule an appointment today!

Common Peripheral Artery Disease Treatments

Peripheral Artery Disease is a severe form of vascular disease that affects the arteries outside of the heart, primarily the lower extremities. Peripheral Artery Disease or PAD is a gradual build-up of plaque on the walls of the arteries. This gradual build-up of plaque hardens the arteries, making them less flexible and narrows the opening for blood to flow from the heart to all the appendages freely. Many PAD patients have burning, aching pain after walking or pain in the calf, thigh, or buttocks. Treatment for PAD is varied and depends on the seriousness of the disease.

Your Vascular Surgeon will discuss an individualized systematic review of all available treatment modalities, generally from the least invasive to most invasive, and suggest the most appropriate treatment based on how the disease has progressed and what is in the best interest of each patient. Vascular Surgeons are the only specialist able to provide all treatment options ranging from medications to open surgical bypass but generally try to provide the least invasive form of treatment first.

Most common treatments for PAD 

Lifestyle Changes:

  1. Walking is one of the most effective measures a patient can take to reduce the symptoms of PAD. Walking has been found to reduce the symptoms and stop further disease progression. Although PAD cannot be totally healed, its progression can be slowed to the point that it does not affect the patient’s activities of daily living. Walking reduces plaque build-up and helps to lower cholesterol and blood pressure, and aids in maintaining a healthy weight.
  2. Smoking cessation – Smoking is one of the main risk factors for PAD. Smoking damages blood vessels and makes it difficult for the blood to flow compressed arteries. Smoking also increases the risk for blood clots by decreasing the movement of cholesterol through the arteries and hardening the arterial walls.
  3. Diet – A healthy diet plays a serious role in overall vascular health. Avoiding foods high in fat and adding fresh fruits and vegetables dramatically reduces the effects of PAD.

Medications Symptom relief medication- Your doctor may prescribe medication to increase blood flow, thin the blood, and assist in widening the vessel body.

  1. Blood clot prevention – Medications such as Plavix are used to reduce the chance of blood clots and improve overall blood flow.
  2. Medication to control blood sugar – For patients with diabetes (Another top risk factor for PAD), reducing sugar levels in the blood is paramount. High levels of sugar in the blood damage the arteries’ lining, making it much more susceptible to atherosclerosis.
  3. Medication for high blood pressure – High blood pressure over time can weaken the arterial walls. Reducing the pressure where/when possible is essential in keeping the arterial walls healthy.
  4. Medication to lower cholesterol – LDL cholesterol is the fatty substance that builds up in your bloodstream and forms a plaque on the arterial walls that reduce the artery’s diameter, making it much more difficult for blood to flow through.

Minimally Invasive (In-office procedure)

When lifestyle changes and medications do not sufficiently reduce PAD symptoms, your Vascular Surgeon may suggest a minimally invasive vascular procedure to widen the artery at the location where the plaque has reduced the flow of blood. These procedures are done in the “In-Office” angiography suite at our Mesa and Phoenix locations.

  1. The first option of in-office PAD treatment is Angioplasty. In an Angioplasty your Vascular Surgeon will insert a small catheter into your artery, using the artery as a raceway, and place a wire within the catheter that has a balloon on the tip down to the disease area. Once in the disease or narrowed area, the balloon is expanded, pressing the plaque against the wall and opening the artery for a more effortless blood flow.
  2. Another treatment offered in the angiography suite is the use of an atherectomy device. An atherectomy device is guided through a catheter inserted into the artery similar to an angioplasty; then, the device uses high-energy laser light to vaporize the plaque blockage resulting in increased blood flow to the peripheral vessels and tissues.
  3. Stents are another minimally invasive in-office treatment offering vascular surgeons use to improve symptomatic PAD patients. Stents are also placed via a catheter in the artery and are guided to the diseased area after ballooning to create a structural scaffold to hold the diameter of the artery wall open for patent blood flow.

These minimally invasive treatments are used in concert to provide patients with minimally invasive yet highly effective treatments for PAD by a Vascular Surgeon. This form of treatment is almost always performed before taking the patient into the hospital, hoping that a less invasive procedure will provide relief and vascular improvement in a more comfortable setting. Patients who have angio procedures in our in-office angiography suite leave the same day as their treatment, generally within a few hours of the operation.

