http://vascularinstitute.com/ Vascular Institute of the Rockies - Blog RSS Feed 2.0 en-us Tue, 10 Mar 2026 09:03:24 GMT Tue, 10 Mar 2026 09:03:24 GMT http://vascularinstitute.com/blog/13285/How-to-Prevent-a-Potentially-Fatal-Aortic-Dissection blog How to Prevent a Potentially Fatal Aortic Dissection High blood pressure is a well-known medical condition that many people understand is a risk factor for heart attacks, strokes, and diabetes. Unfortunately, high blood pressure is also a risk for lesser known but no less serious conditions. High blood pressure is the most common cause of aortic dissections, a condition whose symptoms can be mistaken for a stroke or heart attack and are often fatal. While some hereditary and environmental conditions can lead to aortic dissections, controlling blood pressure can help prevent most aortic dissections. Prevention begins with understanding the relationship between these two conditions. Understanding High Blood Pressure High blood pressure, or hypertension, is a common medical condition in which blood pressure flows through the arteries with a force that is consistently higher than normal. When blood continuously flows through your arterial system with high force, it can damage your cardiovascular system and increase your risk for strokes, heart attacks, and other potentially fatal medical conditions. Unfortunately, high blood pressure does not always present with symptoms that are noticeable by the patient. As many as half of all American adults suffer from high blood pressure without knowing it. Unless they are seeing their primary care provider for regular check-ups, they may not be made aware of their high blood pressure until they present for evaluation for another medical condition. Fortunately, high blood pressure can be prevented in many ways, especially through healthy lifestyle choices. Understanding Aortic Dissections An aortic dissection is a condition that occurs when the inner lining of the aorta - the body's largest artery - separates from the aortic wall's middle layer. This commonly occurs due to the deterioration of the aortic wall, many times because of high blood pressure. And when it occurs, the results can be fatal. People who suffer an aortic dissection typically experience severe, tearing pain (which can induce fainting) in the location where the dissection is occurring.  An aortic dissection may also cause a rection in blood flow to other parts of the circulatory system, often resulting in additional complications such as stroke, heart attack, renal failure, or spine and nerve damage. When people develop chest pain and are rushed to the ER, a conventional chest X-ray may show a severely enlarged aorta, which is a well-established sign of aortic dissection. However, an enlarged aorta can also be indicative of other cardiac conditions and therefore additional imaging modalities such as computerized tomography angiography (CTA), or echocardiography may be necessary. While high blood pressure is one of the most common causes of aortic dissections, several other conditions put people at risk for this condition. Certain congenital abnormalities and hereditary disorders that narrow the aorta can increase one's risk. Arteriosclerosis, a condition in which the arteries thicken and harden, resulting in abnormal blood flow, is also a risk factor. Some chest injuries can also result in aortic dissections. Additionally, the natural aging process can compromise the aortic wall's integrity to some degree, creating an increased risk of dissection. necessitating preventative measures. Preventing Aortic Dissections While certain risk factors such as genetics, accidents, and aging are unavoidable, high blood pressure certainly is avoidable. High blood pressure prevention starts with a healthy diet, active lifestyle and maintaining a healthy weight. It is well known that obesity is a risk factor for high blood pressure. Smoking and alcohol can raise blood pressure as well and should be avoided. And while many people may find it challenging, getting sufficient, good quality sleep is essential. Not getting enough sleep can increase your risk of high blood pressure and other cardiovascular conditions. Preventing high blood pressure starts with knowing your current blood pressure measurements. And, if your pressures are elevated, working with experienced healthcare providers on a plan to get your blood pressure within an acceptable range is the next step.   Tue, 23 Apr 2024 06:00:00 GMT http://vascularinstitute.com/blog/13285/How-to-Prevent-a-Potentially-Fatal-Aortic-Dissection http://vascularinstitute.com/blog/13284/Vascular-Ultrasound--What-Is-It-and-How-Does-It-Work-- blog Vascular Ultrasound: What Is It and How Does It Work? When it comes to monitoring the condition of your veins and arteries, a vascular ultrasound can help. Whether you are showing signs of a vascular concern, have been diagnosed with a disease, or are striving to prevent a vascular illness from occurring in the future, a vascular ultrasound can give your healthcare provider a clear image of how well blood is flowing to the organs and tissues throughout your body. Here is what you need to know about how undergoing a vascular ultrasound at The Vascular Institute of the Rockies may benefit you. What is Vascular Ultrasound? Vascular ultrasound, also known as a duplex study, is a noninvasive procedure that uses sound waves to examine the blood flow of the veins and arteries in a person's arms, legs, and neck. This procedure is safe, fast, and painless. It is commonly performed by an ultrasound technician who has been specially trained to administer ultrasound tests. A radiologist or qualified physician will then interpret the results of the ultrasound.  How Does It Work? Vascular ultrasounds do not use radiation in the way that an X-ray would. Instead, vascular ultrasounds are performed using a small probe, called a transducer, and special gel that is applied directly to the person's skin, allowing high-frequency sound waves to move from the probe, through the gel, into the person's body, and back into the probe. These sound waves are then transmitted to a computer where detailed images of the person's blood vessels and soft tissues are displayed. Benefits of Vascular Ultrasound Undergoing a vascular ultrasound can provide a variety of benefits to individuals who have been diagnosed with a vascular condition or who are interested in using it as a screening tool. Some of these benefits include: Detecting blood clots in the deep veins of the body, such as the legs, (DVT). Determine if arteries are narrowing and how severe the condition may be. Evaluate how well blood is flowing through veins and arteries  Evaluate how a patient is doing after undergoing a procedure, such as having a stent placed. Diagnose venous insufficiency, a condition in which the valves inside of your veins may not be functioning well and causing swelling Common Uses for Vascular Ultrasound Vascular ultrasounds can be used to monitor the condition of your veins and arteries along with diagnosing potential concerns. Your healthcare provider may recommend having a vascular ultrasound for many reasons, including: Evaluating varicose veins. Monitoring how your blood is flowing to certain organs and/or tissues. Locating blockages or other vascular abnormalities. Vascular ultrasounds are also a safe and effective procedure to use on children. They are often used to determine where to put a catheter or needle in a vein or artery to avoid complications, such as bleeding or nerve injury. Likewise, they can monitor congenital vascular malformations that a child may be born with. Schedule Your Vascular Ultrasound at The Vascular Institute of the Rockies Being aware of your vascular health has never been easier. With vascular specific ultrasound, your healthcare provider can evaluate both venous and arterial circulation. If you are having symptoms concerning for venous or arterial insufficiency, consult your primary care provider to discuss a potential referral to the specialists with the trusted team at The Vascular Institute of the Rockies.   