On January 15, 2012, 6 cardiovascular interventional radiologists from across the United States joined Dr. William Julien, medical director of South Florida Vascular Associates for a specialized national training course in learning new techniques for treating patients suffering from critical limb ischemia. Critical Limb Ischemia or CLI, is the end stage of lower extremity peripheral artery disease (PAD) in which severe obstruction of the arteries decreases blood flow to the lower extremities resulting in severe and debilitating pain, skin ulcers, and a significant risk for loss of limb. CLI is often present in people with severe peripheral arterial disease (PAD) where plaque builds-up in the arteries and blocks the passage of normal blood flow through the arteries into the lower extremities to prevent deterioration of a limb.
In his course, Dr. Julien demonstrated a procedure called atherectomy, a non-surgical, minimally invasive option for treating hardening of the arteries or calcified blockages in patients with PAD. Atherectomy procedure uses a tiny, rotating diamond-coated tip to gently sand away tough plaque build- up and creates a large opening to restore blood flow to the affected area. A balloon angioplasty is also used to widen the artery and provide ample return of blood flow to the affected lower extremity to assist with salvaging the limb.
Atherectomy in combination with balloon angioplasty has proven to be a very successful treatment option and offers hope for those patients who suffer from CLI as an alternative to surgery or amputation.
Monday, January 23, 2012
Thursday, December 8, 2011
Ground-Breaking South Florida Interventional Radiologist Achieves Excellent Patient Outcomes With Continuum of Care Model of Delivery
William Julien, MD, is a leading expert in the development of office-based clinical endovascular practices
Coconut Creek, Fl- South Florida Vascular Associates Medical Director William Julien, M.D., is one of only a few interventional radiologists in the nation to have an office-based clinical practice where he provides pre- to post-operative care to his patients suffering from vascular diseases. His practice is unique because, unlike most interventional radiologists, Dr. Julien sees his own patients and treats 95% of them in his office in a sophisticated endovascular suite, one of the first of its kind in the country. Recently, Dr. Julien opened an 8,000-sq.-ft. facility equipped with three state-of-the-art operating suites coupled with a team of the region's most highly skilled medical staff, offering patients a unique and convenient continuum of care compared to a traditional hospital setting where traditional interventional radiologists typically see and treat their patients.
South Florida Vascular Associates' medical staff treats a variety of vascular conditions, including peripheral artery disease, abdominal aortic aneurysm, varicose veins, deep vein thrombosis and carotid artery disease.
Each year the practice's physicians perform more than 1,000 image-guided endovascular procedures in their office-based setting utilizing the latest cutting-edge technology, which is implemented by specialty-trained vascular medical professionals. Office-based procedures are easier on the patient because the patients are in a relaxed environment, there is little to no wait time for surgery, the procedures are performed under IV sedation as opposed to general anesthesia, and there is a comfortable waiting area for the families. In-office endovascular procedures are also less expensive than hospital procedures for insurance carriers.
"Our endovascular practice focuses on the continuity of patient care from our first meeting until the patient is fully recovered," said Dr. Julien. "I have the opportunity to know each of my patients personally and patient outcomes are excellent with this advanced model of delivering vascular care. We emphasize the importance of patient education, offering patients clear explanations of their diagnosis and treatment plan, including providing the most comprehensive endovascular services in a fully-equipped, private, comfortable setting."
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. Endovascular procedures are minimally invasive, require less or no hospital time, have fewer complications, result in reduced cost, and faster recovery time for the patient.
Dr. Julien and his staff also provide angioplasty, stenting, atherectomy, bypass surgery, embolization and many other vascular treatments.
About South Florida Vascular Associates
William H. Julien, MD, is the medical director of South Florida Vascular Associates and is one of few interventional radiologists in the nation to offer a clinical-based practice. His philosophy is to treat the patient as a whole person and he does much of his own testing and procedures in his state-of-the-art facility equipped with three in-office operating suites, allowing patients to feel more comfortable in a non-hospital setting. His highly skilled staff provides one-on-one attention to each patient focusing on his/her needs and care. To learn more about Dr. Julien and South Florida Vascular Associates, call (954) 725-4141 or visit www.southfloridvascular.com.
