Wednesday, September 5, 2012
Minimally Invasive Procedure Saves Limbs and Lives for Those Suffering From Peripheral Artery Disease
Peripheral Artery Disease(PAD) is the hardening or narrowing of the arteries in the leg caused by fatty deposits or calcium which accumulate in the blood vessels of the buttocks, legs, and feet blocking normal blood flow.
Early signs of PAD can include pain to the hips, legs, and feet during normal activities such as walking. When PAD advances, it can lead to Critical Limb Ischemia (CLI) which includes leg pain at rest, wounds that are slow to heal, and gangrene. This puts a patient at risk for amputation. Depending on the severity of PAD, it can be treated through lifestyle changes, medication, or minimally invasive procedures such as an atherectomy.
An atherectomy is a minimally invasive procedure that utilizes a catheter with a sharp blade on the end to remove plaque from a blood vessel. The catheter is inserted into the artery through a small puncture in the artery and is navigated under x-ray guidance. It is designed to pulverize the plaque and sands it into tiny particles that are washed away with the patient’s blood flow. By restoring blood flow in the legs, a significant outcome can be achieved for most patients. Interventional radiologists have been using minimally invasive atherectomy procedures for the treatment of PAD for several years, however the technology continues to improve allowing doctors to treat many more people. Atherectomy has been a breakthrough in the treatment of PAD and has proven to improve a patient’s quality of life by alleviating pain, enhancing mobility, re-establishing blood flow to non-healing wounds and reducing the number of amputations.
If you have been diagnosed with PAD there are many treatments that can help you regain your quality of life. If you have any questions or would like to schedule an appointment for a consultation with Dr. William Julien or Dr. Warren Swee.
Thursday, August 30, 2012
Could Leg Pain Be a Sign Of Something Serious?
Peripheral artery disease (PAD) often goes undetected. But being aware of the warning signs can help you spot PAD early on and get prompt treatment to protect your health.
Peripheral Artery Disease is caused by a thickening of the inside walls of the arteries of your legs. This thickening, called atherosclerosis, usually occurs when a person has high levels of cholesterol, a fat-like substance in the blood. Cholesterol and fat, circulating in the blood, build up on the walls of the arteries and plaque formations can grow large enough to significantly reduce the blood's flow through an artery narrowing the space where the blood can flow and decreases the supply of oxygen and nutrients to the legs and feet. It can affect both legs, but most often symptoms begin in one leg.
Dr. William Julien explains more about PAD in the video below.
It’s important to know the signs of PAD, such as leg pain or heaviness and it is most important to discuss these symptoms with your doctor right away so that you can get be evaluated and begin treatment immediately to reduce your risk of heart attack or stroke.
Warning Signs of PAD:
• Pain that occurs when you walk and goes away when you stand still. It is important to understand that pain from PAD differs from other conditions because of how and when it occurs. Blockages in the leg can be so severe that blood is not getting to the muscles, and when muscles don't get enough blood, they get painful. This type of leg pain is called intermittent claudication and is one of the main symptoms of PAD. Leg pain can also be an indicator of back or spinal conditions. If your pain stops when you stand still after walking, chances are it’s related to PAD.
• Cold feet. A blockage or reduced blood flow to the lower leg muscles can make feet feel noticeably and abnormally cold. You may find that the leg with the blockage feels colder than your other leg.
• Discoloration in the legs or feet. Without blood flowing properly through the leg, your foot and toes may become discolored. A common PAD symptom is a foot that appears unusually pale or has a blue tint due to lack of blood flow.
• Persistent sores on the feet. If you have wounds on the bottom of your feet that take a long time to heal, this can also be could be a sign of PAD. When blood flow is blocked from reaching an area wounds won’t improve as quickly as they did prior to the blockage or don’t heal at all, making you more prone to foot infections. If you are experiencing any of the symptoms please take answer the questions in our survey to see if you are at risk and contact our office immediately to schedule a consultation with one of our physicians for proper diagnosis and treatment plan.
