In May 2011, The Food and Drug Administration approved carotid artery stenting for use in standard risk patients. Previously, only patients at high risk for surgery were approved for the procedure. High risk patients are typically older, sicker or have abnormalities of their neck that make it difficult for a surgeon to operate. Dr. William Julien was one of the first endovascular surgeons in the region to perform this procedure.
More than 60% of United States patients are standard risk. Now patients who need carotid revascularization have the option of choosing a minimally invasive endovascular procedure rather than traditional open surgery known as an endarterectomy, which is a major surgical procedure performed under general anesthesia.
During carotid stenting, a tiny incision the size of a pencil head is made in the patient’s groin and the doctor inserts a specially designed guide wire with a filter that is placed beyond the site of the narrowing or blockage in the carotid artery. Once the filter is in place, a small balloon catheter is guided to the area of the blockage. When the balloon is inflated, the fatty plaque or blockage is compressed against the artery walls and the diameter of the blood vessel is widened to increase blood flow. The balloon is removed and a stent is placed inside the artery to widen the opening and support the artery wall. The final step is to remove the filter device along with any particles that may have been trapped during the procedure. The patient typically spends one night in the hospital and is able to resume their normal activities immediately.
Wednesday, September 21, 2011
FDA Approves Carotid Artery Stenting for Standard Risk Patients
South Florida Interventional Radiologist One of First in the Region to Perform Procedure
COCONUT CREEK (August 19, 2001)-Carotid Artery Disease occurs when the major arteries in the neck become narrowed or blocked. “These arteries are the main supplier of blood to the brain; when blocked, they often cause strokes or in some cases, be fatal,” explained William Julien, MD, medical director of South Florida Vascular Associates. Carotid Artery Stenting is a minimally invasive procedure used to re-open the carotid arteries, restoring blood flow and preventing stroke.
In May 2011, The Food and Drug Administration approved Carotid Artery Stenting for use in standard risk patients. Previously, only patients at high risk for surgery were approved for the procedure. High risk patients are typically older, sicker or have abnormalities of their neck that make it difficult for a surgeon to operate.
More than 60% of United States patients are standard risk. Now patients who need carotid revascularization have the option of choosing a minimally invasive procedure rather than traditional open surgery known as an endarterectomy, which is a major surgical procedure performed under general anesthesia. During carotid stenting, a tiny incision the size of a pencil head is made in the patient’s groin and the doctor inserts a specially designed guide wire with a filter that is placed beyond the site of the narrowing or blockage in the carotid artery. Once the filter is in place, a small balloon catheter is guided to the area of the blockage. When the balloon is inflated, the fatty plaque or blockage is compressed against the artery walls and the diameter of the blood vessel is widened to increase blood flow. The balloon is removed and a stent is placed inside the artery to widen the opening and support the artery wall. The final step is to remove the filter device along with any particles that may have been trapped during the procedure. The patient typically spends one night in the hospital and is able to resume their normal activities immediately.
With traditional endarterectomy surgery the patient experiences more pain and must remain in the hospital for several days. The incision also leaves unsightly post operative scars on the neck. The recent FDA approval for carotid stenting is likely to have a significant impact on how many patients are now able to be treated for carotid artery disease.
75-year-old Dent Lackey experienced a 4-hour dizzy spell in April 2011. The Tamarac resident, who plays the bass fiddle for local bands, was encouraged by his family to go to the emergency room. “I felt fine except for the dizziness,” said Lackey. “I had no other symptoms and was not dizzy any other time. If it weren’t for my children, I would not have gone to the hospital.” But he’s sure glad he did. A number of tests revealed he had severe stenosis or plaque build-up in his left carotid artery.
Lackey was referred to Dr. William Julien, an interventional radiologist in Coconut Creek. He was one of the first doctors in South Florida to perform carotid artery stenting in 2004 when it was first approved by the FDA for high-risk patients. Dr. Julien discovered Lackey had 85% blockage of the left carotid artery. This could have led to a severe stroke or been fatal if it was ignored.
Lackey was given the choice of endarterectomy or stenting. Some patients are not candidates for stenting because of anatomical issues such as extreme calcification or unusually curvy vessels. Fortunately for Lackey he was a candidate. During the procedure, Dr. Julien was able to re-establish blood flow to the arteries. “He is currently asymptomatic with no signs or symptoms of stroke. He is doing well on Plavix and aspirin daily,” added Dr. Julien.
Resistant at first to going to the doctor, Lackey is now singing a different tune. “I am so grateful that I was referred to Dr. Julien and that I learned about other options than surgery. I am lucky to be alive.” Just this month, he felt so good Lackey traveled to Ireland for a family vacation and will be able to continue playing his bass fiddle which is his passion and his livelihood.
About South Florida Vascular Associates
Dr.William Julien 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 does much of his own testing and procedures in his new state-of-the-art facility equipped with 3-in-office operating suites. This allows 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 find out more about Dr. Julien and South Florida Vascular Associates call 954-725-4141 or visit www.southfloridvascular.com
COCONUT CREEK (August 19, 2001)-Carotid Artery Disease occurs when the major arteries in the neck become narrowed or blocked. “These arteries are the main supplier of blood to the brain; when blocked, they often cause strokes or in some cases, be fatal,” explained William Julien, MD, medical director of South Florida Vascular Associates. Carotid Artery Stenting is a minimally invasive procedure used to re-open the carotid arteries, restoring blood flow and preventing stroke.
In May 2011, The Food and Drug Administration approved Carotid Artery Stenting for use in standard risk patients. Previously, only patients at high risk for surgery were approved for the procedure. High risk patients are typically older, sicker or have abnormalities of their neck that make it difficult for a surgeon to operate.
More than 60% of United States patients are standard risk. Now patients who need carotid revascularization have the option of choosing a minimally invasive procedure rather than traditional open surgery known as an endarterectomy, which is a major surgical procedure performed under general anesthesia. During carotid stenting, a tiny incision the size of a pencil head is made in the patient’s groin and the doctor inserts a specially designed guide wire with a filter that is placed beyond the site of the narrowing or blockage in the carotid artery. Once the filter is in place, a small balloon catheter is guided to the area of the blockage. When the balloon is inflated, the fatty plaque or blockage is compressed against the artery walls and the diameter of the blood vessel is widened to increase blood flow. The balloon is removed and a stent is placed inside the artery to widen the opening and support the artery wall. The final step is to remove the filter device along with any particles that may have been trapped during the procedure. The patient typically spends one night in the hospital and is able to resume their normal activities immediately.
With traditional endarterectomy surgery the patient experiences more pain and must remain in the hospital for several days. The incision also leaves unsightly post operative scars on the neck. The recent FDA approval for carotid stenting is likely to have a significant impact on how many patients are now able to be treated for carotid artery disease.
75-year-old Dent Lackey experienced a 4-hour dizzy spell in April 2011. The Tamarac resident, who plays the bass fiddle for local bands, was encouraged by his family to go to the emergency room. “I felt fine except for the dizziness,” said Lackey. “I had no other symptoms and was not dizzy any other time. If it weren’t for my children, I would not have gone to the hospital.” But he’s sure glad he did. A number of tests revealed he had severe stenosis or plaque build-up in his left carotid artery.
Lackey was referred to Dr. William Julien, an interventional radiologist in Coconut Creek. He was one of the first doctors in South Florida to perform carotid artery stenting in 2004 when it was first approved by the FDA for high-risk patients. Dr. Julien discovered Lackey had 85% blockage of the left carotid artery. This could have led to a severe stroke or been fatal if it was ignored.
