PERIPHERAL ARTERIAL DISEASE (PAD); EARLY RECOGNITION AND REFERRAL TO A VASCULAR SURGEON

According to the U.S. Centers for Disease Control and Prevention (CDC), approximately 18 million people in the United States suffer from Peripheral Artery Disease (PAD), a common circulatory problem in which narrowed arteries reduce blood flow to the limbs. Estimates suggest that anywhere from 12 to 20 percent of individuals over the age of 60 are living with PAD. Approximately 160,000 to 180,000 of the estimated 18 million Americans with PAD will undergo a limb amputation as result of PAD-related condition this year, resulting in lower quality of life, high medical costs, and shorter life expectancy.

But even with these alarming numbers, APPROXIMATELY 3 OUT OF 4 AMERICANS are unaware of PAD Symptoms.

Severe PAD symptoms include:

  • Leg pain,
  • Wounds on the toes or feet,
  • Gangrene and
  • A loss of leg mass compared to the rest of the body.
  • Individuals are at greatest risk for PAD if you have high cholesterol, high blood pressure, or diabetes.

Dr. Polly G Kokinos, a board certified Vascular and General Surgeon in Campbell, CA. is recognized as one of the regions foremost authorities in the diagnosis and treatment of PAD. With offices in both Campbell and Gilroy, CA. Dr Kokinos has dedicated her entire career to serving the South County community as an independent physician and as a pioneer in the evaluation and treatment of patients suffering from Peripheral Arterial Disease.

Unburdened by the productivity metrics, financial benchmarks and administrative red tape commonly found in Big Box Medical Systems, Dr. Kokinos has focused her entire career on providing exceptional vascular care building her practice one patient at a time. Her Campbell Surgery center, a nationally accredited Vascular Surgery Center of Excellence, is entirely dedicated to treating patients suffering from complex vascular surgical disorders. Unlike a traditional hospital or university operating room, Dr. Kokinos’ surgery center is entirely dedicated to addressing vascular issues ensuring that she has the most advanced imaging and device technology available anywhere in the world.

Unfortunately, even with all of her skill experience and technology, many patients don’t find Dr. Kokinos until its too late. Many patients go under diagnosed or undiagnosed until it is too late and their medical condition has declined to the point where no one can help. In this circumstance patients lose limbs, suffer unnecessarily and become an incredible burden on their family and loved ones. In the worst cases, patients can die if their leg wounds are left untreated.

In an effort to help front line medical doctors better evaluate and diagnose peripheral arterial disease Dr. Kokinos has spoken extensively to the Primary Community Care Team (Internists, Podiatrists, Orthopaedic Surgeons) in the management of lower extremity arterial and venous disease. As is the case in most instances, early detection of peripheral arterial disease has a dramatic impact on the success of any future treatments.

Bridging this educational gap was the topic of a recent talk Dr. Kokinos was honored to give in March of 2020 to a group of Northern California primary care physicians. The focus of this talk was to help primary care and referring physicians better understand the etiology (the cause of a disease or condition) its diagnosis, management, and referral strategies for peripheral arterial and venous disease.

The key takeaways from her talk are outlined below:

  • Prevalence of PAD and Venous Disease have reached epidemic proportions.
  • Peripheral Arterial and Venous Disease are both associated with high rates of disability and death.
  • Identifying arterial disease early may improve a patients quality of life and allow early medical and surgical interventions to lower the risk of critical limb ischemia and amputation.
  • Identifying venous disease can greatly improve a patients quality of live and lower their risk of dying from this disease.
  • Despite greater awareness, PAD and Venous disease are still under-recognized and under treated.
  • Due to the complex nature of vascular disease, an evidence-based multidisciplinary approach is essential to early assessment, proper diagnosis and optimal treatment
  • Minimally invasive endovascular techniques now enable vascular surgeons to treat significantly higher numbers of patients with a lower complication and death rate
  • Appropriate referrals to specialists must be emphasized if physicians are to continue to improve the lives of patients with PAD

Her underlying message to the audience was that primary care physicians are a patients first line of defense. Helping patients achieve better outcomes requires early recognition and management on the part of the primary care physician and that early referral to a vascular surgeon is essential to the successful outcome of advanced treatments.

