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Western Vascular Institute Voted Arizona’s Best Medical Specialists

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Lovin’ Life After 50 has awarded Western Vascular Institute as America’s Best Medical Specialist!

We are grateful to be voted as the best medical specialist recommended by readers and peers in the Lovin’ Life after 50 Magazine and website.

Check out our award in Lovin’ Life After 50 (see page 34)!

Visit Western Vascular Institute Today!

If you are in the Phoenix, Arizona area and looking for a vein or vascular clinic, visit Western Vascular Institute today! Our board-certified surgeons specialize in utilizing the latest in technology to provide the best in vein and vascular care. For more information, call (480) 668-5000 and schedule an appointment today!

 

Diabetes and Vascular Disease

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Diabetes and Vascular Disease: Understanding the Connection and Taking Control

Diabetes is a chronic condition that affects millions of people worldwide. While most individuals are aware of the impact of diabetes on blood sugar control, many may not fully understand the profound effect it can have on the vascular system. Diabetes significantly increases the risk of developing various vascular diseases, emphasizing the importance of managing the condition effectively. Let’s delve into the connection between diabetes and vascular disease and explore strategies to minimize its impact.

Understanding the Link:

Diabetes is characterized by elevated blood glucose levels, which can damage blood vessels over time. The persistently high levels of glucose in the bloodstream can lead to the accumulation of fatty deposits in the vessel walls, causing a condition called atherosclerosis. Atherosclerosis is a significant contributor to various vascular diseases, including:

Peripheral Artery Disease (PAD):

Diabetes increases the risk of developing PAD, which affects the blood vessels supplying the legs and feet. Reduced blood flow to the lower extremities can result in pain, slow wound healing, and an increased risk of infections and amputations.

Coronary Artery Disease (CAD):

Individuals with diabetes are more prone to CAD, a condition that affects the blood vessels supplying the heart. Narrowed or blocked arteries can lead to chest pain (angina), heart attacks, and other cardiovascular complications.

Stroke:

Diabetes raises the risk of stroke by accelerating the development of atherosclerosis in the arteries supplying the brain. A clot or rupture in these arteries can result in a stroke, causing lasting damage or even death.

Diabetic Retinopathy:

The blood vessels in the retina can be damaged by diabetes, leading to diabetic retinopathy. This condition can cause vision loss or even blindness if left untreated.

Diabetic Nephropathy:

High blood glucose levels can impair the kidneys’ ability to filter waste products, leading to diabetic nephropathy. It is a progressive kidney disease that can eventually result in kidney failure.

Managing Diabetes and Vascular Disease:

While the connection between diabetes and vascular disease may seem daunting, it’s important to remember that taking proactive steps can significantly reduce the risks. Here are some strategies to manage diabetes and minimize the impact on the vascular system:

Maintain Blood Sugar Levels:

Consistently monitoring and managing blood sugar levels through a healthy diet, regular exercise, and appropriate medication or insulin therapy is crucial. Keeping blood glucose within target ranges helps minimize damage to blood vessels.

Control Blood Pressure and Cholesterol:

High blood pressure and elevated cholesterol levels further contribute to vascular disease. Regular monitoring and effective management of these factors through lifestyle modifications and medications are essential.

Adopt a Healthy Lifestyle:

Engage in regular physical activity, such as walking, swimming, or cycling, to improve circulation and maintain a healthy weight. Follow a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats while limiting sugary and processed foods.

Quit Smoking:

Smoking damages blood vessels and significantly increases the risk of vascular disease. Quitting smoking is one of the most beneficial steps individuals with diabetes can take to protect their vascular health.

Regular Check-ups:

Maintain regular check-ups with healthcare professionals to monitor blood sugar control, blood pressure, cholesterol levels, and overall vascular health. Early detection and intervention can prevent or minimize the progression of vascular diseases.

Diabetes and vascular disease are intricately linked, underscoring the importance of proactive management. By effectively managing blood sugar levels, controlling blood pressure and cholesterol, adopting a healthy lifestyle, and seeking regular medical care, individuals with diabetes can significantly reduce their risk of developing or worsening vascular disease. Empower yourself with knowledge, take control of your diabetes, and prioritize your vascular health for a better quality of life.

