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Category: End Stage Renal

Why do I need a vascular surgeon?

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Why do I need a vascular surgeon?

 

Vascular Disease:

If you have been diagnosed with vascular diseases such as peripheral artery disease (PAD), deep vein thrombosis (DVT), varicose veins, aneurysms, or carotid artery disease, a vascular surgeon specializes in the treatment of these conditions.

Circulation Problems:

If you experience symptoms related to poor blood circulation, such as leg pain or cramping during walking or at rest, non-healing wounds or ulcers, or coldness in your extremities, a vascular surgeon can evaluate and provide appropriate treatment options.

Vascular Trauma:

In cases of traumatic injuries that involve blood vessels, such as a severe laceration or damage to arteries or veins, a vascular surgeon can perform surgical procedures to repair and restore blood flow.

Aortic Aneurysm:

If you have an abdominal or thoracic aortic aneurysm, which is a weakened and bulging area in the aorta, the main blood vessel in your body, a vascular surgeon may perform surgery to repair or replace the affected segment to prevent the risk of rupture.

Endovascular Procedures:

Vascular surgeons are trained in minimally invasive endovascular techniques, such as angioplasty, stenting, and embolization, to treat various vascular conditions. These procedures involve using catheters and imaging guidance to access and treat the affected blood vessels from within.

Vascular Access:

If you require long-term dialysis, a vascular surgeon can create and manage vascular access points, such as arteriovenous fistulas or grafts, to allow repeated access to your blood vessels.

With many years of extensive vascular experience, Western Vascular Institute’s providers are able to provide unparalleled diagnosis & management for all venous & vascular diseases as well as exceptional patient care.

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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.

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.

 

The Joint Commission

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The Joint Commission Certification

The Joint Commission, also known as TJC, is an independent, non-profit organization in the United States that accredits and certifies healthcare organizations and programs. It was founded in 1951 and is recognized as a leader in setting quality and safety standards for healthcare.

The goal of The Joint Commission:

The primary goal of The Joint Commission is to improve the quality and safety of patient care. They achieve this by establishing rigorous standards and conducting thorough evaluations of healthcare organizations to ensure compliance. Accreditation by The Joint Commission is voluntary but highly valued and widely recognized as a mark of quality in the healthcare industry.

The accreditation process:

The accreditation process involves an in-depth review of various aspects of an organization’s operations, including patient care, infection control, medication management, leadership, and performance improvement. Surveyors from The Joint Commission visit healthcare facilities to assess compliance with the standards. If an organization meets the standards, they are awarded accreditation, which is typically valid for a specific period.

The Joint Commission certification:

In addition to accreditation, The Joint Commission offers various certification programs for specific areas of healthcare, such as disease-specific care, primary stroke centers, and advanced certification in healthcare quality.

The Joint Commission & Patient Saftey:

The Joint Commission plays a crucial role in promoting patient safety and quality improvement in healthcare organizations. Their standards and accreditation process help organizations identify areas for improvement, implement evidence-based practices, and continuously enhance the quality of care provided to patients.

It’s important to note that while The Joint Commission sets standards and evaluates healthcare organizations, they do not have regulatory authority. Their focus is on voluntary accreditation and continuous improvement rather than enforcing compliance through legal means.

Western Vascular Institute is a Joint Commission Accredited vascular-surgery-center garnering the gold seal of approval. These certifications demonstrate a higher level of expertise and specialization in particular areas of care.

Vascular Ultrasound

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Vascular ultrasound

Vascular ultrasound, also known as duplex ultrasonography or Doppler ultrasound, is a non-invasive imaging technique used to evaluate blood vessels and blood flow in the body.

During this study, a small handheld device called a transducer is used to emit high-frequency sound waves into the body. These sound waves bounce back off the blood vessels and are detected by the transducer, which converts them into images that can be viewed on a monitor.

Vascular ultrasound is commonly used to diagnose and monitor various vascular conditions, including:

 

Peripheral artery disease (PAD):

Evaluating blood flow and detecting blockages or narrowing in the arteries of the legs, arms, or neck.

Deep vein thrombosis (DVT):

Detecting blood clots in the deep veins, usually in the legs.

Carotid artery disease:

Assessing the carotid arteries in the neck to detect plaques or other abnormalities that may increase the risk of stroke.

Abdominal aortic aneurysm (AAA):

Evaluating the aorta in the abdomen for the presence of an abnormal bulge or enlargement that could potentially rupture.

Venous insufficiency:

Assessing the veins and valves in the legs to identify valve dysfunction or venous reflux, which can lead to conditions like varicose veins.

Vascular ultrasound is a safe and painless procedure that does not involve radiation. It provides real-time images and can be used to measure blood flow velocity and direction using the Doppler effect, which allows the assessment of blood flow characteristics such as speed and turbulence.

The results of a vascular ultrasound can help vascular surgeons make accurate diagnoses, develop appropriate treatment plans, and monitor the effectiveness of interventions over time.

Introducing Dr. David J. Paolini

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Dr. David J. Paolini vascular surgeon in Arizona.
Dr. David J. Paolini Vascular Surgeon with Western Vascular Institute. Board Certified Vascular Surgeon

Dr. David Paolini is a Vascular Surgeon with over 15 years of Vascular Surgery experience.  Dr. Paolini recently joined Western Vascular Institute as one of our acclaimed vascular surgeons from the Jobst vascular center in Toledo, Ohio. Dr. Paolini has had a passion for medicine and physics from a young age, feeling that Vascular Surgery is the perfect combination of the two scientific areas. Dr. Paolini completed his medical school training from Temple University (One of the best Medical Schools in the united states) in 1999 and after that moved to New Mexico to begin his residency at the University of New Mexico Health Sciences Center Department of Surgery. After completing a 5-year surgical residency Dr. Paolini then moved to Toledo, Ohio to complete a Vascular Surgery specific fellowship at the prestigious Jobst Vascular Center. Dr. Paolini quickly gained accolades as one of the most innovative and competent vascular surgeons in the area as well as being heavily invested in Vascular Surgery research and publications. Dr. Paolini’s care philosophy is “ to take care of patients like you would want your kids’ taken care of ”. As a father of two wonderful children and supported by his beautiful wife Dr. Paolini is poised to join the ranks of the great caring vascular surgeons here at Western Vascular Institute. Dr. Paolini’s previous patients have described dr. Paolini as being kind, compassionate, & honest. We are excited to have Dr. Paolini as part Western Vascular Institute. Dr. Paolini is now accepting new patients in the Mesa and Payson office locations. For an appointment with Dr. Paolini please contact one of our new patient coordinators at (480) 668-5000 ext. 332

 

Diabetes and Vascular Disease

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Diabetes Mellitus is a disease that changes the bodies ability to absorb a specific type of surgar (Glucose).

Diabetes causes high levels of this sugar in the blood which can cause long term side effects to the vascular system.

When the blood stream has too high a level of sugar the inner lining of the arteries can be damaged.