Tue, 23 Apr 2024 06:00:00 GMT http://vascularinstitute.com/blog/13284/Vascular-Ultrasound--What-Is-It-and-How-Does-It-Work-- http://vascularinstitute.com/blog/13283/Tips-for-Preventing-Blood-Clots-During-Travel-- blog Tips for Preventing Blood Clots During Travel  When you travel for long periods of time (four hours or more), you are at an increased risk to develop a venous blood clot in one of your legs due to a lack of mobility. The good news is that you don't have to avoid traveling to protect your cardiovascular health. Check out these simple steps that can help prevent blood clots while you travel. Understanding Blood Clots Blood clots in your veins occur when the blood flowing through your blood vessels is significantly restricted or blocked. When a blood clot occurs in a deep vein in your body (a vein that's not near the surface of the skin), it's called a deep vein thrombosis (DVT). Blood clots will sometimes dissolve on their own, however, in some circumstances they can be very dangerous. For instance, when a blood clot in a deep vein of your leg breaks loose, it can travel to your lungs and cause a pulmonary embolism (PE), which can be fatal. For this reason, it's worth taking the necessary steps to lower your risk of developing a blood clot when you are more susceptible, such as while traveling. Tips for Prevention During Travel While blood clots can affect anyone regardless of their age or health history, certain factors can increase your chances of developing a clot. These include having a family history of blood clots, pregnancy, obesity, and being sedentary for long periods of time. Knowing how to prevent a blood clot from forming while you travel is important, especially if you have other blood clot risk factors. Keep these tips in mind before your next cross-country flight or road trip. Hydration: When you're properly hydrated, it's easier for your blood to circulate through your blood vessels as it should. It's a good idea to drink plenty of water before and during your travel day. Compression: Wearing compression socks or stockings can promote good blood circulation in your legs as they gently squeeze. Because they come in varying levels of compression, be sure to consult your healthcare provider to ensure that you wear stockings that are appropriate for your needs.  Regular Movement: Be sure to get up to move around at least one time every hour while you're traveling. This will keep the blood flowing freely through your legs. Likewise, you can also exercise your calf muscles while sitting down to encourage good blood flow. Medication/Doctor Consultation: Depending on your health history and individual risk of developing a blood clot, your healthcare provider may prescribe medications to take before or during your travels, including Aspirin or other blood thinners. If you have a family history of blood clots or another health conditions that put you at a higher risk of developing a blood clot, don't hesitate to schedule an appointment with your healthcare provider before traveling. Tue, 23 Apr 2024 06:00:00 GMT http://vascularinstitute.com/blog/13283/Tips-for-Preventing-Blood-Clots-During-Travel-- http://vascularinstitute.com/blog/12896/How-Smoking-Affects-Your-Blood-Vessels-- blog How Smoking Affects Your Blood Vessels   For nearly a century, healthcare providers have informed people of the negative health effects that come from smoking cigarettes. While it is true that the research and education shared with the public over recent decades have encouraged millions of people to stop using tobacco, the CDC estimates that up to 42 million Americans smoke regularly, making it a major public health concern. The list of complications caused by smoking is extensive, including impacting one's blood vessels and cardiovascular health. Here is what you need to know about how smoking affects your blood vessels and why it is worth quitting.  Immediate Effects of Smoking on Blood Vessels Cigarettes are filled with a variety of chemicals that all have different effects on your body, both in the short and long term. When you smoke a cigarette, nicotine makes your blood vessels constrict and become narrow. When this happens to smaller blood vessels it can make it much harder for blood to move as it should to other areas of the body, including the heart. As a result, oxygen is not able to travel adequately to various organs. This can lead to high blood pressure and an increased heart rate. Long-term Consequences of Smoking on Blood Vessels After smoking for an extended period of time, it is common for people to experience a negative impact on their cardiovascular system. Here are some long-term consequences from smoking on the bodies blood vessels: Atherosclerosis: Plaque builds up on the inside of the blood vessels, making them stiff and limiting the flow of oxygen-rich blood to different areas of the body. Aneurysms: Areas of the artery walls may become weak and may begin to bulge over time. Peripheral artery disease: Certain areas of the body might experience poor blood flow, particularly the limbs, which can lead to pain. Smoking and Specific Vascular Diseases Smoking cigarettes contributes to 1 out of every 5 deaths in the United States every year. Undoubtedly, many of those occur in part because of vascular diseases caused by smoking. Some common vascular diseases that smoking can cause include: Coronary artery disease (CAD): This develops when coronary arteries become narrow; sometimes this can lead to a heart attack. Cerebrovascular disease (CVD): This occurs when blood flow to the brain is restricted, which can lead to a stroke. Peripheral artery disease (PAD): This develops when narrow blood vessels reduce blood flow to certain areas of the body, particularly the arms, legs, and feet. Quitting Smoking and Vascular Health Improvement While inhaling the chemicals found in cigarettes can have profound consequences, your body can start to recover after quitting. It typically takes about 5 years of being cigarette-free for your blood vessels to experience a significant benefit. In that amount of time, your risk of having a stroke will be the same as that of a nonsmoker. Likewise, your risk of developing CAD will drop by 50% after just one year. Along with improving your overall health, quitting smoking is a wonderful way to improve your quality of life for years to come. Maintain Healthy Blood Vessels with The Vascular Institute Smoking cigarettes can lead to a variety of severe health complications, including peripheral arterial disease and stroke. For this reason, quitting is worth it. Even if you have been smoking for many years, quitting can help your blood vessels begin to heal, which can help you live a healthier, happier life. To learn more about maintaining healthy blood vessels, the trusted team at The Vascular Institute of the Rockies is here for you. Contact us today to schedule your next appointment.   Thu, 15 Feb 2024 06:00:00 GMT http://vascularinstitute.com/blog/12896/How-Smoking-Affects-Your-Blood-Vessels-- http://vascularinstitute.com/blog/12895/How-to-Improve-Your-Venous-Circulation-with-Compression-Therapy-- blog How to Improve Your Venous Circulation with Compression Therapy   Venous circulation is the part of your blood circulation system that carries oxygen-depleted blood back to the heart. Poor venous circulation causes a variety of unpleasant symptoms, including varicose veins, swelling in the lower extremities, leg pain, and slow healing. If left untreated, it could lead to ulcers and in some cases limb loss. Compression therapy improves venous blood circulation. It can treat associated conditions such as chronic venous insufficiency and varicose veins. With the proper approach, this therapy can alleviate these symptoms and improve your quality of life. The Significance of Compression Therapy Compression therapy involves applying pressure to the limbs using compression stockings or compression bandages. These devices help improve venous circulation by exerting external pressure on your veins. This pressure assists the one-way valves in the veins, preventing blood from pooling and reducing the risk of blood clots. The main benefits of compression therapy are: Reduced leg pain and swelling Improvement in symptoms caused by varicose veins, venous insufficiency, and venous ulcers If you have a venous circulation problem, your doctor is likely to recommend compression therapy as part of the treatment.  