Tag: Leg Swelling

TREATMENT OF VARICOSE VEINS IN LOS GATOS

Posted on by Angelica Rodezno

WE CAN TREAT YOUR VARICOSE VEINS, SWOLLEN, ACHING LEGS, NON HEALING LEG WOUNDS, AND PERIPHERAL ARTERIAL DISEASE

For 20 years, the physicians and staff of South Bay Vascular Center and Vein Institute have successfully treated tens of thousands of patients in the Silicon Valley communities of Los Gatos, San Jose, Campbell, Los Altos, Palo Alto, Morgan Hill, Gilroy and the greater South Bay. Our ABMS Boarded Vascular Surgeons are experts in the treatment of varicose veins and swollen legs and can help patients get their lives back by successfully treating these conditions.

Spider and varicose veins are a common problem that many men and women have to confront. Spider veins are small, reddish veins that appear on the surface on the skin, while varicose veins are blue, tangled, bulging, knotted vessels that are much larger. Women are more likely to experience varicose veins than men, but they are common among both genders.

Aside from their unsightly appearance, varicose veins can cause a feeling of heaviness or tiredness in the leg, swelling, tenderness or pain when touched, and a general sense of restlessness. Age and family history are two major factors in a person’s risk of varicose or spider veins, but lifestyle also has a role to play. People who do not exercise regularly, are overweight or obese, or who sit or stand for long periods of time have a higher risk of varicose veins and venous insufficiency. Women who are pregnant also have a higher chance of these issues.

Varicose and spider veins are most common among people who are middle­aged, but even those in their teens and twenties can have this problem. No matter what a person’s age, there is no reason to wait to have these issues examined.

Vein issues can occur if a vein becomes weakened. Elastic vein walls and tiny one­way valves help send blood back to the heart, but if they lose their strength blood can start to pool backwards into the vein. Varicose veins may not be symptomatic at first, but many patients eventually report achiness and a sense of heaviness in their legs. Often accompanying these symptoms are ankle and lower leg swelling, cramps, a sense of restlessness, and an irritated or itchy rash around the ankles. The area around the vein may become numb or tender to the touch.

Varicose vein symptoms can also be aesthetic. Bulging, twisted, or knotted veins can form over the ankle and foot while the skin around them becomes discolored, leathery, and thick. In advanced stages this skin may begin to break down, leading to ulceration.

Spider veins are similar to varicosities, but they are smaller and appear closer to the skin’s surface. As their name suggest, they often form in patterns similar to spider webs. They are often red in color and may be a sign of more serious ​vein disease​ under the skin

Varicose veins can lead to more serious conditions, including:
● Thromboses – blood clots that form in an enlarged vein
● Phlebitis – vein inflammation
● Venous Stasis Ulcers – Ulcers that form due to a lack of proper drainage in an enlarged vein

Lots of centers treat the complications of poor flow through the venous system when it shows up as spider veins, varicose veins, and other cosmetic issues. Fast cosmetic fixes, however, can often mask more serious underlying circulation issues that only a vascular surgeon is trained to address. At South Bay Vascular Center and Vein Institute our goal is simple: to ensure the best possible outcomes in the safest and most comfortable environment possible.

If you suffer from varicose veins, leg swelling, especially Left Leg Swelling, after cosmetic vein treatments, please call our office at 408-376-3626 to discuss how we can treat your varicose vein and other circulatory issues. We Can Help!

TREATING SWOLLEN, ACHING LEGS

Posted on by Angelica Rodezno

Leg swelling is a difficult symptom to diagnose. There is a long list of underlying causes for leg swelling and it is important to note two things:

1. Is the leg swelling unilateral (in one leg) or is it in both?

If it is in both, it is more likely to be a “systemic” issue, that is a problem with one’s general health. This can be something as simple as too much time in a chair, to something as serious as congestive heart failure. Many medications can also contribute to bilateral leg swelling as can liver disease, kidney problems, and obesity.

2. What part of the leg is swollen?

If the swelling extends into the foot, it is more likely to be lymphedema than a venous problem.

If it goes all the way up into the thigh it may be ​ Iliac Vein Compression ​or, if the onset of swelling is rapid, it may be the result of an ​ileofemoral blood clot​ (DVT).

It is important not to ignore leg swelling, especially if it comes on abruptly as it may be a sign of a serious and potentially life threatening issue.

