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Introducing Adam Calarese M.D.

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Introducing Adam Calarese M.D.

Please join us in Welcoming Doctor Adam Calarese.

We are pleased to announce the addition of Adam Calarese M.D. to the team of talented Vascular Surgeons here at Western Vascular Institute.

Dr. Calarese is from Boston, MA, and graduated from Boston College with his undergraduate degree. He then earned a post-baccalaureate premedical degree from Harvard University. After Harvard, he attended Drexel University College of Medicine where he received his medical degree.

Dr. Calarese then completed a full General Surgery residency at Atrium Health in Charlotte, North Carolina. Once his General Surgery residency was complete, Dr. Calarese finalized his extensive training with a two-year fellowship in Vascular Surgery from the Sanger Heart and Vascular Institute. He is excited to be in the Phoenix Metro Area and ready to serve all those with vein and vascular issues.

For an appointment with Dr. Calarese, please contact one of our new patient coordinators at (480) 668-5000 ext. 332.

Appointments

Wound Care

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How To Care For a Wound

When it comes to wound care, understanding the unique aspects of vascular wounds is essential for effective treatment and optimal healing. Vascular wounds are caused by compromised blood flow, often resulting from conditions such as peripheral artery disease (PAD), venous insufficiency, or diabetes. These wounds require specialized care to promote healing and prevent complications. Let’s delve into the world of vascular wound care and explore key strategies for nurturing healing and promoting recovery.

Assessment and Diagnosis:

Proper assessment and accurate diagnosis are fundamental in vascular wound care. A thorough evaluation by a healthcare professional with expertise in vascular conditions is crucial to identify the underlying cause of the wound and determine the most appropriate treatment approach. This may involve diagnostic tests, such as vascular imaging or Doppler studies, to assess blood flow and identify any arterial or venous blockages.

Optimizing Blood Flow:

Promoting adequate blood flow is a primary goal in vascular wound care. For arterial wounds, improving circulation is crucial. This may involve interventions such as angioplasty or bypass surgery to restore blood flow to the affected area. In venous wounds, managing venous insufficiency and promoting venous return are key. Compression therapy, elevation of the affected limb, and lifestyle modifications can aid in reducing swelling and improving venous circulation.

Wound Cleaning and Dressing:

Proper wound cleaning and dressing play a vital role in vascular wound care. The wound should be cleaned with gentle solutions to remove debris and bacteria without causing further damage. The choice of dressings will depend on the characteristics of the wound, including its size, depth, and level of exudate. Specialized dressings, such as those with antimicrobial properties or those that support moist wound healing, may be used to facilitate optimal healing.

Infection Prevention:

Preventing infection is crucial in vascular wound care. Vascular wounds are at a higher risk of infection due to compromised blood flow and reduced immune response. Strict adherence to sterile techniques during wound care, appropriate use of antibiotics when necessary, and close monitoring of the wound for signs of infection is essential to prevent complications.

Offloading and Pressure Redistribution:

For individuals with vascular wounds, offloading, and pressure redistribution are vital to relieve pressure on the affected area and promote healing. This may involve the use of specialized footwear, orthotic devices, or pressure-relieving cushions to reduce pressure and prevent further tissue damage. Collaborating with podiatrists can ensure the best offloading strategies are implemented.

Multidisciplinary Approach and Patient Education:

Vascular wound care often requires a multidisciplinary approach involving healthcare professionals from various specialties, including vascular surgeons, wound care specialists, podiatrists, and nurses. Collaboration and communication among the healthcare team are crucial to ensure comprehensive care tailored to the individual’s needs. Patient education is essential to empower individuals to actively participate in their care, recognize signs of complications, and make lifestyle modifications to support healing.

Vascular wound care is a specialized field that demands expertise, close monitoring, and individualized treatment plans. By combining advanced techniques, multidisciplinary collaboration, and patient education, we can nurture healing, promote recovery, and improve the quality of life for individuals with vascular wounds.