Types of Compression Therapy The two key types of compression therapy include graduated compression stockings and compression bandages: Graduated Compression Stockings These special stockings fit tighter than regular sock. As a result of a tight fit, your legs experience extra pressure, which is the highest around the ankles. The pressure gradient causes the blood to flow toward the heart instead of going back down to the foot. Compression Bandages  A compression bandage is a strip of elastic cloth that a doctor applies around your ankles and legs. They work the same way as compression stockings. However, unlike stockings, these bandages must be applied professionally. Compression bandages are often used in the initial stages of treatment for acute conditions, such as severe edema or venous ulcers. Conditions that Benefit from Compression Therapy The following conditions may benefit from compression therapy: Chronic Venous Insufficiency (CVI) CVI occurs when the veins in the legs fail to efficiently return blood to the heart, leading to symptoms like swelling, pain, and varicose veins. Compression therapy helps by improving venous blood flow, reducing swelling, and relieving symptoms. Deep Vein Thrombosis (DVT) DVT is a blood clot that forms in a deep vein, usually in the lower extremities. This is a highly risky condition that can lead to a fatality. Compression therapy helps prevent DVT by promoting blood circulation and reducing the risk of blood pooling. Tips for Wearing Compression Stockings Choose the right size and compression level for your needs (consult your doctor) Put on compression stockings in the morning when swelling is minimal Ensure a proper fit by smoothing out wrinkles and avoiding bunching Take breaks and elevate your legs periodically Follow the recommended wearing schedule provided by your healthcare professional Wash at least once every two days with mild detergent Lifestyle Changes for Improved Venous Circulation While undergoing compression therapy, you can optimize the treatment by making several important lifestyle changes. Engage in regular physical activity Maintain a healthy weight to reduce pressure on the veins Avoid prolonged periods of sitting or standing (take breaks to move and stretch) Elevate your legs whenever possible Consume a diet rich in fiber, antioxidants, and foods like citrus fruits, berries, and leafy greens Please consult your doctor about a comprehensive approach to changing your lifestyle, especially if it's mostly sedentary. Frequently Asked Questions : What causes poor venous circulation? Poor venous circulation can be caused by obesity, a sedentary lifestyle, aging, and certain medical conditions. How do I know if I need compression therapy? You may need compression if you experience symptoms like swelling and pain in the legs or live with conditions such as venous insufficiency. Are there any side effects of compression therapy? Possible side effects of compression therapy can include skin irritation, pressure sores, and discomfort. Proper fitting and care can usually help you avoid them.  If you have arterial disease, please consult your physician before using compression therapy, as this may be contraindicated for some patients. Can compression therapy be used during pregnancy? Compression therapy during pregnancy should be used under the guidance of a healthcare professional. Are there alternatives to compression therapy? Alternatives to compression therapy include leg elevation, exercise, weight management, and medications. However, these modalities work best when used together with compression therapy. At the Vascular Institute of the Rockies, we have an experienced medical team that is well equipped to diagnose and treat venous disorders. To create a personalized treatment plan and start addressing your venous circulation issues immediately, please schedule a consultation today.   Thu, 15 Feb 2024 06:00:00 GMT http://vascularinstitute.com/blog/12895/How-to-Improve-Your-Venous-Circulation-with-Compression-Therapy-- http://vascularinstitute.com/blog/12894/What-to-Expect-Before--During--and-after-a-Carotid-Endarterectomy-- blog What to Expect Before, During, and After a Carotid Endarterectomy   Carotid Endarterectomy is a procedure that is used to remove plaque buildup from the inside of one of the carotid arteries, an artery located on each side of your neck.  If you have been diagnosed with carotid disease, these vessels may be narrower as a result of plaque buildup within the walls of the artery.  Undergoing carotid endarterectomy can help reduce your risk of experiencing serious complications from carotid artery disease, including a stroke. Here is what you need to know about the process, potential risks, and benefits of a carotid endarterectomy. Before the Procedure If you have been diagnosed with carotid artery disease or atherosclerosis, your healthcare provider may recommend a carotid endarterectomy to reduce your risk of having a stroke, which is the main risk with carotid artery disease. Prior to the procedure, you will have a consultation and evaluation. This is what you can expect during the appointment: Discuss the purpose and details of the procedure Perform a comprehensive medical evaluation to assess your risks and candidacy for surgery Discuss the potential complications and alternative treatment options If your healthcare provider determines that you are a suitable candidate for a carotid endarterectomy, they may also recommend certain steps to ensure you are prepared prior to the procedure. These could include: Adjusting or discontinuing any medications you may be taking Modifying or restricting your diet Avoiding tobacco use and alcohol consumption Arranging for transportation and home care assistance following the procedure During the Procedure The surgery time for a carotid endarterectomy usually lasts between an hour and a half to two and a half hours. You will be given general anesthesia for this procedure. Here is what you can expect during your carotid endarterectomy: Once you are anesthetized, an incision will be made on your neck to expose the carotid artery. Next, the carotid artery will be temporarily clamped to restrict blood flow.  The plaque buildup will be removed from within the artery. Then, the artery will be repaired with or without a patch.  During surgery,  there is a team that will continuously monitor your brain function to ensure that the brain is receiving adequate blood flow despite having one carotid artery clamped temporarily. After the Procedure Once your carotid endarterectomy is complete, you will be transferred to a recovery room for close observation. Here, your blood pressure, heart rate, and neurological status will be carefully monitored. Your healthcare team will also care for your wounds, change dressings, and ensure that your pain is managed appropriately. Most patients can expect to recover in the hospital for 1-2 days after surgery. Your healthcare provider will also schedule follow-up appointments and prescribe any new prescriptions you may need. Be sure to follow your health care provider's recommendations for physical activity restrictions and gradually reintroduce normal activities. It is also important to be aware of potential complications following your surgery. To prevent the recurrence of plaque buildup in your arteries, maintaining a healthy lifestyle is essential. This includes eating a balanced diet, exercising regularly, and not smoking.  Learn More About a Carotid Endarterectomy at The Vascular Institute of the Rockies Plaque buildup in your arteries is a serious health concern that should be treated as such. A carotid endarterectomy is a procedure that is helpful in reducing overall risk of stroke. If you have been diagnosed with carotid artery disease, do not wait to learn more about your treatment options, including surgery.  Contact the trusted team at The Vascular Institute of the Rockies to schedule your. We look forward to helping you keep your vascular system in great shape for life!   