Hospital-based surgical procedures are the last level of treatment when the other treatments options have not been sufficient, or the disease has progressed past their efficacy. Vascular Surgeons are the only “vascular specialist” that can provide all the other procedures and hospital-based open and endovascular surgical procedures. Our surgeons are Board Certified and Fellowship Trained, holding hospital privileges at all local hospitals with vascular capabilities. These in-hospital vascular treatment options are as follows:

  1. Bypass surgery – Your vascular surgeon may choose to perform bypass surgery to treat your PAD. Bypass is accomplished by redirecting the flow of blood around the diseased area. In bypass surgery, a Vascular Surgeon will either use a synthetic graft or the patient’s vein to make a new route around the blocked or narrowed area “bypassing” to the site of best blood flow.
  2. Endarterectomy – A Vascular Surgeon performs this treatment in the hospital by making an incision at the site of the arterial blockage. The blood from the artery will be rerouted around the blocked area during the surgery. The artery is opened at the blockage site and then removed. After removal, the artery is stitched up, and the reroute removed. The artery now has open blood flow throughout, improving the patients’ symptoms.

Schedule an Appointment for Peripheral Artery Disease Treatment in Phoenix, Arizona

Western Vascular Institute’s team of Board-Certified Fellowship-Trained Vascular Surgeons are privileged at all local hospitals with vascular capabilities. Our surgeons can provide individualized and unparalleled care for patients suffering from Peripheral Artery Disease (PAD) throughout Arizona.

If you or someone you know has PAD, or you would like to find out if you have PAD call (480) 668-5000 to schedule a new patient appointment or follow this hyperlink to a Peripheral Artery Disease quiz.

Peripheral Artery Disease Quiz

What are compression stockings?

Compression stockings are used in the treatment of varicose veins and venous insufficiency. They help reduce or completely alleviate the symptoms of venous disease, prevent blood clots, and are used after varicose vein treatment.

Compression stockings squeeze legs to compress veins and keep blood moving in the right direction which is back to the heart. The strength of compression stockings is measured in millimeters of mercury or mmHg. This is represented in a range (i.e. 20-30mmHg) from the lowest compression to the highest compression.  20-30mmHg is a commonly prescribed strength of stocking for by our vascular surgeons.

 

Get Compression Stockings at Western Vascular Institute

If you are in the Phoenix, Arizona area and in need of compression socks, contact Western Vascular Institute at (480) 668-5000 today!

Intrasight Mobile IVUS

Western Vascular Institute is excited and honored to announce that we have been chosen as 1 of only 6 locations globally to apply a new intravascular ultrasound technology, the IntraSight Mobile IVUS by Philips.

This amazing new technology provides smart, accurate images inside vessels allowing vascular surgeons the ability to more accurately visualize, plan, diagnosis, and treat peripheral vascular disease during interventional procedures.

We are grateful for this opportunity to be a part of the rollout of this new device. It is not only an incredible honor, but it also shows the caliber of Doctors and staff here at Western Vascular Institute.

https://www.usa.philips.com/healthcare/resources/landing/intrasight

https://www.westernvascular.com/vascular-surgery/peripheral-vascular-disease/

 

 

Vascular Surgeons the real “vascular specialists”

Vascular Surgeons diagnose, treat, and manage the full spectrum of vascular diseases.

“If you only have a hammer you tend to see every problem as a nail.”

Some vascular “specialists” perform one or two kinds of vascular interventions, so their patients tend to get those treatments. Vascular Surgeons are trained in all treatment modalities and are able to perform every type of procedure skillfully: open, complicated surgery and minimally invasive, in-office endovascular procedures. Some patients need one, some need the other, while many need no surgery at all. Vascular Surgeons are “treatment agnostic,” that is, they do not prefer any treatment over another.

Some types of surgeons come into your life to perform a procedure, make sure you heal and then leave; that’s their role. A vascular surgeon is someone who treats you on an ongoing basis for decades. A vascular surgeon very often has long-term relationships with patients because vascular disease can be a long-term condition.

At Western Vascular Institute, patients will get the best treatment for their particular needs in a caring and safe environment by a vascular surgeon with a full toolbox of treatment options!

https://vascular.org/patients/what-vascular-surgeon

https://www.westernvascular.com/about/

Ankle Brachial Index

An ankle-brachial index is a simple and non-invasive test performed to diagnose peripheral vascular disease. The index compares the blood pressure of the legs and arms and creates a ratio that shows the availability of blood to flow freely from one extremity to the other. The ABI is calculated by dividing the systolic blood pressure at the ankle by the systolic blood pressure in the arm.

During this test, patients lie on their back and a technician places blood pressure cuffs on the ankles and arms. The machine then inflates the cuffs alternating to get the ratio. This test may include exercise by walking on a treadmill for several minutes in order to simulate when a patient would feel pain due to peripheral artery disease and then takes the reading afterward to understand the severity of the said disease.

https://www.westernvascular.com/testing-center/

https://vascular.org/patient-resources/vascular-tests

 

What Causes A Stroke?

Strokes are caused by an interruption of blood flow to the brain and are classified by the type of blood flow interruption as listed below.

 

Ischemic stroke – occurs when blood vessel blockage prevents blood flow to the brain due to a plaque build-up in the carotid arteries.

