South Florida Vascular Associates South Florida Vascular Associates

Wednesday, May 29, 2013

Show Off Legs With Confidence – Attacking Varicose Veins

South Florida is known for its year-long balmy temperatures. Because of the heat, shorts, skirts and dresses are fashion staples – a way for men and women to show off their sexy legs.
But some folks will keep their legs hidden because of embarrassing varicose veins or spider veins. 40 million Americans in all are affected.

Symptoms

Varicose veins are blue, twisted and thick veins that typically develop on the calves or lower legs. Not only are these veins unattractive but they can hurt. Symptoms of varicose veins include aching, debilitating pain, swelling and rashes.

When valves in the legs' superficial veins stop closing, gravity pulls blood back down and pools inside the veins. This is called venous insufficiency.

Varicose veins affect both men and women over 50. But below the age of 50, more women have them.

Varicose Veins Causes

The most common reasons for varicose veins are:
•    Heredity
•    Multiple Pregnancies
•    Obesity
•    History of Blood Clots

Spider Veins Causes

Spider veins can be caused by the backup of blood. They can also be caused by hormone changes, exposure to the sun, and injuries.

Prevention

There are steps you can take to reduce your chances of developing both spider and varicose veins. These are things that can also help to ease the discomfort from the ones you already have:
•    Wear Sunscreen
•    Exercise/Focus on strengthening the legs
•    Don’t cross legs
•    Don’t stand for long periods of time
•    Eat a high fiber diet
•    Avoid wearing high heels

Treatments

Some spider veins and varicose veins cannot be prevented. When you get them, exercising, elevating the legs and wearing support stockings can help to relieve the symptoms of varicose veins. But when these and the other suggestions above do not work, surgery may bring relief.

At South Florida Vascular Associates, we treat vascular problems in minimally invasive ways. Our team of interventional radiologists offers the most advanced procedures in our state-of-the-Art endovascular suites.

If you have varicose or spider veins and want to know your treatment options, call South Florida Vascular Associates today at 954-573-2929.



Preventing Peripheral Artery Disease

America’s population is aging and is contributing to the increasing health care costs in the country. One of the most prevalent conditions affecting America’s older population is Peripheral Artery Disease or PAD.

One in five people over age 60 has it - an estimated 8 million Americans, according to the Centers for Disease Control. PAD is a narrowing of the arteries caused by a plaque buildup. This limits blood flow to your head, organs and limbs which can potentially be life threatening.

Symptoms and Complications

PAD can go undetected for years, slowly and silently developing in your body. UW Medicine Health has some very important information on what you can do to prevent PAD. The most common cause of PAD is hardening of the arteries or atherosclerosis. If the arteries that deliver blood to the legs are blocked, this will cause debilitating leg pain, ulcers and can lead to amputation. The most common cause of stroke is blocked arteries to the brain. And when PAD affects arteries to the kidneys, this can lead to severe high blood pressure and kidney failure.

Common risk factors include:
•    Older than 60
•    Ethnicity- more African Americans are affected
•    Family History
•    High Cholesterol
•    High Blood Pressure
•    High blood sugars and diabetes
•    Obesity
•    Smoking/History of Smoking

Treatment Options

In some cases, lifestyle changes are enough to improve the condition. If routine screenings of Peripheral Artery Disease for blood pressure, blood cholesterol, lipids and sugar levels show you are at risk for PAD, medications are often necessary. When medication does not work, surgery is needed to open up the arteries.

Endovascular Surgery

The doctors at South Florida Vascular Associates focus on vascular problems and treating them in minimally invasive ways. This rapidly growing area of medicine is known as interventional radiology. The minimally invasive techniques used by interventional radiologists often replace open surgical procedures. This means smaller incisions, less risk, less pain and shorter recovery time for patients.

At South Florida Vascular Associates, with offices in Coconut Creek, Boynton Beach and Plantation, we are very successful treating patients with PAD because we use the latest multidisciplinary approaches that treat the whole patient. Our patients are also treated in our unique office setting which has 3 sophisticated endovascular surgery suites where the majority of our patients are treated. SFVA is one of few interventional radiology practices in the US where patients can be treated in the comfort of an office setting.

If you’re suffering from PAD, the doctors at SFVA can help. Contact us today for an appointment - (954) 725-4141.

Thursday, March 21, 2013

10 years after NBC Journalist David Bloom's death, greater awareness of DVT

By Linda Carroll Today Health

Ten years ago while covering the war in Iraq, NBC journalist David Bloom was struck and killed, not by a stray bullet or roadside bomb, but by a clot that traveled to his lungs and blocked blood flow.  The clot had started in Bloom’s legs as a deep vein thrombosis and then traveled silently up to his lungs until it lodged in an artery there.

Bloom’s family was stunned when they heard the news.