 

Common treatments for PAD

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Common treatments for PAD 

The treatment of peripheral artery disease (PAD) aims to reduce symptoms, improve quality of life, and prevent complications. The specific treatment approach may vary based on the severity of the condition and individual patient factors. Here are some of the most common treatments for PAD:

Lifestyle Modifications:

Making certain lifestyle changes can help manage PAD effectively. These may include quitting smoking, adopting a healthy diet low in saturated fats and high in fruits and vegetables, regular exercise, and maintaining a healthy weight. Lifestyle modifications can improve overall cardiovascular health and reduce symptoms.

Medications:
Antiplatelet Medications:

Medications such as aspirin or clopidogrel are commonly prescribed to reduce the risk of blood clots and improve blood flow.

Cholesterol-lowering Medications:

Statins are often prescribed to control cholesterol levels and slow down the progression of atherosclerosis.

Blood Pressure Medications:

Controlling high blood pressure is crucial in managing PAD and reducing the risk of complications.

Symptom-relief Medications:

Medications such as cilostazol may be prescribed to relieve leg pain and improve walking distance.
Exercise Therapy:

Supervised exercise:

Supervised exercise programs, known as supervised exercise therapy (SET), can improve symptoms and walking distance in PAD. These programs typically involve structured exercise routines tailored to individual abilities and needs.

Endovascular Interventions:

 

Angioplasty and Stenting:

In this minimally invasive procedure, a catheter is inserted into the affected artery to inflate a small balloon, which helps open the blocked or narrowed artery. In some cases, a stent may be placed to help keep the artery open.

Atherectomy:

This procedure involves using a catheter with a rotating device or laser to remove plaque buildup from the artery walls, improving blood flow.
Bypass Surgery: In severe cases of PAD, bypass surgery may be necessary. During this procedure, a blood vessel graft is used to create a detour around the blocked or narrowed artery, allowing blood to bypass the affected area.

Wound Care and Amputation Prevention:

For individuals with PAD-related wounds or ulcers, proper wound care is crucial to prevent infection and promote healing. Specialized wound care techniques and treatments may be employed to facilitate healing and avoid amputations.

It’s important to note that the appropriate treatment plan for PAD should be determined by a healthcare professional based on individual circumstances. Early diagnosis, lifestyle modifications, and adherence to the prescribed treatment plan can significantly improve outcomes, alleviate symptoms, and reduce the risk of complications associated with peripheral artery disease.

 

What are compression stockings?

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What are compression stockings?

Compression stockings, also known as compression socks or support stockings, are specialized garments designed to apply pressure to the legs and improve blood circulation. They are commonly used in the treatment and management of various conditions, including:

Peripheral Artery Disease (PAD):

Compression stockings can help improve blood flow and reduce symptoms such as leg pain, cramping, and fatigue in individuals with PAD.

Deep Vein Thrombosis (DVT):

Compression stockings are often recommended to prevent and manage DVT, a condition characterized by blood clot formation in deep veins. They help promote blood circulation, prevent blood pooling, and reduce the risk of clotting.

Varicose Veins:

Compression stockings can alleviate symptoms associated with varicose veins, such as swelling, discomfort, and heaviness in the legs. They help compress the veins, improving circulation and reducing swelling.

Lymphedema:

Compression garments, including stockings, are used to manage lymphedema, a condition characterized by swelling due to the accumulation of lymphatic fluid. The gentle pressure exerted by the stockings helps reduce swelling and maintain proper lymphatic flow.

Post-Surgical Recovery:

After certain surgical procedures, such as vein stripping or vein ablation, compression stockings may be prescribed to aid in the healing process, reduce swelling, and prevent blood clots.

 

The benefits of compression stockings include:

 

Improved Blood Circulation:

Compression stockings apply graduated pressure, meaning the pressure is highest at the ankle and gradually decreases up the leg. This compression helps enhance blood flow by aiding the muscles and veins in pumping blood back to the heart.

Reduced Swelling and Discomfort:

By promoting better circulation, compression stockings can alleviate swelling, heaviness, and achiness in the legs.

