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Category: Vascular Surgery Center

Introducing Adam Calarese M.D.

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Introducing Adam Calarese M.D.

Please join us in Welcoming Doctor Adam Calarese.

We are pleased to announce the addition of Adam Calarese M.D. to the team of talented Vascular Surgeons here at Western Vascular Institute.

Dr. Calarese is from Boston, MA, and graduated from Boston College with his undergraduate degree. He then earned a post-baccalaureate premedical degree from Harvard University. After Harvard, he attended Drexel University College of Medicine where he received his medical degree.

Dr. Calarese then completed a full General Surgery residency at Atrium Health in Charlotte, North Carolina. Once his General Surgery residency was complete, Dr. Calarese finalized his extensive training with a two-year fellowship in Vascular Surgery from the Sanger Heart and Vascular Institute. He is excited to be in the Phoenix Metro Area and ready to serve all those with vein and vascular issues.

For an appointment with Dr. Calarese, please contact one of our new patient coordinators at (480) 668-5000 ext. 332.

Appointments

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,”.

Appointments

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!

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.

 

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/

 

 

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.

What is Atherosclerosis?

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Atherosclerosis – is a disease process that leads to the hardening or clogging of arteries. The build-up over time of substances such as fat, cholesterol, & calcium, collectively called plaque, narrows the artery and restricts the amount of blood able to pass through the arteries, and provides oxygen-rich blood to the body. This stenosis or narrowing of the artery can lead to serious problems such as stroke, amputation, heart attack, and death.