Here are some steps to taking care of your wound:

  • Keep your cut, scrape, or skin injury clean at all times. Gently cleanse the area with mild soap and water to eliminate germs and remove debris.
  • Maintain moisture in the wound to facilitate healing by using petroleum jelly. Applying petroleum jelly prevents the wound from drying out and forming a scab, as scabs tend to prolong the healing process. Additionally, this helps prevent the formation of large, deep, or itchy scars. Remember, if you clean the wound daily, there is no need to use antibacterial ointments.
  • After cleaning the wound and applying petroleum jelly or a similar ointment, cover the skin with an adhesive bandage. In the case of larger scrapes, sores, burns, or persistent redness, hydrogel or silicone gel sheets may be beneficial.
  • Change your bandage on a daily basis to maintain cleanliness as the wound heals. If your skin is sensitive to adhesives, you can try using non-adhesive gauze pads secured with paper tape. When utilizing silicone gel or hydrogel sheets, follow the instructions provided on the packaging for changing them.
  • If your injury necessitates stitches, follow your doctor’s instructions on wound care and the appropriate time for stitch removal. This approach can help minimize the visibility of scars.
  • Once the wound has fully healed, apply sunscreen to the affected area. Sun protection aids in reducing red or brown discoloration and accelerates the fading of scars. Ensure that you always use a broad-spectrum sunscreen with an SPF of 30 or higher and reapply it frequently.

Horse Chestnut extract for veins

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Horse Chestnut extract for veins

Horse chestnut extract, derived from the seeds of the Aesculus hippocastanum tree, has been used for centuries in traditional medicine for various health conditions, including venous disorders. It contains a compound called aescin, which is believed to have beneficial effects on veins and blood vessels. Let’s explore the potential benefits of horse chestnut extract for veins.

Improving Venous Circulation:

Horse chestnut extract is commonly used to support healthy venous circulation. It is believed to strengthen the walls of blood vessels and reduce their permeability, potentially improving blood flow and reducing symptoms associated with venous insufficiency.

Relieving Symptoms of Varicose Veins:

Varicose veins occur when veins become enlarged, twisted, and often painful. Horse chestnut extract has been traditionally used to alleviate symptoms associated with varicose veins, such as pain, swelling, and heaviness in the legs. It is thought to reduce inflammation and improve blood circulation, which may help relieve discomfort.

Managing Chronic Venous Insufficiency:

Chronic venous insufficiency (CVI) is a condition in which the veins have difficulty returning blood from the legs to the heart. Horse chestnut extract has been studied for its potential benefits in managing CVI. It may help reduce leg swelling, pain, and itching associated with the condition, improving overall quality of life.

Anti-Inflammatory Effects:

Horse chestnut extract possesses anti-inflammatory properties, which can help reduce inflammation in the veins and surrounding tissues. This anti-inflammatory action may contribute to its potential benefits in alleviating symptoms of venous disorders.

Antioxidant Activity:

Horse chestnut extract contains antioxidants that can help protect blood vessels from oxidative damage caused by free radicals. By neutralizing these harmful molecules, horse chestnut extract may help maintain the health and integrity of veins.

While horse chestnut extract has shown promising potential for vein health, it is important to note that scientific research on its efficacy and safety is ongoing. It is recommended to consult with a healthcare professional before starting any new supplementation, especially if you have underlying medical conditions or are taking other medications.

In summary, horse chestnut extract has been traditionally used to support vein health and alleviate symptoms associated with venous disorders. However, more research is needed to fully understand its mechanisms of action and determine its effectiveness. If you are considering using horse chestnut extract for vein-related concerns, consult with a healthcare professional to ensure it is safe and appropriate for your specific situation.

 

Introducing Daniel Krcelic M.D.

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Introducing Daniel Krcelic M.D.

 

Daniel Krcelic, MD a vascular surgeon in Arizona.

Western Vascular Institute is excited to introduce Daniel Krcelic M.D. has joined our group of exceptional vascular surgeons. We are very grateful for his addition and look forward to the unparalleled vascular care he will provide to the WVI patients.

Doctor Krcelic is trained in all aspects of vascular surgery in both the inpatient and outpatient settings. He completed his fellowship in vascular surgery at Carolinas Medical Center and Sanger Heart & Vascular Institute in Charlotte. Dr. Krcelic said. “I care deeply about my patients, and joining Western Vascular Institute brings another skilled vascular specialist to meet the needs of patients in the Phoenix Metro Area,”.

Appointments

Arteriovenous Fistula Creation

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Arteriovenous Fistula Creation: Enhancing Dialysis Access and Patient Well-being

For individuals with end-stage renal disease (ESRD) who require long-term dialysis, the creation of an arteriovenous fistula (AVF) is a critical step in establishing reliable and efficient vascular access. An AVF is a surgically created connection between an artery and a vein, typically in the forearm or upper arm. Let’s explore the importance of AVF creation, its benefits, and the process involved.

