Category: Vascular Wellness

The “Five P’s” of Peripheral Vascular Disease

The “Five P’s” of Peripheral Vascular Disease

The “Five P’s” of Peripheral Vascular Disease (PVD) are a set of clinical signs and symptoms used to assess and diagnose vascular compromise in the extremities. These indicators help healthcare professionals evaluate the severity and progression of PVD. The Five P’s include:

Pain:

Patients with PVD may experience pain in the affected limb, typically described as cramping, aching, or sharp discomfort. The pain may occur during physical activity (intermittent claudication) and subside with rest. In advanced cases, pain may persist even at rest or during the night.

Pallor:

Pallor refers to the pale appearance of the skin in the affected limb. Reduced blood flow due to narrowed or blocked arteries can result in decreased oxygen supply to the tissues, leading to paleness.

Pulselessness:

Pulselessness indicates the absence or diminished quality of the peripheral pulses in the affected limb. A weak or absent pulse may suggest arterial insufficiency due to PVD.

Paralysis:

Paralysis refers to the loss of motor function in the affected limb. Severe PVD, often associated with advanced stages or acute arterial occlusion, can cause muscle weakness or even complete paralysis.

Paresthesia:

Paresthesia refers to abnormal sensations in the affected limb, such as tingling, numbness, or a “pins and needles” sensation. Reduced blood flow and nerve damage associated with PVD can lead to altered or diminished sensation.

Assessing and documenting the presence of the Five P’s can aid in diagnosing PVD and determining the appropriate treatment course. However, it is important to note that not all individuals with PVD will exhibit all five signs, and the severity of each symptom can vary depending on the extent of the vascular compromise.

Prompt medical evaluation is crucial for individuals experiencing the Five P’s, as it may indicate significant vascular compromise requiring immediate intervention to restore blood flow and prevent potential complications, such as tissue damage or limb loss. Healthcare professionals, particularly those specializing in vascular medicine, use the Five P’s as part of a comprehensive assessment to guide diagnosis, treatment planning, and ongoing management of patients with suspected or confirmed PVD.

Intravascular Ultrasound (IVUS)

Intravascular Ultrasound

Intravascular ultrasound (IVUS) is a medical imaging technique that allows for the visualization of blood vessels from the inside. It involves the use of a tiny ultrasound probe that is threaded into the blood vessels through a catheter, providing detailed images of the vessel walls and structures.

Here’s how intravascular ultrasound works and why it is used in clinical practice:

Procedure:

Insertion of the Catheter:

A catheter, which has a small ultrasound probe at its tip, is inserted into a blood vessel, typically through the groin or the arm. The catheter is carefully guided through the blood vessels until it reaches the area of interest.

Ultrasound Imaging:

Once the catheter is in place, high-frequency sound waves are emitted from the ultrasound probe. These sound waves bounce off the vessel walls and other structures inside the blood vessel.

Image Capture:

The reflected sound waves are picked up by the probe and converted into real-time images. These images are then displayed on a monitor and can be recorded for further analysis.

Benefits and Applications of Intravascular Ultrasound:

 

Detailed Visualization:

IVUS provides high-resolution, cross-sectional images of blood vessels, allowing vascular surgeons to assess the vessel size, structure, and any abnormalities present. IVUS provides more detailed information compared to other imaging techniques.

Assessment of Atherosclerosis:

IVUS is commonly used in the evaluation of atherosclerosis, a condition characterized by the buildup of plaque inside the arteries. Intravascular ultrasound also helps determine the extent and composition of the plaque, identify areas of vessel narrowing or blockage, and guide treatment decisions.

Guidance for Interventions:

IVUS is often utilized during various vascular procedures, such as angioplasty or stent placement. IVUS provides real-time feedback to guide the placement of devices and assess their effectiveness in improving blood flow.

Assessment of Stent Deployment:

IVUS can evaluate the proper positioning and expansion of stents within the blood vessels. IVUS helps ensure that the stent is fully expanded and properly apposed to the vessel walls, reducing the risk of complications.

Research and Clinical Trials:

Intravascular ultrasound is also utilized in research studies and clinical trials to investigate new treatment approaches, assess the effectiveness of medications, and gather data on vascular conditions.

IVUS is a valuable tool in the field of vascular medicine. It helps vascular surgeons make accurate diagnoses, guide treatment decisions, and monitor the progress of interventions. The information obtained through IVUS enhances patient care by providing detailed insights into the condition of the blood vessels, allowing for personalized treatment plans and improved outcomes.

Transcatheter Deep Vein Arterialization

Transcatheter Deep Vein Arterialization

Transcatheter arterialization of the deep vein system is a minimally invasive procedure used to treat chronic limb-threatening ischemia (CLI). CLI is a condition in which the blood supply to the limbs is severely reduced, leading to pain, ulcers, gangrene, and possibly amputation.

Procedure:

In this procedure, a catheter is inserted into a blood vessel in the groin and threaded up to the deep veins in the leg. A small balloon is inflated at the tip of the catheter to create a new pathway for blood flow. A stent, a mesh tube, is then placed in the new pathway to keep it open.