Peripheral Artery Disease is caused by a thickening of the inside walls of the arteries of your legs. This thickening, called atherosclerosis, usually occurs when a person has high levels of cholesterol, a fat-like substance in the blood. Cholesterol and fat, circulating in the blood, build up on the walls of the arteries and plaque formations can grow large enough to significantly reduce the blood's flow through an artery narrowing the space where the blood can flow and decreases the supply of oxygen and nutrients to the legs and feet. It can affect both legs, but most often symptoms begin in one leg.
Dr. William Julien explains more about PAD in the video below.
Warning Signs of PAD:
• Pain that occurs when you walk and goes away when you stand still. It is important to understand that pain from PAD differs from other conditions because of how and when it occurs. Blockages in the leg can be so severe that blood is not getting to the muscles, and when muscles don't get enough blood, they get painful. This type of leg pain is called intermittent claudication and is one of the main symptoms of PAD. Leg pain can also be an indicator of back or spinal conditions. If your pain stops when you stand still after walking, chances are it’s related to PAD.
• Cold feet. A blockage or reduced blood flow to the lower leg muscles can make feet feel noticeably and abnormally cold. You may find that the leg with the blockage feels colder than your other leg.
• Discoloration in the legs or feet. Without blood flowing properly through the leg, your foot and toes may become discolored. A common PAD symptom is a foot that appears unusually pale or has a blue tint due to lack of blood flow.
• Persistent sores on the feet. If you have wounds on the bottom of your feet that take a long time to heal, this can also be could be a sign of PAD. When blood flow is blocked from reaching an area wounds won’t improve as quickly as they did prior to the blockage or don’t heal at all, making you more prone to foot infections. If you are experiencing any of the symptoms please take answer the questions in our survey to see if you are at risk and contact our office immediately to schedule a consultation with one of our physicians for proper diagnosis and treatment plan.
Tuesday, August 21, 2012
Margate Man Survives a Two and Half Long (DVT)Blood Clot
How is that even possible? Luck and the miracle of modern medicine!
59 year old Gerald Cunha felt pain in his leg and had a bit of swelling. He went to his internist and who put him on the blood thinner Coumadin, the standard treatment to dissolve what his doctor believed was a blood clot or deep vein thrombosis (DVT).
A couple of days later his leg blew up to three times its normal size.
The newest technology - EKOS Ultrasound which delivers clot busting drugs with an ultrasound-enhanced delivery system, could reduce the amount of drugs needed to break up dangerous blood clots in the legs and pelvis. Ultrasound catheters significantly reduce the amount of time it takes to dissolve blood clots and could help improve outcomes for victims of deep vein thrombosis, or DVT, according to new research. Blood clots are often treated through intravenous infusion of drugs, but the process of
dissolving the clot can take up to 48 hours. Longer infusion times increase the risk of life-threatening bleeding elsewhere in the body, particularly in the brain.The EKOS Ultrasound was used to detect a massive blood clot in the patients leg which started behind his knee and went up to his belly button. A clot this size is extremely rare. The most effective way to treat it was to administer clot busting medication to dissolve the clot. Instead of taking medication, blood thinners, for several months hoping the clot will dissolve, the EKOS allows doctors to drip TPA (clot busting medicine) right into the vein, directly onto the clot dissolving it like an ice cube melting. This treatment was performed for 3 consecutive days in order to dissolve a clot so large.
The patient's vascular specialist says, had this not been done in time he would have been permanently disabled or could have died from a pulmonary embolism. In fact, the patient was so nervous prior to the clot busting meds, he put his affairs in order for fear that a piece of the clot could travel to his lungs and be fatal.