Lackey was given the choice of endarterectomy or stenting. Some patients are not candidates for stenting because of anatomical issues such as extreme calcification or unusually curvy vessels. Fortunately for Lackey he was a candidate. During the procedure, Dr. Julien was able to re-establish blood flow to the arteries. “He is currently asymptomatic with no signs or symptoms of stroke. He is doing well on Plavix and aspirin daily,” added Dr. Julien.
Resistant at first to going to the doctor, Lackey is now singing a different tune. “I am so grateful that I was referred to Dr. Julien and that I learned about other options than surgery. I am lucky to be alive.” Just this month, he felt so good Lackey traveled to Ireland for a family vacation and will be able to continue playing his bass fiddle which is his passion and his livelihood.
About South Florida Vascular Associates
Dr.William Julien 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 does much of his own testing and procedures in his new state-of-the-art facility equipped with 3-in-office operating suites. This allows 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 find out more about Dr. Julien and South Florida Vascular Associates call 954-725-4141 or visit www.southfloridvascular.com
Thursday, September 15, 2011
Carotid Artery Stenting
The Boynton Times
Local Surgeon Implants New Minimally Invasive Carotid Stent Device and Saves One Man's Life
Boynton Beach, FL. By the time Joseph Camiso was 73, he already had a six-vessel coronary bypass surgery. He had also undergone carotid artery surgery, called endartectomy, which is performed for patients whose carotid arteries have narrowed because of cholesterol buildup. The threat of stroke caused by clogged carotid arteries is not uncommon.
The endartectomy created a large scar on the left side of his neck, but more concerning was that the nerve supplying the left vocal cord was damaged leaving that side of his throat paralyzed.
“I sounded like a character from ‘The Godfather,’” said Mr. Comiso.
Unfortunately, his carotid artery on the right side was also dangerously narrowed and needed to be opened to prevent a stroke. Mr. Comiso and his wife, Marie, then visited an ear, nose, and throat specialist to discuss having an endartectomy for the right carotid artery, but the specialist told them that it was too dangerous. If the nerve supplying the right vocal cord was damaged from the incision, he would be unable to speak or breathe and an emergency tracheotomy tube would be needed.
“My doctor thought that I was too high risk to have another surgery because of the vocal cord paralysis,” he said.
Traditional carotid artery surgery can pose complications in healthier patients as well, including strokes and heart attacks. For Mr. Comiso, the traditional surgery would have been dangerous and likely impossible.
The Comisos then visited their neurologist who referred them to Dr. William Julien, a Board Certified Interventional Radiologist who practices full time endovascular surgery in Margate, FL.
“We were buying against time,” said Mrs. Comiso.
Dr. Julien enrolled Mr. Comiso into an FDA-approved carotid stent research trial for patients who are considered high risk for traditional carotid endartectomy surgery. The procedure offers a life-saving alternative for these patients and was sponsored by Boston Scientific Corporation. Only 780 people were enrolled, and Mr. Comiso was one of them. Since his left vocal cord was already paralyzed, his physicians determined that traditional surgery was too high a risk. Losing control of both sides of his vocal cords could have led to an emergency tracheotomy.
Carotid stenting is a minimally invasive procedure performed by inserting a catheter in the femoral artery passing it through the blood system and up into the carotid artery using X-ray guidance to navigate through the bloodstream. A novel filter device which looks like a tiny butterfly net is first inserted and positioned in the carotid artery downstream from the narrowing. The filter captures any particles that are inadvertently dislodged during the procedure while maintaing blood flow to the brain. An angioplasty balloon then expands the carotid narrowing followed by placement a tubular metal mesh called a stent. This stent acts as a scaffolding to hold the artery open. The final step is removing the filter along with any debris that was trapped during the procedure.
"I feel great. My voice is much better," said Mr. Comiso. "Dr. Julien was wonderful. This procedure not only saved my life but gave me my voice back. I am happy to share my story with others because it may save more lives. Patients and doctors need to know that this is available."
"Mr. Comiso was a delight to work with, and it was gratifying to use this new technology for his serious situation. Since the carotid stent procedure avoids any neck incisions, there is zero risk of vocal cord paralysis," said Dr. Julien. "My practice philosophy is to offer each patient the latest and best technologies, procedures, and medications currently available. Clearly, we were able to accomplish that here."
Dr. Julien emphasizes the importance of patient education and clear explanations on the details of a diagnosis, including short and long-term treatment plans, alternative treatment, and precisely what each patient should expect to experience. His practice has been highlighted as a model for the next generation of Interventional Radiology Practices.
The Guidant Corporation received the first FDA approval for a carotid stent platform on August 31, 2004 and Dr. Julien was the first South Florida physician to implant the newly approved device. The Boston Scientific device that Mr. Comiso had implanted as part of the research trial is expected to be FDA approved third quarter 2005. Dr. Julien's practice will serve as one of a few physician training sites. One of the innovative techniques used during the training will be the use of a sophisticated simulator that allows surgeons to practice on a dummy rather than a real patient.
“We think simulator training will become an important tool in training surgeons performing technically demanding and risky procedures such as carotid stenting,” said Dr. Julien.
For more information, visit www.southfloridavascular.com.
Local Surgeon Implants New Minimally Invasive Carotid Stent Device and Saves One Man's Life
Boynton Beach, FL. By the time Joseph Camiso was 73, he already had a six-vessel coronary bypass surgery. He had also undergone carotid artery surgery, called endartectomy, which is performed for patients whose carotid arteries have narrowed because of cholesterol buildup. The threat of stroke caused by clogged carotid arteries is not uncommon.
The endartectomy created a large scar on the left side of his neck, but more concerning was that the nerve supplying the left vocal cord was damaged leaving that side of his throat paralyzed.
“I sounded like a character from ‘The Godfather,’” said Mr. Comiso.
Unfortunately, his carotid artery on the right side was also dangerously narrowed and needed to be opened to prevent a stroke. Mr. Comiso and his wife, Marie, then visited an ear, nose, and throat specialist to discuss having an endartectomy for the right carotid artery, but the specialist told them that it was too dangerous. If the nerve supplying the right vocal cord was damaged from the incision, he would be unable to speak or breathe and an emergency tracheotomy tube would be needed.
“My doctor thought that I was too high risk to have another surgery because of the vocal cord paralysis,” he said.
Traditional carotid artery surgery can pose complications in healthier patients as well, including strokes and heart attacks. For Mr. Comiso, the traditional surgery would have been dangerous and likely impossible.
The Comisos then visited their neurologist who referred them to Dr. William Julien, a Board Certified Interventional Radiologist who practices full time endovascular surgery in Margate, FL.
“We were buying against time,” said Mrs. Comiso.
Dr. Julien enrolled Mr. Comiso into an FDA-approved carotid stent research trial for patients who are considered high risk for traditional carotid endartectomy surgery. The procedure offers a life-saving alternative for these patients and was sponsored by Boston Scientific Corporation. Only 780 people were enrolled, and Mr. Comiso was one of them. Since his left vocal cord was already paralyzed, his physicians determined that traditional surgery was too high a risk. Losing control of both sides of his vocal cords could have led to an emergency tracheotomy.
Carotid stenting is a minimally invasive procedure performed by inserting a catheter in the femoral artery passing it through the blood system and up into the carotid artery using X-ray guidance to navigate through the bloodstream. A novel filter device which looks like a tiny butterfly net is first inserted and positioned in the carotid artery downstream from the narrowing. The filter captures any particles that are inadvertently dislodged during the procedure while maintaing blood flow to the brain. An angioplasty balloon then expands the carotid narrowing followed by placement a tubular metal mesh called a stent. This stent acts as a scaffolding to hold the artery open. The final step is removing the filter along with any debris that was trapped during the procedure.
"I feel great. My voice is much better," said Mr. Comiso. "Dr. Julien was wonderful. This procedure not only saved my life but gave me my voice back. I am happy to share my story with others because it may save more lives. Patients and doctors need to know that this is available."