Iliac vein compression syndrome occurs because of the anatomic compression of the left iliac vein between the lumbar spine and the right iliac artery. Although originally thought to be a rare syndrome, it is now believed that about 30% of all people have significant compression of their iliac vein. In most people, this is asymptomatic and will never cause a problem. However, it is being recognized that in more people who have chronic leg swelling, especially of the left side, continued aching despite treatment of superficial venous disease, recurrent left leg blood clots, and /or nonhealing ulcerations at the ankle or shin that this compression prevents the adequate drainage of blood from the leg. Although about 80% of the compressions are of the left iliac vein, we do sometimes find them on the right, especially as a result of scarring from pelvic or back surgery. This is the most common cause of ileofemoral DVT and should be worked up aggressively.

This is a special area of interest of ours, and we are active in doing clinical research to find better ways to diagnose and to treat iliac vein compression. Unfortunately, many physicians are unaware of these latest treatment options and tell their patients that not much can be done to treat this condition. Consequently, we find that way too many patients live with this painful and difficult condition of leg swelling and the non-healing wounds that often accompany it. There is hope.

We can help.

The physicians at South Bay Vascular Center and Vein Institute are board certified vascular surgeons and not “phlebologists” or “vein specialists”. As such we can do significantly more to treat generalized leg swelling and the leg swelling that often accompanies failed cosmetic vein procedures. Our surgeons are at the forefront of diagnosing iliac vein compression and leg swelling secondary to cosmetic procedures using regular vascular ultrasound. Most importantly, we can treat this painful condition with the newest endovascular techniques using IVUS (intravascular ultrasound) and stents in an outpatient office setting. To date, we have successfully treated over 75 patients in our outpatient angio suite here in Campbell, CA. If you suffer from leg swelling, especially left leg swelling there is hope. Please give us a call at South Bay Vascular Center and Vein Institute to schedule an appointment to discuss your treatment options. 408-376-3626

WHAT ARE VARICOSE VEINS?

Posted on by Angelica Rodezno

Varicose veins are raised, ropey, enlarged veins. They usually appear on the legs and can cause the leg to swell, itch, ache, and in severe cases, can cause ulcers. Normal vein valves close after blood travels up the vein, preventing blood from moving backwards (refluxing) down the vein. Varicose veins form when valves in the vein fail (become incompetent). Valves become incompetent for a variety of reasons, including trauma and pregnancy. Once a valve becomes incompetent, the vein below the valve is exposed to higher pressure and becomes dilated. This causes other valves to fail and other veins to dilate.

WHAT ARE THE SYMPTOMS OF VARICOSE VEINS?
Varicose veins are dark blue in color and commonly appear on the backs of the calves or on the inside of the legs. But they can form anywhere on your legs, from your groin to your ankle. They protrude or bulge from under the skin and feel ropey. Varicose veins cause an achy or heavy feeling in the legs, and burning, itching, throbbing, muscle cramping and swelling in your legs. Prolonged sitting or standing makes your legs feel worse, while elevating your legs makes them feel better. Varicose veins can also cause skin ulcers near your ankle.

HOW ARE VARICOSE VEINS TREATED?
Both invasive and non-invasive methods are available to treat varicose veins. Non-invasive methods include wearing compression stockings, exercising, leg elevation, losing weight, not wearing tight clothes, avoiding long periods of standing or sitting and not crossing your legs while seated. Invasive treatments include endovenous therapy, ligation, and phlebectomy. Endovenous therapy is treatment from inside the vein using heat generated by lasers, radiofrequency devices or chemicals to irritate the vein walls and cause the vein to close and then be reabsorbed by the body. Ligation is tying off a vein to cause it to shrink. Phlebectomy is the term used for the removal of varicose veins.

WHAT IS ENDOVENOUS LASER THERAPY?

Posted on by Angelica Rodezno

Endovenous Laser Ablation (EVLT), a treatment for varicose veins, is an advanced, highly effective treatment for varicose veins. EVLT works by using targeted laser energy to close off problem veins, thus relieving the symptoms and appearance of varicose veins and restoring healthy, attractive legs. This treatment is ideal for large varicose veins, including the greater saphenous veins.

The EVLT™ Procedure is minimally-invasive and virtually pain-free. While surgical vein treatment methods can cause scarring and other side effects, the laser energy used in EVLT minimizes risks and complications. Laser energy is delivered directly to the target vein to shrink the walls, which eventually causes the vein to close. Blood flow is diverted to other, healthy veins, eliminating the varicose vein bulging, discoloration, and pain.

EVLT is performed as an outpatient procedure, usually in less than an hour, with only local anesthesia. This means that recovery time is dramatically reduced. Most patients can resume normal activities immediately following treatment, while enjoying superior clinical and aesthetic results.

