Category: Venous Insufficency

What is Deep Vein Thrombosis?

DVT occurs when a blood clot forms in the deep veins, obstructing blood flow. If left untreated, the clot can break loose and travel to the lungs, causing a pulmonary embolism, a life-threatening complication. This potentially life-threatening condition occurs when a blood clot forms in one of the deep veins, typically in the legs. It is crucial to raise awareness about DVT and its potential risks, symptoms, and prevention strategies.

Understanding DVT:

Deep Vein Thrombosis (DVT) is a condition that often goes unnoticed until it becomes a serious health concernDeep Vein Thrombosis.. Anyone can develop DVT, but certain factors increase the risk, such as prolonged immobility, surgery, pregnancy, obesity, smoking, and a family history of blood clots.

Recognizing the Symptoms:

DVT may present with various symptoms, including leg pain, swelling, warmth, and redness. However, it’s important to note that some individuals may not experience any noticeable signs. If you notice any unusual leg symptoms or suspect DVT, it’s crucial to seek medical attention promptly.

How To Prevent DVT

Fortunately, there are several preventive measures that can significantly reduce the risk of developing DVT. Regular exercise, especially leg movement during long periods of sitting or standing, can improve blood circulation. Maintaining a healthy weight, quitting smoking, and avoiding excessive alcohol consumption also contribute to reducing the risk.

For individuals at higher risk, such as those undergoing surgery or prolonged immobility, preventive measures like wearing compression stockings or taking blood thinners may be recommended. It is important to discuss these options with your healthcare provider.

How DVT Is Diagnosed

If DVT is suspected, diagnostic tests such as ultrasound imaging can confirm the presence of a blood clot. Early diagnosis is crucial for timely treatment and to prevent complications.

How DVT Is Treated

Treatment often involves the use of blood thinners to prevent the clot from growing and to reduce the risk of pulmonary embolism. In some cases, procedures like thrombolysis or placement of a filter in the vein may be necessary to manage the clot effectively.

Raising Awareness and Sharing Knowledge:

By increasing awareness about DVT, we can empower individuals to recognize the symptoms, seek early medical attention, and adopt preventive measures. Remember, DVT can affect anyone, so it is essential to spread the word and educate others about this silent threat.

If you have concerns about DVT or if you fall into a high-risk category, consult with your Western Vascular Institute. Together, we can work towards preventing DVT and promoting healthier lives.


Why do I need a vascular surgeon?

Why do I need a vascular surgeon?


Vascular Disease:

If you have been diagnosed with vascular diseases such as peripheral artery disease (PAD), deep vein thrombosis (DVT), varicose veins, aneurysms, or carotid artery disease, a vascular surgeon specializes in the treatment of these conditions.

Circulation Problems:

If you experience symptoms related to poor blood circulation, such as leg pain or cramping during walking or at rest, non-healing wounds or ulcers, or coldness in your extremities, a vascular surgeon can evaluate and provide appropriate treatment options.

Vascular Trauma:

In cases of traumatic injuries that involve blood vessels, such as a severe laceration or damage to arteries or veins, a vascular surgeon can perform surgical procedures to repair and restore blood flow.

Aortic Aneurysm:

If you have an abdominal or thoracic aortic aneurysm, which is a weakened and bulging area in the aorta, the main blood vessel in your body, a vascular surgeon may perform surgery to repair or replace the affected segment to prevent the risk of rupture.

Endovascular Procedures:

Vascular surgeons are trained in minimally invasive endovascular techniques, such as angioplasty, stenting, and embolization, to treat various vascular conditions. These procedures involve using catheters and imaging guidance to access and treat the affected blood vessels from within.

Vascular Access:

If you require long-term dialysis, a vascular surgeon can create and manage vascular access points, such as arteriovenous fistulas or grafts, to allow repeated access to your blood vessels.

With many years of extensive vascular experience, Western Vascular Institute’s providers are able to provide unparalleled diagnosis & management for all venous & vascular diseases as well as exceptional patient care.


What is Vascular Surgery?

What is Vascular Surgery?

Vascular surgery is a surgical specialty that deals with diseases of the blood vessels. It is a relatively new specialty, having been founded in the early 1970s. The first residency program was started at the University of Minnesota in 1973.

The specialty of vascular surgery is divided into two main branches: open surgery and endovascular surgery.

Open surgery is the traditional form of surgery, where the surgeon makes a large incision in the patient’s body in order to access the blood vessels. Endovascular surgery is a newer form of surgery that uses tiny instruments and a camera to access the blood vessels through small incisions.

Vascular surgery is a highly specialized field, and there are only a few hundred surgeons in the United States who specialize in it. The majority of vascular surgeons are based in large metropolitan areas, and there are few rural areas that have vascular surgeons.

