Do You Have Varicose Veins? A New Study Shows: When Treating Varicose Veins, Laser Therapy (EVLT) Remains the Best Option

When treating varicose veins, laser therapy remains the best option, a new study says. Laser is preferred over surgery or foam due to higher success rates with the least amount of complications.

Researchers in the study examined 798 participants who had varicose veins and were treated at 11 vascular surgery centers in the United Kingdom, between November 2008 and October 2012. The participants underwent one of three types of treatments: closing off the veins with a laser, injecting a drug "foam" into the vein or surgically removing the vein.

After six months, the researchers compared the outcomes, looking at how well the treatments worked and at their complication rates, as well as how the participants rated the change in their quality of life since their treatments.

The main findings indicated that laser therapy, endovenous laser treatment was the preferred treatment for varicose veins. It was determined that all three treatments reduced symptoms associated with varicose veins, but there were fewer complications after laser treatment.

What causes varicose veins?

Varicose veins are blood vessels that have become swollen, enlarged and twisted. Improperly working valves in the veins cause the disorder. In people who have this condition, blood returns up to the heart from the veins in the legs because of the contraction of the calf muscles. Normally, valves in these veins prevent blood from flowing backwards, down towards the feet.

People with varicose veins have leaky valves, which means that some blood flows backward and pools in the veins, causing them to become enlarged.

The procedure called endovenous laser ablation (EVLT), uses heat generated by laser energy to seal off faulty blood vessels, diverting blood flow to nearby healthy veins.

Foam or saline treatment, sclerotherapy, involves injecting drugs into a blood vessel. The medicines, when mixed with air, cause the vessel wall to thicken and helps to seal off blood flow. The recent study showed that foam was less likely than the other treatments to completely close a vein that had leaky valves, which may increase the likelihood that a patient will need future treatment.

In the study, about 1 percent of patients who underwent treatment with a laser experienced complications such as lumpiness, skin staining and numbness. About 6 percent of those who received the foam treatment, and 7 percent of those who underwent surgery experienced such complications, according to the study.

The researchers of the study also found that successful ablation of the great saphenous vein occurred in 83 percent of those who received the laser treatment and 84.4 percent of the participants who underwent surgery.  These numbers were significantly higher than the 54.6 percent who had such successful ablation after the foam treatment. The great saphenous vein, the longest in the body, runs along the length of the leg.

Can varicose veins be prevented?

Varicose vein treatment is not only done for cosmetic reasons, it is done because people with who have them often suffer from pain and discomfort. Varicose veins can also cause swelling of the ankles, skin changes and sometimes even ulcers. Some people with severe varicose veins have difficulty walking.

Both men and women get varicose veins and the condition is very common in pregnant women, older patients, overweight people and those who stand for long periods of time. It is also more prevalent in people who have a family history of varicose veins.

According to the National Institutes of Health (NIH), people cannot prevent varicose veins from forming, but may be able to delay their formation or prevent existing varicose veins from getting worse. The NIH recommends that people avoid standing or sitting for a long time without taking breaks; avoid crossing their legs when sitting; and keep their legs raised when sitting, resting or sleeping.

Losing weight and doing exercise that works the leg muscles can also help, the NIH said.

South Florida Vascular Associates offers endovenous laser treatments and they are done right in our office. The treatment takes less than 1 hour, provides immediate relief, there is no use of anesthesia, quick recovery period, no scarring and provides a much less rate of complication compared to surgery. If you have unsightly or painful varicose veins call our office today to make an appointment for a consultation at one of our 3 convenient office locations, Coconut Creek, Plantation or Boynton Beach. We can help you to feel better and look better. Call 954-724-4141.

SFVA Physicians Educate JFK Hospital Podiatry Residents on PAD

Dr. Curtis Anderson

Endovascular Surgeons, Dr. William Julien and Dr. Curtis Anderson invited Palm Beach Podiatrists and 6 Resident from JFK Hospital to learn more about peripheral artery disease (PAD) as it appears in Podiatric patients. The talk was held at Morton's Steakhouse in West Palm Beach. Also in attendance at the dinner, the President of The Palm Beach County Podiatric Medical Association (PBCPMA).

PAD is caused by a thickening of the inside walls of the arteries of your legs. This thickening, called atherosclerosis, narrows the space through which blood can flow, decreasing the supply of oxygen and nutrients to the legs and feet. Poor circulation in the feet can lead to open wounds, gangrene and potentially loss of limb. Endovascular surgey has become very instrumental in the treatment of PAD in podiatric patients because it is a minimally invasive procedure performed inside your artery using a thin, long tube called a catheter which enters through a small incision in the groin. The catheter is then guided to the blocked area in the blood vessel where the vessel can be kept opened by either a stent or a balloon angioplasty.

Endovascular approaches are advantageous for many patients because they are minimally invasive; easier on the patient, result in fewer complications and faster recovery times which have replaced open surgery for most vascular disorders.Endovascular approaches are particularly beneficial to podiatric patients because the endovascular procedure re-establishes blood flow to the feet enabling wounds to heal and provides patients with the opportunity to walk again.

We thank all of the doctors and residents who attended our talk last night.

Could Dark Chocolate Help Ease Poor Leg Circulation?

In a recent article in HealthDay News it was reported that the antioxidants contained in dark chocolate might help people suffering from reduced blood flow to their legs, according to researchers from an Italian report.

In a small study, people with artery problems in their legs walked a little longer and farther right after eating a bar of dark chocolate. Dark chocolate is rich in antioxidants called polyphenols. Researchers believe polyphenols improve blood flow to the legs by affecting biochemicals that prompt arteries to widen.

The body secretes chemicals that naturally dilate blood vessels in response to certain stimuli, improving the blood flow to certain areas. Some of the chemicals inside dark chocolate could affect the way these enzymes are metabolized in the body.

The pilot study involved 20 people aged 60 to 78 who suffered from peripheral artery disease, a narrowing of the arteries that carry blood from the heart to the legs, stomach, arms and head. Reduced blood flow can cause pain, cramping or fatigue in the legs or hips while walking.
In the study, patients walked on a treadmill in the morning and again two hours after eating 40 grams of dark or milk chocolate which is the size of an average American chocolate bar -- on separate days. The dark chocolate in the study had a cocoa content of more than 85 percent, making it rich in polyphenols. The milk chocolate, with a cocoa content below 30 percent, had far fewer polyphenols, the study authors noted.

After eating dark chocolate, patients walked an average 11 percent farther and 15 percent longer than they did earlier in the day. That's about 39 feet farther and about 17 seconds longer, according to the study, published July 2 in the Journal of the American Heart Association.

Milk chocolate did not improve time or distance, according to study co-author Dr. Lorenzo Loffredo, assistant professor at the Sapienza University of Rome, and colleagues.

The researchers found that levels of nitric oxide, a gas linked to improved blood flow, were higher after eating dark chocolate. They suggested that the higher nitric oxide levels may be responsible for widening peripheral arteries and improving the patients' ability to walk.

While the study results and the theory are intriguing regarding identifying the way that polyphenols might affect blood flow to the legs, more research needs to be documented to confirm these observations. However, polyphenols also can be found in foods with less added sugar and saturated fats, such as cloves, dried peppermint, celery seed, capers and hazelnuts.

It is also noted that chocolate is also high in fat and sugar, and eating too much can contribute to other health problems such as obesity, diabetes and high cholesterol.

So before you run to the nearest candy store to stock up on dark chocolate, remember, everything in moderation. While the study results indicate that moderate amounts of chocolate might be helpful in improving blood flow to the legs, more research is needed.

If you do try eating dark chocolate in moderation and notice a difference in how far and how long you can walk, we’d love to hear from you.

An Open Sore on your Foot that Won’t Heal Can Be a Sign of a Serious Condition

If you have an open sore on your foot that isn’t healing, you should seek medical attention immediately for diagnosis and treatment.  Sometimes people will ignore an open sore and think that it will heal on its own but an open sore, especially if it’s been on your foot for a long period of time, can be an indication that you have diabetes, poor circulation in your arteries possibly due to peripheral artery disease, or infection. In addition, some people who have diabetes suffer from a condition called neuropathy, damage to the nerves in the peripheral nervous system which can cause numbness in your feet.  If you experience numbness in your feet, you probably wouldn’t even feel an open sore. For these patients, it is always a good idea to check your feet on a daily basis to ensure that your feet are in good condition free of any sores.

Open sores that won’t heal can potentially be a very serious condition that could even lead to amputation of a lower limb if it is not caught and treated in time. In advanced cases of peripheral artery disease, the blockages in your leg vessels may become so severe that almost no blood can make it to your feet and the tissue becomes starved of oxygen causing a sore that doesn’t heal.  This condition is known as critical limb ischemia or CLI. CLI is a serious, complex disease that requires a multidisciplinary approach.  At South Florida Vascular Associates, our board certified endovascular surgeons, Dr. William Julien, Dr. Warren Swee, and Dr. Curtis Anderson work closely with your primary care physician, wound care physician, and other specialty physicians to provide the best comprehensive care needed to treat CLI effectively and prevent major amputation.

If you have open sores on your feet that won’t heel, contact our office today at 954-725-4141 to set up a consultation for evaluation, diagnosis, and treatment plan. We have 3 office locations for your convenience, Coconut Creek, Boynton Beach and Plantation, Florida.

New Non-Surgical Procedure for Removal of Uterine Fibroids Offered at South Florida Vascular Associates

Uterine fibroids are tumors or growths made of smooth muscle cells and other tissue that arise within the wall of the uterus or womb. They are the most common non-cancerous tumors in women of childbearing age.

Uterine fibroids can cause painful symptoms and abnormal bleeding from the uterus. Fibroids that are located in certain parts of the uterus, such as the uterine cavity, can also make it difficult for a woman to get pregnant or maintain a pregnancy.

Currently the only cure for fibroids is hysterectomy, removal of the uterus.

Most women with fibroids don’t have symptoms severe enough to warrant treatment. For those who do, there are a variety of therapies which are usually selected based on a woman’s age, medical history and whether she may want to get pregnant at some point; other factors include the size and location of the fibroids.