Deep vein arterialization (DVA) is not a novel procedure;  Creating arterial-venous bypass, reverses venous flow, and limb perfusion can restore after the arterialization. It is however a new use of deep vein materialization in its treatment of Critical Limb Ischemia and its use for patients who are not eligible for other treatments such as angioplasty or surgery.

Deep vein arterialization is performed under general anesthesia. The procedure typically takes about two hours. Patients typically stay in the hospital for one to two days after the procedure.

Side Effects:

The most common side effects of Deep vein arterialization are pain, bruising, and swelling at the injection site. Other potential side effects include bleeding, infection, and blood clots.

Deep vein arterialization is a promising new treatment for CLI. It is a less invasive alternative to surgery and angioplasty, and it has been shown to be safe and effective in clinical trials.

Why are vascular ultrasounds necessary?

Why are vascular ultrasounds necessary?

 

Detailed Vascular Assessment:

A vascular ultrasound study is necessary because it provides a non-invasive and painless way to evaluate your blood vessels. It helps identify blockages, narrowing, or abnormalities in the arteries and veins throughout your body. This detailed assessment aids in diagnosing various vascular conditions.

Early Detection of Problems:

By undergoing a vascular ultrasound study, potential issues can be detected at an early stage. Early detection allows for prompt intervention and treatment, helping prevent further complications and ensuring better outcomes.

Monitoring Vascular Health:

For individuals with existing vascular conditions, regular ultrasound studies are essential for monitoring disease progression and treatment effectiveness. This consistent monitoring enables vascular surgeons to make informed decisions and adjust treatment plans as needed.

Avoiding Invasive Procedures:

In many cases, a vascular ultrasound study can provide valuable information without the need for invasive procedures. It reduces the need for exploratory surgeries, minimizing risks, discomfort, and recovery time.

Customized Treatment Plans:

The results of a vascular ultrasound study help vascular surgeons develop personalized treatment plans tailored to your specific needs. This individualized approach ensures that you receive the most appropriate interventions, medications, or lifestyle modifications for optimal vascular health.

Preventing Serious Complications:

Conditions like deep vein thrombosis, arterial stenosis, aneurysms, and peripheral artery disease can have severe consequences if left untreated. A vascular ultrasound study aids in early identification, allowing for timely interventions to prevent potentially life-threatening complications.

Empowering Patient Education:

Undergoing a vascular ultrasound study gives you a clearer understanding of your vascular health. By seeing the images and discussing the findings with your vascular surgeon, you can actively participate in your care, make informed decisions, and take proactive steps toward better vascular wellness.

Schedule Your Vascular Ultrasound Study:

If you have risk factors such as diabetes, high blood pressure, smoking, or a family history of vascular disease, or if you’re experiencing symptoms like leg pain or swelling, it’s crucial to discuss the possibility of a vascular ultrasound study with your vascular surgeon. Don’t delay—early detection and prevention are key!

 

Why should patients focus on Peripheral Vascular Disease?

Why should patients focus on Peripheral Vascular Disease?

 

Beyond the Heart:

Why Patients Should Focus on Peripheral Vascular Disease. When it comes to cardiovascular health, heart disease often takes the spotlight. However, there is another crucial condition that deserves our attention: Peripheral Vascular Disease (PVD). While heart disease affects the arteries supplying blood to the heart, PVD affects the arteries outside the heart, particularly those that supply blood to the limbs. It’s important for patients to understand the significance of PVD and why it should be on their radar alongside heart disease. In this blog post, we will explore the reasons why patients should focus on PVD in addition to heart disease.

Prevalence and Risk Factors:

PVD is more common than many people realize. It affects millions of individuals worldwide, particularly those over the age of 50. The risk factors for PVD overlap with those of heart disease, including smoking, diabetes, high blood pressure, high cholesterol, obesity, and a sedentary lifestyle. By focusing on PVD, patients can address these risk factors and make positive changes to improve their overall vascular health.

Impact on Quality of Life:

Peripheral Vascular Disease can significantly impact a patient’s quality of life. The reduced blood flow to the limbs can cause symptoms such as leg pain, cramping, numbness, and weakness. These symptoms can make it difficult to walk, engage in physical activities, and carry out daily tasks. By addressing PVD, patients can seek appropriate treatment to alleviate these symptoms and regain their mobility and independence.

Increased Risk of Cardiovascular Events:

PVD is not an isolated condition. It is associated with a higher risk of cardiovascular events, such as heart attacks and strokes. The same underlying process of atherosclerosis, the buildup of plaque in the arteries, occurs in both PVD and heart disease. By managing PVD and its risk factors, patients can potentially reduce their overall cardiovascular risk and improve their long-term health outcomes.