Thu, 15 Feb 2024 06:00:00 GMT http://vascularinstitute.com/blog/12894/What-to-Expect-Before--During--and-after-a-Carotid-Endarterectomy-- http://vascularinstitute.com/blog/12649/The-Role-of-Exercise-in-Improving-Vascular-Health- blog The Role of Exercise in Improving Vascular Health  Having a healthy vascular system is an important part of living an overall healthy life. Strong blood vessels lead to good circulation which can have a big impact on how you feel physically and how well your body functions. While many factors can affect your vascular health, including genetics and diet, the good news is that exercise can have a noticeable impact on vascular health. You don't have to be a bodybuilder to develop a healthy vascular system. Even low-impact workouts, such as walking or swimming, can promote good blood circulation and stronger blood vessels. Here's what you need to know about the role exercising can have in improving vascular health. Effects of Exercise on Vascular Health When you move your body, your muscles need more blood to function properly. Because of this, your body strengthens and improves functionality of your blood vessels as it moves oxygen-rich blood from your heart to your muscles. Additionally, staying active can help you maintain a healthy weight, which puts less stress on your vascular system. As a result, exercising can lead to: Increased blood flow Vasodilation (widening of blood vessels) Reduced blood pressure Improved endothelial function (the function of the inner lining of blood vessels) Increased nitric oxide production (a vasodilator and anti-inflammatory molecule) Reduced inflammation Reduced risk of atherosclerosis (plaque buildup in the arteries) Benefits of Exercise for Vascular Health Whether you've been diagnosed with a vascular condition or you're striving to live a long, healthy life, incorporating regular exercise into your daily routine is an excellent way to promote the well-being of your vascular system. Some of the many benefits that exercise can provide for your vascular health include: Reduced risk of heart disease Reduced risk of stroke Reduced risk of peripheral artery disease Reduced risk of chronic kidney disease Improved cognitive function Improved sexual function Tips to Incorporating Exercise into Your Daily Routine Learning how to incorporate exercise into your everyday life may be a big adjustment. It's important to remember that no two people's health or circumstances are exactly the same, so you should find a routine that works for you and your particular needs. Here are some tips to make living an active, healthy lifestyle simple: If you have any medical conditions, speak to your healthcare provider about how to safely begin exercising Start small. Do what you're comfortable with, then work your way up to more challenging tasks Make exercising fun by doing things you enjoy, such as dancing or taking your dog for a walk  Ask a friend to walk, swim, or bike with you to keep you accountable   Exercise is not reserved for people who are young and in shape, anyone can improve their vascular health by staying active in ways that are tailored to their capabilities.  Striving to stay active with simple exercises, such as walking, swimming, or biking, can lead to an array of health benefits, including promoting good circulation and preventing heart disease. The good news is that it's never too late to start prioritizing your vascular health. Tue, 12 Dec 2023 06:00:00 GMT http://vascularinstitute.com/blog/12649/The-Role-of-Exercise-in-Improving-Vascular-Health- http://vascularinstitute.com/blog/12648/Arteriovenous-Fistula--What-It-Is-and-How-It-Is-Treated-in-Vascular-Surgery- blog Arteriovenous Fistula: What It Is and How It Is Treated in Vascular Surgery An Arteriovenous Fistula (AVF) is an abnormal connection between a vein and an artery. Typically, veins are connected to arteries by tiny blood vessels called capillaries. The capillaries bring oxygen-rich blood to other tissues around the body as it circulates through the arteries of the body. In the case of an AVF, however, blood travels directly from the artery to the vein, preventing the tissues around it from receiving the blood they need. While an AVF can develop anywhere in the body, they are most common in the legs. Small AVFs do not often exhibit symptoms. However, larger AVF's can cause bulging along the surface of the skin, similar to varicose veins although they are NOT varicose veins. Some cause swelling or pain. People can be born with an AVF while others may develop them later, often from trauma or dialysis-related surgery. AVFs can range from mildly symptomatic to severe. If left untreated, serious AVFs can lead to other health complications including heart failure, internal bleeding, blood clots, or claudication. Diagnosis and Treatment of AVFs AVFs are diagnosed by a healthcare provider. They will start by using a stethoscope to listen to the blood flowing through your limbs. In people who have an AVF, the blood flow through the fistula can sound like it is humming. If the healthcare provider suspects you have an AVF, they will request other tests to confirm it. These may include: Duplex ultrasound Computerized tomography (CT) angiogram Magnetic resonance angiography (MRA) If you are diagnosed with an AVF, your healthcare provider will recommend a treatment plan based on its severity and your overall health. If the AVF is small, they may choose to monitor it without performing any procedures. Sometimes, small AVFs can resolve on their own over time. If it is larger and causing symptoms, they may recommend one of the following treatment options: For AVFs in the legs that are easily detected on an ultrasound, ultrasound-guided compression may help by pressing an ultrasound probe on the affected area, thereby impeding blood flow to the fistula, and causing it to shut down. Catheter embolization: a small tube is inserted into the AVF followed by placement of a small coil or stent. This causes the blood to reroute around the fistula. For severe cases with larger AVFs, surgical treatment may be necessary. The time it takes to completely recover from each treatment depends on which procedure you undergo, the severity of your condition, and your overall health. Your healthcare provider will let you know what to expect before undergoing treatment. Living with an AVF The way an AVF can impact your life depends on its location and size. Small AVFs may provoke no symptoms and will only require monitoring, while larger AVFs can lead to uncomfortable or even life-threatening symptoms. If you have been diagnosed with an AVF or are exhibiting signs of an AVF, be sure to work closely with your healthcare professional to manage the condition before it leads to other complications. Schedule Your Appointment at The Vascular Institute of the Rockies The trusted team at The Vascular Institute of the Rockies is committed to helping you live the healthiest life possible by promoting a healthy vascular system. If you think you may be suffering from symptoms of an Arteriovenous fistula, do not wait to schedule an appointment with your healthcare provider. They can determine if you need specialized care from the experiences team at Vascular Institute of the Rockies.   Tue, 12 Dec 2023 06:00:00 GMT http://vascularinstitute.com/blog/12648/Arteriovenous-Fistula--What-It-Is-and-How-It-Is-Treated-in-Vascular-Surgery- http://vascularinstitute.com/blog/12602/The-Link-Between-Diabetes-and-Peripheral-Arterial-Disease blog The Link Between Diabetes and Peripheral Arterial Disease Diabetes is a serious health condition that causes a person's blood sugar to rise because their body does not produce or use insulin properly. Peripheral artery disease (PAD) occurs when the arteries that carry blood away from a person's heart to other areas of their body become narrow, most commonly in the legs and feet. It is estimated that between 20-30% of people with diabetes also have PAD. This is because both diabetes and PAD have many of the same risk factors and complications. If you have been diagnosed with diabetes or PAD, managing your condition is the best way to prevent it from worsening and contributing to other health issues. Here is what you need to know about the link between diabetes and PAD. Risk Factors for PAD Certain risk factors increase your chances of developing PAD. Additionally, if you have been diagnosed with diabetes, one or more of these risk factors could put you at risk for developing PAD. These risk factors include: Obesity Smoking Inactivity High blood pressure High cholesterol Family history of diabetes, PAD, or heart disease Symptoms and Complications of PAD It is normal for some individuals with PAD to have symptoms that are mild or not noticeable at all. Others may experience symptoms that include: Leg pain when walking that subsides with rest Leg weakness Numbness in the feet or toes Hair loss on legs Ulcer formation