LEG SWELLING: SYMPTOMS AND SIGNS

Do you Suffer From Iliac Vein Compression?

To answer that question, take a few seconds to consider the following:

  • Are your legs swollen? Is your left leg larger than your right?
  • Is it harder to slip one shoe on in the morning than the other?
  • Have you had cosmetic or other surgical procedure done and not gotten the outcome you wanted?
  • Are you a cancer patient undergoing treatment or procedures?
  • Have you ever suffered from a blood clot or (DVT) in your leg
  • Do you visit a wound care clinic with little to no success?

If you’ve answered yes to any of these questions, you MAY be suffering from a well known, but previously difficult to diagnose problem called May-Thurner’s Syndrome.

May Thurner’s Syndrome, also known as iliac Vein Compression, is a condition where the main artery supplying blood to the leg pushes down or compresses the main vein taking blood back to your heart. In the illustration below you can see in the far right graphic a “representation” of this compression. One way to help think of what happens when a patient suffers from iliac vein compressions is to consider what happens when a car tire partially runs over a garden hose in your driveway.

If the hose was “on” when you drove over it, water will continue to come out of the hose end but the flow rate will decrease. In a similiar way, blood returning to your heart will continue to flow if you have developed iliac vein compression, but the rate at which it returns is slowed down, resulting in a pooling of blood (i.e. swelling) in your leg.

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. In fact, studies have shown that in a full 30% of ALL people, the left iliac vein can be significantly compressed by the right iliac artery resulting in some kind of leg symptom….aching, heaviness, and most commonly, swelling or non-healing of wounds in the leg veins.

Swollen legs ARE 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. To diagnose and to treat this condition and the potentially deadly side effects caused by it (Blood Clots or Deep Venous Thrombosis) Dr. Kokinos has assembled a highly skilled team of vascular ultrasonographer’s who have developed a specialized screening protocol to evaluate for Iliac Vein Compression. Using state of the art ultrasonic imaging technology Dr. Kokinos’ Registered Vascular Ultrasonographer’s use this new protocol to scan up into the abdomen of their patients to examine the physics of the blood flow in this area. If a compression is identified during this ultrasound exam, Dr. Kokinos is able to further verify and treat this problem using a super specialized device called IVUS (Intra-vascular ultrasound) where she can insert a miniuture camera into the actual vein to determine the length of the compression after which she can place a stent to “re-open” this compressed vessel to re-establish normal blood flow.

To date, Dr. Kokinos has successfully performed over 200 of these iliac vein stent procedures in her state of the art out-patient angiography suite. She has lectured extensively at major vascular surgery meetings on her approach and success helping patients reduce leg swelling, increase the rate of wound healing and return to a normal way of living and is seen by her peers as an expert in this technique.

If you are currently experiencing a swollen leg, have a non healing leg, foot,or ankle wounds or have ever suffered a blood clot (DVT) please contact our office at 408-376-3626 to schedule an appointment.

Don’t suffer from swollen legs or non-healing leg ulcers any longer.

We can help!

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.

TREATING DIABETIC FOOT ULCERS

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

SEPTEMBER IS PAD AWARENESS MONTH

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.

DR. KOKINOS SELECTED TO SPEAK AT 2017 UCSF VASCULAR SYMPOSIUM

Dr. Kokinos is honored to be a featured speaker at this years world renown UCSF Vascular Symposium. Dr. Kokinos will present her on-going research on the treatment of venous ulcers. This years session will be presented on April 6, 2017 in San Francisco, CA. Congratulation’s Dr. Kokinos on your selection as a speaker.

Dr. Kokinos is a Board Certified Vascular and General Surgeon and is the medical director of the wound care clinics at Verity’s O’Connor Hospital in San Jose and St. Louise Hospital in San Martin Ca. Together with her partner, Dr. Carlos Pineda, Dr. Kokinos operates the leading varicose vein treatment center in Northern California and has provided specialized vein care treatment and repair for over 20 years. Recognized as the leading Vein Specialist and Varicose Vein Doctor in Northern California, Dr. Kokinos is known as the Doctor’s Doctor and is honored to work alongside her patients to help them return to a healthy and normal lifestyle.