Why is AVF Creation Important?

AVF creation plays a vital role in hemodialysis, a life-sustaining treatment for individuals with ESRD. During hemodialysis, blood is filtered and cleansed by a dialysis machine, and reliable vascular access is essential to facilitate the movement of blood to and from the dialysis machine. AVFs are considered the preferred form of vascular access due to their longevity, lower risk of complications, and improved dialysis outcomes compared to other access options such as arteriovenous grafts or central venous catheters.

Benefits of AVF Creation:
Improved Long-Term Vascular Access:

AVFs have the potential to provide long-lasting access for dialysis, reducing the need for repeated procedures and minimizing the risk of infection or other complications associated with temporary access options.

Increased Blood Flow and Dialysis Efficiency:

By connecting an artery to a vein, AVFs create a direct pathway for blood flow. This increased blood flow allows for efficient dialysis by facilitating the removal of waste products and excess fluid from the body during each dialysis session.

Lower Risk of Infection and Thrombosis:

AVFs have a lower risk of infection and clot formation compared to other access methods. The natural connection created between the artery and vein promotes better blood flow and reduces the likelihood of complications such as infection or blockages.

Preservation of Central Veins:

AVFs help preserve central veins, such as the subclavian or jugular veins, which may be necessary for future access options if AVF complications arise or if the AVF is no longer viable.

The AVF Creation Process:

The creation of an AVF involves a surgical procedure that is typically performed by a vascular surgeon. The process generally includes the following steps:

Preoperative Evaluation:

Before AVF creation, the surgeon assesses the patient’s vascular anatomy and determines the most suitable site for the fistula. Factors such as the diameter and quality of the veins and arteries are considered.

Surgical Procedure:

The surgeon makes an incision to access the artery and vein chosen for the AVF. The artery is dissected, and a segment of the vein is isolated. The artery and vein are then connected to create the fistula, allowing blood to flow from the artery into the vein.

Postoperative Care and Maturation:

After the surgery, the AVF requires time to “mature” and develop the necessary blood flow. This maturation process typically takes several weeks to months. During this time, the vein gradually enlarges, becoming suitable for dialysis needle insertion.

Monitoring and Maintenance:

Regular follow-up visits with the healthcare team are essential to monitor the AVF’s functionality and detect any potential issues early on. The patient is educated on proper care and maintenance of the AVF to minimize complications and maximize its longevity.

Arteriovenous fistula creation is a crucial step in establishing reliable vascular access for individuals requiring hemodialysis. By providing long-term access, improving dialysis efficiency, and reducing the risk of complications, AVFs contribute significantly to the well-being and quality of life of patients with ESRD.

Matters of the Heart

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Matters of the Heart

The heart is a muscular organ about the size of a fist, located at the center of our chest that pumps blood through the network of arteries and veins. It pumps around 6 liters of blood per minute. The heart’s vital performance can be affected by a number of factors, causing it to beat too slow, too fast, or even cause it to fail. Aside from physical ailments, emotions such as joy, sadness, and grief can positively or negatively affect the heart’s performance and health.

Figuratively, the deepest and most noble thoughts and feelings, as well as the darker ones, have been attributed to originating from the heart. Matters of the heart are the most important things in our lives and move us deeply. They bring us joy and laughter, along with sadness and tears. They are things that touch our hearts, fill our hearts, and break our hearts. They are what makes us fully human. Matters of the heart connect us to each other and to God.

This exhibition showcases new and original works of art by Dr. Julio Rodriguez-Lopez (renowned vascular surgeon) in acrylic paint with some new watercolor features. These pieces in essence merge the clinical with the metaphorical presentations of the heart and reveal the connection between both.

Schedule an Appointment with Renowned Vascular Surgeon Dr. Julio Rodriguez

Not only is Dr. Julio Rodriguez an amazing artist but, he is also a highly-trained vascular surgeon. Dr. Rodriguez is an internationally renowned vascular surgeon who has devoted his life to Vascular education, research, and teaching. He is dedicated to providing you with comprehensive diagnosis and treatment for all of our vascular conditions. For more information, contact Western Vascular Institute at (480) 668-5000 and schedule an appointment today!

Western Vascular Institute Voted Arizona’s Best Medical Specialists

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Lovin’ Life After 50 has awarded Western Vascular Institute as America’s Best Medical Specialist!