Prevention of Complications:

Compression stockings can help prevent the formation of blood clots, particularly during long periods of immobility, such as during air travel or bed rest.

Support during Physical Activity:

Athletes and individuals engaged in physical activity may wear compression stockings to improve performance, reduce muscle fatigue, and enhance post-exercise recovery.

When considering compression stockings, it is essential to choose the correct size and compression level based on the specific condition and the advice of a vascular surgeon. They are available in different strengths, lengths, and styles, including knee-high, thigh-high, and full-length stockings. It’s important to follow the instructions for proper usage, including wearing them consistently and correctly to achieve maximum benefit.

If you have any vascular conditions or concerns, consult with a vascular surgeon to determine if compression stockings are suitable for your situation and to receive guidance on the appropriate type and compression level needed to support your vascular health.

 

What is a Unna Boot?

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An Unna Boot is a type of compression bandage that is specifically designed to treat and manage venous leg ulcers. It consists of a layer of zinc-impregnated, semi-rigid gauze wrapped around the affected leg, followed by an outer layer of cohesive compression bandage.

What is the purpose of an Unna Boot?

The purpose of an Unna Boot is to provide sustained, therapeutic compression to the lower leg, which helps improve venous circulation, reduce swelling, and promote the healing of venous ulcers. Here are some key benefits and functions of a Unna Boot:

Compression:

The primary purpose of an Unna Boot is to apply compression to the affected leg. The bandage provides consistent and graduated pressure, typically ranging from 20-30 mmHg, which helps to reduce venous congestion and increase blood flow toward the heart. Compression aids in controlling edema (swelling) and enhances venous return, thereby improving overall circulation.

Healing Environment:

The zinc-impregnated gauze layer within the Unna Boot provides several benefits. Zinc is known for its antibacterial and antimicrobial properties, which help create an optimal environment for wound healing by reducing the risk of infection. The semi-rigid nature of the gauze offers support and protection to the wound site.

Moisture Management:

The gauze layer in the Unna Boot acts as a moisture barrier, helping to absorb excess exudate (fluid) from the wound and maintain an appropriate level of moisture for wound healing. It prevents the wound from becoming too dry or too moist, facilitating the healing process.

Immobilization:

The Unna Boot offers some degree of immobilization, which helps prevent excessive movement of the affected leg. Immobilization can reduce pain and irritation, allowing the wound to heal more effectively.

Convenience and Long-lasting Effect:

The Unna Boot remains in place once applied, for an extended period (typically 1 to 2 weeks) without requiring frequent changes. This convenience reduces the need for frequent dressing changes and provides a continuous, therapeutic compression effect.

Unna Boot applications should be performed by a vascular surgeon with expertise in wound care. The bandage needs to be applied correctly, ensuring appropriate tension and coverage, to achieve optimal therapeutic benefits. Regular monitoring and assessment by a healthcare provider are essential to evaluate the progress of wound healing, adjust compression levels, and address any potential complications.

If you have a venous leg ulcer or a similar condition, consult with a vascular surgeon to determine if an Unna Boot is suitable for your situation and to receive proper guidance on its application and usage.

Intrasight Mobile IVUS

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Intrasight Mobile IVUS

Western Vascular Institute is excited and honored to announce that we have been chosen as 1 of only 6 locations globally to apply a new intravascular ultrasound technology, the IntraSight Mobile IVUS by Philips.

This amazing new technology provides smart, accurate images inside vessels allowing vascular surgeons the ability to more accurately visualize, plan, diagnosis, and treat peripheral vascular disease during interventional procedures.

We are grateful for this opportunity to be a part of the rollout of this new device. It is not only an incredible honor, but it also shows the caliber of Doctors and staff here at Western Vascular Institute.

https://www.usa.philips.com/healthcare/resources/landing/intrasight

https://www.westernvascular.com/vascular-surgery/peripheral-vascular-disease/

 

 

Vascular Surgeons the real “vascular specialists”

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Vascular Surgeons diagnose, treat, and manage the full spectrum of vascular diseases.

“If you only have a hammer you tend to see every problem as a nail.”

