ARE YOU AT RISK FOR PERIPHERAL ARTERIAL DISEASE (PAD)?

WHAT IS PAD?

Peripheral Artery Disease (PAD) is a common and often underdiagnosed circulatory disease where blood flow to the legs and feet is restricted by the narrowing of blood vessels due to plaque buildup.

ARE YOU AT RISK FOR PAD?

  • Smoking is the most powerful predictor of PAD: Are you a current or former smoker?
  • 1 in 10 Americans over the age of 40 have PAD
  • Do you or your loved one have diabetes?
  • Struggle with high blood pressure or cholesterol?
  • Suffer from kidney disease?
  • Risk for amputation is 10 times greater in patients with both PAD and diabetes vs PAD alone

THE GOOD NEWS IS THAT PAD CAN BE TREATED!

With an early diagnosis, you may have more treatment options and may have a better chance to reduce or eliminate your symptoms. Left untreated, however, PAD can lead to amputation and put you or your loved one’s quality of life and long-term health at serious risk.

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 24 year career to serving the South County community as a Vascular Surgeon and is a pioneer in the evaluation and treatment of patients suffering from Peripheral Arterial Disease.

Unlike other Vascular Surgeons in the region who do their work at a local hospital or in shared facilities, Dr. Kokinos’ does her surgeries in a private, nationally accredited Vascular Surgery Center of Excellence. She focuses entirely on treating patients suffering from complex vascular disorders and unlike a traditional hospital she has the most advanced imaging and device technology available anywhere in the world. Most importantly, unlike a Univeristy or community hospitals, Dr. Kokinos’ patients experience the individualized care of “One Patient, One Doctor and One Nurse” rather than the cold, informal “production” environment of a typical hospital.

If you or anyone you love suffers from any of the conditions listed above, please call our office at 408-376-3626 to schedule an appointment. Most insurances are accepted and our staff typically can schedule an appointment within a few days for an initial consulation and non-invasive vascular ultrasound study. All ultrasound testing is done in our on-site Vascular Ultrasound Lab, The Institute for Vascular Testing making it significantly easier for our patients to be fully evaluated in a single visit and in a single facility.

South Bay Vascular Center and Vein Institute: We Offer Hope When Others Say There Is None

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.

COULD THAT LEG PAIN BE PERIPHERAL ARTERY DISEASE

Dr. Polyxene (Polly) a vascular surgeon located in San Jose, CA specializes in the diagnosis and treatment of peripheral artery disease. In private practice for 24 years, Dr. Kokinos has served the South Bay Community as an independent physician for her entire career and has built her practice by delivering exceptional outcomes and by providing hope for patients suffering from complex vascular disease.

Graduating high school at 14 years old, Dr. Kokinos enrolled at Barnard College (Columbia University) and after finishing in 3 years, earned a coveted spot in Columbia University’s prestigious medical school by the time she was 16 years old. Finishing medical school at 20, Dr. Kokinos was accepted at UCSF Surgical, the top ranked general surgery residency program in the world. Seven years later, Dr. Kokinos was accepted into Washington University in Saint Louis, the number one ranked Vascular Surgery fellowship training program in the United States. Finishing her training at 29 years old, Dr. Kokinos was the youngest board certified vascular surgeon in the country. Continuing her unmatched reputation as a vascular surgeon, Dr. Kokinos continues to be recognized by her peers as a gifted clinician, Vascular Surgeon and overall leader in her field.

Experience matters when it comes to your health. In private practice for 24 years, no other vascular surgeon in Northern California can claim the depth and breath of vascular surgery experience nor the specialized facilities needed to treat complex vascular disease that Dr. Kokinos can share. Unmatched in her experience and capabilities, Dr. Kokinos offers hope when others say there is none.

Unlike doctors leaving Big Box Medical Systems (Kaiser, PAMF, Stanford, Sutter) to enter private practice in search of financial payouts, Dr. Kokinos has spent her entire career focused on the “Why” behind an illness. Rather than simply treating the symptom, Dr. Kokinos takes the time to understand a patients symptoms so that her patients have real solutions to living a healthy life. Instead of a medical career driven by production metrics and profitability, Dr. Kokinos has built her career around a patients needs and not an institutions needs

Of particular interest to Dr. Kokinos is the diagnosing and treatment of peripheral arterial disease and chronic limb ischemia. As the only vascular surgeon in the South Bay to own and operate their own state of the art nationally accredited ambulatory surgery center and full time vascular ultrasound laboratory, Dr. Kokinos provides unmatched care for her patients suffering from this disease. Dedicated entirely to the treatment of vascular disease, Dr. Kokinos’ surgical suite has the most advanced imaging and device technology found anywhere in the world.

Partnering with the community to provide the best information possible, Dr. Kokinos encourages anyone suspecting to be suffering from PAD to read the following article. Published by her peers at Harvard University Medical School we believe this article can help our patients better understand the symptoms of PAD. After reading this article, if you or anyone you know suffers from or thinks they may be suffering from Peripheral Artery Disease we encourage them to schedule an appointment at 408-376-3626 to discuss their symptoms. In the meanwhile, we hope you find the following article educational.

https://www.health.harvard.edu/diseases-and-conditions/could-that-leg-pain-be-peripheral-artery-disease

DON’T SUFFER FROM SWOLLEN LEGS OR NON-HEALING LEG ULCERS ANY LONGER. WE CAN HELP!!

The sequence of photos below shows the before and after pictures of an 87 year old man who had seen multiple doctors over a 3-4 months period of time for his severe right leg swelling. This was not only causing him discomfort, but caused him to fall because of the imbalance it led to. He was found on a regular venous ultrasound in our accredited vascular lab to have abnormal flow in his right iliac vein.

The next day, we took him to our Campbell angiography suite for a 45 minute outpatient procedure. There, using both venography (injection of contrast into the vein through a small straw like catheter in the groin) and IVUS (intra-vascular ultrasound) we diagnosed a scarred and blocked right iliac vein system. This was easily treated with a stent and balloon.

Unfortunately, this was found to be a result of a combination of radiation treatment the patient had received 20 years before for his prostate cancer as well as because of a return of his cancer. This tumor (seen on CT scan) was surrounding his vein. When he came back five days later for a check, his right leg swelling was gone as was his leg heaviness and aching.

Please note, compression of the iliac vein usually (80%) occurs on the left. Often, if leg swelling occurs on the right, it may be a sign of a tumor or mass pushing on the vein in the abdomen.

Patient with right lower leg swelling before procedure

Inserting a wire into the diseased vessel. Notice the light colored area where no blood was flowing.

Opening the diseased vessel using a “balloon”.

Placing a stent in to the opened vessel to maintain blood flow. Notice how even blood flows through the opened vessel

Patient 5 days after surgery with leg swelling almost completely resolved

If you or anyone you know suffers from lower leg swelling, call us today to set up a consultation to evaluate your treatment options.

408-376-3626

South Bay Vascular Center and Vein Institute

FREE ILIAC VEIN SCREENING

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.