We are grateful to be voted as the best medical specialist recommended by readers and peers in the Lovin’ Life after 50 Magazine and website.

Check out our award in Lovin’ Life After 50 (see page 34)!

Visit Western Vascular Institute Today!

If you are in the Phoenix, Arizona area and looking for a vein or vascular clinic, visit Western Vascular Institute today! Our board-certified surgeons specialize in utilizing the latest in technology to provide the best in vein and vascular care. For more information, call (480) 668-5000 and schedule an appointment today!

 

Diabetes and Vascular Disease

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Diabetes and Vascular Disease: Understanding the Connection and Taking Control

Diabetes is a chronic condition that affects millions of people worldwide. While most individuals are aware of the impact of diabetes on blood sugar control, many may not fully understand the profound effect it can have on the vascular system. Diabetes significantly increases the risk of developing various vascular diseases, emphasizing the importance of managing the condition effectively. Let’s delve into the connection between diabetes and vascular disease and explore strategies to minimize its impact.

Understanding the Link:

Diabetes is characterized by elevated blood glucose levels, which can damage blood vessels over time. The persistently high levels of glucose in the bloodstream can lead to the accumulation of fatty deposits in the vessel walls, causing a condition called atherosclerosis. Atherosclerosis is a significant contributor to various vascular diseases, including:

Peripheral Artery Disease (PAD):

Diabetes increases the risk of developing PAD, which affects the blood vessels supplying the legs and feet. Reduced blood flow to the lower extremities can result in pain, slow wound healing, and an increased risk of infections and amputations.

Coronary Artery Disease (CAD):

Individuals with diabetes are more prone to CAD, a condition that affects the blood vessels supplying the heart. Narrowed or blocked arteries can lead to chest pain (angina), heart attacks, and other cardiovascular complications.

Stroke:

Diabetes raises the risk of stroke by accelerating the development of atherosclerosis in the arteries supplying the brain. A clot or rupture in these arteries can result in a stroke, causing lasting damage or even death.

Diabetic Retinopathy:

The blood vessels in the retina can be damaged by diabetes, leading to diabetic retinopathy. This condition can cause vision loss or even blindness if left untreated.

Diabetic Nephropathy:

High blood glucose levels can impair the kidneys’ ability to filter waste products, leading to diabetic nephropathy. It is a progressive kidney disease that can eventually result in kidney failure.

Managing Diabetes and Vascular Disease:

While the connection between diabetes and vascular disease may seem daunting, it’s important to remember that taking proactive steps can significantly reduce the risks. Here are some strategies to manage diabetes and minimize the impact on the vascular system:

Maintain Blood Sugar Levels:

Consistently monitoring and managing blood sugar levels through a healthy diet, regular exercise, and appropriate medication or insulin therapy is crucial. Keeping blood glucose within target ranges helps minimize damage to blood vessels.

Control Blood Pressure and Cholesterol:

High blood pressure and elevated cholesterol levels further contribute to vascular disease. Regular monitoring and effective management of these factors through lifestyle modifications and medications are essential.

Adopt a Healthy Lifestyle:

Engage in regular physical activity, such as walking, swimming, or cycling, to improve circulation and maintain a healthy weight. Follow a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats while limiting sugary and processed foods.

Quit Smoking:

Smoking damages blood vessels and significantly increases the risk of vascular disease. Quitting smoking is one of the most beneficial steps individuals with diabetes can take to protect their vascular health.

Regular Check-ups:

Maintain regular check-ups with healthcare professionals to monitor blood sugar control, blood pressure, cholesterol levels, and overall vascular health. Early detection and intervention can prevent or minimize the progression of vascular diseases.

Diabetes and vascular disease are intricately linked, underscoring the importance of proactive management. By effectively managing blood sugar levels, controlling blood pressure and cholesterol, adopting a healthy lifestyle, and seeking regular medical care, individuals with diabetes can significantly reduce their risk of developing or worsening vascular disease. Empower yourself with knowledge, take control of your diabetes, and prioritize your vascular health for a better quality of life.

 

Common treatments for PAD

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Common treatments for PAD 

The treatment of peripheral artery disease (PAD) aims to reduce symptoms, improve quality of life, and prevent complications. The specific treatment approach may vary based on the severity of the condition and individual patient factors. Here are some of the most common treatments for PAD:

Lifestyle Modifications:

Making certain lifestyle changes can help manage PAD effectively. These may include quitting smoking, adopting a healthy diet low in saturated fats and high in fruits and vegetables, regular exercise, and maintaining a healthy weight. Lifestyle modifications can improve overall cardiovascular health and reduce symptoms.