If you or anyone you love suffers from any of the symptoms outlined in this blog, we would be honored to speak with them to discuss their symptoms. Call Dr. Kokinos’ office at South Bay Vascular Center to schedule an appointment at 408-376-3626.

DR. POLYXENE KOKINOS…AN INDEPENDENT COMMUNITY VASCULAR SURGEON SERVING SOUTH BAY RESIDENTS FOR 24 YEARS

For 24 years, Dr. Polyxene (Polly) Kokinos has worked in the greater San Francisco Bay Area community as an independent vascular surgeon, dedicating her time to serving patients suffering from vascular disease.

With offices in both Campbell, CA and Gilroy, CA Dr. Kokinos has worked with over 25,000 patients helping them as they suffer from circulatory illnesses and the impact of their disease. From the most delicate to the most complex surgical care, Dr. Kokinos’ and her staff have remained independent community physicians, offering patients an alternative to the “Big Box” medical systems of Santa Clara, San Mateo and Alameda Counties (Kaiser, PAMF, Sutter, Stanford) by offering unmatched personalized care and innovative surgical techniques to advance the care and treatment of her patients.

“We offer hope when others say there is none” is more than a simple message crafted by a marketing agent. It is at the core of everything we do and is the reason why we our facility operates in the most personal way available…

One Patient, One Doctor, One Nurse

South Bay Vascular Center and Vein Institute, located in Campbell, CA is the only fully accredited privately owned state of surgery center in the South Bay dedicated entirely to the practice of Vascular Surgery. Here, Dr. Kokinos provides unmatched vascular surgical care using cutting edge imaging and device technology that no other vascular surgeon or institution in the area can offer as she continues her pioneering work in the treatment of vascular disease.

Recognized by her peers as a national expert in the care of complex vascular disease, Dr. Kokinos is highly sought after as a speaker at national and international vascular surgical conferences and educational symposia. On March 4 2020 as part of her ongoing commitment to her community, Dr. Kokinos spoke in San Mateo, CA. addressing a large group of her peers as an invited guest of Global Education Group and Educational Awareness Solutions under a grant from Philips Image Guided Therapy. Her topic was “The Essential Role of the Primary Community Care Team in the Management of Lower Extremity Arterial and Venous Disease”

Her talk focused on Vascular diseases, “Including peripheral arterial disease (PAD) and venous thromboembolism and their prevalence in the US. When unrecognized or inadequately treated, these disorders may be life threatening and disabling. The therapeutic an diagnostic landscape for vascular conditions is rapidly evolving; yet there remains an unmet need for more awareness among healthcare professionals and patients.” As a recognized expert in her field, Dr. Kokinos was asked to address these topics with her peers, offering solutions and answering questions and was honored to present at this event.

As an independent community surgeon, Dr Kokinos isn’t forced to achieve the “productivity” targets or revenue targets that are by design a part of “Big Box” Medicine. Her practice has always been one of service to her community and as such continues taking emergency vascular call at Good Samaritan Hospital, O’Connor and El Camino Hospital’s in the Silicon Valley. She has served as the chair of vascular surgery at Good Samaritan Hospital in San Jose, Headed the wound care clinic at Good Samaritan, O’Connor and St Louis hospitals and continues to treat patients at the O’Connor Wound Care Clinic.

As an independent community physician Dr. Kokinos focuses her work on providing cutting edge care in the treatment of the most difficult vascular problems. Free from “corporate” medicine Dr Kokinos’ practice is dedicated to finding the “Why” you are suffering so that you have “real” solutions to living a healthy life. At South Bay Vascular, our first job is to listen. We take the time to fully understand your symptoms so that we can provide the best possible solutions to get your legs and your life back…and that’s what she has been doing for over 24 years.

Unlike Big Box medical practices where doctors see the patients on their “list” every morning, Dr. Kokinos must earn the trust and respect of everyone she sees. She’s knows each and every one of her patients by name and everyone who comes in to see Dr. Kokinos gets her cell phone to call if they ever have a problem. It’s what she does and what she’s always done, building her practice patient by patient, referring physician by referring physician for the past 24 years.