with difficulty healing If left untreated, PAD can lead to many other serious health conditions. Some PAD complications are more likely to occur in individuals who also have diabetes, including: Stroke Heart attack Non healing wounds Diagnosis and Treatment of PAD Since PAD may not produce symptoms, a healthcare provider is necessary in diagnosing this condition. This is done through a combination of a physical exam, a study known as ankle-brachial index, ultrasound, CT angiography, or angiography. If you are diagnosed with PAD, your healthcare provider will create a personalized treatment plan to help manage your symptoms. Your treatment plan will be determined by your overall health, lifestyle, and condition. Treatment options for PAD include: Making healthy lifestyle changes such as eating a balanced diet, exercising regularly, not smoking, and maintaining a healthy weight. Taking certain medications to treat other conditions that could be contributing to your PAD, such as high blood pressure, high cholesterol, or diabetes Surgery may be an option for severe cases to restore blood flow in blocked arteries. Preventing PAD While your family's health history and genetics can certainly play a role in developing PAD and diabetes, there are steps you can take to help you prevent both conditions. These include: Eating a balanced diet Staying active Avoid using tobacco Maintaining a healthy weight If you have diabetes, managing your blood sugar to reduce your risk of developing PAD If you have been diagnosed with PAD, these steps can help prevent your condition from progressing and leading to other serious health conditions. Conclusion Diabetes and PAD are two serious health conditions that can impact your quality of life and even put your life at risk if not treated. The good news is that you have the power to prevent and manage these conditions by making healthy lifestyle choices. If you have been diagnosed with diabetes, keeping your blood sugar under control is a proactive way to lower your risk of developing PAD or other complications including stroke and heart attack. To learn more about preventing or managing PAD, contact the trusted team at The Vascular Institute of the Rockies. Together we can help you live a healthy, happy life for years to come.   Wed, 29 Nov 2023 06:00:00 GMT http://vascularinstitute.com/blog/12602/The-Link-Between-Diabetes-and-Peripheral-Arterial-Disease http://vascularinstitute.com/blog/12601/Unraveling-Lymphedema--Causes--Risk-Factors--and-Treatment-Options-- blog Unraveling Lymphedema: Causes, Risk Factors, and Treatment Options   Your lymphatic system is responsible for maintenance of fluids throughout your body. When your lymphatic system does not function properly, fluids can accumulate in certain areas of your body causing swelling. Lymphedema occurs when protein-rich fluid that is supposed to be drained by the lymphatic system builds up and causes an area to swell. While lymphedema most commonly affects the arms and legs, it can also develop in the neck, abdomen, or genitals. Primary Lymphedema Primary lymphedema is a condition that affects 1 out of 100,000 people in America. It is caused by rare conditions that are inherited. Primary lymphedema can develop at the following stages of life: Infancy: Babies may be born with a form of lymphedema known as Milroy's disease. Puberty through the age of 35 or during pregnancy: This form of lymphedema is called Meige's disease. After the age of 35: This rare form of lymphedema causes swelling exclusively in the legs.  Secondary Lymphedema Unlike primary lymphedema, which is hereditary, secondary lymphedema occurs when your lymphatic system becomes damaged. Common causes of secondary lymphedema include: Trauma Surgery Radiation Therapy Chronic Venous Insufficiency  Secondary lymphedema can also develop in cancer survivors if the cancer cells block the flow of fluid from a particular lymph node or vessel. Recognizing the Symptoms In its earliest stages, lymphedema may not be noticeable. Typically, swelling is the first symptom that occurs. This can come on suddenly or increase slowly over time. Other signs of lymphedema include: Feeling tightness or heaviness in the affected area Thickening of the skin Frequent infections It is best to schedule an appointment with your healthcare provider as soon as you notice one or more symptoms of lymphedema. Risk Factors for Lymphedema While lymphedema can affect anyone, certain risk factors can make you more likely to be affected by the condition. These include: Being overweight or obese Advanced age Psoriatic or rheumatoid arthritis Pregnancy Undergoing surgery Diagnosis and Medical Evaluation If you are exhibiting signs of lymphedema, do not wait to seek medical attention. Early diagnosis could mean a more effective treatment plan. Lymphedema is diagnosed by a healthcare provider using the following techniques: Reviewing medical history, including past surgeries Performing a physical exam Using imaging tests, such as a CT, ultrasound, or Lymphoscintigraphy. Specifically, Lymphoscintigraphy is used to identify how fluid is flowing throughout your body and assess whether something may be causing a blockage. Conservative Treatment Approaches The way in which lymphedema is treated depends on how severe the condition is, and which area of the body is being affected. For cases that are mild to moderate, conservative treatment approaches may be beneficial. These include: Complete Decongestive Therapy (CDT): This combines a variety of techniques such as using compression garments, manual drainage, and exercise to encourage the lymphatic system to work properly. Manual Lymph Drainage (MLD) Techniques: Special massages are used to move the fluid that is collecting in an area of the body to an area where lymph vessels are working as they should. Compression Garments: Elastic stockings or sleeves are worn over the affected leg or arm to help fluids drain and reduce swelling. Advanced Treatment Options More advanced treatment options may be appropriate for severe cases of lymphedema. Some of these could include: Liposuction: Remove hardened tissue that is impairing the function of the limb. Lymphaticovenous Anastomosis: Connect lymphatic vessels to veins to promote proper fluid drainage. Microsurgery and Lymph Node Transplantation: Moving healthy lymph nodes from one area of the body to the affected area. Schedule an Appointment at The Vascular Institute  If you have been diagnosed with lymphedema or are showing signs of the condition, it is important to work closely with an experienced healthcare team to diagnose your symptoms. At The Vascular Institute of the Rockies, our trusted team is able to diagnose your lymphedema and help you coordinate a treatment plan that is tailored to your particular needs.  Contact us today to schedule an appointment.   Wed, 29 Nov 2023 06:00:00 GMT http://vascularinstitute.com/blog/12601/Unraveling-Lymphedema--Causes--Risk-Factors--and-Treatment-Options-- http://vascularinstitute.com/blog/12600/Varicocele--Understanding-Symptoms--Diagnosis--and-Treatment-Options-- blog Varicocele: Understanding Symptoms, Diagnosis, and Treatment Options   Varicocele is a condition that occurs when the veins within the loose pouch of skin that contain the testicles become swollen or enlarged. The veins located inside the testicles are intended to move oxygen-depleted blood back to the heart, however, a varicocele develops when the blood pools in these veins instead of exiting the veins. Here is what you should know about how a varicocele could affect your testicular health. Understanding Varicoceles Each testicle has one artery that brings oxygen-rich blood from the heart, one vein that takes the oxygen-depleted blood back to it, and a series of smaller veins that bring the oxygen-depleted blood to the primary vein. No one knows exactly why varicoceles form in some men and not in others, but it is thought that it may be caused by a problem with the valves that are supposed to keep blood moving in the appropriate direction within the vein. Additionally, the unique path of blood flow withing the left testicle makes it more likely to experience a varicocele than the right. Signs and Symptoms While it is common for men with varicoceles to not notice any unusual symptoms, the following are symptoms that may develop: A dull, aching pain, which may get better when lying down A mass located above the testicle Swelling or shrinking of testicles Infertility Diagnosing Varicoceles If you notice one or more of the symptoms of a varicocele, be sure to schedule an appointment with your healthcare provider. They can diagnose the condition by: Performing a physical exam Using diagnostic imaging such as ultrasound to get a closer look at the blood flow within the scrotum Grading Varicoceles Grades are used to score the severity of varicoceles. These grading scale is as follows: Grade 0: This type is so small that it can only be detected on an ultrasound. Grade I: This type cannot be seen but can be felt by your healthcare provider using the Valsalva maneuver. Grade II: This type cannot be seen but can be felt even without the Valsalva maneuver. Grade III: This type can be easily seen and felt. The Link Between Varicocele and Infertility Varicoceles can contribute to infertility in as many as 20% of the men diagnosed with them. Varicoceles of all sizes can make it harder to conceive a child.  