NEWER ILIAC ARTERY STENTS PROVE TO BE SAFE, EFFECTIVE & LIFE PROLONGING
South Florida Interventional Radiologist Says Nearly 100% of Patients with Peripheral Artery Disease (PAD) Can Now Be Successfully Treated
Clogged leg arteries, or peripheral arterial disease (PAD) affects up to 20% of Americans 65 or older.
William Julien, M.D., medical director of South Florida Vascular Associates says, “As the population ages that number is expected to climb even higher.” Aging, smoking, high blood pressure, diabetes, and obesity are the key risk factors.
PAD often occurs in the iliac arteries, the main arteries which carry blood from the abdominal aorta to the legs and feet. Often, the first sign of iliac artery disease is leg cramps or pain when walking. In its most severe form, PAD can cause painful sores on a patient’s toes and feet. If left untreated, the blood circulation to the lower extremities will diminish causing ulcers that can become dry, gray or black, and eventually gangrenous, which can lead to amputation of a limb.
67 year-old Frank Bartilotta was forced to retire from the grocery business, in part because of PAD. “Life was miserable. I couldn’t do anything. I couldn’t walk any more. I even had to sit in a chair to shower. We went to Las Vegas on vacation and I couldn’t leave the hotel room because I couldn’t walk anywhere,” he says.
Unloading grocery trucks for years and smoking a pack of cigarettes a day took its toll. Bartilotta says, “My walking capability was only a couple of minutes at the most.”
His PAD was so severe, treatment required angioplasty and iliac stenting in both legs.
“Treating PAD with stents is not new. We’ve been doing it more than 20 years, says Dr. Julien, but the technique and the stents are more durable and better constructed these days.”
Mounting research confirms iliac stenting is safe, highly effective and life extending.
“Nearly 100-percent of all patients with PAD can be successfully treated,” says Dr. Julien. The procedure, which takes roughly up to 90 minutes and is performed with local anesthesia, is fairly simple and similar to placing stents in clogged arteries in other parts of the body. Dr. Julien says, “Most patients are usually up on their feet roughly two to six hours after the procedure and can immediately go back to normal activities.”
In Bartilotta’s case, the iliac stents originally put in place by another doctor were too small. Bartilotta was referred to Dr. Julien who fixed the problem by doing balloon angioplasty to open up the stents wider, replacing normal blood flow to his legs.
And it worked!
Tuesday, November 29, 2011
Prevent Episodes of Deep Vein Thrombosis; Keep Moving, Especially When Travelling
One of the worst things you can do if you've had deep vein thrombosis is stay still for long periods of time. Simple exercises may help you to prevent another episode of DVT.
Deep vein thrombosis, or DVT, occurs when blood clots form in the deep veins, usually in a leg. The blood clot can partly or completely block blood flow and damage valves in blood vessels. It can also break free and travel through your blood to major organs, such as your lungs -- which can be fatal.
Doctors diagnose DVT in 600,000 Americans each year. One out of 100 of these people die. If you're at risk, there is much you can do to prevent DVT.
Being still for long periods of time, such as travelling on a long airplane flight or sitting at a desk most of your work day increases your risk of DVT. To prevent the development of DVT, it's important to keep your blood flowing by moving and exercising.
When exercise is recommended by your physician to prevent DVT, this is not necessarily talking about vigorous exercise. There are simple exercises and preventative measures you can follow to prevent blood clots from forming in your legs. By simply moving your legs by stretching them, doing leg bends, fluttering your legs while seated, and walking around every few hours to stimulate your leg muscles, you can help to prevent the development of blood clots.
The best exercises for DVT prevention are walking and swimming because these exercises keep your blood flowing. If you're at risk for DVT, avoid exercises that involve repeated thrusting that may cause trauma to your legs.
Here are some tips to keep your blood moving when traveling:
• Drink plenty of water before and during your trip. This will reduce your risk of dehydration, which can make your blood more likely to clot.
• Perform simple sitting exercises every half hour or so, when on long trips.
• Take a walk up and down the aisle during airplane flights to move around. If traveling by car, stop and get out stretching frequently.