"Mr. Comiso was a delight to work with, and it was gratifying to use this new technology for his serious situation. Since the carotid stent procedure avoids any neck incisions, there is zero risk of vocal cord paralysis," said Dr. Julien. "My practice philosophy is to offer each patient the latest and best technologies, procedures, and medications currently available. Clearly, we were able to accomplish that here."
Dr. Julien emphasizes the importance of patient education and clear explanations on the details of a diagnosis, including short and long-term treatment plans, alternative treatment, and precisely what each patient should expect to experience. His practice has been highlighted as a model for the next generation of Interventional Radiology Practices.
The Guidant Corporation received the first FDA approval for a carotid stent platform on August 31, 2004 and Dr. Julien was the first South Florida physician to implant the newly approved device. The Boston Scientific device that Mr. Comiso had implanted as part of the research trial is expected to be FDA approved third quarter 2005. Dr. Julien's practice will serve as one of a few physician training sites. One of the innovative techniques used during the training will be the use of a sophisticated simulator that allows surgeons to practice on a dummy rather than a real patient.
“We think simulator training will become an important tool in training surgeons performing technically demanding and risky procedures such as carotid stenting,” said Dr. Julien.
For more information, visit www.southfloridavascular.com.
Arteriosclerosis
The Boynton Times
There is a light
I always talk about modern technology and the miracles performed daily. I recently received a story telling about a miracle and a light at the end of the tunnel.
This is a story about a medical breakthrough procedure called CryoPlasty, a frozen balloon angioplasty, which is benefiting many people with bad circulation and immobility.
The living proof of this story is about an 87-year old woman who is now living a normal life because of this procedure.
Jeanette Shorr was an extremely active 87-year old woman. One of her favorite activities as to walk the malls and shop as part of her daily routine. She walked for hours on end with a group of friends while they socialized; they also exercised at the same time.
Two months ago while engaging in her activity, Jeanette noticed she was unable to walk for any length without having to stop to catch her breath. She also experienced extreme pain in her left leg when this happened. After resting for a few minutes, she resumed walking. This was coming a very common occurrence and was getting worse. She noticed her quality of life was diminishing.
One day while engaging in her routine, her knee buckled and gave out completely. She knew that this was a problem needing medical advice immediately.
She asked around and was told there was a new procedure being done by Dr. William Julien, an Interventional Radiologist in Margate, Florida. He is the first physician in Broward County to perform the procedure. She sought him out and became his patient.
She was diagnosed with arteriosclerosis, namely a build-up of plaque in the arteries. With the new medical breakthrough, CryoPlasty, (a frozen balloon angioplasty,) her life was given back.
It is the only procedure to treat this type of problem. The build-up of plaque in the arteries is extremely treacherous, especially in the knee. Conventional angioplasty would not have worked in this part of the body.
The result of not using this procedure could have been the cause of a life threatening complication. Without it this lady would have to alter her lifestyle dramatically and would have been debilitated in movement and quality of life. She had to have the surgery.
Shortly after being operated, she returned to her busy, active lifestyle with her friends once more. She no longer had worries of falling or becoming incapacitated. She is very grateful to her doctor and for being about to live a much more complete life.
"Mr. Comiso was a delight to work with, and it was gratifying to use this new technology for his serious situation. Since the carotid stent procedure avoids any neck incisions, there is zero risk of vocal cord paralysis," said Dr. Julien. "My practice philosophy is to offer each patient the latest and best technologies, procedures, and medications currently available. Clearly, we were able to accomplish that here."
We never stop to think what our lives would be like if we were not able to be mobile. Jeanette was helped because of this breakthrough and procedure.
Her mind is now at ease and she is living a pain free, happy life enjoying what she likes doing best.
Stories like this are very enlightening and when I am sent something I feel can give my readers hope; I enjoy putting it in to the paper. Thank you for sharing your story with us and I hope it is an inspiration to others suffering from the same problem.
Modern medicine never stops finding new possibilities in so many areas thus creating a success story, as the one above.
A short while ago, I wrote on Hope, and the above is exactly what I was talking about. We must never feel that anything is so fatal that the result seems hopeless, you never know!
There is a light
I always talk about modern technology and the miracles performed daily. I recently received a story telling about a miracle and a light at the end of the tunnel.
This is a story about a medical breakthrough procedure called CryoPlasty, a frozen balloon angioplasty, which is benefiting many people with bad circulation and immobility.
The living proof of this story is about an 87-year old woman who is now living a normal life because of this procedure.
Jeanette Shorr was an extremely active 87-year old woman. One of her favorite activities as to walk the malls and shop as part of her daily routine. She walked for hours on end with a group of friends while they socialized; they also exercised at the same time.
Two months ago while engaging in her activity, Jeanette noticed she was unable to walk for any length without having to stop to catch her breath. She also experienced extreme pain in her left leg when this happened. After resting for a few minutes, she resumed walking. This was coming a very common occurrence and was getting worse. She noticed her quality of life was diminishing.
One day while engaging in her routine, her knee buckled and gave out completely. She knew that this was a problem needing medical advice immediately.
She asked around and was told there was a new procedure being done by Dr. William Julien, an Interventional Radiologist in Margate, Florida. He is the first physician in Broward County to perform the procedure. She sought him out and became his patient.
She was diagnosed with arteriosclerosis, namely a build-up of plaque in the arteries. With the new medical breakthrough, CryoPlasty, (a frozen balloon angioplasty,) her life was given back.
It is the only procedure to treat this type of problem. The build-up of plaque in the arteries is extremely treacherous, especially in the knee. Conventional angioplasty would not have worked in this part of the body.
The result of not using this procedure could have been the cause of a life threatening complication. Without it this lady would have to alter her lifestyle dramatically and would have been debilitated in movement and quality of life. She had to have the surgery.
Shortly after being operated, she returned to her busy, active lifestyle with her friends once more. She no longer had worries of falling or becoming incapacitated. She is very grateful to her doctor and for being about to live a much more complete life.
"Mr. Comiso was a delight to work with, and it was gratifying to use this new technology for his serious situation. Since the carotid stent procedure avoids any neck incisions, there is zero risk of vocal cord paralysis," said Dr. Julien. "My practice philosophy is to offer each patient the latest and best technologies, procedures, and medications currently available. Clearly, we were able to accomplish that here."
We never stop to think what our lives would be like if we were not able to be mobile. Jeanette was helped because of this breakthrough and procedure.
Her mind is now at ease and she is living a pain free, happy life enjoying what she likes doing best.
Stories like this are very enlightening and when I am sent something I feel can give my readers hope; I enjoy putting it in to the paper. Thank you for sharing your story with us and I hope it is an inspiration to others suffering from the same problem.
Modern medicine never stops finding new possibilities in so many areas thus creating a success story, as the one above.
A short while ago, I wrote on Hope, and the above is exactly what I was talking about. We must never feel that anything is so fatal that the result seems hopeless, you never know!
Uterine Fibroid Embolization
The South Florida Sun Sentinel
Non-invasive Treatment Helps New Mom In Trouble. Doctor Uses Rare Procedure to stop Bleeding, Save Uterus
Venus Tenerife couldn't wait to thank Dr. William Julien for her first Mother's Day with her husband and new baby. She almost didn't make it.
"I really didn't get a chance to talk to him the first time I saw him and thank him for all he did for me," said Tenerife, 34. "I definitely owe him a lot."
After 11 hours in labor on Easter Sunday, the Coconut Creek woman delivered a healthy 71/2-pound son, Justin Thomas, at Northwest Regional Medical Center in Margate.
But then she had complications -- life-threatening bleeding from her uterus.
"I was really scared when they told me what was happening," she said. "I could see all the commotion that was happening around me. I realized it could be serious and I could lose my uterus."
