South Florida Vascular Associates South Florida Vascular Associates

Wednesday, February 24, 2016

Gabriel's Story: Endovenous Laser Treatment for Varicose Veins

39 year old Gabriel Quiroga is an air conditioner contractor. Part of his everyday routine is going house- to -house or business- to -business, where he climbs up ladders get up to roofs, into attics, and other hard to reach areas. Quiroga is totally dependent upon the use of his legs for his livelihood and a good quality of life.

Quiroga was experiencing severe pain in his left leg and swelling at the ankle, especially while standing and climbing up ladders. “I was in constant discomfort and was concerned that I might have to change careers. I could barely stand for any length of time without feeling severe pain”, said Quiroga.

Quiroga was referred to South Florida Vascular Associates and Dr. William Julien to discuss his symptoms and determine a treatment option. Upon testing and examination, Dr. Julien determined that Quiroga had a large varicose vein in his left leg which was causing venous insufficiency, a common condition resulting from decreased blood flow from the leg veins up to the heart. “When valves become weak and don't close properly, they force blood to flow backward, a condition called reflux”, said Dr. Julien. In normal veins, valves in the vein keep blood moving forward toward the heart. With varicose veins, the valves do not function properly, allowing blood to remain or pool, in the vein. Pooling of blood in a vein causes it to enlarge, which creates pain, especially when a person is standing and placing pressure on the leg.

Varicose vein treatment, also known as endovenous laser treatment (EVLT), is a minimally invasive procedure that uses radiofrequency or laser energy to seal off and close varicose veins in the legs. It may be used for cosmetic purposes, but it is most commonly used to help alleviate related symptoms such as aching, swelling, skin irritation, discoloration or inflammation. EVLT is safe, less invasive than conventional surgery known as vein stripping and leaves virtually no scars.

    Dr. William Julien Explains EVLT
EVLT is an alternative to traditional open surgery and it requires minimal access to the vein.  In the past, if a patient was suffering from painful varicose veins they would need to undergo an open surgical procedure (vein stripping) to seal off the vein. Vein stripping is very painful and a difficult experience for the patient.
Vein stripping is done using general anesthesia and the procedure usually takes up to 1 1/2 hours. After surgery patients have bandages and compression stockings on their leg and the leg may need to be wrapped to control swelling and bleeding for 3 - 5 days or longer after surgery.

EVLT on the other hand, is a much easier on the patient. The procedure typically takes less than one hour, provides immediate relief, no general anesthesia, recovery period is minimized and a patient can immediately return to normal activities, without scarring or stitches. There is a lower rate of complication and a higher success rate.

“I can’t believe how simple this procedure was”, said Quiroga. “I postponed having the procedure for so long thinking I would be out of work for several weeks and the day after the procedure, I was able to climb my ladder, something I thought I might never be able to do again”. Aside for wearing a compression stocking for a few weeks, Quiroga did not experience any discomfort and was immediately able to return to his job. “This procedure is amazing, said Quiroga, I can’t believe how easy and painless it was”.

If you suffer from unsightly and painful varicose veins,call our office for a consultation or call 954-725-4141

Friday, February 5, 2016

Today is National Wear Red Day: What women need to know about heart disease and stroke

As Featured On Fox News

February 5 is the day that the American Heart Association asks everyone to wear red in order to raise awareness for heart disease in women.  Created in 2004, Go RED day was designed to promote healthier lives for women of all ages.

Today 1 in 3 women are affected by heart disease in the United States, and nearly 44 million American women are living with heart disease. Even though cardiovascular disease is quite prevalent in women, only 1 in 5 women are aware that heart disease is their greatest health risk.

While we have made great strides in reducing cardiovascular death rates in women over the last 20 years, we still must continue to educate and advocate for women of all ages—this advocacy begins with dispelling the common myths surrounding heart disease in general. It is my hope that through efforts such as the Go Red campaign, we can promote better heart health for millions of American women. Ultimately, we must engage women and their families in order to most effectively eliminate needless cardiac related deaths in the next decade.

Myth 1: Heart Disease is predominantly a disease of men

The truth: More women than men die of heart disease every single year. Heart disease kills more women than all types of cancer combined. While most women believe that their greatest health risk comes from breast or uterine cancer—in actuality, a woman’s greatest health risk is from heart disease and stroke.  Nearly 90 percent of all women have at least one risk factor for heart disease.

Myth 2: Heart Disease affects men and women in the same way

The truth: Heart disease affects men and women differently. Biologic and hormonal differences in men and women contribute to the ways in which heart disease develops and progresses.   Studies have shown that after menopause, women have an even higher risk for heart disease—estrogens seem to promote better cholesterol profiles.

Women tend to present to a healthcare provider far later in the course of the disease and have more diffuse blockages in their heart (coronary) arteries. These blockages in coronary arteries result in heart attacks. Heart attacks have several commonly recognized symptoms. Men tend to have more typical symptoms like crushing chest pain and associated shortness of breath, nausea, radiation of pain to neck or jaw.

Women, in contrast, may have very atypical symptoms and some women have no symptoms at all. According to the Centers for Disease Control and Prevention (CDC), nearly two-thirds of women who have sudden cardiac death due to heart disease have no symptoms. While women may certainly have the same symptoms as men, it is more common for them to present with more vague and non-specific symptoms such as feelings of dread, anxiety, back pain and flu-like symptoms.

Heart attacks appear to be much more severe and carry a higher risk for death and complications in women as compared to men.  For example, in the first year following a heart attack women are 40 percent more likely to die than men. In the six years following a heart attack, women are twice as likely to have a second event as compared to men with similar disease.

Myth 3: Women with heart disease are treated the same as men

The truth: Women with heart disease are under-treated and underserved. Women are not screened for and diagnosed with heart disease as aggressively as men. Many times women are sent home from the hospital with atypical symptoms only to find out later that they had suffered a heart attack. When women are diagnosed with heart disease, they are less likely to be treated with the most advanced and aggressive therapies. Men are more likely to undergo cardiac catheterization or coronary artery bypass operations to restore blood flow to the heart after a blockage occurs. Women are more likely to have both minor and major complications from invasive procedures but, in many cases, women seem to see a greater benefit as compared to men. After suffering a heart attack and being treated in the hospital, women are far less likely to be referred for cardiac rehabilitation and are also less likely to be placed on important medications that have been shown to prevent future events.

MYTH 4:  It can’t happen to me

The truth: Heart disease does not discriminate. The risk factors for heart disease are the same in both men and women:



--High Cholesterol

--High Blood Pressure

--Family History of Heart Disease


Nearly 80 percent of all women have at least one risk factor for heart disease. More importantly, many of these risk factors are modifiable. While breast cancer affects 1 in 8 women, heart disease affects one in three. Chronic heart disease and suffering a heart attack can result in physical limitation, significant decrease in quality of life, depression and ultimately heart failure.


Women must take control of their own health.