If you or anyone you love suffers from vascular disease, we would be honored to meet with you to discuss your symptoms. Please call our office at 408-376-3626 to schedule an appointment.

WHY DIABETIC FOOT WOUNDS DON’T HEAL

One of the main complications of diabetes is the development of diabetic foot ulcers. Diabetic foot ulcers occur in 15% of all patients with diabetes. There are four primary contributing factors to the developments of these ulcers.

  • The presence of peripheral neuropathy (loss of feeling over the toes);
  • Changes in the architecture (shape) of the foot causing it to have pressure on areas ot built for it;
  • Poor blood flow to the foot;
  • A decreased ability to fight infection in the foot.

The main reason why diabetic wounds do not heal is due to lack of blood flow to the ulcer and ongoing pressure to the wound

Diabetics must pay special attention to their feet and ankles and it is vitally important to NOT ignore a small wound when it develops. Diabetic wounds, when left untreated, are the cause of 85% of the amputations that occur in these patients. Once these ulcers develop, they often DO NOT HEAL just by putting a Band-Aid over them, or even with wound care and ointments prescribed by your primary care doctor.

Care of Diabetic Foot Wounds

It is very important to see both a podiatrist (foot specialist) and a vascular surgeon (blood flow specialist) to examine your foot. These doctors can help with special treatments such as debridement (cleaning the wound), off-loading (taking pressure of the wound) and improvement of blood flow to help your wound heal. Debridement helps remove dead tissue and bacteria from the wound. Off-loading and special inserts or shoes allow the pressure to be removed from the wound so that it can heal. Diabetes causes blockages with calcium deposits inside your small blood vessels, which are below the knee, and this prevents oxygen and nutrients from getting to your feet. The vascular surgeons at South Bay Vascular Center have a special interest and expertise in opening these blood vessels in order to bring flow to your toes and feet that can help save patients from amputation. If you or anyone you know suffers from diabetes and are experiencing foot wounds that do not heal, call us immediately at 408-376-3626 to schedule an appointment to have these wounds evaluated.

GILROY, CA. VASCULAR SURGERY CARE

South Bay Vascular Center and Vein Institute is a full service vascular surgery clinic and accredited vascular ultrasound testing lab located at 8420 Church in Gilroy, CA. Dr. Polly Kokinos offers cutting edge care to patients suffering from vascular and arterial conditions and continue their 20 year commitment of caring for patients in the South Bay.

Patients suffering from swollen, aching legs; painful, non-healing leg wounds; blood clots (DVT); dialysis access problems; clotted grafts; varicose veins and peripheral arterial disease (PAD) no longer need to travel to the greater San Jose area as local care continues to expand into the South Bay. World class surgeons, bringing state of the art technology offer a whole new level of Vascular care to the greater Gilroy, Hollister, Salinas and Hwy 152 corridor to the Central Valley Community.

Recognized as one of the most experienced and respected vascular surgeons in Northern California, the practice of Dr. Kokinos is focused on restoring the circulatory health of their patients thereby helping them return to a normal way of life. Together, our surgeons have performed more complex vascular procedures than any other Vascular Surgeons in Northern California. Recognized as San Jose’s and Silicon Valley’s most respected varicose vein experts Dr. Kokinos has performed over 20,000 vein procedures over the past 25 years and are not only the most highly trained vein specialists in San Jose, they are also the most experienced varicose vein experts in all of San Jose, Silicon Valley and the entire San Francisco Bay Area.

Call today to schedule an appointment at 408-376-3626.

VENOUS DISEASE AND WOUND HEALING

One of the most common contributors to the development of leg wounds is venous disease. This can occur either because of venous insufficiency—leaky valves in the leg veins or because of issues stemming from a DVT (deep venous thrombosis). Both of these problems contribute by causing high pressure at the ankles that impair the healing of the wounds. Silicon Valley’s South Bay Vascular Center and Vein Institute doctors are recognized as the leading wound care physicians in the greater San Francisco Bay Area and Dr. Kokinos is the medical director at both the Verity/O’Connor Wound Care Center in San Jose and St Louise Hospital Wound Care Center in Morgan Hill, CA.

