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Introducing Daniel Krcelic M.D.

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Introducing Daniel Krcelic M.D.

 

Daniel Krcelic, MD a vascular surgeon in Arizona.

Western Vascular Institute is excited to introduce Daniel Krcelic M.D. has joined our group of exceptional vascular surgeons. We are very grateful for his addition and look forward to the unparalleled vascular care he will provide to the WVI patients.

Doctor Krcelic is trained in all aspects of vascular surgery in both the inpatient and outpatient settings. He completed his fellowship in vascular surgery at Carolinas Medical Center and Sanger Heart & Vascular Institute in Charlotte. Dr. Krcelic said. “I care deeply about my patients, and joining Western Vascular Institute brings another skilled vascular specialist to meet the needs of patients in the Phoenix Metro Area,”.

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Arteriovenous Fistula Creation

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Arteriovenous Fistula Creation: Enhancing Dialysis Access and Patient Well-being

For individuals with end-stage renal disease (ESRD) who require long-term dialysis, the creation of an arteriovenous fistula (AVF) is a critical step in establishing reliable and efficient vascular access. An AVF is a surgically created connection between an artery and a vein, typically in the forearm or upper arm. Let’s explore the importance of AVF creation, its benefits, and the process involved.

Why is AVF Creation Important?

AVF creation plays a vital role in hemodialysis, a life-sustaining treatment for individuals with ESRD. During hemodialysis, blood is filtered and cleansed by a dialysis machine, and reliable vascular access is essential to facilitate the movement of blood to and from the dialysis machine. AVFs are considered the preferred form of vascular access due to their longevity, lower risk of complications, and improved dialysis outcomes compared to other access options such as arteriovenous grafts or central venous catheters.

Benefits of AVF Creation:
Improved Long-Term Vascular Access:

AVFs have the potential to provide long-lasting access for dialysis, reducing the need for repeated procedures and minimizing the risk of infection or other complications associated with temporary access options.

Increased Blood Flow and Dialysis Efficiency:

By connecting an artery to a vein, AVFs create a direct pathway for blood flow. This increased blood flow allows for efficient dialysis by facilitating the removal of waste products and excess fluid from the body during each dialysis session.

Lower Risk of Infection and Thrombosis:

AVFs have a lower risk of infection and clot formation compared to other access methods. The natural connection created between the artery and vein promotes better blood flow and reduces the likelihood of complications such as infection or blockages.

Preservation of Central Veins:

AVFs help preserve central veins, such as the subclavian or jugular veins, which may be necessary for future access options if AVF complications arise or if the AVF is no longer viable.

The AVF Creation Process:

The creation of an AVF involves a surgical procedure that is typically performed by a vascular surgeon. The process generally includes the following steps:

Preoperative Evaluation:

Before AVF creation, the surgeon assesses the patient’s vascular anatomy and determines the most suitable site for the fistula. Factors such as the diameter and quality of the veins and arteries are considered.

Surgical Procedure:

The surgeon makes an incision to access the artery and vein chosen for the AVF. The artery is dissected, and a segment of the vein is isolated. The artery and vein are then connected to create the fistula, allowing blood to flow from the artery into the vein.

Postoperative Care and Maturation:

After the surgery, the AVF requires time to “mature” and develop the necessary blood flow. This maturation process typically takes several weeks to months. During this time, the vein gradually enlarges, becoming suitable for dialysis needle insertion.

Monitoring and Maintenance:

Regular follow-up visits with the healthcare team are essential to monitor the AVF’s functionality and detect any potential issues early on. The patient is educated on proper care and maintenance of the AVF to minimize complications and maximize its longevity.

Arteriovenous fistula creation is a crucial step in establishing reliable vascular access for individuals requiring hemodialysis. By providing long-term access, improving dialysis efficiency, and reducing the risk of complications, AVFs contribute significantly to the well-being and quality of life of patients with ESRD.

Matters of the Heart

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Matters of the Heart

The heart is a muscular organ about the size of a fist, located at the center of our chest that pumps blood through the network of arteries and veins. It pumps around 6 liters of blood per minute. The heart’s vital performance can be affected by a number of factors, causing it to beat too slow, too fast, or even cause it to fail. Aside from physical ailments, emotions such as joy, sadness, and grief can positively or negatively affect the heart’s performance and health.

Figuratively, the deepest and most noble thoughts and feelings, as well as the darker ones, have been attributed to originating from the heart. Matters of the heart are the most important things in our lives and move us deeply. They bring us joy and laughter, along with sadness and tears. They are things that touch our hearts, fill our hearts, and break our hearts. They are what makes us fully human. Matters of the heart connect us to each other and to God.

This exhibition showcases new and original works of art by Dr. Julio Rodriguez-Lopez (renowned vascular surgeon) in acrylic paint with some new watercolor features. These pieces in essence merge the clinical with the metaphorical presentations of the heart and reveal the connection between both.

Schedule an Appointment with Renowned Vascular Surgeon Dr. Julio Rodriguez

Not only is Dr. Julio Rodriguez an amazing artist but, he is also a highly-trained vascular surgeon. Dr. Rodriguez is an internationally renowned vascular surgeon who has devoted his life to Vascular education, research, and teaching. He is dedicated to providing you with comprehensive diagnosis and treatment for all of our vascular conditions. For more information, contact Western Vascular Institute at (480) 668-5000 and schedule an appointment today!

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/