Medications:
Antiplatelet Medications:

Medications such as aspirin or clopidogrel are commonly prescribed to reduce the risk of blood clots and improve blood flow.

Cholesterol-lowering Medications:

Statins are often prescribed to control cholesterol levels and slow down the progression of atherosclerosis.

Blood Pressure Medications:

Controlling high blood pressure is crucial in managing PAD and reducing the risk of complications.

Symptom-relief Medications:

Medications such as cilostazol may be prescribed to relieve leg pain and improve walking distance.
Exercise Therapy:

Supervised exercise:

Supervised exercise programs, known as supervised exercise therapy (SET), can improve symptoms and walking distance in PAD. These programs typically involve structured exercise routines tailored to individual abilities and needs.

Endovascular Interventions:

 

Angioplasty and Stenting:

In this minimally invasive procedure, a catheter is inserted into the affected artery to inflate a small balloon, which helps open the blocked or narrowed artery. In some cases, a stent may be placed to help keep the artery open.

Atherectomy:

This procedure involves using a catheter with a rotating device or laser to remove plaque buildup from the artery walls, improving blood flow.
Bypass Surgery: In severe cases of PAD, bypass surgery may be necessary. During this procedure, a blood vessel graft is used to create a detour around the blocked or narrowed artery, allowing blood to bypass the affected area.

Wound Care and Amputation Prevention:

For individuals with PAD-related wounds or ulcers, proper wound care is crucial to prevent infection and promote healing. Specialized wound care techniques and treatments may be employed to facilitate healing and avoid amputations.

It’s important to note that the appropriate treatment plan for PAD should be determined by a healthcare professional based on individual circumstances. Early diagnosis, lifestyle modifications, and adherence to the prescribed treatment plan can significantly improve outcomes, alleviate symptoms, and reduce the risk of complications associated with peripheral artery disease.

 

What are compression stockings?

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What are compression stockings?

Compression stockings, also known as compression socks or support stockings, are specialized garments designed to apply pressure to the legs and improve blood circulation. They are commonly used in the treatment and management of various conditions, including:

Peripheral Artery Disease (PAD):

Compression stockings can help improve blood flow and reduce symptoms such as leg pain, cramping, and fatigue in individuals with PAD.

Deep Vein Thrombosis (DVT):

Compression stockings are often recommended to prevent and manage DVT, a condition characterized by blood clot formation in deep veins. They help promote blood circulation, prevent blood pooling, and reduce the risk of clotting.

Varicose Veins:

Compression stockings can alleviate symptoms associated with varicose veins, such as swelling, discomfort, and heaviness in the legs. They help compress the veins, improving circulation and reducing swelling.

Lymphedema:

Compression garments, including stockings, are used to manage lymphedema, a condition characterized by swelling due to the accumulation of lymphatic fluid. The gentle pressure exerted by the stockings helps reduce swelling and maintain proper lymphatic flow.

Post-Surgical Recovery:

After certain surgical procedures, such as vein stripping or vein ablation, compression stockings may be prescribed to aid in the healing process, reduce swelling, and prevent blood clots.

 

The benefits of compression stockings include:

 

Improved Blood Circulation:

Compression stockings apply graduated pressure, meaning the pressure is highest at the ankle and gradually decreases up the leg. This compression helps enhance blood flow by aiding the muscles and veins in pumping blood back to the heart.

Reduced Swelling and Discomfort:

By promoting better circulation, compression stockings can alleviate swelling, heaviness, and achiness in the legs.

Prevention of Complications:

Compression stockings can help prevent the formation of blood clots, particularly during long periods of immobility, such as during air travel or bed rest.

Support during Physical Activity:

Athletes and individuals engaged in physical activity may wear compression stockings to improve performance, reduce muscle fatigue, and enhance post-exercise recovery.

When considering compression stockings, it is essential to choose the correct size and compression level based on the specific condition and the advice of a vascular surgeon. They are available in different strengths, lengths, and styles, including knee-high, thigh-high, and full-length stockings. It’s important to follow the instructions for proper usage, including wearing them consistently and correctly to achieve maximum benefit.

If you have any vascular conditions or concerns, consult with a vascular surgeon to determine if compression stockings are suitable for your situation and to receive guidance on the appropriate type and compression level needed to support your vascular health.