As time passed and the bleeding didn't stop, her obstetrician Dr. Tara Solomon was faced with two choices, begin a hysterectomy to remove the damaged uterus or call for a rare procedure that could stop the bleeding and save the uterus without Tenerife having to go through surgery.
The minimally invasive procedure, called uterine artery embolization, seals off the blood flow with a jellylike substance thinned to a slurry that's delivered into the bleeding artery inside the uterus by a tiny catheter. The substance eventually disappears.
Solomon called in Dr. Julien, an interventional radiologist, who alerted his team and rushed to the hospital. He has an endovascular surgery practice, the South Florida Vascular Associates, with offices adjacent to Northwest Medical Center.
"The procedure is rare. We probably only get one or two calls like this a year," Julien said. "When the call comes, you have to arrive with your game face on and ready to go. It's an emergency situation, like a fire drill, where the patient is in danger of dying.
"This is a case where you have got to get moving faster than almost any other situation. You are worried about the patient, the mother of a brand-new baby who potentially may not be around. It's pretty scary for a baby not having its mother."
By the time Julien arrived, Tenerife was in trouble.
"Her blood pressure had dropped, they were giving her transfusions, and they were thinking they might have to start the hysterectomy."
In a specially equipped operating room in the hospital, Julien used imaging equipment to steer the catheter through a tiny incision where the material was injected, and the bleeding was stopped.
For Tenerife, a physical therapist at Woodlake Nursing Rehabilitation Home in West Palm Beach, all Mother's Days from now on will be special.
"I feel very grateful. I am so lucky to have another chance to have a baby," Tenerife said. "I feel so great and thankful for everything they did to save me."
The next day, when Julien made his rounds and saw Tenerife and baby Justin, he said he was nervous until he saw for himself that the procedure was effective.
"It's always a scary period until you see the results. It's most gratifying to see a mom caressing her baby as she was, " he said."I can't express the words right now," Tenerife said, "but telling the doctor is really something that is easy and I have to do."
Non-invasive Treatment Helps New Mom In Trouble. Doctor Uses Rare Procedure to stop Bleeding, Save Uterus
Venus Tenerife couldn't wait to thank Dr. William Julien for her first Mother's Day with her husband and new baby. She almost didn't make it.
"I really didn't get a chance to talk to him the first time I saw him and thank him for all he did for me," said Tenerife, 34. "I definitely owe him a lot."
After 11 hours in labor on Easter Sunday, the Coconut Creek woman delivered a healthy 71/2-pound son, Justin Thomas, at Northwest Regional Medical Center in Margate.
But then she had complications -- life-threatening bleeding from her uterus.
"I was really scared when they told me what was happening," she said. "I could see all the commotion that was happening around me. I realized it could be serious and I could lose my uterus."
As time passed and the bleeding didn't stop, her obstetrician Dr. Tara Solomon was faced with two choices, begin a hysterectomy to remove the damaged uterus or call for a rare procedure that could stop the bleeding and save the uterus without Tenerife having to go through surgery.
The minimally invasive procedure, called uterine artery embolization, seals off the blood flow with a jellylike substance thinned to a slurry that's delivered into the bleeding artery inside the uterus by a tiny catheter. The substance eventually disappears.
Solomon called in Dr. Julien, an interventional radiologist, who alerted his team and rushed to the hospital. He has an endovascular surgery practice, the South Florida Vascular Associates, with offices adjacent to Northwest Medical Center.
"The procedure is rare. We probably only get one or two calls like this a year," Julien said. "When the call comes, you have to arrive with your game face on and ready to go. It's an emergency situation, like a fire drill, where the patient is in danger of dying.
"This is a case where you have got to get moving faster than almost any other situation. You are worried about the patient, the mother of a brand-new baby who potentially may not be around. It's pretty scary for a baby not having its mother."
By the time Julien arrived, Tenerife was in trouble.
"Her blood pressure had dropped, they were giving her transfusions, and they were thinking they might have to start the hysterectomy."
In a specially equipped operating room in the hospital, Julien used imaging equipment to steer the catheter through a tiny incision where the material was injected, and the bleeding was stopped.
For Tenerife, a physical therapist at Woodlake Nursing Rehabilitation Home in West Palm Beach, all Mother's Days from now on will be special.
"I feel very grateful. I am so lucky to have another chance to have a baby," Tenerife said. "I feel so great and thankful for everything they did to save me."
The next day, when Julien made his rounds and saw Tenerife and baby Justin, he said he was nervous until he saw for himself that the procedure was effective.
"It's always a scary period until you see the results. It's most gratifying to see a mom caressing her baby as she was, " he said."I can't express the words right now," Tenerife said, "but telling the doctor is really something that is easy and I have to do."
Dr. Julien Honored as a Top Physician in South Florida
South Florida Hospital News
Dr. William Julien is a board certified interventional radiologist with a full time endovascular practice. Dr. Julien places a strong emphasis on the importance of patient education offering his patients clear explanations on the details of a diagnosis, treatment plans, alternative treatment, and precisely what each patient should expect to experience. His practice is unique in that, unlike most interventional radiologists, Dr. Julien sees his own patients and treats many of them right in his office in a sophisticated endovascular surgery suite – one of the first of its kind in the country. His practice has been highlighted as a model for the next generation of Interventional Radiology Practices.
Currently, Dr. Julien is the President of South Florida Vascular Associates. He is also on staff at Northwest Medical Center. Some of Dr. Julien's past and present achievements are that he has been Director of Interventional Radiology at Florida United Radiology, as well as Chief of Interventional Radiology at a 3 hospital system here in South Florida. Dr. Julien has been principal investigator for several device trials for medical break-through procedures including carotid artery stenting. Because his skills are so specialized, Dr. Julien has frequently been asked to speak at national endovascular meetings and has also had the privilege of training many physicians on cutting-edge minimally invasive procedures. Dr. Julien is on the advisory boards of Boston Scientific and Medcomp.
He is a fellow of the Society of Cardiovascular and Interventional Radiology as well as Council for Cardiovascular Radiology at the American Heart Association.
Dr. Julien was one of the original researchers of Carotid Artery Stenting and was the first South Florida physician to implant the newly approved filter device upon its post-market approval.
Recently, Dr. Julien became the first doctor in South Florida to use a new FDA approved vessel closure system, StarClose™ This device closes the artery securely in a matter of seconds following diagnostic catheterization procedures such as those used to diagnose coronary artery disease. StarClose™ has the potential to change the current standard of vessel closure, which is manual compression. It is in the patient's and physician's best interest to close the femoral artery as securely, quickly and cleanly as possible to reduce complications, as well as allow patients to get up and walk around sooner.
Dr. Julien has also recently become one of the first doctors to implant a new wireless device during an endograft procedure for tracking aneurysm pressure called EndoSure™. This is the first time doctors can implant something in a patient that can send information without the use of batteries or a power source.
Because it is inside the body, the sensor gives doctors information they have never had before.
Dr. William Julien is a board certified interventional radiologist with a full time endovascular practice. Dr. Julien places a strong emphasis on the importance of patient education offering his patients clear explanations on the details of a diagnosis, treatment plans, alternative treatment, and precisely what each patient should expect to experience. His practice is unique in that, unlike most interventional radiologists, Dr. Julien sees his own patients and treats many of them right in his office in a sophisticated endovascular surgery suite – one of the first of its kind in the country. His practice has been highlighted as a model for the next generation of Interventional Radiology Practices.