Additionally, having a varicocele on one side can have an impact on the way both testes are able to function.  Non-surgical Treatment Options For most men, no treatment is necessary to address a varicocele. Your healthcare provider may recommend annual check-ups to monitor the size of the varicocele and recommend lifestyle changes to manage uncomfortable symptoms. Some of these could include: Avoiding tight fitting underwear Taking over-the-counter pain medication if needed for pain Applying ice for 15 minutes intermittently Surgical Treatment: Varicocelectomy In circumstances where symptoms include severe pain or struggling with conception, a varicocelectomy may be recommended. This outpatient surgery entails a surgeon closing the affected veins to redirect blood to other veins within your scrotum that are working properly. The recovery from a varicocelectomy is typically smooth with mild discomfort. Patients can resume normal activities after about a week and should be fully recovered after six weeks. Schedule Your Varicocele Appointment Today If you think you may have a varicocele do not wait to schedule an appointment with your health care provider.  They can help you determine if you need to be evaluated by one of the providers with the trusted team at The Vascular Institute of the Rockies!   Wed, 29 Nov 2023 06:00:00 GMT http://vascularinstitute.com/blog/12600/Varicocele--Understanding-Symptoms--Diagnosis--and-Treatment-Options-- http://vascularinstitute.com/blog/12495/Chronic-Venous-Insufficiency--Causes--Symptoms--and-Treatment- blog Chronic Venous Insufficiency: Causes, Symptoms, and Treatment Options  Understanding Chronic Venous Insufficiency Chronic Venous Insufficiency (CVI) is a condition that occurs when the veins in your legs return blood to your heart as they should. When this happens, blood can flow backward and lead to pooling in your legs.  It's estimated that CVI affects up to forty percent of people in the U.S. and can cause a variety of uncomfortable symptoms including pain, heaviness and swelling. Here is what you should know about CVI in order to manage your symptoms and improve your quality of life. Causes of Chronic Venous Insufficiency Common causes of CVI include: Prolonged standing or sitting Deep vein thrombosis (DVT) Obesity  Pregnancy and hormonal changes Family history and genetic factors Risk Factors for Chronic Venous Insufficiency Certain factors could make you more likely to be affected by CVI. These include: Age: People over the age of 50 have an increased risk Gender: Women are more likely to develop CVI than men Lifestyle: Smoking, poor diet, and inactivity make you more susceptible to developing CVI Signs and Symptoms of Chronic Venous Insufficiency The symptoms of CVI can vary from person to person. While some individuals' symptoms may be mild, others can be severe and even disabling. Common CVI symptoms include: Swelling in the affected areas Varicose veins Leg pain, heaviness, and fatigue Skin changes and ulcers If you notice one or more of these symptoms, be sure to schedule a consultation with your healthcare provider to get your symptoms under control and prevent the condition from worsening. Complications Associated with Chronic Venous Insufficiency While CVI is not considered to be life-threatening, it can have a negative impact on the way you look and feel. CVI can lead to complications that can make performing normal daily activities difficult. These complications could include: Venous ulcers Skin infections and cellulitis Blood clots (both superficial and deep) Treatment Options If your healthcare provider suspects that you could have CVI, they will diagnose you by performing a physical exam and vein ultrasound. In most cases, CVI can be effectively managed with a combination of lifestyle changes and compression therapy. The primary goal of CVI treatment is to promote healthy blood flow from your legs to your heart, which can alleviate symptoms, including swelling and pain. Lifestyle factors that could be used to treat CVI include: Elevating legs throughout the day Maintaining a healthy weight Exercising regularly Wearing compression stockings In more severe cases a more invasive procedure may be recommended.  Prevention Because CVI is often caused by other health conditions or genetics, there may not be anything you can do to fully prevent it from developing.   However, it is possible to minimize your chances of developing CVI by making healthy lifestyle choices, including: Maintaining a healthy weight Exercising regularly Not smoking Not standing or sitting for extended periods of time, and if you must do so, use compression stockings if you have no medical conditions prohibiting their use.  Schedule Your Appointment at The Vascular Institute Today Living with CVI is not always easy. If you are tired of struggling with the discomfort and inconvenience of painful, swollen veins, help is available. At The Vascular Institute of the Rockies, our experienced team can assist you in keeping your symptoms under control and improving your quality of life by promoting healthy blood flow in your legs. To learn more about keeping your vascular system healthy and managing CVI, contact us today to schedule an appointment.    Mon, 06 Nov 2023 06:00:00 GMT http://vascularinstitute.com/blog/12495/Chronic-Venous-Insufficiency--Causes--Symptoms--and-Treatment- http://vascularinstitute.com/blog/12494/Understanding-Pelvic-Venous-Disorders- blog Understanding Pelvic Venous Disorders Pelvic venous congestion is a condition that occurs when the veins in your pelvis do not function properly. The blood that is returning from below your abdomen moves slowly, which causes blood to pool and varicose veins to form. This can lead to uncomfortable symptoms that can negatively impact your quality of life, including pelvic pain. It is estimated that this affects up to thirty percent of individuals with chronic pelvic pain and is most likely to develop in women who have previously given birth. The hormonal and physical changes associated with pregnancy are thought to be the primary cause of pelvic venous Disorders. If you have been diagnosed with pelvic venous disorders or suspect that you might have it, here is what you need to know about understanding the condition. Symptoms of Pelvic Venous Disorders It is common for individuals to experience a variety of symptoms that could be confused with other health conditions. The following symptoms could be consistent with a pelvic venous disorder: Chronic pelvic pain, which can worsen after certain activities such as sexual intercourse or walking Varicose veins in the pelvic or genital area Painful intercourse Heavy and/or painful menses If you experience one or more of these symptoms, be sure to schedule an appointment with your healthcare provider to determine the cause. Diagnosing Pelvic Venous Disorders Diagnosing these conditions can be a challenge since there are many other causes of pelvic pain. In order to determine if you may have pelvic venous congestion, your healthcare provider may use a variety of modalities including: Careful review of your medical history and symptoms Performing a physical examination Imaging such as: Ultrasound Computed Tomography (CT) scan  Diagnostic pelvic venogram Differential Diagnosis for Pelvic Venous Disorders Due to similarities in their