Monday, August 13, 2012
Varicocele Embolization Repair for Infertility
Varicocele Embolization Repair for Infertility
Minimally invasive, No general anesthesia, No pain, No down time
Varicoceles are fairly common, affecting 15% of men overall and 40% of men with known infertility issues. Poor circulation caused by the varicoceles results in a higher blood temperature that raises the temperature of the testes, which can serve as a barrier to sperm production and can damage or destroy sperm that is created.
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 the gonadal vein has weak defective valves resulting in the blood pooling in varicose veins in the scrotum. Sometimes, varicoceles cause no symptoms and are harmless. But sometimes a varicocele causes pain, testicular atrophy (shrinkage), or fertility problems.
Alternatively, at South Florida Vascular Associates, a nonsurgical minimally invasive procedure called varicocele embolization, can be done without general anesthesia by one of our interventional radiologists to repair a varicocele. During this procedure a small tube is inserted into the femoral vein in the groin or a vein in the neck through a small nick in the skin. The skin is numbed for this procedure and it is not painful. Next a small catheter or tube is painlessly guided into the abdomen and into the varicocele vein under the guidance of x-ray imaging. The vein is then intentionally closed off by plugging it with small metal coils and a special medication. This procedure takes 30 minutes and the patient goes home a few hours later with only a band aid at the puncture site. The patient can immediately resume their non external activities.
Advantages of Varicocele Ebolization
• Performed under local anesthesia with mild sedation
• Performed on an outpatient basis in our endovascular suite, not in the hospital
• No surgical incision in the groin, only a tiny hole where a catheter is placed
• If you have varicoceles on both sides, you can have them fixed at the same time through one vein puncture site(surgery requires 2 separate open incision)
• It is as effective as surgery,as measured by improvement in pain, semen analysis and pregnancy rates
• Lower rate of complications compared to surgery, Infection has not been reported after embolization
If you have been diagnosed with varicoceles, call our office to learn more about varicoceles embolization and after your procedure leave our office with only a band aid at the puncture site. To make an appointment for a consultation click here.
Minimally invasive, No general anesthesia, No pain, No down time
Varicoceles are fairly common, affecting 15% of men overall and 40% of men with known infertility issues. Poor circulation caused by the varicoceles results in a higher blood temperature that raises the temperature of the testes, which can serve as a barrier to sperm production and can damage or destroy sperm that is created.
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 the gonadal vein has weak defective valves resulting in the blood pooling in varicose veins in the scrotum. Sometimes, varicoceles cause no symptoms and are harmless. But sometimes a varicocele causes pain, testicular atrophy (shrinkage), or fertility problems.
Varicoceles can be repaired and are commonly treated by a urologist
through a procedure called varicoceleligation surgery. During this
procedure an incision is made is made is the skin above the scrotum,
cutting down to the testicular veins and tying them off with sutures. It
is usually performed under general anesthesia in a hospital setting.
Although patients leave the hospital the same day, there is a two to
three week recovery period.
Alternatively, at South Florida Vascular Associates, a nonsurgical minimally invasive procedure called varicocele embolization, can be done without general anesthesia by one of our interventional radiologists to repair a varicocele. During this procedure a small tube is inserted into the femoral vein in the groin or a vein in the neck through a small nick in the skin. The skin is numbed for this procedure and it is not painful. Next a small catheter or tube is painlessly guided into the abdomen and into the varicocele vein under the guidance of x-ray imaging. The vein is then intentionally closed off by plugging it with small metal coils and a special medication. This procedure takes 30 minutes and the patient goes home a few hours later with only a band aid at the puncture site. The patient can immediately resume their non external activities.
Advantages of Varicocele Ebolization
• Performed under local anesthesia with mild sedation
• Performed on an outpatient basis in our endovascular suite, not in the hospital
• No surgical incision in the groin, only a tiny hole where a catheter is placed
• If you have varicoceles on both sides, you can have them fixed at the same time through one vein puncture site(surgery requires 2 separate open incision)
• It is as effective as surgery,as measured by improvement in pain, semen analysis and pregnancy rates
• Lower rate of complications compared to surgery, Infection has not been reported after embolization
If you have been diagnosed with varicoceles, call our office to learn more about varicoceles embolization and after your procedure leave our office with only a band aid at the puncture site. To make an appointment for a consultation click here.