Currently, Dr. Julien is the President of South Florida Vascular Associates. He is also on staff at Northwest Medical Center. Some of Dr. Julien's past and present achievements are that he has been Director of Interventional Radiology at Florida United Radiology, as well as Chief of Interventional Radiology at a 3 hospital system here in South Florida. Dr. Julien has been principal investigator for several device trials for medical break-through procedures including carotid artery stenting. Because his skills are so specialized, Dr. Julien has frequently been asked to speak at national endovascular meetings and has also had the privilege of training many physicians on cutting-edge minimally invasive procedures. Dr. Julien is on the advisory boards of Boston Scientific and Medcomp.
He is a fellow of the Society of Cardiovascular and Interventional Radiology as well as Council for Cardiovascular Radiology at the American Heart Association.
Dr. Julien was one of the original researchers of Carotid Artery Stenting and was the first South Florida physician to implant the newly approved filter device upon its post-market approval.
Recently, Dr. Julien became the first doctor in South Florida to use a new FDA approved vessel closure system, StarClose™ This device closes the artery securely in a matter of seconds following diagnostic catheterization procedures such as those used to diagnose coronary artery disease. StarClose™ has the potential to change the current standard of vessel closure, which is manual compression. It is in the patient's and physician's best interest to close the femoral artery as securely, quickly and cleanly as possible to reduce complications, as well as allow patients to get up and walk around sooner.
Dr. Julien has also recently become one of the first doctors to implant a new wireless device during an endograft procedure for tracking aneurysm pressure called EndoSure™. This is the first time doctors can implant something in a patient that can send information without the use of batteries or a power source.
Because it is inside the body, the sensor gives doctors information they have never had before.
Minimally Invasive Procedures
By Gail M. Lassner - The Parklander
Painless new medical procedures make traditional surgery a thing of the past
A new and exciting trend in medicine offering minimally invasive surgical procedures has given local resident Franey Way the opportunity to ring in the New Year with a renewed sense of optimism.
It’s difficult to imagine her frustration when Way was told that she was considered too high-risk to undergo necessary surgery after being diagnosed with severe carotid artery stenosis. This disease is characterized as a build-up of plaque in the carotid artery which is the artery that supplies blood to the brain and when left untreated often results in a stroke.
Her frustration was soon replaced with an overwhelming sense of hope, as well as relief when she was introduced to Parkland resident Dr. William Julien, a Board-Certified Interventional Radiologist who practices full-time endovascular surgery in Margate. Dr. Julien told Way that she was a candidate for a new FDA approved minimally invasive life-saving procedure called Carotid Stenting. This procedure involves puncturing the femoral artery in the groin. Under x-ray guidance, a catheter device is then threaded through the blood stream into the carotid artery and then an angioplasty balloon and stent are inserted to hold the artery open.
Also employed is a novel technology involving the insertion of a filter device which stays in place during the procedure that catches particles which are often inadvertently dislodged during angioplasty, thereby minimizing the possibility of any complications which could occur during the surgery. Following her surgery, like so many others treated by Dr. Julien, Way is fully recovered after having undergone the hour long painless procedure. “Now I can enjoy my life,” she said gratefully.
Julien, on staff at Northwest Medical Center, was one of the original researchers of Carotid Stenting and was the first South Florida physician to implant the newly approved filter device. Presently, medicare coverage for this procedure is limited to patients like Way, who are considered too high-risk for traditional carotid endartectomy surgery. Dr. Julien sees this changing in the future. “I think ten years from now pretty much everyone will have carotid stenting procedures and very few people will have open surgery,” he said.
His practice is unique in that, unlike most interventional radiologists, Dr. Julien sees his own patients and treats many of them right in his office in a sophisticated endovascular surgery suite – one of the first of its kind in the country. He now performs minimally invasive varicose vein surgeries right in his office using local anesthesia. Traditionally, patients would have undergone surgery in the hospital under general anesthesia. The new procedure involves the use of an endoluminal laser guided by ultrasound which enters through the blood stream to close the abnormal vein. Patient's can immediately resume their non exertional activities.
Another new trend as we approach the New Year is a relief for the approximately 13 million American women who suffer from uterine fibroids. A new minimally invasive treatment option called Uterine Fibroid Embolization offers an alternative to having a hysterectomy. The procedure is performed with local anesthesia, again using interventional radiology catheter techniques rather than traditional surgery to destroy the blood supply to the fibroid tumors. As more women become aware of the availability of this procedure, Dr. Julien is confident that more will seek this new treatment option.
There are many benefits to minimally invasive endovascular surgery, according to Dr. Julien. Two-thirds of the surgeries are done right in his office, and procedures performed in the hospital are usually outpatient or sometimes a one night stay Also, because patients undergo local anesthesia, the surgeries are not painful and the risks associated with general anesthesia are eliminated. Additionally, these types of surgeries offer a significant savings to the health care system, especially since there is such a quick recovery time. Dr. Julien stresses that consumer awareness is critical. “Whoever performs endovascular surgery must be well trained and have a lot of experience,” he said. “Consumers should ask a lot of questions.” For more information visit www.southfloridavascular.com.
Painless new medical procedures make traditional surgery a thing of the past
A new and exciting trend in medicine offering minimally invasive surgical procedures has given local resident Franey Way the opportunity to ring in the New Year with a renewed sense of optimism.
It’s difficult to imagine her frustration when Way was told that she was considered too high-risk to undergo necessary surgery after being diagnosed with severe carotid artery stenosis. This disease is characterized as a build-up of plaque in the carotid artery which is the artery that supplies blood to the brain and when left untreated often results in a stroke.
Her frustration was soon replaced with an overwhelming sense of hope, as well as relief when she was introduced to Parkland resident Dr. William Julien, a Board-Certified Interventional Radiologist who practices full-time endovascular surgery in Margate. Dr. Julien told Way that she was a candidate for a new FDA approved minimally invasive life-saving procedure called Carotid Stenting. This procedure involves puncturing the femoral artery in the groin. Under x-ray guidance, a catheter device is then threaded through the blood stream into the carotid artery and then an angioplasty balloon and stent are inserted to hold the artery open.
Also employed is a novel technology involving the insertion of a filter device which stays in place during the procedure that catches particles which are often inadvertently dislodged during angioplasty, thereby minimizing the possibility of any complications which could occur during the surgery. Following her surgery, like so many others treated by Dr. Julien, Way is fully recovered after having undergone the hour long painless procedure. “Now I can enjoy my life,” she said gratefully.
Julien, on staff at Northwest Medical Center, was one of the original researchers of Carotid Stenting and was the first South Florida physician to implant the newly approved filter device. Presently, medicare coverage for this procedure is limited to patients like Way, who are considered too high-risk for traditional carotid endartectomy surgery. Dr. Julien sees this changing in the future. “I think ten years from now pretty much everyone will have carotid stenting procedures and very few people will have open surgery,” he said.
His practice is unique in that, unlike most interventional radiologists, Dr. Julien sees his own patients and treats many of them right in his office in a sophisticated endovascular surgery suite – one of the first of its kind in the country. He now performs minimally invasive varicose vein surgeries right in his office using local anesthesia. Traditionally, patients would have undergone surgery in the hospital under general anesthesia. The new procedure involves the use of an endoluminal laser guided by ultrasound which enters through the blood stream to close the abnormal vein. Patient's can immediately resume their non exertional activities.
Another new trend as we approach the New Year is a relief for the approximately 13 million American women who suffer from uterine fibroids. A new minimally invasive treatment option called Uterine Fibroid Embolization offers an alternative to having a hysterectomy. The procedure is performed with local anesthesia, again using interventional radiology catheter techniques rather than traditional surgery to destroy the blood supply to the fibroid tumors. As more women become aware of the availability of this procedure, Dr. Julien is confident that more will seek this new treatment option.
