South Florida Vascular Associates South Florida Vascular Associates

Thursday, August 30, 2012

Could Leg Pain Be a Sign Of Something Serious?

Peripheral artery disease (PAD) often goes undetected. But being aware of the warning signs can help you spot PAD early on and get prompt treatment to protect your health.

Peripheral Artery Disease is caused by a thickening of the inside walls of the arteries of your legs. This thickening, called atherosclerosis, usually occurs when a person has high levels of cholesterol, a fat-like substance in the blood. Cholesterol and fat, circulating in the blood, build up on the walls of the arteries and plaque formations can grow large enough to significantly reduce the blood's flow through an artery narrowing the space where the blood can flow and decreases the supply of oxygen and nutrients to the legs and feet. It can affect both legs, but most often symptoms begin in one leg.

Dr. William Julien explains more about PAD in the video below.

It’s important to know the signs of PAD, such as leg pain or heaviness and it is most important to discuss these symptoms with your doctor right away so that you can get be evaluated and begin treatment immediately to reduce your risk of heart attack or stroke.    
Warning Signs of PAD:   
  •    Pain that occurs when you walk and goes away when you stand still. It is important to understand that pain from PAD differs from other conditions because of how and when it occurs. Blockages in the leg can be so severe that blood is not getting to the muscles, and when muscles don't get enough blood, they get painful. This type of leg pain is called intermittent claudication and is one of the main symptoms of PAD. Leg pain can also be an indicator of back or spinal conditions. If your pain stops when you stand still after walking, chances are it’s related to PAD.
 •    Cold feet. A blockage or reduced blood flow to the lower leg muscles can make feet feel noticeably and abnormally cold. You may find that the leg with the blockage feels colder than your other leg.
 •    Discoloration in the legs or feet. Without blood flowing properly through the leg, your foot and toes may become discolored. A common PAD symptom is a foot that appears unusually pale or has a blue tint due to lack of blood flow.
 •    Persistent sores on the feet. If you have wounds on the bottom of your feet that take a long time to heal, this can also be could be a sign of PAD. When blood flow is blocked from reaching an area wounds won’t improve as quickly as they did prior to the blockage or don’t heal at all, making you more prone to foot infections. If you are experiencing any of the symptoms please take answer the questions in our survey to see if you are at risk and contact our office immediately to schedule a consultation with one of our physicians for proper diagnosis and treatment plan.

Tuesday, August 21, 2012

Margate Man Survives a Two and Half Long (DVT)Blood Clot

How is that even possible? Luck and the miracle of modern medicine!
59 year old Gerald Cunha felt pain in his leg and had a bit of swelling. He went to his internist and who put him on the blood thinner Coumadin, the standard treatment to dissolve what his doctor believed was a blood clot or deep vein thrombosis (DVT).
A couple of days later his leg blew up to three times its normal size.
The newest technology - EKOS Ultrasound which delivers clot busting drugs with an ultrasound-enhanced delivery system, could reduce the amount of drugs needed to break up dangerous blood clots in the legs and pelvis. Ultrasound catheters significantly reduce the amount of time it takes to dissolve blood clots and could help improve outcomes for victims of deep vein thrombosis, or DVT, according to new research. Blood clots are often treated through intravenous infusion of drugs, but the process of
dissolving the clot can take up to 48 hours. Longer infusion times increase the risk of life-threatening bleeding elsewhere in the body, particularly in the brain.
The EKOS Ultrasound was used to detect a massive blood clot in the patients leg which started behind his knee and went up to his belly button. A clot this size is extremely rare. The most effective way to treat it was to administer clot busting medication to dissolve the clot. Instead of taking medication, blood thinners, for several months hoping the clot will dissolve, the EKOS allows doctors to drip TPA (clot busting medicine) right into the vein, directly onto the clot dissolving it like an ice cube melting. This treatment was performed for 3 consecutive days in order to dissolve a clot so large.
The patient's vascular specialist says, had this not been done in time he would have been permanently disabled or could have died from a pulmonary embolism. In fact, the patient was so nervous prior to the clot busting meds, he put his affairs in order for fear that a piece of the clot could travel to his lungs and be fatal.

Monday, August 13, 2012

Varicocele Embolization Repair for Infertility

Varicocele Embolization Repair for Infertility
Minimally invasive, No general anesthesia, No pain, No down time

Varicoceles are fairly common, affecting 15% of men overall and 40% of men with known infertility issues. Poor circulation caused by the varicoceles results in a higher blood temperature that raises the temperature of the testes, which can serve as a barrier to sperm production and can damage or destroy sperm that is created.

Varicoceles are a tangled network of blood vessels or swelling of the veins on the testicles. It is similar to varicose veins in the legs but in this condition, a vein called the gonadal vein has weak defective valves resulting in the blood pooling in varicose veins in the scrotum. Sometimes, varicoceles cause no symptoms and are harmless. But sometimes a varicocele causes pain, testicular atrophy (shrinkage), or fertility problems.


Varicoceles can be repaired and are commonly treated by a urologist through a procedure called varicoceleligation surgery. During this procedure an incision is made is made is the skin above the scrotum, cutting down to the testicular veins and tying them off with sutures. It is usually performed under general anesthesia in a hospital setting. Although patients leave the hospital the same day, there is a two to three week recovery period.

Alternatively, at South Florida Vascular Associates, a nonsurgical minimally invasive procedure called varicocele embolization, can be done without general anesthesia by one of our  interventional radiologists to repair a varicocele.  During this procedure a small tube is inserted into the femoral vein in the groin or a vein in the neck through a small nick in the skin. The skin is numbed for this procedure and it is not painful.  Next a small catheter or tube is painlessly guided into the abdomen and into the varicocele vein under the guidance of x-ray imaging. The vein is then intentionally closed off by plugging it with small metal coils and a special medication. This procedure takes 30 minutes and the patient goes home a few hours later with only a band aid at the puncture site. The patient can immediately resume their non external activities.

Advantages of Varicocele Ebolization
•    Performed under local anesthesia with mild sedation
•    Performed on an outpatient basis in our endovascular suite, not in the hospital
•    No surgical incision in the groin, only a tiny hole where a catheter is placed
•    If you have varicoceles on both sides, you can have them fixed at the same time through one vein   puncture site(surgery requires 2 separate open incision)
•    It is as effective as surgery,as measured by improvement in pain, semen analysis and pregnancy rates
•    Lower rate of complications compared to surgery, Infection has not been reported after embolization

If you have been diagnosed with varicoceles, call our office to learn more about varicoceles embolization and after your procedure leave our office with only a band aid at the puncture site. To make an appointment for a consultation click here.