Here are some exercises that are useful for DVT prevention:
• Tighten your calves. Flex your feet and raise your toes 15 times per set. This will tighten your calf muscles and promote proper blood flow through your legs.
• Turn your ankles. With your feet off the floor, move one foot clockwise, the other, counterclockwise. Repeat, only switch directions.
• Lift your feet. With your heels on the floor, raise your toes up; then lower them to the ground. Then do the opposite — heels up, balls of your feet on the floor.
Risk Factors for DVT
• Being over age 40
• Obesity
• Cancer
• Personal or family history of DVT
• Immobilization
• Pregnancy
• Oral contraception (birth control) or hormone therapy use
• Recent surgery or hospitalization
• Smoking
Regardless of your risk factors in order to prevent DVT, remember to keep moving, especially when sitting for long periods of time while traveling, at work, or even relaxing at home.
Deep vein thrombosis, or DVT, occurs when blood clots form in the deep veins, usually in a leg. The blood clot can partly or completely block blood flow and damage valves in blood vessels. It can also break free and travel through your blood to major organs, such as your lungs -- which can be fatal.
Doctors diagnose DVT in 600,000 Americans each year. One out of 100 of these people die. If you're at risk, there is much you can do to prevent DVT.
Being still for long periods of time, such as travelling on a long airplane flight or sitting at a desk most of your work day increases your risk of DVT. To prevent the development of DVT, it's important to keep your blood flowing by moving and exercising.
When exercise is recommended by your physician to prevent DVT, this is not necessarily talking about vigorous exercise. There are simple exercises and preventative measures you can follow to prevent blood clots from forming in your legs. By simply moving your legs by stretching them, doing leg bends, fluttering your legs while seated, and walking around every few hours to stimulate your leg muscles, you can help to prevent the development of blood clots.
The best exercises for DVT prevention are walking and swimming because these exercises keep your blood flowing. If you're at risk for DVT, avoid exercises that involve repeated thrusting that may cause trauma to your legs.
Here are some tips to keep your blood moving when traveling:
• Drink plenty of water before and during your trip. This will reduce your risk of dehydration, which can make your blood more likely to clot.
• Perform simple sitting exercises every half hour or so, when on long trips.
• Take a walk up and down the aisle during airplane flights to move around. If traveling by car, stop and get out stretching frequently.
Here are some exercises that are useful for DVT prevention:
• Tighten your calves. Flex your feet and raise your toes 15 times per set. This will tighten your calf muscles and promote proper blood flow through your legs.
• Turn your ankles. With your feet off the floor, move one foot clockwise, the other, counterclockwise. Repeat, only switch directions.
• Lift your feet. With your heels on the floor, raise your toes up; then lower them to the ground. Then do the opposite — heels up, balls of your feet on the floor.
Risk Factors for DVT
• Being over age 40
• Obesity
• Cancer
• Personal or family history of DVT
• Immobilization
• Pregnancy
• Oral contraception (birth control) or hormone therapy use
• Recent surgery or hospitalization
• Smoking
Regardless of your risk factors in order to prevent DVT, remember to keep moving, especially when sitting for long periods of time while traveling, at work, or even relaxing at home.
Wednesday, November 16, 2011
NON-INVASIVE TREATMENT FOR VARICOSE VEINS OFFERS IMMEDIATE RELIEF
Endovenous Laser Treatment (EVLT) Enables Patient Suffering from Painful Varicose Veins to Return to Labor Intensive Work Day after Treatment
Several months ago, Quiroga was experiencing 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 William Julien , M.D., a board certified, fellowship trained interventional radiologist who is the medical director of South Florida Vascular Associates (www.southfloridavascular.com) 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.
A non-invasive technique has been developed to treat venous insufficiencies such as varicose veins called Endovenous Laser Treatment (EVLT). EVLT is an alternative to traditional open surgery called vein stripping, and it requires minimal access to the vein. Light emission (heat) from a laser fiber beam is used to cauterize, or seal off, the inside of the varicose vein wall. This method closes the unhealthy, refluxing vein.
During this procedure, a local anesthetic is applied to the vein and the physician inserts a tiny catheter into the problematic vein using ultrasound to guide its entry. The energy from the laser then works to close the unhealthy refluxing vein and thus reduce the tension on the surface skin veins. With the problematic vein permanently closed, the body then reroutes the blood to healthier veins returning the blood back to the heart. EVLT is a reliable and simple way to treat varicose veins without surgery.
In the past, if a patient was suffering from bulging, painful varicose veins, a patient would need to undergo an open surgical procedure called vein stripping to seal off the vein. Vein stripping is a very painful and arduous experience for the patient.
Vein stripping is done using general anesthesia and the procedure usually takes up to 1 1/2 hours. During this procedure a vascular surgeon makes two small surgical cuts in your leg. The cuts will be near the top and bottom of your damaged vein. The surgeon will then thread a thin, flexible plastic wire into the vein through your groin and guide the wire through the vein toward the other cut farther down your leg. The wire is then tied to the vein and pulled out through the lower cut, which pulls the vein out with it.
The vascular surgeon will close the cuts with sutures. After surgery you will have bandages and compression stockings on your leg and your leg may need to be wrapped to control swelling and bleeding for 3 - 5 days after surgery. You may need to keep them wrapped for several weeks.
The advantages of EVLT treatment include: treatment typically takes less than one hour, provides immediate relief, general anesthesia is not needed, recovery period is minimized and a patient can immediately return to normal activities, no scarring or stitches, lower rate of complication, and a higher success rate and durability of the procedure relative to surgery.
“I can’t believe how simple this procedure was”, said Quiroga. “I postponed 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. www.southfloridavascular.com or call 954-573-2929
Monday, October 31, 2011
High Tech Treatment helps to Effectively Eliminate Plaque Build-up from Atherosclerosis
If you suffer from atherosclerosis, our endovascular surgeons offer a very safe and effective procedure called an atherectomy to eliminate the build-up of plaque in your arteries.
You may need this procedure if your arteries become too narrowed or blocked from plaque inside the artery walls. When arteries are blocked, blood cannot get through to nourish the tissues, causing the muscles of the lower extremities to cramp and lose strength.
Atherectomy has been very effective in the treatment of peripheral artery disease (PAD) below the knee and it helps to reduce pain caused by walking to heal non-healing wounds by improving circulation. It also has been an effective treatment for limb salvage of the lower extremities. Atherectomy is especially helpful for treating blockages in arteries that occur around branches or in vessels that are not easily treated with stents.
The procedure is done in our office, as opposed to a hospital setting, in one of our state-of-the art endovascular suites. Local anesthesia is used with a mild sedative if needed. During the procedure a catheter is inserted into the artery through a small puncture in the groin. The catheter has a tiny sharp blade on the end which spins around at a very fast speed and sands away the plaque from the blood vessel to open the vessel and re-establish better blood flow. The plaque is scraped away and collected in a chamber in the tip of the catheter for removal. If you have a significant amount of plaque, the catheter can be passed multiple times in order to remove large amounts of plaque.
Depending on the amount of plaque build-up a patient has, the procedure usually takes about two hours. Atherectomy most often results in immediate relief of the symptoms of atherosclerosis. There are typically no side effects and patients can usually begin normal activities several days after the procedure.
This procedure is not ideal for everyone. Each patient is evaluated, and treatment will be individualized for the patient's circumstances.
To find out if you are a candidate for this procedure contact our office for a consultation.
You may need this procedure if your arteries become too narrowed or blocked from plaque inside the artery walls. When arteries are blocked, blood cannot get through to nourish the tissues, causing the muscles of the lower extremities to cramp and lose strength.
Atherectomy has been very effective in the treatment of peripheral artery disease (PAD) below the knee and it helps to reduce pain caused by walking to heal non-healing wounds by improving circulation. It also has been an effective treatment for limb salvage of the lower extremities. Atherectomy is especially helpful for treating blockages in arteries that occur around branches or in vessels that are not easily treated with stents.