There are many benefits to minimally invasive endovascular surgery, according to Dr. Julien. Two-thirds of the surgeries are done right in his office, and procedures performed in the hospital are usually outpatient or sometimes a one night stay Also, because patients undergo local anesthesia, the surgeries are not painful and the risks associated with general anesthesia are eliminated. Additionally, these types of surgeries offer a significant savings to the health care system, especially since there is such a quick recovery time. Dr. Julien stresses that consumer awareness is critical. “Whoever performs endovascular surgery must be well trained and have a lot of experience,” he said. “Consumers should ask a lot of questions.” For more information visit www.southfloridavascular.com.
Carotid Artery Stenting
Boca Raton News
Local Resident Able to Enjoy Life After New Medical Procedure
Franey Way wasn’t able to garden and tend her flowers outside her Boca Raton home any more.
In fact, she wasn’t able to do much of any of the things she used to enjoy like cooking her favorite meals or making a trip to the local grocery store, after having a series of alarming episodes where her right hand and foot would become numb.
“I discovered it was very difficult to walk and at times I became uncoordinated,” said Way.
After urging from her daughter, the local resident went to the hospital to get checked out.
“I went to the Boca Raton Community Hospital. They admitted me right away, observed me and took tests. After a few days, they diagnosed me with severe carotid artery disease in my neck. It affects the blood supply to you brain, which is why I was having little episodes, which were actually tiny strokes called TIA’s. They told me surgery was too risky for me because of my medical history and that my blockage wasn’t severe enough to take that risk.
So, they sent me home with medication treatment,” said Way.
But the numbness and difficulty to walk started to become worse and more frequent for the 79-year-old resident.
“It was a feeling of clumsiness and lack of coordination. It was getting worse and more frequent,” said Way, who then decided to go to her family doctor, Matthew Pinto.
Since Way was at too-high risk for surgery Dr. Pinto referred her to Dr. William Julien, a Board Certified Interventional Radiologist who practices full-time endovascular surgery in Margate.
“The first time I walked into the examination room, I didn’t feel intimidated by him. He was like an old friend walking into the room,” said Way.
Julien checked out his new patient and thought she would be a perfect candidate for an FDA approved carotid stent research procedure since she was considered too-high risk for traditional carotid endartectomy surgery. The procedure offers a life-saving alternative for these types of patients, according to Julien.
Carotid Stenting is a minimally invasive procedure performed by inserting a catheter in the femoral artery passing it through the blood system and up into the carotid artery using X-ray guidance to navigate through the bloodstream. Then, a novel filter device which looks like a tiny butterfly net is first inserted and positioned in the carotid artery downstream from the narrowing. The filter captures any particles that are inadvertently dislodged during the procedure while maintaining blood flow to the brain.
Next, an angioplasty balloon expands the carotid narrowing followed by placement of a tubular metal mesh called a stent, which acts as a scaffolding to hold the artery open. The final step is removing the filter along with any debris that was trapped during the procedure.
“Franey’s a high risk patient, too-high risk for surgery and gets relegated to a category where no one wants to touch her. Her right carotid artery was closed off because of radiation damage because of that, blood flow to the brain was coming from the left artery and supplying both. The stroked would have been more devastating,” said Dr. Julien, an endovascular surgeon at North West Medical Center, who was involved in the national research trials for the procedure and was the first South Florida physician to implant the newly approved filter device.
Julien’s practice will serve as one of a few training sites, for other physicians who would like to learn how to administer the procedure where patients do not have to be put under anesthiea.
Way said the procedure was painless and took only about an hour and she has fully recovered. Way said now she can enjoy her life.
“Before I didn’t go shopping or I couldn’t have been gardening or out there watching my butterflies. Most of the time I was sure I was gong to fall,” said Way. “Now, all the symptoms are gone. I do my laundry. I do my cooking and I manage the house. I have no more episodes of numbness.”
Way said she encourages others diagnosed with same illness never to give up hope.
“Never give up. Keep looking for a solution and be open to change. Medicine is always changing. What we’ve done for years isn’t always what we should keep on doing,” said Way. For more Information, www.southfloridavascular.com.
Local Resident Able to Enjoy Life After New Medical Procedure
Franey Way wasn’t able to garden and tend her flowers outside her Boca Raton home any more.
In fact, she wasn’t able to do much of any of the things she used to enjoy like cooking her favorite meals or making a trip to the local grocery store, after having a series of alarming episodes where her right hand and foot would become numb.
“I discovered it was very difficult to walk and at times I became uncoordinated,” said Way.
After urging from her daughter, the local resident went to the hospital to get checked out.
“I went to the Boca Raton Community Hospital. They admitted me right away, observed me and took tests. After a few days, they diagnosed me with severe carotid artery disease in my neck. It affects the blood supply to you brain, which is why I was having little episodes, which were actually tiny strokes called TIA’s. They told me surgery was too risky for me because of my medical history and that my blockage wasn’t severe enough to take that risk.
So, they sent me home with medication treatment,” said Way.
But the numbness and difficulty to walk started to become worse and more frequent for the 79-year-old resident.
“It was a feeling of clumsiness and lack of coordination. It was getting worse and more frequent,” said Way, who then decided to go to her family doctor, Matthew Pinto.
Since Way was at too-high risk for surgery Dr. Pinto referred her to Dr. William Julien, a Board Certified Interventional Radiologist who practices full-time endovascular surgery in Margate.
“The first time I walked into the examination room, I didn’t feel intimidated by him. He was like an old friend walking into the room,” said Way.
Julien checked out his new patient and thought she would be a perfect candidate for an FDA approved carotid stent research procedure since she was considered too-high risk for traditional carotid endartectomy surgery. The procedure offers a life-saving alternative for these types of patients, according to Julien.
Carotid Stenting is a minimally invasive procedure performed by inserting a catheter in the femoral artery passing it through the blood system and up into the carotid artery using X-ray guidance to navigate through the bloodstream. Then, a novel filter device which looks like a tiny butterfly net is first inserted and positioned in the carotid artery downstream from the narrowing. The filter captures any particles that are inadvertently dislodged during the procedure while maintaining blood flow to the brain.
Next, an angioplasty balloon expands the carotid narrowing followed by placement of a tubular metal mesh called a stent, which acts as a scaffolding to hold the artery open. The final step is removing the filter along with any debris that was trapped during the procedure.
“Franey’s a high risk patient, too-high risk for surgery and gets relegated to a category where no one wants to touch her. Her right carotid artery was closed off because of radiation damage because of that, blood flow to the brain was coming from the left artery and supplying both. The stroked would have been more devastating,” said Dr. Julien, an endovascular surgeon at North West Medical Center, who was involved in the national research trials for the procedure and was the first South Florida physician to implant the newly approved filter device.
Julien’s practice will serve as one of a few training sites, for other physicians who would like to learn how to administer the procedure where patients do not have to be put under anesthiea.
Way said the procedure was painless and took only about an hour and she has fully recovered. Way said now she can enjoy her life.
“Before I didn’t go shopping or I couldn’t have been gardening or out there watching my butterflies. Most of the time I was sure I was gong to fall,” said Way. “Now, all the symptoms are gone. I do my laundry. I do my cooking and I manage the house. I have no more episodes of numbness.”
Way said she encourages others diagnosed with same illness never to give up hope.
“Never give up. Keep looking for a solution and be open to change. Medicine is always changing. What we’ve done for years isn’t always what we should keep on doing,” said Way. For more Information, www.southfloridavascular.com.
Advances in Radiology and Imaging Lead to Medical Breakthroughs in the Field
By Julie Laviolette - South Florida Hospital News
New advances in radiology and imaging have led to a medical breakthrough in the way doctors are now able to locate and treat veins and arteries
The Vein Viewer™, which became available in June, is a new technology that uses infrared light to image red blood cells, allowing a video camera to capture the images through a computer and project them onto a patient’s skin. This device allows healthcare providers to quickly and accurately map a patient’s veins, regardless of age, gender, body type or skin tone. It is particularly beneficial for patients with hard-to-find veins, including blood donors, children and cancer patients whose veins have been weakened by chemotherapy.
