Of the many reasons that a patient can be referred to a vascular surgeon, one is that their referring physicians believes that their patient may have developed an aneurysm.  Aneurysms, typically speaking, form in arteries which are the specialized vessels that carry blood from the heart to the rest of the body under high pressure.  When the wall of an artery weakens, it can develop into a balloon-like dilation called an aneurysm. (See below). This most commonly occurs in the main blood vessel in your abdomen, which is called the abdominal aorta. When the blood vessels dilate to 50% greater than their normal diameter, the vessel has become an aneurysm.



Interestingly, the reason why aneurysms form is actually poorly understood.  We know that smoking cigarettes and a family history of aneurysms increases the risk that a patient will develop an aneurysm, but no direct cause-effect relationship has been established.  Diabetes mellitus, however, appears to have a protective effect.  That is, the presence of diabetes appears to help prevent aneurysms!  The other health risks of diabetes including neuropathy and infection, of course, make diabetes an undesirable health problem to have.

Aneurysms have two main catastrophic problems: Rupture and thromboembolization.  (to learn more about aneurysms visit our website at  Rupture refers to a tear in the wall of the blood vessel resulting in a leakage of blood.  When aneurysms in the abdomen rupture, the amount of blood loss into abdomen can be life threatening and result in death within seconds.  Thromboembolization refers to the formation of blood clot within the aneurysm that then breaks off and goes somewhere else.  When aneurysm and associated blood clot form in the abdomen, these blood clots can break off and travel to the leg resulting in a lack of blood flow to the legs.  Such a sudden cessation of flow to the legs can result in the death of the foot and/or legs within hours.

As you can see arterial aneurysms can be very troublesome.  Luckily, vascular surgeons have many tools and instruments that we can use to treat these aneurysms in a minimally invasive way.  In my blog next week, I will go over the different options for treating aneurysms in the abdomen.  If you or someone you love have been told that you may have an aneurysm, please call our office immediately to schedule an appointment for a full vascular work-up. 408-376-3626

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Most hospital surgeries require patients be put under general or epidural anaesthesia. Anaesthesia allows the patient to “sleep” through their procedures helping patients avoid both the physical and emotional stress of the operation. Anesthesia is also very important because it keeps the patient from moving during surgery. This “stillness” allows the surgeon to undertake their procedure without jeopardizing patient safety due to unwanted movement.

This same lack of movement, however might also cause other problems for the patient. The most concerning of these problems is the formation of a blood clot developing in the legs, or deep venous thrombosis (DVT) while the patient lies motionless on the table. In fact, in some surgical procedures (typically those lasting more than 3 hours, those involving bones or the back, or those done to treat a cancer) the risk of developing a blood clot can be as high as 80%. For that reason, national guidelines recommend that patients undergoing these long and complex surgeries (as well as some minor surgeries) are treated prophylactically- in advance- of a problem. This treatment can include the use of blood thinners before and after surgery, the use of compression pumps, and the use of early mobilization after surgery.

Blood clots that develop after a knee or hip surgery are also very common; unfortunately, these clots can be quite difficult to diagnose. One expects the affected joint to be painful and swollen after a procedure. Unfortunately, what could be a life threatening condition is often overlooked or misdiagnosed.

How can one know if post operative swelling is a part of the normal recovery or something more concerning? Only by getting a vascular ultrasound study can a definitive determination be made as to the presence or absence of a clot.

It is important to ask your surgeon to order an ultrasound if:

  • You feel tenderness and swelling in your calf or thigh after a surgical procedure.
  • These symptoms last longer than what your doctor told you to expect.

  • These symptoms prevent you from performing the activities for recovery you expected to do.