symptoms, there are many other conditions that could be mistaken for a pelvic venous disorder. These include: Endometriosis Adenomyosis Ovarian cysts Chronic pelvic inflammatory disease (PID) Finding a healthcare provider who you can trust and who is willing to perform the necessary tests to differentiate this diagnosis from other conditions that can also cause pelvic pain is the best way to achieve an accurate diagnosis. Treatment Options for Pelvic Venous Disorders: There is no cure, and in most instances these conditions cannot be prevented. However, there are a variety of treatment options that can help manage your symptoms and improve your quality of life. Some of these include:  Conservative management Lifestyle modifications Pain management techniques Close surveillance  Minimally invasive interventions Transcatheter embolization of incompetent pelvic veins Surgical interventions Ligation of incompetent veins Hysterectomy Manage Your Pelvic Venous Disorders with The Vascular Institute Anyone with a Pelvic Venous Disorder will tell you that their symptoms can make performing normal daily activities difficult. Fortunately, it is possible to keep your pelvic pain and other symptoms under control with an effective treatment strategy. At The Vascular Institute of the Rockies, our experienced team can provide an accurate diagnosis and personalized treatment plan to help you regain your life back. If you are living with the negative effects of this condition, do not wait to schedule a free consultation.    Mon, 06 Nov 2023 06:00:00 GMT http://vascularinstitute.com/blog/12494/Understanding-Pelvic-Venous-Disorders- http://vascularinstitute.com/blog/11600/What-are-the-Consequences-of-Venous-Disease-- blog What are the consequences of Venous Disease?   Healthy blood circulation is an essential element to virtually every other normal function your body performs. After all, you can't breathe, digest food, or even move without blood flowing to your heart. This also means that when problems occur in your veins, your overall health can be compromised. Here's what you should know about how diseases affecting your veins, also known as venous diseases, could impact you.  What is Venous Disease? Veins are a part of your circulatory system that are responsible for carrying blood all around your body and transporting it back to your heart. They are essentially hollow tubes with thin walls and special flaps inside them called valves. These valves open as the muscles in your body contract, which allows blood to flow through them. These valves open and close to allow blood to flow in the desired direction when your muscles are relaxed. When the valves or walls of your veins become damaged, blood can begin to collect in them or even flow in the opposite direction that is intended, this is due to venous disease. This can cause a variety of health concerns ranging from cosmetic to life-threatening. Types of Venous Disease Venous diseases affect millions of people every year. Some of the most common types of venous disease include: Varicose veins and spider veins: These veins are located near the surface of the skin and can appear to bulge or look twisted. They develop when valves that are weak or damaged let blood flow backward and pool in one area, usually the legs. Superficial thrombophlebitis: This may occur near the surface of the skin in response to a blood clot developing in the blood vessel such as a varicose vein. It is not serious, however, can cause pain and redness at the site. Ulcers: These are sores or wounds that won't heal or continue to recur. They are typically found on the inner part of the leg above the ankle.  They are caused by poor blood circulation in the veins. Deep vein thrombosis (DVT):  This occurs when a blood clot develops in a deep vein, including the arms and legs. If the blood clot breaks free it could travel to your lungs, causing a pulmonary embolism. While DVT does not always produce symptoms, it can be life-threatening if left untreated. Symptoms of Venous Diseases As with many other cardiovascular diseases, venous diseases can present a wide range of symptoms depending on the type of disease and the person who has it. While some people may not experience any symptoms at all, others may notice these signes of veous disease:  Swelling Itching Tenderness or pain Burning sensation Heaviness of the lower extremity Lower extremity restlessness What are the possible consequences if Venous Disease goes untreated? Because venous diseases do not  always produce noticeable warning signs or symptoms, you may be worried about what could happen if you do not have symptoms.  Fortunately, many venous diseases are not considered life-threatening. While certain conditions may impact the way your body looks aesthetically, such as varicose veins, or may cause uncomfortable symptoms, such as swelling, it is rare for most venous diseases to lead to fatal health problems. The most common complication from venous disease is a lower quality of life due to symptoms. If you've been diagnosed with a venous disease or are interested in protecting your vein health, there are practical steps you can take to manage and prevent symptoms. Exercising regularly, eating a balanced diet, and managing your weight can help keep your cardiovascular system in good condition, including your veins. The trusted team at the Vascular Institute of the Rockies can  help diagnose, treat, and prevent venous diseases and their consequences.  Contact us today to schedule your appointment!   Tue, 07 Mar 2023 06:00:00 GMT http://vascularinstitute.com/blog/11600/What-are-the-Consequences-of-Venous-Disease-- http://vascularinstitute.com/blog/11298/What-You-Need-to-Know-About-Anesthesia-Before-Vascular-Surgery blog Anesthesia Before Vascular Surgery: Things to Know  As with any surgery, a major consideration for patients is whether their bodies can handle anesthesia  safely. With vascular surgery, this is just the same. When anesthesiologists evaluate a patient before  vascular surgery, the two most important factors they consider are what type of vascular surgery the  patient is getting and what other diseases the patient may already have.   Every surgical procedure a vascular surgeon performs requires a unique approach from anesthesia to  help guide the patient through a safe and pain-free surgery. Depending on the procedure, an  anesthesiologist will have a specifically tailored approach to how they administer and manage anesthesia  from the beginning and till the end of the surgery. They will also have a plan for how they limit post surgical pain and nausea. Common procedures related to vascular surgery include procedures to treat  peripheral artery disease, aneurysmal disease, and thromboembolic disease.  Likewise, common diseases such as chronic kidney disease, heart disease, and chronic obstructive  pulmonary disease also significantly influence how an anesthesiologist plans a procedure. In the next  portion of this article, I will talk about how those common diseases can affect the delivery of anesthesia.  Chronic Kidney Disease:  Very common in Vascular Surgery is to perform procedures endovascularly, which means the entire  surgery is performed inside of arteries and veins and does not require making any large incisions into the  body. However, doing this involves using "contrast dyes," which allows the surgeons to see exactly where  in the body they are working without having to cut open the skin! The problem, however, is that patients  with chronic kidney disease do not handle these "contrast dyes" very well and risk having their kidneys  injured.  Fortunately, anesthesiologists can avoid exposing a person with chronic kidney disease to kidney injury  from contrast dyes by carefully hydrating the patient with intravenous fluids. Specific hydration protocols  exist to significantly reduce the risk of kidney injury, so patients with kidney disease can feel assured that  they'll safely tolerate the contrast dyes used in endovascular procedures.   