Early Detection and Prevention:

Detecting PVD at an early stage is crucial for effective management. Unfortunately, PVD often goes undiagnosed or overlooked due to its subtle symptoms. However, routine screenings and awareness can lead to early detection and intervention. By focusing on PVD, patients can work closely with their healthcare providers to identify the condition early, initiate appropriate treatments, and prevent its progression.

Holistic Approach to Vascular Health:

Taking a comprehensive approach to vascular health means addressing both heart disease and PVD. By understanding the connections between the two and recognizing the importance of overall vascular wellness, patients can adopt a proactive mindset. This includes making lifestyle modifications, such as quitting smoking, adopting a heart-healthy diet, managing blood pressure and cholesterol levels, and engaging in regular physical activity. It’s about viewing the body’s entire vascular system as interconnected and deserves equal attention.

Peripheral Vascular Disease should not be overlooked or overshadowed by heart disease. By focusing on PVD alongside heart health, patients can proactively manage their vascular well-being, improve their quality of life, and reduce their risk of cardiovascular events. Awareness, early detection, and a comprehensive approach to vascular health are essential for optimal long-term outcomes. Remember, your limbs deserve the same level of care as your heart. Take action today for a healthier vascular future.

 

PAD Checklist

References:

Society for Vascular Surgery: Peripheral Artery Disease (PAD)
Western Vascular Institute: What Is Peripheral Arterial Disease?
Mayo Clinic: Peripheral artery disease (PAD)

Why do I need a vascular surgeon?

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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What is Peripheral Vascular Disease?

What is Peripheral Vascular Disease?

 

Peripheral Vascular Disease (PVD) is a condition that affects the blood vessels outside of the heart and brain, primarily in the legs and feet. PVD is caused by narrowed or blocked blood vessels, which can lead to reduced blood flow to the limbs. This can cause a range of symptoms, including pain, cramping, and numbness in the legs, especially during physical activity.

Causes:

The most common cause of PVD is atherosclerosis, a condition where fatty deposits (plaques) build up in the arteries, narrowing the blood vessels and restricting blood flow. Other factors that can contribute to PVD include smoking, diabetes, high blood pressure, high cholesterol, and obesity. In rare cases, PVD can also be caused by a blood clot or inflammation of the blood vessels.

Symptoms:

The symptoms of PVD can vary depending on the severity of the condition. Some people may experience no symptoms at all, while others may experience pain or discomfort in the legs, especially during physical activity. Other symptoms may include numbness, tingling, or weakness in the legs; coldness in the feet or legs; and slow healing of wounds or sores on the feet or legs.

Diagnosis:

To diagnose PVD, your healthcare provider will perform a physical exam and may order diagnostic tests such as an ankle-brachial index (ABI) test, which compares blood pressure readings in the arms and legs, or an ultrasound or angiogram to visualize the blood vessels in the affected area.

Treatment:

The goal of treatment for PVD is to improve blood flow and manage symptoms. Lifestyle changes such as quitting smoking, exercising regularly, and maintaining a healthy weight can help manage PVD and reduce the risk of complications. Medications such as blood thinners or cholesterol-lowering drugs may also be prescribed to manage PVD. In some cases, minimally invasive procedures such as angioplasty or stenting may be recommended to open up narrowed or blocked blood vessels.

Prevention:

Preventing PVD involves making lifestyle changes to reduce risk factors, such as quitting smoking, maintaining a healthy weight, exercising regularly, and managing conditions such as high blood pressure, high cholesterol, and diabetes. Regular checkups with a vascular surgeon can also help detect and manage risk factors before they lead to PVD.

Conclusion:

Peripheral Vascular Disease is a common condition that can cause pain and discomfort in the legs and feet. By understanding the causes, symptoms, diagnosis, and treatment options available for PVD, you can take steps to manage this condition and improve your overall health. Don’t suffer in silence – talk to your vascular surgeon today to learn more about your options for managing PVD.

What is Vascular Surgery?

What is Vascular Surgery?

Vascular surgery is a surgical specialty that deals with diseases of the blood vessels. It is a relatively new specialty, having been founded in the early 1970s. The first residency program was started at the University of Minnesota in 1973.

The specialty of vascular surgery is divided into two main branches: open surgery and endovascular surgery.

Open surgery is the traditional form of surgery, where the surgeon makes a large incision in the patient’s body in order to access the blood vessels. Endovascular surgery is a newer form of surgery that uses tiny instruments and a camera to access the blood vessels through small incisions.

Vascular surgery is a highly specialized field, and there are only a few hundred surgeons in the United States who specialize in it. The majority of vascular surgeons are based in large metropolitan areas, and there are few rural areas that have vascular surgeons.

 Treating a variety of diseases and conditions, including:

Vascular surgery is a life-saving procedure in many cases. For example, an aortic aneurysm is a life-threatening condition that can lead to a ruptured aorta. If the aneurysm is detected early, it can be treated with surgery. It is a highly specialized field, and patients should seek out a vascular surgeon who is experienced in treating the specific condition that they have.

Introducing Adam Calarese M.D.

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.

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Introducing Daniel Krcelic M.D.

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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