WHAT IS RADIOFREQUENCY ABLATION OF VARICOSE VEINS?

Posted on by Angelica Rodezno

Radiofrequency ablation – the Closure Procedure – is similar to endovenous laser therapy. A radiofrequency probe is placed in the vein under ultrasound guidance. Then the vein is anesthetized using local anesthesia. Next, the vein is heated along its entire length by slowly withdrawing the probe from the vein. This causes the vein to clot and close, stopping the reflux (Leaking valves). Radiofrequency ablation is an outpatient procedure, can be performed under local anesthesia, and takes about 45 minutes. Possible complications are continued leg swelling, numbness, tingling, and blood clots in the legs. Patients may have bruising and mild pain for up to 4 weeks.

To date, Dr. Kokinos has successfully performed over 10,000 cosmetic vein procedures and is regarded as one of the premier Vascular Surgeons in the area to provide this service. If you suffer from painful varicose or unsightly legs, please call our office today to discuss your treatment options.

If you have already undergone a cosmetic vascular procedure and continue to experience pain and leg swelling, Dr. Kokinos is one of the few physicians in the area offering an FDA approved treatment to address this complication. We are happy to meet to evaluate your leg swelling, especially if it is left leg swelling and to discuss available treatment options for this unfortunate complication of cosmetic vein procedures.

WHAT IS VASCULAR ULTRASOUND*

Posted on by Angelica Rodezno

The medical specialty of vascular technology utilizes diagnostic ultrasound to generate images of blood flow within the veins and arteries. Ultrasound uses high frequency sound waves, similar to the sonar that a ship uses to detect structures beneath the surface of the water. Vascular ultrasound can also be known as a Doppler or duplex study. For example, if your physician wants to make sure that you do not have a blood clot in your leg, he or she might order a venous duplex or venous Doppler examination.

Vascular ultrasound procedures are noninvasive, meaning they do not require the use of needles, dyes, radiation or anesthesia and are, therefore, relatively painless and harmless.

The information obtained through vascular ultrasound examinations is extremely helpful to physicians in diagnosing a variety of conditions related to cardiovascular disease, disorders of the heart and blood vessels. Early detection of life-threatening vascular diseases is possible through the use of noninvasive vascular testing techniques performed within vascular facilities.

Vascular ultrasound’s reliability in diagnosing conditions related to heart disease and stroke is encouraging as we strive for ways to reduce the more than 500,000 lives lost in the United States each year to these disorders. However, it is critical that the public realizes there are many facets that contribute to an accurate diagnosis based on vascular ultrasound examinations. These factors include the skill of the technologist/sonographer performing the examination, the type of equipment used, the background and knowledge of the interpreting physician and quality assurance measures. In fact, poor ultrasound examinations often lead to inconvenient, redundant studies, misdiagnosis and even unnecessary tests or surgery.

*Taken from the Intersocietal Accreditation Commission Website

VASCULAR ULTRASOUND LAB ACCREDITATION: WHY IT’S IMPORTANT

Posted on by Angelica Rodezno

Taken from the IAC Vascular Testing Accreditaton Website

IAC accreditation demonstrates a commitment to quality care.

The purpose of the IAC Vascular Testing accreditation program is “to ensure high quality patient care and to promote health care by providing a mechanism to encourage and recognize the provision of quality vascular diagnostic evaluations by a process of accreditation.” Through the accreditation process, facilities assess every aspect of daily operation and its impact on the quality of health care provided to patients. While completing the accreditation application, facilities often identify and correct potential problems, revise protocols and validate quality improvement programs. Because accreditation is renewed every three years, a long-term commitment to quality and self-assessment is developed and maintained. Facilities may use IAC accreditation as the foundation to create and achieve realistic quality care goals.

IAC accreditation provides a confidential peer-review.

Designed to serve facilities as an educational tool, IAC accreditation is made up of two crucial steps. First, facilities conduct a detailed self-evaluation using the IAC Standards and Guidelines for Vascular Testing Accreditation and the Online Accreditation application. Completion of the application requires detailed information on all aspects of facility operation as well as the submission of actual case studies for review. The case studies are crucial in determining the facility’s compliance with the IAC Standards, and are the basis for judgment of the quality of work that facilities perform. Once the self-evaluation is completed, the documents and case studies are reviewed by the IAC Vascular Testing Board of Directors. All aspects of the review are confidential.

IAC accreditation is a recruiting tool.

