LEG SWELLING: SYMPTOMS AND SIGNS

Do you Suffer From Iliac Vein Compression?

To answer that question, take a few seconds to consider the following:

  • Are your legs swollen? Is your left leg larger than your right?
  • Is it harder to slip one shoe on in the morning than the other?
  • Have you had cosmetic or other surgical procedure done and not gotten the outcome you wanted?
  • Are you a cancer patient undergoing treatment or procedures?
  • Have you ever suffered from a blood clot or (DVT) in your leg
  • Do you visit a wound care clinic with little to no success?

If you’ve answered yes to any of these questions, you MAY be suffering from a well known, but previously difficult to diagnose problem called May-Thurner’s Syndrome.

May Thurner’s Syndrome, also known as iliac Vein Compression, is a condition where the main artery supplying blood to the leg pushes down or compresses the main vein taking blood back to your heart. In the illustration below you can see in the far right graphic a “representation” of this compression. One way to help think of what happens when a patient suffers from iliac vein compressions is to consider what happens when a car tire partially runs over a garden hose in your driveway.

If the hose was “on” when you drove over it, water will continue to come out of the hose end but the flow rate will decrease. In a similiar way, blood returning to your heart will continue to flow if you have developed iliac vein compression, but the rate at which it returns is slowed down, resulting in a pooling of blood (i.e. swelling) in your leg.

Chronic pain and swelling in one leg (especially the left side) may be caused by Iliac Vein Compression. This is a little-known but fairly common condition that can greatly impact your quality of life—and may lead to more serious complications. In fact, studies have shown that in a full 30% of ALL people, the left iliac vein can be significantly compressed by the right iliac artery resulting in some kind of leg symptom….aching, heaviness, and most commonly, swelling or non-healing of wounds in the leg veins.

Swollen legs ARE NOT a normal part of aging or weight gain. And it’s not something you have to “just live with.”

Leg swelling is a special area of interest of Dr. Polly Kokinos, and she has been active in doing clinical research to find better ways to diagnose and to treat this condition. To diagnose and to treat this condition and the potentially deadly side effects caused by it (Blood Clots or Deep Venous Thrombosis) Dr. Kokinos has assembled a highly skilled team of vascular ultrasonographer’s who have developed a specialized screening protocol to evaluate for Iliac Vein Compression. Using state of the art ultrasonic imaging technology Dr. Kokinos’ Registered Vascular Ultrasonographer’s use this new protocol to scan up into the abdomen of their patients to examine the physics of the blood flow in this area. If a compression is identified during this ultrasound exam, Dr. Kokinos is able to further verify and treat this problem using a super specialized device called IVUS (Intra-vascular ultrasound) where she can insert a miniuture camera into the actual vein to determine the length of the compression after which she can place a stent to “re-open” this compressed vessel to re-establish normal blood flow.

To date, Dr. Kokinos has successfully performed over 200 of these iliac vein stent procedures in her state of the art out-patient angiography suite. She has lectured extensively at major vascular surgery meetings on her approach and success helping patients reduce leg swelling, increase the rate of wound healing and return to a normal way of living and is seen by her peers as an expert in this technique.

If you are currently experiencing a swollen leg, have a non healing leg, foot,or ankle wounds or have ever suffered a blood clot (DVT) please contact our office at 408-376-3626 to schedule an appointment.

Don’t suffer from swollen legs or non-healing leg ulcers any longer.

We can help!

A SWOLLEN LEG IS NOT NORMAL

Leg Swelling: Iliac Vein Compression
Chronic pain and swelling in one leg, (especially the left side) may be caused by iliac Vein Compression. This is a little-known but fairly common condition that can greatly impact your quality of life – and may lead to more serious complications. Leg swelling is NOT a normal part of aging or weight gain. And it’s NOT something you have to “just live with.”

Leg swelling is a special area of interest of Dr. Polly Kokinos, and she has been active in doing clinical research to find better ways to diagnose and to treat this condition. South Bay Vascular Center and Vein Institute is recognized as the leading treatment center for evaluating and treating left leg swelling. If you have been told there is nothing to do for your leg swelling, call us at 408-376-3626 for an evaluation. We offer hope when others say there is none!

About Iliac Vein Compression:
Iliac vein compression (also known as May-Thurner Symptom) is an anatomic condition that occurs when the left iliac vein gets squeezed and compressed between the lumbar spine and the right iliac artery. This compression prevents the adequate drainage of blood from the leg, which can cause serious problems such as swelling, aching, blood clots, and non-healihg ulcerations. (See Diagram)

Symptoms:

  • Swelling, heaviness and aching in one leg, especially the left leg
  • Recurrent blood clots, especially in the left leg
  • Non healing wounds or dark dry skin in the ankle or shin

Solutions
South Bay Vascular Center and Vein Institute is the leading leg swelling clininc in Northern California offering cutting-edge treatment options that very few other facilities can deliver. We are at the forefront of diagnosing Iliac Vein Compression using regular vascular ultrasound and in treating it with the newest endovascuar techniques using IVUS (intravascular ultrasound) and stents in an outpationt office setting.