A special note of caution: ultrasound studies can be done at the hospital or at a nearby vascular surgeon’s office where the technologists are specialists in examining the veins and arteries of patient’s legs for clots

At SBVC, we perform dozens of exams for DVT monthly; mostly for orthopedic surgeons, podiatrists, and primary care doctors who want fast and accurate results. We also help these doctors immediately start treatment should a DVT be diagnosed because we can evaluate their patients immediately and if necessary we can beginning them on blood thinners in the office. As vascular surgeons we are able to begin care immediately saving patients from an expensive, frustrating, and time-consuming visit to the emergency room. We are aware how difficult this unsuspected surgical complication can be, especially when you are still in pain and recovering, but, we do our best to help you through this unfortunate occurrence.

If you experience any of the post surgical complications outlined above and suspect that it may be a blood clot, contact your surgeons office immediately to schedule an appointment.


South Bay Vascular Center and Vein Institute, with offices in Campbell and Gilroy CA., is recognized as one of the leading vascular surgery practices in Northern California. In addition to their cutting edge work in amputation prevention, South Bay Vascular Center is widely recognized as the leading center for the diagnosis and treatment of iliac-vein compression, medically know as May-Thurners disease, in the whole of the Western United States. Using the most advanced diagnostic imagining technology, Intra Vascular Ultrasound (IVUS), Dr’s Kokinos and Pineda have treated more patients for this mostly undiagnosed cause of leg swelling….a condition which often presents in patients as left leg swelling, than any other medical practice in the region.

Delivering exceptional care, however, involves much more than simply being the best practitioner. Exceptional patient care demands compassionate care. Exceptional patient care is born of a philosophy that understands the patient apart from their disease….it requires an understanding of how disease impacts every part of a patients life…their lifestyle, their family, their friends and most importantly, their future. Communicating this understanding to patients is difficult in the best of circumstances and when patients come from a different cultural system, communication becomes even more difficult.

At South Bay Vascular Center and Vein Institute, we pride ourselves in being able to communicate with our patients across multiple cultural and language barriers. To this point, our physicians and staff speak many different languages and represent a diversity of cultural and faith traditions. As native speakers South Bay Vascular Staff can communicate with our patients in the following languages:

  • Spanish
  • Greek
  • German
  • Hindi
  • Farsi
  • Russian
  • English
  • Tagalog
  • French
  • Turkish

Additionally, our staff is sensitive to many diverse cultural traditions, faith based gender sensitivities and ethnic differences.

South Bay Vascular Center is a community based surgical practice operating at the forefront of vascular medicine. Our physicians provide unmatched medical care by providing the best possible outcomes in the most difficult of circumstances. In our private, nationally accredited state of the art ambulatory surgery center and vascular ultrasonography laboratory we treat each and every patient with the utmost of respect allowing them to maintain their dignity in difficult times

Large medical systems, often referred to as “Big Box” medicine, are an operationally efficient and a very profitable way to practice medicine but delivering exceptional care is difficult as the underlying drivers are often constrained by larger “business” decisions instead of what’s in the best interest of the patient. At South Bay Vascular, we operate with a care philosophy wholly different than big box medicine and as such, provide an unmatched level of care not found anywhere else in the region.

A multi-cultural approach to providing exceptional vascular care is just one of the many ways that the physicians and staff at South Bay Vascular Center and Vein Institute strive to be the best at what we do. Together with providing the most sophisticated medical care we deliver exceptional patient care in the most difficult of circumstances.

If you our anyone else that you know suffers from problems in any part of their circulatory system, call us today to learn how we can help.


On Friday, February 3, 2017 Dr. Kokinos and Dr. Pineda of South Bay Vascular Center and Vein Institute were featured in a full length cover story discussing their Northern California Regional Amputation Prevention efforts. The physicians and staff of South Bay Vascular wish to thank the Gilroy Dispatch for their work writing this story and for recognizing the importance of educating the South Bay Community on alternatives to amputation. We invite everyone to read this incredible story of how our South Bay Vascular Center Surgeons and staff are serving their community by giving them hope in the face of these tragic circumstances. Congratulations to the entire staff.

The full story can be accessed by clicking the following link: