Tag: vascular surgery

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:

Procedure:

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.

Procedure:

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.

Endovascular surgery

Endovascular surgery, also known as endovascular therapy or intervention, is a minimally invasive procedure performed to treat various conditions within blood vessels, typically in the arteries and veins. Unlike traditional open surgery, which requires large incisions, endovascular surgery involves accessing the affected blood vessels through small punctures or incisions.

What conditions do healthcare providers treat with endovascular surgery?

Atherosclerosis:

It is a condition characterized by the buildup of plaque within the arteries, narrowing the vessel and obstructing blood flow. Endovascular procedures like angioplasty and stenting can be performed to open up the blocked or narrowed arteries and restore blood flow.

Aneurysms:

An aneurysm is a weakened area in the blood vessel wall that bulges or balloons out. Endovascular techniques, such as endovascular aneurysm repair (EVAR) or endovascular coiling, can be used to reinforce the weakened vessel wall or fill the aneurysm with coils to prevent rupture.

Peripheral artery disease (PAD):

PAD occurs when arteries supplying blood to the limbs (usually the legs) become narrowed or blocked. Endovascular procedures like angioplasty, atherectomy, or stenting can be performed to improve blood flow and relieve symptoms.

Deep vein thrombosis (DVT):

DVT is the formation of blood clots in the deep veins, typically in the legs. Endovascular techniques, such as catheter-directed thrombolysis or thrombectomy, can be used to dissolve or remove the blood clot and restore normal blood flow.

Varicose veins:

Endovascular treatments like endovenous laser ablation (EVLA) or radiofrequency ablation (RFA) can be used to close off and seal malfunctioning varicose veins, redirecting blood flow to healthier veins.

Endovascular surgery offers several advantages over traditional open surgery, including smaller incisions, reduced blood loss, shorter hospital stays, faster recovery times, and fewer complications. However, not all conditions can be treated using endovascular techniques, and the suitability of the procedure depends on the specific case and the patient’s overall health. It is essential to consult with a vascular surgeon to determine the most appropriate treatment approach.

How common is vascular disease?

According to recent data, there are approximately 200 million people affected by peripheral artery disease (PAD), one of the most common types of vascular disease. In the United States alone, PAD affects around 8 to 12 million people, with the incidence rising with age. Additionally, another prevalent vascular condition is deep vein thrombosis (DVT), which affects an estimated 900,000 individuals in the United States annually. When it comes to aortic aneurysms, statistics indicate that around 1.5 million people worldwide are living with this condition, with men over the age of 65 being particularly susceptible. These numbers show how common vascular disease is and emphasize the importance of awareness, early detection, and timely treatment to improve patient outcomes.

What happens before endovascular surgery?

During an endovascular procedure, a vascular surgeon uses imaging guidance, such as fluoroscopy or ultrasound, to navigate thin, flexible catheters and medical instruments through the blood vessels to the targeted site. These instruments can be used for diagnostic purposes, as well as for therapeutic interventions.

What happens after endovascular surgery?

After your endovascular surgery, it’s important to continue with follow-up care to ensure your blood vessels heal properly. Before you leave the hospital, your healthcare provider will discuss your post-surgical plan with you. This plan includes regular visits to see your healthcare provider and undergo imaging tests. These visits are designed to check how your blood vessels are healing. Your healthcare provider will review the results of the imaging tests to make sure everything is progressing well. By following through with these follow-up visits and tests, you and your healthcare team can keep a close eye on your recovery and address any issues that may arise, leading to a successful outcome after your endovascular surgery.

Wound Care

Wound Care and the Role of a Vascular Surgeon

Introduction:

Wound care is a critical aspect of healthcare, especially for individuals with underlying vascular conditions. Vascular surgeons play a crucial role in managing and treating wounds, particularly those related to compromised blood flow. In this section, we will explore the significance of wound care and how vascular surgeons contribute to this field.

Understanding Wound Care:

Wounds can occur due to various reasons, such as injuries, surgical procedures, or underlying health conditions. Proper wound care involves a comprehensive approach to promote healing, prevent infections, and minimize complications. Key aspects of wound care include:

Cleaning and Dressing:

Thoroughly cleaning the wound and applying appropriate dressings help create a clean environment for healing. Dressings may vary depending on the type and severity of the wound.

Infection Prevention:

Preventing infection is crucial for successful wound healing. This involves maintaining proper hygiene, using sterile techniques, and administering antibiotics when necessary.

Debridement:

In some cases, removing dead or infected tissue from the wound (debridement) is necessary to promote healing and prevent the spread of infection.

Moisture Control:

Managing the moisture level of the wound is important. Some wounds may require moisture to aid in healing, while others may benefit from dry environments. Healthcare professionals assess each wound’s needs and employ appropriate techniques.

Offloading and Pressure Redistribution:

For wounds caused by pressure, such as pressure ulcers, offloading techniques and specialized devices are used to relieve pressure on affected areas and promote healing.

The Role of a Vascular Surgeon in Wound Care:

Vascular surgeons play a vital role in wound care, particularly when wounds are associated with vascular conditions. Here’s how they contribute:

Diagnosis and Assessment:

Vascular surgeons assess wounds in the context of a patient’s vascular health. They examine blood flow, identify potential circulation issues, and determine if underlying vascular conditions contribute to delayed wound healing.

Vascular Interventions:

In cases where compromised blood flow contributes to poor wound healing, vascular surgeons may perform interventions to restore circulation. This may involve procedures such as angioplasty, stent placement, or bypass surgeries to improve blood flow to the affected area.

Collaborative Care:

Vascular surgeons work closely with other healthcare professionals involved in wound care, such as wound care nurses, plastic surgeons, and infectious disease specialists. They provide expertise on vascular aspects and ensure a comprehensive approach to wound management.

Long-Term Management:

Vascular surgeons not only address the immediate wound care needs but also focus on long-term management. They develop personalized treatment plans to optimize vascular health, prevent future wounds, and promote overall well-being.

Conclusion:

Wound care is a critical aspect of healthcare, and vascular surgeons play a crucial role, especially when wounds are associated with vascular conditions. By addressing underlying circulation issues, vascular surgeons contribute to improved wound healing and overall patient outcomes. Their expertise in diagnosing, treating, and managing vascular conditions ensures comprehensive and effective wound care. Collaborative efforts among healthcare professionals involved in wound care result in holistic approaches tailored to individual patient needs. If you have wounds associated with vascular conditions, consulting with a vascular surgeon can provide valuable insights and appropriate interventions for optimal wound healing and vascular health.

 

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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.

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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.

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,”.

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Western Vascular Institute Voted Arizona’s Best Medical Specialists

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

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.