If you or a loved one are suffering from leg swelling or any other vascular problems, please call our office today at 408-376-3626 to schedule an appointment. Our offices in Campbell and Gilroy remain open to safely treat patients even during the COVID-19 crisis.

DOES YOUR PATIENT HAVE PAD? A REFERENCE GUIDE FOR PHYSICIANS

Does Your Patient Have PAD? A Reference Guide for Physicians

Know the Facts about Peripheral Arterial Disease (PAD)

According to the U.S. Centers for Disease Control and Prevention (CDC), approximately 18 million people in the United States suffer from Peripheral Arterial Disease (PAD), a common circulatory problem in which narrowed arteries reduce blood flow to the limbs. Although estimates suggest that anywhere from 12 to 20 percent of individuals over the age of 60 are living with PAD, most Americans remain unaware of PAD symptoms.

Unfortunately, as many as 180,000 Americans will undergo a limb amputation as result of PAD-related condition this year. But amputation is not the only answer! Identifying arterial disease early may improve a patient’s quality of life and allow early medical and surgical interventions to lower the risk of critical limb ischemia and amputation.

As a physician, you are your patients’ first line of defense. So it is critically important to be on the lookout for typical symptoms of Peripheral Arterial Disease, which can include:

  • Leg pain with walking
  • Numbness in the toes
  • Wounds on the toes or feet
  • Gangrene

Individuals with high cholesterol, high blood pressure, or diabetes are at greatest risk for PAD. Anyone who has suffered from diabetes for over 15 years should be evaluated by a vascular surgeon.

The Importance of Early Detection and Proper Diagnosis

Dr. Polly G. Kokinos, a board-certified Vascular and General Surgeon in Campbell, CA, is recognized as one of the region’s foremost authorities in the diagnosis and treatment of PAD. Dr. Kokinos has dedicated her entire career to serving the South Bay community as an independent physician and a pioneer in the treatment of patients suffering from Peripheral Arterial Disease.

Early detection and treatment are critical to controlling the disease and allowing patients a full selection of treatment options. In an effort to help front line doctors better evaluate and diagnose PAD, Dr. Kokinos has given many lectures to primary care physicians, internists, podiatrists, and orthopedic surgeons about the management of lower extremity arterial and venous disease and the signs and symptoms to look for.

Due to the complex nature of vascular disease, an evidence-based multidisciplinary approach is essential to early assessment, proper diagnosis, and optimal treatment.

How Treatment for PAD Has Changed

Over the past 15 years, the interventional treatment of peripheral arterial disease (PAD) has changed significantly. Minimally invasive endovascular procedures have replaced many traditional surgical procedures as the dominant intervention.

More recently, pedal access techniques, which access the blocked area from the toe instead of a traditional access point in the patient’s groin, have shown, in certain instances, to be significantly more successful than earlier methods of revascularizing the impacted area. Because Dr. Kokinos has performed more pedal access approach procedures than anyone in Northern California, she can provide patients with more options for treating their disease.

Other treatment options for PAD include medical management, exercise and lifestyle modifications, and surgical bypass amputation (when absolutely necessary).

South Bay Vascular Center & Vein Institute: Designed for PAD Treatment

Founded by Dr. Polly Kokinos, South Bay Vascular Center & Vein Institute is a nationally accredited Vascular Surgery Center of Excellence. Unlike traditional hospital operating rooms, this state-of-the-art facility in Campbell, CA was specifically designed as a PAD intervention and treatment facility.

At South Bay Vascular, physicians leverage advanced technology (including Ziehm C-Arms with Flat Panel Detectors and Phillips Intra Vascular Ultrasound imaging systems) to provide the most advanced surgical techniques available in this area.

With a vast inventory of specialized medical devices not found in traditional operating rooms, South Bay Vascular’s surgeons can perform advanced, minimally invasive surgical procedures to provide the best possible outcomes in the most difficult circumstances.

If you suspect any of your patients may have symptoms of Peripheral Arterial Disease or other complex vascular or arterial issues, we would be honored to meet with them to discuss their symptoms. Please refer them to South Bay Vascular Center & Vein Institute (with offices in Campbell and Gilroy, CA) or call 408-376-3626 to schedule an appointment.

For more information, go to southbayvascular.com.