Accredited facilities can use their accreditation as a recruiting tool to attract the best and brightest physicians, sonographers and technologists. Talented professionals look for high-quality programs, and accreditation assures potential employees that a facility is dedicated to achieving the highest standards for patient care.

IAC accreditation is intersocietal.

The intersocietal, multi-specialty approach is the foundation of the accrediting divisions under the IAC umbrella. IAC Vascular Testing is a nonprofit organization established with the support of the sponsoring organizations. Representatives from these sponsoring organizations, including physicians, sonographers and technologists, serve on the IAC Vascular Testing Board of Directors. All areas of vascular testing were represented on the Board during the creation of the Standards for accreditation, and all areas continue to steer the accreditation process.

IAC accreditation is proven successful.

Offering accreditation for more than 20 years, the IAC Vascular Testing (formerly ICAVL) pioneered the intersocietal approach to imaging accreditation in 1990, as the first of the Intersocietal Accreditation Commission (IAC) divisions to be developed. Today, reimbursement in more than 30 states hinges on either facility accreditation or technologist certification. The number of IAC Vascular Testing accredited facilities in the U.S., Canada and Puerto Rico continues to grow, with more than 2,600 sites currently holding the accreditation. The IAC offers multi-modality accreditation through its programs dedicated to Vascular Testing, Echocardiography, Nuclear/PET, MRI, CT / Dental CT, Carotid Stenting, Vein Center and Cardiac Electrophysiology.

IAC accreditation demonstrates accountability.

Health care organizations are held to very high levels of accountability, by peers and by the general public. In numerous states, reimbursement directives that require accreditation of the facility have been instituted by Medicare carriers as well as private, third-party insurers (please visit Payment Policies section for the current list). Similar draft payment policies are pending throughout the United States. Facilities attaining accreditation before it is required for reimbursement demonstrate a willingness to surpass current expectations. The general public and members of the vascular testing community will recognize an unmatched commitment to providing quality health care by facilities that achieve IAC accreditation.

HOW ARE VARICOSE VEINS TREATED?

Posted on by Angelica Rodezno

Both invasive and non-invasive (i.e surgical and non-surgical) methods are available to treat varicose veins. Non-invasive methods include wearing compression stockings, exercising, leg elevation, losing weight, not wearing tight clothes, avoiding long periods of standing or sitting and not crossing your legs while seated. Invasive treatments include endovenous therapy, ligation, and phlebectomy.

Endovenous therapy is treatment from inside the vein using heat generated by lasers, radiofrequency devices or chemicals to irritate the vein walls and cause the vein to close and then be reabsorbed by the body. Ligation is tying off a vein to cause it to shrink. Phlebectomy is removal of varicose veins. Only after your physician evaluates a patients vascular ultrasound study are they in a position to discuss the best treatment option for their patients. The vascular surgeons of South Bay Vascular Center and Vein Institute have successfully treated tens of thousands of varicose vein patients in their 20 year history of serving the silicon valley community. With offices in Campbell and Morgan Hill, Dr. Kokinos and her staff are honored to meet with you to discuss any questions you may have regarding varicose veins or any other circulatory related medical condition. Please call our office today to schedule an appointment to help us evaluate your treatment options. 408-376-3626

IS VEIN DISEASE COVERED BY INSURANCE

Posted on by Angelica Rodezno

One of the questions I am most often asked when doing screenings for vein disease is “Is treatment covered by insurance?” As usual, most medical questions are not easily answered and so the answer is yes, and no. All insurance companies consider varicose vein disease treatments medically necessary, and will therefore cover it, if there are complications such as bleeding or ulceration. Most consider treatment medically necessary if there are symptoms and reflux can be demonstrated on a Doppler exam. Of course some of the newer treatments are considered “experimental” and therefore not covered. Spider vein treatments are considered cosmetic and no longer covered by any insurance plans of which we are aware. Lastly, not only does each insurance company have its own requirements but each individual policy can vary within the general guidelines of the company. Sounds confusing and it is. The best way to find out if your particular situation meets the requirements necessary for insurance coverage is to come in for an evaluation. Call us at 408-376-3626 to schedule an appointment to discuss your options.

FREE ILIAC VEIN SCREENING

Posted on by Angelica Rodezno

During the months of May and June, in order to help our patients who have been suffering with left leg swelling for a long period of time, we are offering a free iliac vein ultrasound screening. This ultrasound will be offered on a limited basis to our current patients or someone who has a history of a DVT (deep venous thrombosis). These screenings need to be done in the early morning in fasting patients, and cannot be done on those who weigh more than 250 pounds. Please call our office at 408-376-3626 to inquire about availability of the free limited openings.