South Florida Vascular Associates South Florida Vascular Associates

Tuesday, October 23, 2012

South Florida Vascular Associates Announces Its First In-Office Surgical Placement of the Newly Approved Flexible iDev Supera Stent for PAD


iDev Supera® Stent Is The First Flexible Artery Stent Allowing Endovascular Surgeons To  Restore Blood Flow To Parts Of The Body Never Before Possible


 Drs. Warren Swee and William Julien, board certified and fellowship trained interventional radiologists, are pleased to announce that they recently implanted their first iDev Flexible Supera Stent in their office - based catherization lab. South Florida Vascular Associates is one of the first office-based cath labs in South Florida to do this procedure. The stent was used to treat a patient who had critical stenosis, or blockage of the superficial femoral artery and the popliteal artery, which is located behind the knee and supplies blood to the knee joint and muscles in the thigh and calf.

“Until recently, stents were hard, inflexible cylinders that could only be used in certain areas of the body, but if a stent was needed in an area such as behind a knee which bends, the older hard, inflexible stents would not hold”, said Dr. Warren Swee. Prior to the development of the new titanium flexible stent, this area was very difficult to treat.

According to the American Heart Association, peripheral artery disease (PAD) of the lower extremities affects approximately 8 million -12 million people in the United States alone. People suffering from PAD have pain, or claudication while walking, often limiting their life-style activities. In order for doctors to open-up the diseased arteries and re-establish blood blow to the lower extremities, stents are often used to keep the arteries open. Stents are a less invasive alternative to surgery for some conditions, which results in a lower procedure-related complication rate and potentially have better outcomes.

“The iDev Stent is a relatively new stent that has good data accumulating about its efficacy”, said Dr. William Julien. This stent is approved for use in the billary ducts of the liver, but we often use it off-label to treat hard to reach areas in the body that require a stent with flexibility needed for areas that bend, such as behind the knee. The new stent’s unique design and composition is improving patient outcomes.

Friday, October 5, 2012

Alberto's Story: Varicoceles



IS SEX PAINFUL?

IS YOUR SCROTUM SWOLLEN AND HURTS?

IS YOUR WIFE HAVING TROUBLE GETTING PREGNANT?

ANSWER YES TO ANY OF THESE QUESTIONS AND YOU MAY SUFFER FROM A COMMON PROBLEM KNOWN AS VARICOCELES WHICH IS OFTEN MISTREATED PUTTING MEN THROUGH UNNECESSARY PAIN AND SURGERY


 It is estimated that 15-percent of men between the ages of 25-40, at some point in their lives will suffer from varicocele. Simply put, its pain and swelling of the testicles caused by tangled blood vessels and weak defective valves in the scrotum resulting in blood pooling.  When the valves in the testis work properly, they only allow the blood to flow away from the testicle, but sometimes these one-way valves can fail and reverse the flow of blood.

“It’s often described as feeling like a bag of worms,” says Dr. William Julien, interventional radiologist and medical director of South Florida Vascular Associates. Sometimes varicocele causes no symptoms and is harmless, but sometimes it causes pain, testicular shrinkage and low sperm count resulting in fertility problems.

39-year-old Alberto Gonzalez, a grounds maintenance worker suffered with it for five excruciating months. “The pain became so severe I was unable to sit for any length of time and driving the tractor for work was excruciating for me.  Even sex was painful,”

This extremely active man, who works out regularly and takes long walks with his wife, could no longer enjoy the lifestyle he was accustomed to.

“I could barely do anything without experiencing pain.”

After many tests and seeing numerous doctors, Alberto was finally diagnosed with varicocele and underwent a procedure called Minimally Invasive Varicocele Embolization.

Dr. Julien says, “This procedure is done on an outpatient basis, requires light anesthesia known as twilight sedation, is less painful, has fewer complications and recovery is much faster.”

Performed by an interventional radiologist, first a tiny incision is made in the groin. Then using x-ray guided imaging a small catheter is inserted to close off the vein with small metal coils and sclerosant medication may be injected to shrink it. The procedure takes about 30 minutes and the patient goes home shortly afterwards with only a band aid at the puncture site.

While this procedure is the gold standard for treating varicocele, unfortunately many urological surgeons still do it the old fashioned way, making a large incision in the scrotum, requiring general anesthesia and a long, painful recovery. It’s called Varicocele Ligation Surgery.

Dr. Julien says minimally invasive varicocele embolization is underutilized and patients need to educate themselves and find an interventional radiologist who performs the procedure which is much easier on the patient.

Alberto feels lucky he found Dr. Julien. “I was back to my old active self within 10 days. My wife and I have been trying to start a family, but she hasn’t gotten pregnant. Maybe now she will.”