DR. KOKINOS SELECTED TO SPEAK AT 2017 UCSF VASCULAR SYMPOSIUM

Dr. Kokinos is honored to be a featured speaker at this years world renown UCSF Vascular Symposium. Dr. Kokinos will present her on-going research on the treatment of venous ulcers. This years session will be presented on April 6, 2017 in San Francisco, CA. Congratulation’s Dr. Kokinos on your selection as a speaker.

Dr. Kokinos is a Board Certified Vascular and General Surgeon and is the medical director of the wound care clinics at Verity’s O’Connor Hospital in San Jose and St. Louise Hospital in San Martin Ca. Together with her partner, Dr. Carlos Pineda, Dr. Kokinos operates the leading varicose vein treatment center in Northern California and has provided specialized vein care treatment and repair for over 20 years. Recognized as the leading Vein Specialist and Varicose Vein Doctor in Northern California, Dr. Kokinos is known as the Doctor’s Doctor and is honored to work alongside her patients to help them return to a healthy and normal lifestyle.

DR. KOKINOS HONORED AS A SPEAKER AT THE 2017 AMERICAN VENOUS FORUM

Dr. Kokinos was recently honored at the American Venous Forum in New Orleans as a expert on the treatment of deep venous disease. Her groundbreaking research on the Correlation of Transabdominal Ultrasound with IVUS in Diagnosing Iliac Vein Stenosis adds to the growing body of medical literature in the evolving field of deep venous pathology and treatment. Congratulations Dr. Kokinos on your recent honor.

DR. KOKINOS SELECTED TO PRESENT AT THE AMERICAN VENOUS FORUM

Dr. Kokinos will be presenting an abstract on her clinical research regarding iliac vein compression at the national American Venous Forum in New Orleans early next year. This meeting is the largest venous meeting of the year, and is sponsored by the Society for Vascular Surgery.

Dr. Kokinos has been recognized nationally as an expert on May-Thurner’s Syndrome, or iliac vein compession. This problem can cause symptoms of (predominantly) left leg swelling, heaviness, aching, deep venous clots, and non-healing ankle or leg wounds. She has performed more intravascular ultrasound exams and stents of the deep venous system than any other doctor on the West Coast in the last year. She will be presenting her clinical research on using regular ultrasound, done by the specially trained registered vascular technologists in the ICAVL accredited Institute for Vascular Testing to diagnose this fairly common but widely underdiagnosed issue. Previously, patients needed to get CT scans which used significant amounts of radiation and contrast for the diagnosis. This problem is not only seen because of a common anatomic situation, but also often as a result of an undiagnosed blood clot (DVT) in the iliac or femoral vein after orthopedic, back, or gynecologic surgery.

If you have one leg that is more swollen or painful than then other, or have had a leg blood clot in the past, please call us at 408-376-3626 or visit us at www.southbayvascular.com.

DR. KOKINOS APPOINTED AS NEW WOUND CARE DIRECTOR AT O’CONNOR AND ST. LOUISE HOSPITALS

Polyxene Kokinos MD, a Board Certified Vascular and General Surgeon of South Bay Vascular Center and Vein Institute was named today as the new medical director of the O’Connor and St. Louise Hospital’s wound care clinics. Dr. Kokinos brings over 25 years of vascular surgery experience to her new position as medical director and is recognized as a national expert in the treatment of peripheral vascular and arterial disease. Dr. Kokinos has a special interest in the treatment of lower extremity and deep venous disease and is recognized as one of the country’s leading experts in this area. Currently, Dr. Kokinos serves as the Chairman of the Cardio Vascular department at Good Samaritan hospital in San Jose. and is honored to accept her new medical directorship at O’Connor and St Louise hospitals.

Highly sought after as a speaker, over the past 4 months Dr. Kokinos has presented her research in deep venous disease at the OEIS national meeting in Miami, Fl.; Western Vascular Society in Colorado Springs, Co; Northern California Vascular Vascular in San Francisco, CA.; and has recently accepted an invitation to speak at the nations largest gathering of Vascular Surgeons at the American Venous Form of the Society for Vascular Surgeons scheduled for New Orleans, Louisiana in Feb of 2017.

Together with her Vascular Surgeon Partner, Dr. Carlos E. Pineda, Dr. Kokinos is excited to expand the current wound care practices at O’Connor and St. Louise Wound Care Clinics to include a specific focus on Chronic Limb Ischemia and Limb Salvage. To this extent, her experience using intravenous ultrasound (IVUS) to help diagnose and to treat deep venous disease, together with her experience delivering state of the art minimally invasive treatments for deep venous disease promises to be an exciting time as she works to transform these regional wound care clinics into world class centers of excellence.

Congratulations Dr. Kokinos on this new appointment.