 Treating a variety of diseases and conditions, including:

Vascular surgery is a life-saving procedure in many cases. For example, an aortic aneurysm is a life-threatening condition that can lead to a ruptured aorta. If the aneurysm is detected early, it can be treated with surgery. It is a highly specialized field, and patients should seek out a vascular surgeon who is experienced in treating the specific condition that they have.

Wound Care

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

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.

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,”.


What are compression stockings?

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.


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.


What is a Unna Boot?

An Unna Boot is a type of compression bandage that is specifically designed to treat and manage venous leg ulcers. It consists of a layer of zinc-impregnated, semi-rigid gauze wrapped around the affected leg, followed by an outer layer of cohesive compression bandage.

What is the purpose of an Unna Boot?

The purpose of an Unna Boot is to provide sustained, therapeutic compression to the lower leg, which helps improve venous circulation, reduce swelling, and promote the healing of venous ulcers. Here are some key benefits and functions of a Unna Boot:


The primary purpose of an Unna Boot is to apply compression to the affected leg. The bandage provides consistent and graduated pressure, typically ranging from 20-30 mmHg, which helps to reduce venous congestion and increase blood flow toward the heart. Compression aids in controlling edema (swelling) and enhances venous return, thereby improving overall circulation.

Healing Environment:

The zinc-impregnated gauze layer within the Unna Boot provides several benefits. Zinc is known for its antibacterial and antimicrobial properties, which help create an optimal environment for wound healing by reducing the risk of infection. The semi-rigid nature of the gauze offers support and protection to the wound site.

Moisture Management:

The gauze layer in the Unna Boot acts as a moisture barrier, helping to absorb excess exudate (fluid) from the wound and maintain an appropriate level of moisture for wound healing. It prevents the wound from becoming too dry or too moist, facilitating the healing process.


The Unna Boot offers some degree of immobilization, which helps prevent excessive movement of the affected leg. Immobilization can reduce pain and irritation, allowing the wound to heal more effectively.

Convenience and Long-lasting Effect:

The Unna Boot remains in place once applied, for an extended period (typically 1 to 2 weeks) without requiring frequent changes. This convenience reduces the need for frequent dressing changes and provides a continuous, therapeutic compression effect.

Unna Boot applications should be performed by a vascular surgeon with expertise in wound care. The bandage needs to be applied correctly, ensuring appropriate tension and coverage, to achieve optimal therapeutic benefits. Regular monitoring and assessment by a healthcare provider are essential to evaluate the progress of wound healing, adjust compression levels, and address any potential complications.

If you have a venous leg ulcer or a similar condition, consult with a vascular surgeon to determine if an Unna Boot is suitable for your situation and to receive proper guidance on its application and usage.

Radio-Frequency Ablation for Varicose Veins.

Radio-Frequency Ablation for Varicose Veins.



Radiofrequency ablation (RFA) for varicose veins addresses the venous reflex disease that often causes varicose veins. RFA serves as an alternative to traditional vein stripping, which requires invasive surgical removal of the diseased veins. RFA Instead, 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. Radiofrequency ablation (RFA) for varicose veins is the standard treatment for varicose veins and has been shown to be the most effective and long-lasting treatment modality to date.

Radio-Frequency Ablation
Radio-Frequency Ablation
Radio-Frequency Ablation
Radio-Frequency Ablation


Sclero-Therapy for Spider Veins

Sclero-Therapy for Spider Veins.

Sclerotherapy is a medical procedure used to treat varicose veins and spider veins. It involves injecting a solution, known as a sclerosant, directly into the affected veins. The sclerosant irritates the vein walls, causing them to swell, stick together, and eventually close off. This leads to the reabsorption of the treated veins by the body, resulting in improved blood flow and the fading or disappearance of visible veins.

Sclerotherapy is typically performed as an outpatient procedure and does not require anesthesia.

The process involves the following steps:

The patient will lie down, and the targeted veins will be cleaned and sterilized.


A fine needle is used to inject the sclerosant solution into the vein. The number of injections depends on the extent and location of the veins being treated.


After the injection, the treated area is compressed using compression stockings or bandages to apply pressure and help the vein walls seal together.

Post-treatment care:

Patients are usually advised to walk and engage in light physical activity to promote blood circulation. They may also be instructed to wear compression stockings for a certain period of time to assist with healing and prevent blood clots.

Sclerotherapy is considered a safe and effective treatment for varicose veins and spider veins. However, it may require multiple sessions to achieve desired results, and some patients may experience temporary side effects such as bruising, swelling, or skin discoloration at the injection site. Rarely, more serious complications such as blood clots or allergic reactions can occur.

It’s important to consult with a vascular surgeon to determine if sclerotherapy is an appropriate treatment option for your specific condition. They can assess your veins, discuss potential risks and benefits, and provide personalized recommendations for your situation.