Saturday, May 12, 2012
Do You Know That Tangerines May Protect the Body From Coronary Artery Disease?
An article on Everyday Health.com reports that tangerines are metabolic masters
A flavonoid (a type of antioxidant) in this citrus fruit may protect the body against the triad of diseases known as metabolic syndrome — coronary artery disease, stroke, and type 2 diabetes — according to research from the University of Western Ontario published in the journal Diabetes. When researchers fed mice a typical “western” diet (high in fat and refined sugar) that was supplemented with the tangerine antioxidant nobiletin, the mice experienced no increase in cholesterol, triglycerides, insulin, or blood sugar, but mice who didn’t get the nobiletin did see a rise. Other long-term animal studies have found that the compound prevents atherosclerosis, the hardening of the arteries that can lead to a heart attack or stroke. Tangerines may also help cancer-proof your body — if you eat the peel. A compound in the peel called salvestrol Q40 halts the activity of an enzyme that incites the growth of cancer cells, a British study found. Try some tangerine zest in your tea or sprinkled on a salad for a citrusy twist.
We look forward to hearing your comments.
A flavonoid (a type of antioxidant) in this citrus fruit may protect the body against the triad of diseases known as metabolic syndrome — coronary artery disease, stroke, and type 2 diabetes — according to research from the University of Western Ontario published in the journal Diabetes. When researchers fed mice a typical “western” diet (high in fat and refined sugar) that was supplemented with the tangerine antioxidant nobiletin, the mice experienced no increase in cholesterol, triglycerides, insulin, or blood sugar, but mice who didn’t get the nobiletin did see a rise. Other long-term animal studies have found that the compound prevents atherosclerosis, the hardening of the arteries that can lead to a heart attack or stroke. Tangerines may also help cancer-proof your body — if you eat the peel. A compound in the peel called salvestrol Q40 halts the activity of an enzyme that incites the growth of cancer cells, a British study found. Try some tangerine zest in your tea or sprinkled on a salad for a citrusy twist.
We look forward to hearing your comments.
Friday, May 11, 2012
Yankees' Rivera Says Blood Clot Caused More Complications
According to the New York Yankees Blog written by Mike Fitzpatrick, AP, Mariano Rivera has a blood clot in his right calf, the latest health problem for the longtime Yankees closer who tore a knee ligament last week while shagging fly balls during batting practice.
Rivera is on blood-thinning medication intended to dissolve the clot and said Wednesday he is OK, though he was scared when he received the diagnosis. He needs to spend at least a week or two strengthening his knee before he has surgery to repair his torn anterior cruciate ligament, but said that would have been the case regardless of the blood clot.
Strengthening the knee now will put him in a better position when he begins his rehabilitation program after the operation. He must stop taking the blood thinners 24 hours before the surgery, he said.
The 42-year-old, baseball’s career saves leader with 608, said he can guarantee he will work hard and do “whatever it takes” to return next season. But if his leg doesn’t come back strong enough, then he will take it as a sign that it’s time to retire.
“If it’s my call, I don’t want to leave the game the way it happened. ... My will and my desire is to stay,” Rivera said, adding that he was leaning toward pitching in 2013 even before the injury. “The traveling, I hate it. And the game, I love it.”
Rivera was injured last Thursday in Kansas City, tearing his ACL and damaging the meniscus in his right knee, when he stumbled and fell while chasing a fly ball during batting practice, a regular part of his pregame routine. He is expected to miss the rest of the season.
The following day he announced he was determined to get back on the mound next season and he was examined Monday by three doctors at two hospitals as he prepared to decide where to have knee surgery.