Venous wounds have a classic appearance. The wound is generally around the inner or outer ankle bone and the skin around the wound is often very dark (hyperpigmented). The skin can also be quite leathery. Not everyone with a venous wound has varicose (bulgy) veins, but many do. These can often be painful, and even with excellent care, can take many months to heal. Although the diagnosis can be made by simple examination, it is important to do an ultrasound to get a roadmap of the venous system so that any problems that can be fixed are addressed.

The specialists who deal with the venous system best are called vascular surgeons. These doctors can deal with both leaky valves as well as blockages in the system. It is felt to be very important not only in helping these wounds heal, but in preventing them from coming back, to treat the underlying venous issues. For the leaky valves, this is done by sealing the veins closed, often using the VNUS closure catheter or a laser fiber. For blocked veins, they can often be treated with stents that will hold them open. These procedures are all minimally invasive and can be done in the office setting. With all venous ulcers, compression using medical grade stockings is vitally important. In addition, there is evidence that using an old drug called Trental or a newer one called Vasculera can help heal these wounds faster.

PERIPHERAL ARTERIAL DISEASE (PAD) INTERVENTION AND TREATMENT

Over the past 15 years the interventional treatment for peripheral arterial disease (PAD) has changed significantly with endovascular revascularization replacing surgically invasive procedures as the dominant intervention. Early detection and treatment are important to control the disease and to allow patients a full selection of treatment options.

Diagnosis
Many types of health care providers can diagnose and treat PAD. Family physicians, internists, physician assistants, nurse practitioners and vascular specialists can all diagnose PAD by examining a patient’s medical and family history, performing a physical exam, and conducting diagnostic tests. PAD can be diagnosed through a variety of diagnostic procedures including:

  • Ankle-brachial index (ABI):A common test used to measures the difference between blood pressure at the arm and at the ankle. A difference in the two areas indicates restricted blood flow.
  • Ultrasound
  • CT and MR angiograms
  • Angiography
  • Blood tests

Treatment
There are multiple options for treatment of PAD, ranging from medical interventions, surgical revascularization, and endovascular therapy. Vascular Surgeons are uniquely qualified and trained to treat patients diagnosed with PAD. Approaches to treatment include:

  • Minimally invasive endovascular procedures
  • Medical management
  • Exercise and lifestyle modifications
  • Surgical bypass Amputation

South Bay Vascular Center and Vein Institute is the recognized as the regional treatment center for the treatment and care of patients suffering from Peripheral Arterial Disease. Dr.’s Kokinos and Pineda specialized training and state of the art interventional facility offers patients a unique alternative to a hospital setting and provides the highest level of care for the treatment of PAD as an alternative to limb amputation.

If you or a loved ones suffers from PAD, call our office today at 408-376-3626 to schedule a visit.

We offer hope when others say there is none.

www.southbayvascular.com

DR. KOKINOS CHOSEN TO PRESENT AT 2017 OEIS MEETING

Dr. Kokinos was selected as a speaker at this years OEIS (Outpatient Endovascular and Interventional Society)meeting that will be held March 31- April 2 in San Diego California. Dr Kokinos will be presenting her expertise in the establishment and operation of cutting edge outpatient treatment facilities.

Congratulations Dr. Kokinos on this honor.

Dr. Polyxene Kokinos and her partner, Dr. Carlos E Pineda of South Bay Vascular Center and Vein Institute, operate San Jose’s leading center for the treatment of Varicose Veins. As a Board Certified Vascular and General Surgeon, Dr. Kokinos is recognized by her peers as the one of the countries leading experts on the treatment of deep venous disease and is frequently sought out as a speaker. South Bay Vascular specializes in treating peripheral arterial disease (PAD) and is the regional center of excellence for amputation prevention.

If you or anyone you know suffers from unsightly and painful varicose veins, peripheral arterial disease, non-healing wounds or is facing a diabetic amputation, please call our office at 408-376-3626 to schedule a consultation. WE CAN HELP!