“We had braced ourselves for all the war-related dangers that that assignment entailed,” his wife, Melanie Bloom told TODAY.com. “But when I got that call, I had never heard  of DVT myself and I don’t think David ever had. The more I learned, the more shocked I was. It wasn’t an IED or a bomb that took his life. It was this DVT.”

As a way of finding some meaning in her husband’s death Bloom set out to educate the public about DVT and has been working to alert everyone to the danger.

Thursday, she told TODAY how far that effort has come.

“In the past ten years we’ve established March as national DVT awareness month and we’ve raised awareness by about 20 percent,  which is quite significant because the year David passed a study showed that 74 percent of Americans were completely unaware of DVT,” she told TODAY’s Matt Lauer.

DVT can be treated and pulmonary embolism sometimes averted, Dr. Geno Merli, a clinical professor at Jefferson University and co-director of the Jefferson Vascular Center, told TODAY. Merli is also a paid consultant to Sanofi-Aventis, which makes a DVT therapy.


David Bloom, 39, died of a pulmonary embolism while covering the U.S.-led war in Iraq, on April 6, 2003.

Further, we can lower our risk of dying by changing the way we live and by knowing the warning signs that a DVT is developing, Merli said.

“There’s a personal risk through obesity, and age, which of course we can’t change,” Merli said. “And there are some, such as cancer, medications that could cause [a DVT] or immobility, say from the fracture of a leg.”

Other risk factors include injury, surgery, illness, pregnancy, smoking, and prolonged immobility, which can occur if you’re sitting on a long plane trip without moving your legs.

DVT warning signs include pain, swelling, tenderness, discoloration or redness of the affected area, and skin that is warm to the touch. Symptoms of pulmonary embolisms include shortness of breath, an apprehensive feeling, chest pain, rapid pulse, sweating, or a bloody cough.

However, “50 percent of the time there are no symptoms,” Bloom said, “so it’s important to know if you fall into any of those risk categories.”

DVT and pulmonary embolism strikes about 300,000 to 600,000 people a year, according to the Centers for Disease Control and Prevention.  The Surgeon General’s office estimates that more than 100,000 people die each year as a result of  DVT and pulmonary embolism.

Five years after her husband’s death Melanie Bloom remarried and had two more children in addition to the three she had with Bloom. Still, “we think about David every single day. It’s been so cathartic and wonderful to know we’ve saved lives in his memory and in his honor,” she said.

At South Florida Vascular Associates we have successfully treated hundreds of patients. If you have been diagnosed with DVT and would like more information on treatment options please contact our office to schedule a consultation with one of our board certified endovascular surgeons.

Monday, March 4, 2013

March is Deep Vein Thrombosis (DVT) Awareness Month


Did you know?
•    According to the Vascular Disease Foundation, blood clots affect over 600,000 Americans each year and cause more deaths each year than the more well-publicized conditions of breast cancer, AIDS, and motor vehicle accidents.
•    Blood clots are a leading cause of preventable hospital deaths in the United States.
•    Blood clots are the leading cause of maternal death in the United States.
•    One-half of clot patients will have long-term complications and one-third will have a recurrence within 10 years.
•    An estimated $10 billion in medical costs in the US each year can be attributed to DVT and Pulmonary Embolism (PE).
 
What is DVT?

This patient has a DVT in his left leg.
 Deep vein thrombosis is a blood clot in the deep veins in the legs.  These clots can break loose and travel to the lungs, causing a potentially fatal pulmonary embolism (PE).  DVT’s can cause permanent damage to the leg veins that result in long-term pain, swelling, change in skin color and skin ulcers.

Some people experience swelling and varying levels of discomfort in the affected area, while others don't feel anything at all.  The symptoms of DVT can also be similar to those of other conditions, like a pulled muscle. Because some people with DVT don't have any symptoms, and because the symptoms can masquerade as a more benign ailment, there's often a delay in diagnosis.  That's when DVT can be fatal.  DVT/PE is the fourth leading cause of death in western society.

What Causes Blood Clots (DVT and PE)?
Blood clots may form when either the flow of blood in a vein slows, damage to a vein occurs, or the blood is more clotable. Many factors can increase a person’s risk for developing a blood clot in a vein.

Common risk factors for developing a blood clot include:
Immobility:
• Hospitalization
• Being paralyzed
• Prolonged sitting

Surgery and Trauma:
• Major surgery (especially of the pelvis, abdomen, hip, knee)
• Bone fracture or cast
• Catheter in a big vein (PICC line, central venous catheter, or port)

Increased estrogens:
• Birth control pills, patches, rings
• Pregnancy, including up to 6 weeks after giving birth
• Estrogen and progestin hormone therapy

Medical conditions:
• Cancer and chemotherapy
• Heart failure
• Inflammatory disorders (lupus, rheumatoid arthritis, inflammatory bowel disease)
• The kidney disorder called nephrotic syndrome

Other risk factors:
• Previous blood clot
• Family history of clots
• Clotting disorder (inherited or acquired)
• Obesity
• Older age
• Cigarette smoking
• Varicose veins

Tips for Preventing Blood Clots (DVT and PE)

•    Stay active.  Immobility increases the risk of developing clots. If you've been sitting for a long period of time (such as long-distance travel)   stop and take a break to stretch your legs.
•    Maintain an ideal body weight. 
•    Know your risk factors for developing a clot and discuss these with your doctor.
•    Know your family medical history.  Make sure your doctor knows about any history of blood clots.