The procedure is done in our office, as opposed to a hospital setting, in one of our state-of-the art endovascular suites. Local anesthesia is used with a mild sedative if needed. During the procedure a catheter is inserted into the artery through a small puncture in the groin. The catheter has a tiny sharp blade on the end which spins around at a very fast speed and sands away the plaque from the blood vessel to open the vessel and re-establish better blood flow. The plaque is scraped away and collected in a chamber in the tip of the catheter for removal. If you have a significant amount of plaque, the catheter can be passed multiple times in order to remove large amounts of plaque.
Depending on the amount of plaque build-up a patient has, the procedure usually takes about two hours. Atherectomy most often results in immediate relief of the symptoms of atherosclerosis. There are typically no side effects and patients can usually begin normal activities several days after the procedure.
This procedure is not ideal for everyone. Each patient is evaluated, and treatment will be individualized for the patient's circumstances.
To find out if you are a candidate for this procedure contact our office for a consultation.
Tuesday, October 18, 2011
Do you Suffer from Varicose Veins?
At South Florida Vascular Associates we use the latest, state-of-the-art techniques for the treatment of varicose veins and venous insufficiencies
Venous insufficiency involves one or more veins. Valves in the veins usually push the flow of blood toward the heart. When these valves are damaged, the blood leaks and pools in the legs and feet. This condition may also be caused by a blockage in a vein from a clot (deep vein thrombosis).
Chronic venous insufficiency is a long-term condition. It occurs because of partial vein blockage or blood leakage around the valves of the veins.
Risk factors for venous insufficiency include:
• History of deep vein thrombosis in the legs
• Age
• Being female (related to levels of the hormone progesterone)
• Being tall
• Genetic factors
• Obesity
• Pregnancy
• Prolonged sitting or standing
Symptoms
• Dull aching, heaviness, or cramping in legs
• Itching and tingling
• Pain that gets worse when standing
• Pain that gets better when legs are raised
• Swelling of the legs
• The tortuous blue vein disease seen running down the leg
• Areas of small red/blue blood vessels in the skin known as spider veins
Treatments
Use compression stockings to decrease chronic swelling.
Avoid long periods of sitting or standing. Even moving your legs slightly will help the blood in your veins return to your heart.
• Aggressive wound care should be taken if any skin breakdown or infection occurs
Endovenous Laser Ablation (EVLT)
EVLT is a minimally invasive procedure where light emission (heat) from a laser fiber beam is used to cauterize, or seal, the inside of the varicose vein wall. This method closes the unhealthy, refluxing vein. EVLT is an alternative to both traditional surgery such as vein stripping. EVLT requires minimal access to the vein.
If you suffer from any of the symptoms above, contact our office for more information on how we can help you to alleviate painful, unsightly varicose veins.
Venous insufficiency involves one or more veins. Valves in the veins usually push the flow of blood toward the heart. When these valves are damaged, the blood leaks and pools in the legs and feet. This condition may also be caused by a blockage in a vein from a clot (deep vein thrombosis).
Chronic venous insufficiency is a long-term condition. It occurs because of partial vein blockage or blood leakage around the valves of the veins.
Risk factors for venous insufficiency include:
• History of deep vein thrombosis in the legs
• Age
• Being female (related to levels of the hormone progesterone)
• Being tall
• Genetic factors
• Obesity
• Pregnancy
• Prolonged sitting or standing
Symptoms
• Dull aching, heaviness, or cramping in legs
• Itching and tingling
• Pain that gets worse when standing
• Pain that gets better when legs are raised
• Swelling of the legs
• The tortuous blue vein disease seen running down the leg
• Areas of small red/blue blood vessels in the skin known as spider veins
Treatments
Use compression stockings to decrease chronic swelling.
Avoid long periods of sitting or standing. Even moving your legs slightly will help the blood in your veins return to your heart.
• Aggressive wound care should be taken if any skin breakdown or infection occurs
Endovenous Laser Ablation (EVLT)
EVLT is a minimally invasive procedure where light emission (heat) from a laser fiber beam is used to cauterize, or seal, the inside of the varicose vein wall. This method closes the unhealthy, refluxing vein. EVLT is an alternative to both traditional surgery such as vein stripping. EVLT requires minimal access to the vein.
If you suffer from any of the symptoms above, contact our office for more information on how we can help you to alleviate painful, unsightly varicose veins.
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