While he was being examined, Rivera mentioned to the doctor that his right calf was “sore and painful.” He was diagnosed with a blood clot and spent Monday night in the hospital, beginning treatment right away.
That was the complication Yankees general manager Brian Cashman and Rivera’s agent, Fernando Cuza, referred to this week when discussing Rivera’s schedule and prognosis. Cashman would not elaborate Tuesday at Yankee Stadium.
“I was more concerned with the blood clot than the knee. For a minute I was like, what else is going to happen?” Rivera said. “I was scared because I never hear good things about blood clots. ... I take it like, OK, what do we have to do?”
In the worst cases, blood clots can be life-threatening if they travel to the lungs. Rivera said he’s not sure what caused the clot, and he didn’t even ask.
“I know that I’ve got to deal with it,” he said. “They don’t know if it happened before or after the trauma of the injury.”
Rivera said he planned to speak to his doctor later Wednesday and he will soon go back for a check-up. He hasn’t decided on a doctor to perform the knee surgery yet, but the clot will not affect the date of the operation.
“I really believe if Mo wants to continue to play, he’ll play,” manager Joe Girardi said. “I mean, obviously he’s got to go through a process of rehab here, but I don’t see any reason why that’s not going to happen and he’s not going to get through that, so I look forward to seeing him back in a Yankee uniform.”
Rivera appeared in good spirits at a 25-minute news conference Wednesday before the Yankees played the Tampa Bay Rays. Wearing a long-sleeve shirt and jeans, he hobbled up to the podium on a set of crutches he’s already grown tired of.
“I just feel old. Walking with these crutches is not fun at all,” he said.
Later, he joked that would begin running again in 5 or 10 minutes.
Rivera said he’ll be at the ballpark as much as possible to help his teammates however he can this season, but for the first time in his life he thinks he needs to be a bit “selfish” and focus on his rehab. He said he watched nervously from his couch at home as fill-in closer David Robertson loaded the bases Tuesday night before saving New York’s 5-3 victory over the Rays.
“It’s still tough, though, mentally. These games don’t help me. He did a good job,” Rivera said. “I was sweating and screaming. It was difficult, but I was screaming at Robby on the TV.”
And when he returns, Rivera said he’ll resume shagging flies during batting practice.
“Oh, no doubt about it,” he said. “I don’t know what the Yankees will do. They might need to tie me up,” he said.
Read more: http://www.nypost.com/p/blogs/yankeesblog/yankees_rivera_says_knee_complications_h2jC6heHleZmOTtyCZnO6I#ixzz1uZqFxkjW
Rivera is on blood-thinning medication intended to dissolve the clot and said Wednesday he is OK, though he was scared when he received the diagnosis. He needs to spend at least a week or two strengthening his knee before he has surgery to repair his torn anterior cruciate ligament, but said that would have been the case regardless of the blood clot.
Strengthening the knee now will put him in a better position when he begins his rehabilitation program after the operation. He must stop taking the blood thinners 24 hours before the surgery, he said.
The 42-year-old, baseball’s career saves leader with 608, said he can guarantee he will work hard and do “whatever it takes” to return next season. But if his leg doesn’t come back strong enough, then he will take it as a sign that it’s time to retire.
“If it’s my call, I don’t want to leave the game the way it happened. ... My will and my desire is to stay,” Rivera said, adding that he was leaning toward pitching in 2013 even before the injury. “The traveling, I hate it. And the game, I love it.”
Rivera was injured last Thursday in Kansas City, tearing his ACL and damaging the meniscus in his right knee, when he stumbled and fell while chasing a fly ball during batting practice, a regular part of his pregame routine. He is expected to miss the rest of the season.
The following day he announced he was determined to get back on the mound next season and he was examined Monday by three doctors at two hospitals as he prepared to decide where to have knee surgery.
While he was being examined, Rivera mentioned to the doctor that his right calf was “sore and painful.” He was diagnosed with a blood clot and spent Monday night in the hospital, beginning treatment right away.