"It’s a breakthrough technology that allows you to see veins that you wouldn’t see with the naked eye," said Dr. William Julien, an endovascular surgeon and President of South Florida Vascular Associates in Margate. Dr. Julien was one of six doctors in the country and the first in South Florida to acquire the technology.
In his practice, the Vein Viewer™ has been successfully used to guide the physicians while they perform sclerotherapy, a procedure where spider veins are eliminated by injecting them with caustic chemicals.
"Without this sophisticated viewing technology, physicians can only see the veins on the surface," Dr. Julien said. "If you want to destroy the veins that are at the root of the spider veins, it’s a bit of a problem because you can’t see them with the naked eye, but you can see them with the Vein Viewer™."
It’s like being Superman and having X-ray vision, he said.
Dr. Julien said hospitals could benefit from this technology for inserting I.V.s, drawing blood, administering chemotherapy or even identifying good-quality veins in dialysis patients. Because the Vein Viewer™ illuminates the position of the target area, doctors know exactly where to access a vein, alleviating multiple needle sticks that can cause stress, bruising and discomfort for the patient.
"Its uses are quite dramatic for the patient", says Dr. Julien. The Vein Viewer™ is even being used to help wounded soldiers in the battle field by shortening the time it takes to insert an IV. There’s even talk of Homeland Security one day using it as an identification system, since no two persons’ veins are alike.
"Because this technology is so new, we are still determining the full extent of all of its uses in the medical community," Dr. Julien said.
A nother recent technological advance in imaging and radiology relates to carotid artery stenting, a procedure which is utilized to prevent strokes.
In addition to preventing strokes, "There’s new information that the carotid artery stenting procedure may actually improve executive brain functions such as memory and mental acuity," Dr. Julien said.
During the procedure, an angioplasty balloon and then a stent are used to widen the carotid artery narrowed by plaque. Prior to the angioplasty, a tiny filter is placed in the carotid artery to capture any particles that are unintentionally dislodged during the procedure. The final step is to remove the filter along with any trapped debris.
"Filtering takes place because there was a concern that the particles were causing a subtle deterioration in mental function," Dr. Julien said. "Instead, they found, in a statistically significant number of people, that there were increased mental functions. Colors were brighter. Memory was sharper."
Dr. Julien said the Food and Drug Administration has approved carotid artery stenting for use only in high-risk patients.
"These new findings indicate that if you have a patient with reduced mental function, they may have a narrowing of the carotid artery that no one may be aware of and can be screened for it," he said. "If there is depression or dementia in the elderly, there are many possible causes, but it may be caused by stenosis, a narrowing of the carotid artery, and carotid stenting may help that."
Dr. Julien said advances in image guided technology are reducing instances when patients have to go "under the knife."
"Endovascular surgery is guided by imaging, and advancements in imaging techniques are nearing us to the day where people won’t necessarily have to be subjected to major surgery," he said. "If you don’t have to cut people open, it means faster surgery, less pain for the patient and faster recovery time."
Dr. William Julien is a board certified interventional radiologist with a full-time endovascular practice. He is president of South Florida Vascular Associates in Margate and is on staff at Northwest Medical Center. Dr. Julien can be reached at (954) 975-6161 or www.southfloridavascular.com. www.southfloridavascular.com.
New advances in radiology and imaging have led to a medical breakthrough in the way doctors are now able to locate and treat veins and arteries
The Vein Viewer™, which became available in June, is a new technology that uses infrared light to image red blood cells, allowing a video camera to capture the images through a computer and project them onto a patient’s skin. This device allows healthcare providers to quickly and accurately map a patient’s veins, regardless of age, gender, body type or skin tone. It is particularly beneficial for patients with hard-to-find veins, including blood donors, children and cancer patients whose veins have been weakened by chemotherapy.
"It’s a breakthrough technology that allows you to see veins that you wouldn’t see with the naked eye," said Dr. William Julien, an endovascular surgeon and President of South Florida Vascular Associates in Margate. Dr. Julien was one of six doctors in the country and the first in South Florida to acquire the technology.
In his practice, the Vein Viewer™ has been successfully used to guide the physicians while they perform sclerotherapy, a procedure where spider veins are eliminated by injecting them with caustic chemicals.
"Without this sophisticated viewing technology, physicians can only see the veins on the surface," Dr. Julien said. "If you want to destroy the veins that are at the root of the spider veins, it’s a bit of a problem because you can’t see them with the naked eye, but you can see them with the Vein Viewer™."
It’s like being Superman and having X-ray vision, he said.
Dr. Julien said hospitals could benefit from this technology for inserting I.V.s, drawing blood, administering chemotherapy or even identifying good-quality veins in dialysis patients. Because the Vein Viewer™ illuminates the position of the target area, doctors know exactly where to access a vein, alleviating multiple needle sticks that can cause stress, bruising and discomfort for the patient.
"Its uses are quite dramatic for the patient", says Dr. Julien. The Vein Viewer™ is even being used to help wounded soldiers in the battle field by shortening the time it takes to insert an IV. There’s even talk of Homeland Security one day using it as an identification system, since no two persons’ veins are alike.
"Because this technology is so new, we are still determining the full extent of all of its uses in the medical community," Dr. Julien said.
A nother recent technological advance in imaging and radiology relates to carotid artery stenting, a procedure which is utilized to prevent strokes.
In addition to preventing strokes, "There’s new information that the carotid artery stenting procedure may actually improve executive brain functions such as memory and mental acuity," Dr. Julien said.
During the procedure, an angioplasty balloon and then a stent are used to widen the carotid artery narrowed by plaque. Prior to the angioplasty, a tiny filter is placed in the carotid artery to capture any particles that are unintentionally dislodged during the procedure. The final step is to remove the filter along with any trapped debris.
"Filtering takes place because there was a concern that the particles were causing a subtle deterioration in mental function," Dr. Julien said. "Instead, they found, in a statistically significant number of people, that there were increased mental functions. Colors were brighter. Memory was sharper."
Dr. Julien said the Food and Drug Administration has approved carotid artery stenting for use only in high-risk patients.
"These new findings indicate that if you have a patient with reduced mental function, they may have a narrowing of the carotid artery that no one may be aware of and can be screened for it," he said. "If there is depression or dementia in the elderly, there are many possible causes, but it may be caused by stenosis, a narrowing of the carotid artery, and carotid stenting may help that."
Dr. Julien said advances in image guided technology are reducing instances when patients have to go "under the knife."
"Endovascular surgery is guided by imaging, and advancements in imaging techniques are nearing us to the day where people won’t necessarily have to be subjected to major surgery," he said. "If you don’t have to cut people open, it means faster surgery, less pain for the patient and faster recovery time."
Dr. William Julien is a board certified interventional radiologist with a full-time endovascular practice. He is president of South Florida Vascular Associates in Margate and is on staff at Northwest Medical Center. Dr. Julien can be reached at (954) 975-6161 or www.southfloridavascular.com. www.southfloridavascular.com.
Vein Viewer
High-Tech Device Makes It Easy To Locate Hard-To-Find Veins
Using a high -tech device placed on top of the skin, doctors can now see veins inside your body. The device is called the Vein Viewer and will benefit many patients, including children and cancer patients. It also works well for spider veins. Debbie Andersen, 52, is a breast cancer survivor. But after going through chemotherapy, her veins didn't survive the trauma.
"After the chemotherapy I did not have a port at the time. I could only use my right arm. So they pretty much burnt out all the veins," said Andersen.
Now she gets her blood taken every three months.So it can be difficult and painful finding a vein. That's where the Vein Viewer comes in.