If you or someone you know has been diagnosed or is experiencing symptoms of DVT, please contact our office to set up an appointment with one of our board certified endovascular surgeons to discuss which treatment option works best for you.  We have 3 convenient offices located thoughout Broward and Palm Beach Counties.

Tuesday, February 12, 2013

Do You Have Wounds on Your Feet that Won’t Heal? Seek Medical Attention Immediately



If you have wounds on your feet that won't heal, you may have critical limb ischemia which can lead to the loss of a limb.

Critical limb ischemia (CLI) is the most advanced stage of peripheral artery disease (PAD) and is the leading cause of amputation worldwide. Critical limb ischemia results from a progressive thickening of the lining of an artery caused by a buildup of plaque known as atherosclerosis, which narrows or blocks blood flow reducing circulation of blood to the legs and feet.  If PAD is left untreated, CLI can develop because the leg vessels may become so severe that almost no blood can make it through the vessels to your feet causing the tissue in your feet and leg to become starved of oxygen.  You may feel severe foot pain even at rest, and form ulcers on your legs and feet. In severe cases, tissue can die due to poor circulation, causing gangrene and this can ultimately lead to loss of a limb.  If you have advanced diabetes or kidney disease, you are at particularly high risk of developing CLI.

CLI needs to be treated promptly because the symptoms can progress very quickly.
The goal of treatment is to relieve your pain and allow ulcerations and wounds to heal.  In the case of gangrene, the goal is to remove the dead tissue with subsequent healing of the underlying tissue. Treatment requires aggressive revascularization of blocked arteries as with PAD.  However, because blockages are so advanced in CLI, more advanced techniques are often required.
 The illustration shows how P.A.D. can affect arteries in the legs. Figure A shows a normal artery with normal blood flow. The inset image shows a cross-section of the normal artery. Figure B shows an artery with plaque buildup that's partially blocking blood flow. The inset image shows a cross-section of the narrowed artery.

What can you do to protect yourself?
Stop smoking. Smoking doesn't only increase your risk of cardiovascular disease but it increases your risk of PAD and CLI as well. Women who smoke are at the greatest risk.

Pay attention to the condition of your legs and feet. Are your feet often in pain or numb, especially when elevated? Are your toes slightly blue? Signs of CLI also include shiny, dry skin and thickening toenails.

CLI is closely associated with advanced age, men over 60 and women after menopause. It is also associated with diabetes and kidney disease.

Be aware of symptoms. Ischemic rest pain is a common symptom where legs ache and cramp during exercise or movement. Other symptoms include skin ulcers, lesions and a slow pulse in legs and feet.

CLI is a serious, complex disease that requires a multidisciplinary approach.  At South Florida Vascular Associates we work closely with your primary care physician, wound care physician, and other specialty physicians to provide the comprehensive care needed to treat CLI effectively and preserve the limb.

If you suspect or if you have been diagnosed with CLI, please call our office to schedule an appointment with one of our board certified endovascular surgeons to evaluate your condition and discuss the best treatment plan for you. For your convenience, we have 3 office locations throughout Broward and Palm Beach counties, Coconut Creek, Plantation and Boynton Beach.

Tuesday, December 11, 2012

SOUTH FLORIDA VASCULAR ASSOCIATES OPENS NEW LOCATION IN PLANTATION, FLORIDA

Patients Residing in South Broward County Who Suffer from Vascular Diseases Can Now be Treated at our Newest Center of Excellence for Minimally Invasive Endovascular Care
Dr. William Julien and South Florida Vascular Associates are proud to announce the opening of a new location in Plantation, Florida. Our new office is located at 201 Northwest 82nd Avenue, Suite 105, Plantation, Fl. 33324

Our physicians, William Julien, MD and Warren Swee, MD are board certified interventional radiologists who specialize in the treatment of vascular diseases using minimally invasive, endovascular procedures with imaging guidance. Minimally invasive techniques often replace the need for traditional open surgical procedures. They are generally easier for the patient because they involve no large incisions, less traumatic on the patient, less pain and shorter recovery times. Unlike vascular surgery, which treats vascular disease with open surgery, endovascular surgery is a branch of medicine that treats disease processes through the vascular system, using catheter-based image-guided techniques.