That was the complication Yankees general manager Brian Cashman and Rivera’s agent, Fernando Cuza, referred to this week when discussing Rivera’s schedule and prognosis. Cashman would not elaborate Tuesday at Yankee Stadium.
“I was more concerned with the blood clot than the knee. For a minute I was like, what else is going to happen?” Rivera said. “I was scared because I never hear good things about blood clots. ... I take it like, OK, what do we have to do?”
In the worst cases, blood clots can be life-threatening if they travel to the lungs. Rivera said he’s not sure what caused the clot, and he didn’t even ask.
“I know that I’ve got to deal with it,” he said. “They don’t know if it happened before or after the trauma of the injury.”
Rivera said he planned to speak to his doctor later Wednesday and he will soon go back for a check-up. He hasn’t decided on a doctor to perform the knee surgery yet, but the clot will not affect the date of the operation.
“I really believe if Mo wants to continue to play, he’ll play,” manager Joe Girardi said. “I mean, obviously he’s got to go through a process of rehab here, but I don’t see any reason why that’s not going to happen and he’s not going to get through that, so I look forward to seeing him back in a Yankee uniform.”
Rivera appeared in good spirits at a 25-minute news conference Wednesday before the Yankees played the Tampa Bay Rays. Wearing a long-sleeve shirt and jeans, he hobbled up to the podium on a set of crutches he’s already grown tired of.
“I just feel old. Walking with these crutches is not fun at all,” he said.
Later, he joked that would begin running again in 5 or 10 minutes.
Rivera said he’ll be at the ballpark as much as possible to help his teammates however he can this season, but for the first time in his life he thinks he needs to be a bit “selfish” and focus on his rehab. He said he watched nervously from his couch at home as fill-in closer David Robertson loaded the bases Tuesday night before saving New York’s 5-3 victory over the Rays.
“It’s still tough, though, mentally. These games don’t help me. He did a good job,” Rivera said. “I was sweating and screaming. It was difficult, but I was screaming at Robby on the TV.”
And when he returns, Rivera said he’ll resume shagging flies during batting practice.
“Oh, no doubt about it,” he said. “I don’t know what the Yankees will do. They might need to tie me up,” he said.
Read more: http://www.nypost.com/p/blogs/yankeesblog/yankees_rivera_says_knee_complications_h2jC6heHleZmOTtyCZnO6I#ixzz1uZqFxkjW
Tuesday, May 8, 2012
Witnessing someone experiencing a stroke can be very frightening. Staying calm might just save a life.
If you have the unfortunate experience of witnessing someone having a stroke, act quickly! The sooner a person suffering a stroke gets to the emergency room, the better their chances are that doctors will have the ability to intervene quickly to restore blood flow to the affected area saving brain cells and creating better chances for a good recovery.
Many strokes are caused by blockage in an artery. These arteries, called the carotid arteries, supply your brain with blood. Approximately 25 percent of strokes are caused by carotid artery disease from atherosclerosis, a buildup of plaque in the arteries that carry blood to the brain. Some strokes are even caused by bleeding from an artery that burst
According to the American Stroke Association, learn the many warning signs of a stroke.
Act FAST and CALL 9-1-1 IMMEDIATELY at any sign of a stroke.
Use FAST to remember the warning signs:
F FACE: Ask the person to smile. Does one side of the face droop?
A ARMS: Ask the person to raise both arms.Does one arm drift downward?
S SPEECH: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
T TIME: If you observe any of these signs, call 9-1-1 immediately.
Factors that put people at greater risk for carotid artery disease include:
Smoking;
High blood pressure;
Diabetes mellitus
Family history of atherosclerosis (build-up of plaque in the arteries)
If you experience any of the symptoms referred to in this blog or you suspect someone else is experiencing these symptoms call 911 immediately! If you have any questions or comments about carotid artery disease or stroke please comment on our blog and we will be happy to answer you questions.
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