Endovascular Surgeon William Julien uses the Vein Viewer in his practice.
"The Vein Viewer is breakthrough technology, that uses an infrared camera to see the veins immediately under the skin, that you can't see with the naked eye, but because of the heat in the blood vessel, you can see with the infrared camera. The computer processes that information and projects an LCD image back onto the skin surface," said Dr. Julien.
The Vein Viewer also works well for locating spider veins, something Michele Guarnari of Coral Springs could have used a few years ago.
"The spider veins are superficial and they were injected. But a few years later, they came back, and mostly because they couldn't see the deeper veins that were feeding the superficial veins," said Guarnari.
The Vein Viewer allows doctors to locate deeper veins, cutting off the supply to those superficial spider veins. This technology may help patients avoid duplicating procedures and eliminate unnecessary pain.
Homeland Security is also investigating this technology for use as an identification device, since no two people have the same vein pattern. To contact Dr. William Julien about the Vein Viewer call 954-975-6161 or visit his Web site at www.southfloridavascular.com.
Using a high -tech device placed on top of the skin, doctors can now see veins inside your body. The device is called the Vein Viewer and will benefit many patients, including children and cancer patients. It also works well for spider veins. Debbie Andersen, 52, is a breast cancer survivor. But after going through chemotherapy, her veins didn't survive the trauma.
"After the chemotherapy I did not have a port at the time. I could only use my right arm. So they pretty much burnt out all the veins," said Andersen.
Now she gets her blood taken every three months.So it can be difficult and painful finding a vein. That's where the Vein Viewer comes in.
Endovascular Surgeon William Julien uses the Vein Viewer in his practice.
"The Vein Viewer is breakthrough technology, that uses an infrared camera to see the veins immediately under the skin, that you can't see with the naked eye, but because of the heat in the blood vessel, you can see with the infrared camera. The computer processes that information and projects an LCD image back onto the skin surface," said Dr. Julien.
The Vein Viewer also works well for locating spider veins, something Michele Guarnari of Coral Springs could have used a few years ago.
"The spider veins are superficial and they were injected. But a few years later, they came back, and mostly because they couldn't see the deeper veins that were feeding the superficial veins," said Guarnari.
The Vein Viewer allows doctors to locate deeper veins, cutting off the supply to those superficial spider veins. This technology may help patients avoid duplicating procedures and eliminate unnecessary pain.
Homeland Security is also investigating this technology for use as an identification device, since no two people have the same vein pattern. To contact Dr. William Julien about the Vein Viewer call 954-975-6161 or visit his Web site at www.southfloridavascular.com.
Blame Genetics for Varicose Veins
Miami Herald.com ASK DR. SEAN By Dr. Sean Kenniff
Q - Does standing or sitting for a long time cause varicose veins?
A - Varicose veins are unsightly and sometimes painful bulges of the superficial veins of the legs. According to Dr. William Julien, an interventional radiologist and vein specialist in Margate, the cause is mostly due to faulty anatomy.
“The veins in the legs have one-way valves that help keep the blood from flowing backward,” he said. “Some people have defective valves, or they begin to malfunction, and that causes the blood to pool in the legs.”
When the blood pools in the legs, the pressure inside the veins of the legs is increased and the superficial veins start to bulge. Although genetics play a strong role in determining who is at most risk, varicose veins are more common in women. It’s believed hormones like estrogen and progesterone may weaken the walls of the leg veins, causing them to expand and the valves to leak. Pregnancy raises the risk, so does estrogen replacement therapy, and taking birth control pills. Age is also important and the risk gradually increases as we get older.
Genetics, hormones, and age may be the most important causes of varicose veins, but several lifestyle factors have also been linked to their development. Prolonged standing or sitting can increase the venous pressure in the legs and therefore cause varicose veins. High heel shoes, restrictive clothing, and obesity may also be contributing factors. But there are some things you can do to protect yourself, Julien says.
“Elevating your legs, and wearing compression stockings may help”, he said. “And exercise helps because the muscles squeeze the blood in the leg veins and push it back to the heart.”
Most varicose veins pose no health risk, and do not need to be treated. But new treatments, such as Endovascular Thermal Ablation, can correct the problem in the majority of cases.
Dr. Sean Kenniff covers health for WFOR CBS-4. The advice in this column is not a substitute for consulting a physician.
Q - Does standing or sitting for a long time cause varicose veins?
A - Varicose veins are unsightly and sometimes painful bulges of the superficial veins of the legs. According to Dr. William Julien, an interventional radiologist and vein specialist in Margate, the cause is mostly due to faulty anatomy.
“The veins in the legs have one-way valves that help keep the blood from flowing backward,” he said. “Some people have defective valves, or they begin to malfunction, and that causes the blood to pool in the legs.”
When the blood pools in the legs, the pressure inside the veins of the legs is increased and the superficial veins start to bulge. Although genetics play a strong role in determining who is at most risk, varicose veins are more common in women. It’s believed hormones like estrogen and progesterone may weaken the walls of the leg veins, causing them to expand and the valves to leak. Pregnancy raises the risk, so does estrogen replacement therapy, and taking birth control pills. Age is also important and the risk gradually increases as we get older.
Genetics, hormones, and age may be the most important causes of varicose veins, but several lifestyle factors have also been linked to their development. Prolonged standing or sitting can increase the venous pressure in the legs and therefore cause varicose veins. High heel shoes, restrictive clothing, and obesity may also be contributing factors. But there are some things you can do to protect yourself, Julien says.
“Elevating your legs, and wearing compression stockings may help”, he said. “And exercise helps because the muscles squeeze the blood in the leg veins and push it back to the heart.”
Most varicose veins pose no health risk, and do not need to be treated. But new treatments, such as Endovascular Thermal Ablation, can correct the problem in the majority of cases.
Dr. Sean Kenniff covers health for WFOR CBS-4. The advice in this column is not a substitute for consulting a physician.
Margate Hospital Takes Part in Clinical Trial
The Forum Procedure is for those who are high-risk for surgery to unclog carotid arteries
Wednesday, September 7, 2011
Peripheral arterial disease affects 12-20 percent of Americans 65 and older
According to the Society of Interventional Radiologists http://www.sir.org, peripheral arterial disease, or PAD, is a common condition affecting 12-20 percent of Americans age 65 and older that may be a signal of future heart attack and stroke -- and many with the disease may be unaware they have it.
For more than a decade, the Society of Interventional Radiology's national screening program, Legs For Lifehttp://www.legsforlife.com, has helped identify this very serious and potentially life-threatening condition.
An estimated 10 million people in the United States suffer from peripheral arterial disease. PAD develops mostly as a result of atherosclerosis, a condition that occurs when cholesterol and scar tissue buildup, forming a substance called plaque, which narrows and clogs the arteries and slows blood flow to the legs. Since plaque blocks the smaller leg arteries first, PAD is considered a red flag for several life-threatening vascular diseases, such as heart attack (the number one killer in the United States) and stroke. More than 50 percent of PAD patients are asymptomatic and cannot feel the classic warning sign of PAD—leg pain that occurs when walking or exercising and disappears when the person stops the activity. This symptom is typically dismissed as a sign of getting older, as is numbness and tingling in the lower legs and feet, coldness in the lower legs and feet, and ulcers or sores on the legs or feet that don't heal.
In many cases, PAD can be treated with medication (such as blood thinners or drugs that dilate an affected artery), lifestyle changes (such as smoking cessation), diet and a structured exercise program. With early detection, patients could see an interventional radiologist when intervention is most effective and less invasive treatments are still an option. If needed, interventional radiologists can perform minimally invasive angioplasty (the widening of a narrowed or obstructed blood vessel) and/or stenting (the insertion of a tiny mesh tube) to open a blocked artery in the leg and restore blood flow.
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