Tag: PERIPHERAL ARTERIAL DISEASE

TREATING DIABETIC FOOT ULCERS

Posted on by Angelica Rodezno

Millions of patients every year are seen in wound care centers for the treatment of their foot and leg ulcers. This is absolutely the correct place for anyone who has had a wound that is “non-healing” or “chronic”. That is, a wound that is still there after four weeks. Unfortunately, sometimes the physicians in these wound care centers are quick to put on expensive savs or other advanced treatment options. After all, isn’t that why the patients go to the wound care center instead of just their physician’s office? Partially. Good wound care centers treat by guidelines.

Guidelines are a scientifically proven set of steps that have been shown to help wounds heal faster. For EVERY wound on the leg or foot, the very first step is to assess BLOOD FLOW. This means that every patient with a leg or foot wound that hasn’t healed in four weeks MUST be seen by both a vascular surgeon AND a podiatrist (foot specialist).

The vascular surgeon will assess the circulation and order appropriate diagnostic tests, such as vascular ultrasounds to look at the blood flow. This is important to examine, as a large number of the patients who have ulcers, have not previously been diagnosed with an arterial or venous problem. Without fixing the underlying cause of the ulcer, even if it does heal initially, it will soon recur, and cause further problems. It is important for patients to take an active role in asking for these referrals so that the problem does not progress and become a wound that can lead to an amputation.

If you or anyone you know is diabetic and suffers from non-healing leg wounds call today to schedule an appointment at our office. South Bay Vascular Center and Vein Institute Surgeons are recognized as the regional experts in wound care healing and amputation prevention. Our Vascular Surgeons have performed more lower extremity re-vascularizations than any other surgeons in the region and offer hope when others say there is none.

Call today at 408-376-3626

PERIPHERAL ARTERIAL DISEASE (PAD) INTERVENTION AND TREATMENT

Posted on by Angelica Rodezno

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

SEPTEMBER IS PAD AWARENESS MONTH

Posted on by Angelica Rodezno
What is Peripheral Arterial Disease?
Peripheral artery disease (PAD), also known as claudication, poor circulation, vascular disease, or hardening of arteries, is a chronic, life-threatening circulatory condition. PAD causes narrowing or blockage of the vessels that carry blood from the heart to the legs. The primary cause of PAD is atherosclerosis, or the buildup of plaque in the arteries. This occurs when arterial inflammation, cholesterol, calcium and scar tissue build up, forming plaque that clogs the arteries and slows blood flow to the legs. The more plaque that builds up on the inside walls of the blood vessels carrying blood from the heart to legs and arms, the more the arteries lose flexibility and narrow, putting patients at greater risk.
Risk factors for PAD
Smoking
High blood pressure
Diabetes,
High cholesterol
60+ years old.
PAD patients are at high risk of developing critical limb ischemia (CLI), a chronic condition that results in severe pain in the feet or toes, even while resting. Complications of poor circulation can include sores and wounds that won’t heal in the legs and feet. Left untreated, the complications of CLI could result in amputation of the affected limb. PAD patients are also at greater risk for heart attack and stroke. Studies have found that the total annual US costs for patients with PAD exceed $21 billion, including nearly $10 billion for hospitalizations. In Medicare alone, one study estimated spending on PAD accounted for more than 2% of all Medicare spending. PAD has been identified by the Institute of Medicine (IOM) as a priority area for comparative effectiveness research. One study suggested that endovascular therapy appears to be the least costly option in the short-run for patients with PAD.
Symptoms Blockages can restrict blood flow to the muscles, causing muscle cramps, tightness or weakness, especially during activity. In the early stages of PAD, patients may not experience any symptoms. If PAD is not treated, though, blockages may continue to grow and restrict, or even completely block, blood flow.
Common symptoms include:
Leg pain when walking
Muscle pain or cramping in legs and calf triggered by activity
Leg numbness or weakness
Coldness on lower leg or foot
Sores on toes, legs or feet that won’t heal
Change in color of legs
IF YOU OR ANYONE YOU KNOW SUFFERS FROM ANY OF THESE CONDITIONS WE CAN HELP! CALL US TODAY AT
408-376-3626 TO SCHEDULE AN APPOINTMENT.

ACHING TIRED OR HEAVY LEGS?

Posted on by Angelica Rodezno

DR. KOKINOS SELECTED TO PRESENT AT THE AMERICAN VENOUS FORUM

Posted on by Angelica Rodezno

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.

SOUTH BAY VASCULAR CENTER IS “TAKING A STAND AGAINST AMPUTATION”

Posted on by Angelica Rodezno

18 Million Americans Suffer from Peripheral Arterial Disease (PAD). Left untreated, PAD can lead to amputation. Each year 160,000 amputations are performed as a result of peripheral arterial disease.

South Bay Vascular Center and Vein Institute is Taking A Stand Against Amputation. Dr. Pineda and Dr. Kokinos recently attended the “Advanced Orbital Atherectomy Course in the Treatment of Complex PAD Below the Knee” at Metro Health Hospital, in Grand Rapids, Michigan. This course was led by Dr. Jihad Mustapha, a thought leader in the field of critical limb ischemia. The techniques included using alternate access sites (using the arteries at the ankle and foot for access), instead of using the traditional groin site. The course also included treatment of arteries in the foot, with the main goal being on limb preservation and amputation prevention. To date, Dr.’s Kokinos and Pineda have performed more procedures using pedal access than any other surgeons in the greater San Francisco Bay Area, and are recognized as leaders in this area.

The practices expounded by Dr. Mustapha and his team are the same techniques and principles the vascular surgeons at South Bay Vascular use in their care and treatment of PAD. These include: identification and aggressive medical management of risk factors, minimally invasive interventions when indicated, and continued surveillance to detect issues before they become clinically apparent.

At South Bay Vascular, we do use alternate sites frequently, and by using this approach, decrease the rate of groin complications and the length of time that the patient has to remain flat after a procedure. Furthermore, with our growing population of diabetics and patients with kidney disease, we are better equipped to manage critical limb ischemia and prevent amputations. This course is in support of our focus on taking care of patients at risk of losing a limb.

If you or a loved one is diabetic, has kidney disease (is on dialysis), or has been told they need an amputation, please contact us for a consultation with one of our surgeons and together we will Take A Stand Against Amputation.

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

Posted on by Angelica Rodezno

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.