“We are pleased to offer our unique, comprehensive, endovascular services to the people of Plantation and the surrounding South Broward communities,” says Dr. Julien who is one of the first interventional radiology physicians in the country to have an office-based clinical practice. Typically, interventional radiologists see patients in the hospital at the time of surgery then after the procedure, the patients are returned to their referring physician.  Dr. Swee explains, “Our philosophy is to follow our patients from the time of diagnosis through treatment and follow-up to ensure that they receive optimal results”.  Drs. Julien and Swee perform 95% of their minimally invasive endovascular procedures in their office-based operating suites offering their patients the comfort and convenience of an office setting rather than a hospital.

“We look forward to working with our new patients and colleagues in South Broward community. We are pleased to have the opportunity to work together within the community to offer the best medical outcome for our patients”, said Dr. Warren Swee.

For more information call 954-725-4141 or visit www.southfloridavascular.com   

About South Florida Vascular Associates
At South Florida Vascular Associates we provide expert vascular care using the most advanced technology possible. Dr. William Julien and Dr. Warren Swee place a strong emphasis on the importance of patient education offering their patients clear explanations of their diagnosis, treatment plan, and precisely what each patient should expect to experience. We provide our patients with detailed information of the plan of care and are always available to answer any questions. Our dedicated and knowledgeable staff offers the best care to each and every patient.

Our state-of-the-Art Endovascular Suites are equipped with the newest devices to assist in performing minimally invasive procedures without the inconvenience of going to a hospital.

At South Florida Vascular Associates we pride ourselves as a Center for Excellence in patient care as the premier vascular experts in the community.

For more information call 954-725-4141 or visit www.southfloridavascular.com   

Media Contact:
Debbie Liebross
M.D. Media Connection
Debbie@mdmediaconnection.com
(954)-436-3644 (office)

Joe's Story: Critical Limb Ischemia


DO YOUR LEGS HURT WHILE WALKING OR EVEN SITTING STILL?

             
IF SO, TAKE IT SERIOUSLY OR YOU COULD END UP LOSING A LIMB!
                     
MILLIONS OF PEOPLE ARE AT RISK AND DON’T KNOW IT.
                        
WHAT YOU NEED TO KNOW BEFORE IT'S TOO LATE.

Joe Langer no longer takes walking for granted. “One day I was fine, the next my toes turned purple and I was in horrific pain. I developed open wounds on the bottom of my feet, gangrene set and I could barely walk. It happened very fast and the next thing I knew, I was facing amputation on both legs from the knees down.”

Every 30 seconds some one, some where in the world is undergoing an amputation, according the American Diabetes Association.

Most tragic, the majority can be prevented according to endovascular surgeon, Dr. William Julien founder of South Florida Vascular Associates, “As more people develop diabetes, amputations are becoming more common, yet 96-percent of them can be avoided. Unfortunately the vast majority of patients aren’t aware of that so they end up losing their limbs or worse yet, their lives.”
People at highest risk are diabetics, those with high cholesterol, heart disease and smokers.

The condition is known as critical limb ischemia (CLI). Simply put, plaque builds up in the arteries, seriously decreasing blood flow to extremities including the hands, feet and legs causing extreme pain and at worst, loss of limbs.

Joe, a diabetic and former smoker considers himself lucky. His podiatrist sent him to South Florida Vascular Associates where they specialize in treating CLI. Joe’s brother-in-law, also a diabetic was not so lucky. Joe says, “His podiatrist did not send him to experts like Dr. Julien and unfortunately his toes were cut off. We now know that could have been prevented.”

Endovascular surgeons at South Florida Vascular Associates take a multi-disciplinary approach to saving limbs and lives. Joe is a great example, they opened the blockages in his arteries then worked very closely with his wound care, infectious disease, and primary care doctors to make sure his wounds were properly healed”.

Using state-of-the-art ultrasound and angiogram technology, he first pinpoints blockages inside artery walls. Then an atherectomy procedure is done in which tiny rotating tools can pulverize and remove the plaque. If necessary, stents are used or angioplasty to re-open the arteries and restore blood flow to the limbs. In addition, hyperbaric oxygen therapy is sometimes prescribed to help heal wounds faster.

It’s a crime to amputate when most of the time it can be prevented. The biggest problem is getting the word out and educating the public.

Joe is trying to help do just that, “These docs performed a miracle. I was in such pain, it was killing me and now I’m back to normal and I consider myself a very lucky man.”

Dr. Julien says, “We urge patients who are told that their limbs must be amputated to get a second opinion. By spreading the word we can significantly reduce the number of amputations from wounds that just won’t heal.”


If you are diagnosed with critical limb ischemia and are told you need your limb amputated, please contact one of our our offices to schedule a consultation with our board certified endovascular surgeons. We may be able to save your limb.