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.

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

COCONUT CREEK, FL (November 16, 2011) - 39 year old Gabriel Quiroga is an air conditioner contractor. Each day he drives from house- to -house or business- to -business, pulls out his ladder and climbs up on top of roofs, into attics, and other hard to reach areas. Quiroga is totally dependent upon the use of his legs for his livelihood and a good quality of life.

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

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.

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.

SOUTH FLORIDA VASCULAR ASSOCIATES WELCOMES WARREN SWEE, MD, MPH FELLOWSHIP TRAINED INTERVENTIONAL RADIOLOGIST TO THE PRACTICE

Dr. Swee’s Specialized Endovascular Surgical Skills Enhances Treatment Options for Patients Suffering from Complex Vascular Diseases

COCONUT CREEK, FL (October 12, 2011 ) – South Florida Vascular Associates (www.southfloridavascular.com), an office-based clinical practice specializing in image-guided, minimally invasive endovascular surgeries, today announced that Warren Swee, MD, MPH, a fellowship trained and board certified Vascular and Interventional Radiologist has joined the practice.

Dr. Swee will work with William Julien, MD, Medical Director of South Florida Vascular Associates, to offer cutting-edge endovascular surgical techniques to treat patients who suffer from a wide array of vascular diseases including Peripheral Artery Disease (PAD), a condition in which plaque build-up causes a narrowing of the arteries which diminishes normal blood flow to the lower extremities.
People with vascular diseases are typically treated in a hospital setting. South Florida Vascular Associates (SFVA) is one of few office-based, endovascular practices in the region that can treat patients outside of the hospital. “I am very privileged to have the opportunity to work with Dr. Julien and to provide high quality care in a well-developed office based practice”, said Dr. Swee. SFVA is equipped with 3 in-office endovascular surgical suites where our physicians perform over 1,000 image-guided endovascular surgeries a year. This is done in the comfort of a state-of-the-art facility using the latest technology to treat vascular conditions. “We are pleased that Dr. Swee has joined our practice”, said Dr. Julien. “The addition of Dr. Swee’s specialized training in the treatment of advanced limb threatening peripheral artery disease adds to our vision of offering the most comprehensive endovascular services in a fully-equipped, private, comfortable setting to our patients”, said Dr. Julien.
Dr. Swee earned his medical degree and Master’s of Public Health degree from the George Washington School of Medicine and Public Health. He completed his residency through the Vascular and Interventional Radiology Clinical Pathway at the University of Virginia in Charlottesville, VA., where he was awarded Clinical Resident of the Year. Dr. Swee then completed a fellowship in Vascular & Interventional Radiology from the University of Virginia Health System, where he later served as Assistant Professor of Radiology.

He is board certified in Vascular and Interventional Radiology by the ABR (American Board of Radiology) and board certified in Endovascular Medicine by the ABVM (American Board of Vascular Medicine). He is also a member of the American Medical Association, the Society of Interventional Radiology , the Society of Vascular Medicine, , and the American College of Radiology.

For more information visit us at www.southfloridavascular.com or 954-573-2929.

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

Varicoceles Can be Treated with a Minimally Invasive, Painless Procedure

Varicoceles are a tangled network of blood vessels or swelling of the veins on the testicles. It is similar to varicose veins in the legs, but in this condition a vein called a gonadal vein has weak defective valves resulting in the blood pooling in varicose veins in the scrotum. It is a relatively common condition affecting approximately 10% of men usually in their 20's or 30's. Sometimes, varicoceles do not cause any symptoms and are not harmless, but sometimea they can cause pain, testicular atrophy (shrinkage) or fertility problems.

Very often varicoceles are treated through open surgery in which an incision is made in the skin above the scrotum, cutting down to the testicular veins and tying them off with sutures. This open procedure is done as an outpatient procedure in a hospital, under general anesthesia, with a 2-3 week recovery period.

South Florida Vascular Associates offers a minimally invasive varicocele embolization procedure that is performed under twilight anesthesia. A small tube is inserted through a small nick in the groin and a small catheter is painlessly guided into the abdomen and into the varicocele vein under the guidance of x-ray imaging. The vein is sealed off by plugging it with small metal coils and a special medication is used to dissolve the excess veins. This painless minimally invasive procedure takes only 30 minutes and the patient goes home several hours later with a band aid at the puncture site.The patient can resume normal non-exertion activities immediately. Obviously, this procedure is much easier on the patient.

If you have a varicocele and would like more information call our office to schedule a consultation or send a comment through our blog.

Standard Risk Carotid Artery Surgical Patients Now Have Option for Minimally Invasive Procedure

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.