Some vascular “specialists” perform one or two kinds of vascular interventions, so their patients tend to get those treatments. Vascular Surgeons are trained in all treatment modalities and are able to perform every type of procedure skillfully: open, complicated surgery and minimally invasive, in-office endovascular procedures. Some patients need one, some need the other, while many need no surgery at all. Vascular Surgeons are “treatment agnostic,” that is, they do not prefer any treatment over another.

Some types of surgeons come into your life to perform a procedure, make sure you heal and then leave; that’s their role. A vascular surgeon is someone who treats you on an ongoing basis for decades. A vascular surgeon very often has long-term relationships with patients because vascular disease can be a long-term condition.

At Western Vascular Institute, patients will get the best treatment for their particular needs in a caring and safe environment by a vascular surgeon with a full toolbox of treatment options!

https://vascular.org/patients/what-vascular-surgeon

https://www.westernvascular.com/about/

Ankle Brachial Index

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Ankle Brachial Index

The Ankle-Brachial Index (ABI) is a simple and non-invasive test that measures the blood pressure in the ankles and arms to evaluate the presence of peripheral artery disease (PAD) or other vascular conditions. It is an essential diagnostic tool used by healthcare professionals to assess the circulation in the lower extremities. Here’s how the ABI works and why it is important:

Procedure:

During an ABI test, blood pressure measurements are taken at the ankles and arms using a blood pressure cuff and a Doppler ultrasound device.

The procedure typically involves the following steps:
  • The person undergoing the test lies down in a supine position.
  • Blood pressure cuffs are placed on the arms and ankles.
  • The healthcare provider uses a Doppler ultrasound device to detect and amplify the sounds of blood flow in the arteries.
  • The cuffs are inflated to temporarily stop blood flow, and then gradually deflated to measure the systolic blood pressure at each location.
  • The ratio of ankle pressure to arm pressure is calculated to determine the Ankle-Brachial Index.
    Interpretation:
  • The ABI is calculated by dividing the higher of the ankle pressures by the higher of the arm pressures. Here’s how the ABI results are interpreted:
Normal ABI (0.90-1.30): A normal range indicates that blood flow in the lower extremities is normal, and there is no significant obstruction or blockage in the arteries.
ABI < 0.90: A lower ABI value suggests the presence of peripheral artery disease (PAD), which indicates reduced blood flow to the legs and feet. The lower the ABI value, the more severe the blockage or narrowing of the arteries.
ABI > 1.30: A higher ABI value may indicate the presence of non-compressible arteries, often seen in individuals with calcified or hardened arteries.

 

Importance of ABI Testing: The ABI test is an important diagnostic tool for several reasons:

Early Detection of Peripheral Artery Disease (PAD):

ABI testing helps identify PAD at an early stage, allowing for timely intervention and management. Early detection and treatment can prevent the progression of PAD, reduce symptoms, and lower the risk of complications such as non-healing wounds or amputation.

Assessing Cardiovascular Risk:

PAD is often associated with an increased risk of cardiovascular events such as heart attack or stroke. ABI testing helps identify individuals who may be at a higher risk for these events, allowing for appropriate interventions and preventive measures.

Monitoring Treatment Effectiveness:

For individuals diagnosed with PAD, ABI testing can be used to monitor the effectiveness of treatment and track changes in blood flow over time. Regular ABI measurements help healthcare providers assess the response to interventions such as lifestyle modifications, medication, or surgical procedures.

Screening in High-Risk Populations:

ABI testing is recommended for individuals who are at a higher risk of developing PAD, such as those with diabetes, a history of smoking, hypertension, or high cholesterol. It is a valuable screening tool to identify early signs of peripheral artery disease in these populations.

Remember, ABI testing should be conducted by a qualified healthcare professional, such as a vascular specialist or a cardiologist, to ensure accurate results and appropriate interpretation. If you have concerns about your leg circulation or risk factors for peripheral artery disease, consult with your healthcare provider to determine if ABI testing is necessary.

 

What Causes A Stroke?

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What Causes A Stroke?

 

Type of Stroke:

Ischemic stroke – occurs when blood vessel blockage prevents blood flow to the brain due to a plaque build-up in the carotid arteries.

Hemorrhagic stroke – occurs when the vessel ruptures inside of the brain and bleeds.