Hemorrhagic stroke – occurs when the vessel ruptures inside of the brain and bleeds.

Transient Ischemic stroke or TIA – is a temporary blockage or mini-stroke which can cause permanent damage and are a sign of more severe stroke in the future.

Like Peripheral Arterial/Vascular Disease, Carotid Artery Disease is a narrowed blood flow through the vessel. This narrowing or blocked vessel becomes occluded by fatty deposits of plaque built up along the vessel wall leading to atherosclerotic disease. The Carotid artery is the primary source of blood to your brain. Therefore, a narrowing or blockage in the carotid artery is a serious complication and requires thorough and appropriate diagnosis and treatment.

Symptoms

Many people with Carotid Artery Disease do not experience symptoms even with quite a bit of arterial blockage. Generally, this condition is found after the patient experiences a stroke or by a routine patient examination.

Causes

Generally, Carotid Artery Disease is caused by atherosclerosis, where a build-up of plaque in the arteries reduces the flow of blood or blocks the flow entirely. This lack of blood flow and reduced oxygen supply to the brain can lead to stroke.

Risk Factors include:

Sedentary lifestyle, Overweight obesity, Diabetes, smoking, high cholesterol levels, high blood pressure, Family history, high fat diet, and age above 75 are all factors.

Diagnosis

Diagnosis of Carotid Artery Disease is generally diagnosed through thorough physical examination and medical history. Your physician will also most likely be looking for a (bruit) swooshing sound in the carotid artery that is indicative of a narrowed artery. A Carotid Artery duplex ultrasound scan will also be performed to assess the flow of blood through the artery as well as the pressure.

Treatments

The reason for the treatment of carotid artery disease is to reduce or mitigate the possibility of stroke.

For mild blockage:

Lifestyle changes such as eating a healthier diet, reducing salt intake, exercising regularly, losing weight, and quitting smoking are all ways that patients themselves can manage the disease and reduce the chance of blockage and stroke.

Medication management:

Medications may be given to lower the amount of cholesterol in the blood and lower your blood pressure. Additionally, blood thinner medications may be given to prevent blood clots.

Surgical intervention:

Carotid endarterectomy – generally performed when there is a blockage of 50% or above accompanied with symptoms such as a stroke.

TCAR – Western Vascular Institute is pioneering the use of a breakthrough technology called TransCarotid Artery Revascularization (TCAR) to treat patients with carotid artery disease who are at risk for open surgery. While any repair of the carotid artery carries some risk of causing a stroke because of the repair itself, TCAR was designed to help minimize that risk by keeping potential stroke-causing fragments away from the brain.

Carotid angioplasty/stenting – This procedure is performed to treat narrowed or occluded carotid arteries. In this procedure, the Vascular Surgeon inserts a wire through the groin and guided via x-ray imaging to the carotid artery. Once there, the balloon is placed to expand the narrowed section, and a stent is left in place afterward to maintain the vessel diameter and allow the blood to flow through the artery.

https://vascular.org/patient-resources/vascular-conditions/stroke

https://vascular.org/patients/vascular-conditions/carotid-artery-disease

https://silkroadmed.com/patient-caregivers/

 

What is Claudication?

Claudication, also referred to as intermittent claudication, is pain caused by reduced blood flow to the lower extremities.  Claudication is a symptom of the disease called Peripheral artery or peripheral vascular disease (PAD or PVD) rather than a disease itself.

Claudication can cause:

  • Pain in calves, thighs, feet, or other parts of the lower extremities
  • Pain at rest, that gets worse with movement
  • Discolored skin
  • Weakness in leg
  • Aching or burning sensation in extremities

https://www.westernvascular.com/vascular-surgery/peripheral-vascular-disease/

https://vascular.org/patient-resources/vascular-conditions/peripheral-arterial-disease

Radio-Frequency Ablation for Varicose Veins.

 

Radiofrequency closure, also known as radiofrequency ablation, addresses the venous reflex disease that often causes varicose veins. It serves as an alternative to traditional vein stripping, which requires invasive surgical removal of the diseased veins. Instead, radiofrequency ablation uses heat energy to prompt the closure of diseased veins.

The surgeon starts by numbing the area with a topical and local anesthetic. Then, by way of a small incision, he or she passes a catheter or similar tool into the affected vein. The catheter serves as a channel through which the surgeon introduces an electrode.

When the surgeon pulls back on the catheter to expose the end of the fiber or electrode, energy passes into the vein as heat. This heat shrinks the collagen in the vein wall, which in turn causes the vein to shrink and close. The surgeon then removes the catheter and the patient’s body proceeds to heal the closure by rerouting blood to healthy veins.

 

https://www.westernvascular.com/vein-center/varicose-veins/

https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/superficial-vein/closurefast-rfa-system.html