According to an article in the Journal of Vascular and Interventional Radiology, doctors are now utilizing a new way to access a woman's fibroids by entering a catheter through a woman’s wrist and treating via an arm instead of a groin artery to non-surgically shrink noncancerous growths in the muscular wall of the uterus. This method, offered at South Florida Vascular Associates is less painful and traumatic for women, allowing them to immediately sit up and move after uterine fibroid embolization (UFE) with no overnight stay.

Researchers at Mount Sinai Hospital in New York City studied the access treatment used by cardiologists for coronary interventions and applied it to a minimally invasive treatment for women's uterine fibroids. By flipping access for treatment from the artery in the groin to the artery in the wrist, women experienced less pain and trauma than the traditional groin technique opening the door to potential savings in health care costs. Complications related to bleeding at the puncture site are significantly reduced using this approach and patients are able to walk immediately after treatment, which dramatically improves their experience.

Uterine Fibroid Embolization (UFE) is a nonsurgical interventional radiology treatment for women that cuts off blood flow to painful fibroids to kill the noncancerous tumors. Uterine fibroids, which affect up to 40 percent of all women 35 and older, can cause prolonged, heavy menstrual bleeding that can be severe enough to cause anemia or require transfusion; disabling pelvic pain and pressure; urinary frequency; pain during intercourse; and miscarriage. Typically, interventional radiologists have delivered treatment directly to the fibroid by threading a catheter through a woman's femoral artery in her thigh. In this new approach, doctors thread a catheter through one of two arteries in a woman's left wrist. They then made a tiny nick in the skin and inserted a catheter into the artery. Using real-time imaging, the doctor guided the catheter through the artery and then released tiny particles, the size of grains of sand, into the uterine arteries that supply blood to the fibroid tumor. This blocked the blood flow to the fibroid tumor and caused it to shrink and symptoms to subside. UFE is more desired than the traditional hysterectomy procedure that removes the entire uterus.

If you are suffering from painful fibroids, we invite you to contact our office to have a consultation with one of our board certified interventional radiologists, Dr. William Julien, Dr. Warren Swee, and Dr. Curtis Anderson. We have three office locations for your convenience. Coconut Creek, Boynton Beach, and Plantation.

March is National Deep Vein Thrombosis Awareness Month: What You Need To Know

What is Deep Vein Thrombosis or DVT?  

DVT occurs when a blood clot forms within one of the large veins, usually in the lower leg or thigh.  The clot can then break off and travel through the bloodstream to the lungs and block blood flow.  This is called a pulmonary embolism.  DVT and pulmonary embolism can seriously damage the lungs and other organs and be life threatening, if not treated.

How many people are affected?

According to the American Heart Association, DVT occurs in about 2 million Americans every year.

What are the symptoms?

Symptoms of DVT include

• Leg swelling
• Leg pain
• Tenderness and leg warmth and redness

Are there any risk factors?

Risk factors of deep vein thrombosis may include 

• Recent surgery, especially of the leg joint or hip
• Hospitalization; trauma
• Traveling for a long distance such as a long car or airplane ride

If you are experiencing any of the symptoms above, contact South Florida Vascular Associates at 954-725-4141 and one of our board certified interventional radiologists will evaluate you and advise the best treatment plan for you.

Vascular Disease is #3 Killer of Women and it is Preventable

February is American Heart Month, here are some important facts about heart and vascular disease in women.


According to the American Heart Association, heart disease and stroke are women’s No. 1 and No. 3 killers and it is important to know what puts you at risk for developing these diseases.


High blood pressure causes our hearts to work harder than normal which can damage the heart and arteries over time, increasing the risk of heart attack and stroke. Women are at risk of developing high blood pressure if they are 20 or more pounds over a healthy weight for their height and build, have a family history of high blood
pressure, take certain types of oral contraceptives, are pregnant or are age 55
or older. 


Cholesterol, a wax-like substance found in your arteries can create plaque buildup on the walls of your blood vessels which can restrict blood flow to the heart and increase your risk of clots, heart attack and stroke. Eating a healthy diet enriched with fruits,
vegetables, and protein can keep your cholesterol under control. Stay away from
foods high in saturated and trans fats which produce high levels of
cholesterol.



Being overweight and living a sedentary lifestyle can also increase one’s risk of developing cardiovascular disease. Being more active is one of the best things you can do to improve your overall health and quality of life. Exercise helps you to maintain a healthy weight, lowers blood pressure and cholesterol, and can help to prevent or
control diabetes, which puts you at a higher rate of developing heart attack,
stroke and peripheral artery disease.


In addition, exercise is also important for bone health; it reduces stress and depression by increasing your hormone serotonin which is responsible for mood control, and keeps your mind sharp as you get older. 


Smoking is the top preventable cause of early death in women. Women who smoke increase their chances of developing heart disease, heart attack, stroke and peripheral artery disease. Once you quit smoking, your risk of heart disease and stroke starts to gradually drop until it is as low as a nonsmoker’s risk.


Maintaining a healthy lifestyle is the always the best way to stay healthy and prevent heart and cardiovascular disease.