Transient Ischemic stroke or TIA – is a temporary blockage or mini-stroke which can cause permanent damage and are a sign of more severe stroke in the future.

Like Peripheral Arterial/Vascular Disease, Carotid Artery Disease is a narrowed blood flow through the vessel. This narrowing or blocked vessel becomes occluded by fatty deposits of plaque built up along the vessel wall leading to atherosclerotic disease. The Carotid artery is the primary source of blood to your brain. Therefore, a narrowing or blockage in the carotid artery is a serious complication and requires thorough and appropriate diagnosis and treatment.

Stroke Symptoms:

Many people with Carotid Artery Disease do not experience symptoms even with quite a bit of arterial blockage. Generally, this condition is found after the patient experiences a stroke or by a routine patient examination.

Stroke Causes:

Generally, Carotid Artery Disease is caused by atherosclerosis, where a build-up of plaque in the arteries reduces the flow of blood or blocks the flow entirely. This lack of blood flow and reduced oxygen supply to the brain can lead to stroke.

Stroke Risk Factors include:

Sedentary lifestyle, Overweight obesity, Diabetes, smoking, high cholesterol levels, high blood pressure, Family history, high fat diet, and age above 75 are all factors.

Stroke Diagnosis:

Diagnosis of Carotid Artery Disease is generally diagnosed through a physical examination and medical history. Your physician will also most likely be looking for a (bruit) swooshing sound in the carotid artery that is indicative of a narrowed artery. A Carotid Artery duplex ultrasound scan will also be performed to assess the flow of blood through the artery as well as the pressure.

Stroke Treatments:

The reason for the treatment of carotid artery disease is to reduce or mitigate the possibility of stroke.

For mild blockage:

Lifestyle changes such as eating a healthier diet, reducing salt intake, exercising regularly, losing weight, and quitting smoking are all ways that patients themselves can manage the disease and reduce the chance of blockage and stroke.

Medication management:

Medications may be given to lower the amount of cholesterol in the blood and lower your blood pressure. Additionally, blood thinner medications may be given to prevent blood clots.

Surgical intervention for stroke prevention:

Carotid endarterectomy – generally performed when there is a blockage of 50% or above accompanied by symptoms such as a stroke.

TCAR – Western Vascular Institute is pioneering the use of a breakthrough technology called TransCarotid Artery Revascularization (TCAR) to treat patients with carotid artery disease who are at risk for open surgery. While any repair of the carotid artery carries some risk of causing a stroke because of the repair itself, TCAR was designed to help minimize that risk by keeping potential stroke-causing fragments away from the brain.

Carotid angioplasty/stenting – This procedure is performed to treat narrowed or occluded carotid arteries. In this procedure, the Vascular Surgeon inserts a wire through the groin and guided via X-ray imaging to the carotid artery. Once there, the balloon is placed to expand the narrowed section, and a stent is left in place afterward to maintain the vessel diameter and allow the blood to flow through the artery.

 

Radio-Frequency Ablation for Varicose Veins.

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Radio-Frequency Ablation for Varicose Veins.

 

Introduction:

Radiofrequency ablation (RFA) for varicose veins addresses the venous reflex disease that often causes varicose veins. RFA serves as an alternative to traditional vein stripping, which requires invasive surgical removal of the diseased veins. RFA Instead, uses heat energy to prompt the closure of diseased veins.

Treatment:

The surgeon starts by numbing the area with a topical and local anesthetic. Then, by way of a small incision, he or she passes a catheter or similar tool into the affected vein. The catheter serves as a channel through which the surgeon introduces an electrode.

When the surgeon pulls back on the catheter to expose the end of the fiber or electrode, energy passes into the vein as heat. This heat shrinks the collagen in the vein wall, which in turn causes the vein to shrink and close. The surgeon then removes the catheter and the patient’s body proceeds to heal the closure by rerouting blood to healthy veins. Radiofrequency ablation (RFA) for varicose veins is the standard treatment for varicose veins and has been shown to be the most effective and long-lasting treatment modality to date.

Radio-Frequency Ablation
Radio-Frequency Ablation
Radio-Frequency Ablation
Radio-Frequency Ablation