Heart Disease:  Patients undergoing vascular surgery commonly have underlying issues with their hearts. In preparing  for anesthesia, an anesthesiologist will evaluate each patient's heart condition carefully to ensure that  they are safe for surgery. Patients with heart disease will likely receive an EKG, echocardiogram, and  coronary angiography before surgery to ensure they will be safe. After a patient undergoes these tests,  an anesthesiologist will review the results and either clear a patient for surgery or decide to cancel the  surgery. As a patient, if you have a heart condition and were cleared for surgery, feel assured that lots of  time was spent making sure your heart is strong enough to handle the procedure.   Chronic Obstructive Pulmonary Disease:  Often patients in need of vascular surgery have a long history of tobacco use. Chronic tobacco use causes  significant damage to many organ systems in our body, including our lungs and arteries. For this reason,  many patients undergoing vascular surgery also happen to have COPD. An anesthesiologist's most  important consideration before caring for a patient during their procedure is that they have stopped  smoking for at least 8 weeks. These eight weeks of smoking cessation will decrease the risk of  experiencing many surgical complications. Some of these surgical complications include heart attack and  limb loss.  Post-Operative Anesthetic and Pain Management: Your level of pain and recovery from vascular surgery will depend on the complexity of your procedure.  Sometimes, you will have to spend some time in the intensive care unit for close monitoring, and other  times you'll feel good enough to go home in a few hours. Depending on your surgery, your vascular  surgeon and anesthesiologist will inform you of what to expect regarding recovery and pain. Fortunately,  with the use of special nerve-blocking medications and long-acting painkillers, the pain and recovery  from vascular surgery is often very mild.   Thu, 12 Jan 2023 06:00:00 GMT http://vascularinstitute.com/blog/11298/What-You-Need-to-Know-About-Anesthesia-Before-Vascular-Surgery http://vascularinstitute.com/blog/11297/Lymphedema-Treatment---Vascular-Institute-of-the-Rockies- blog What is lymphedema?  Lymphedema is edema, or swelling, due to obstruction or destruction of lymphatic vessels or  lymph nodes. The lymphatic system functions to return fluids to the heart, allow large  molecules like hormones and fats to enter the blood, and participate in detecting and  destroying infected and cancerous cells. When there is a disruption in this system the excess  fluid remains in the extracellular space which causes swelling.  Who is at risk of lymphedema?  Lymphedema is rarely caused by congenital abnormalities in lymphatic vessels. Most often it is  caused by secondary mechanisms such as:  • Tumors  • Operations  • Trauma  • Radiation therapy  • Infections   Symptoms of lymphedema  Symptoms of lymphedema typically occur in stages starting with a latent period without any  swelling and progressing to hardening and thickening of the skin (fibrosis) and, in serious cases,  elephantiasis (enlarged and hardened skin with significant fibrosis). Many patients will notice  signs and symptoms once reversible swelling begins. The typical symptoms include:  • Swelling of the limbs and/or digits that is non-pitting – meaning when you push on the  site of swelling and release there is no residual indentation  • Feeling of heaviness or tightness  • Restricted range of motion  • Recurring infections  • Hardening and thickening of the skin  What are the treatment options?  Before treating lymphedema, it is important to rule out other vascular causes related to venous  or arterial disease as the treatment options vary significantly based on the vessel type. Once the  diagnosis of lymphedema has been made by a medical professional, treatment can be started.  Initial treatments for lymphedema are conservative in nature and include: • Compression stockings  • Elevating the affected limb  • Exercise  • Management of the underlying disease (if applicable) If conservative measures fail there are some surgical options available, but these are rarely  done, are extremely difficult due to the small size and thin walls of lymphatic vessels, and often  have poor results. The surgical options are microsurgery, where the blocked lymph vessels are  bypassed or replaced. Unfortunately in the leg, there are dozens of blocked lymph vessels in  patients who have lymphedema, and trying to "fix" numerous tiny thin walled vessels invisible  to the naked eye is often unsuccessful in reversing the edema. Conservative measures like  compression, pumps, and elevation are the mainstay of treatment, and must be continued daily  for life. Ask your doctor about what they can do to help you manage this problem.  Thu, 12 Jan 2023 06:00:00 GMT http://vascularinstitute.com/blog/11297/Lymphedema-Treatment---Vascular-Institute-of-the-Rockies- http://vascularinstitute.com/blog/10924/Renal-Artery-Stenosis--Is-It-Common---Life-Threatening- blog Renal Artery Stenosis: Is It Common & Life Threatening? Renal artery stenosis (RAS) occurs when one or more of the arteries that carry blood to your kidneys become narrow. Narrowed arteries make it harder for oxygen-rich blood to travel from your heart to your kidneys. As a result, your kidneys may not be able to properly function, which can lead to other serious health complications. Here is what you should know about RAS before scheduling your next appointment with the trusted team at the Vascular Institute of the Rockies. How Common is RAS? RAS affects over 200,000 people in the United States every year. The majority of individuals who develop RAS also have atherosclerosis,  a condition that causes sticky plaque to build up on the inside of your artery walls. Other factors that could make you more likely to be affected by RAS include: High blood pressure High cholesterol Diabetes Smoking Unhealthy diet Men over the age of 45 and women over the age of 55 Obesity What Are the Symptoms, Diagnosis, and Complications? In most cases, RAS does not exhibit any noticeable signs or symptoms. Once it has progressed,  RAS symptoms may include High blood pressure that is difficult to manage despite the use of blood pressure medication Signs of a problem with kidney function such as elevated protein levels in urine A whooshing sound that your doctor can hear when listening to your kidneys with a stethoscope Swelling of different body parts, such as your legs   If your healthcare provider suspects that you may have RAS, they will perform a series of tests to confirm the diagnosis. First, they will perform a physical exam, review your health history, and check your kidney function with blood and urine tests. Imaging studies may also be used such as: CT scan Ultrasound Renal arteriography Magnetic resonance angiography (MRA)   Possible complications from RAS include: Chronic kidney disease Kidney failure Retaining fluid in your legs Shortness of breath Renal hypertension (high blood pressure) Peripheral artery disease What Happens If It Goes Untreated? If left untreated, RAS can potentially worsen over time. The rate at which the disease can progress, and its prognosis will depend on how severe your condition is. For people whose renal arteries are almost totally blocked (95%), the four-year survival rate is only about 50%. For this reason, it is important to seek treatment as quickly as possible after experiencing symptoms or being diagnosed with RAS.  What Are the Treatment Options? Treatment options for RAS will depend on your particular symptoms, lifestyle, and overall health condition. Possible RAS treatment options include: Making lifestyle changes: eating a balanced diet, limiting salt consumption, drinking more water, and exercising regularly can help keep your blood pressure under control. Taking medications: Diuretics, angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, and other medications may help manage your blood pressure as well as other conditions contributing to RAS, such as atherosclerosis. Renal angioplasty and stenting: This procedure is performed to open up narrowed blood vessels and maximize blood flow to the kidney. Renal artery bypass surgery: This is an open surgical procedure that involves creating a new route for blood to flow from your heart to your kidney via a new conduit such as a bypass graft. Schedule Your RAS Consultation at The Vascular Institute When it comes to protecting the health of your renal arteries, there's no time to waste. If you have been diagnosed with atherosclerosis, are experiencing RAS symptoms, or have a family history of cardiovascular disease, working with your healthcare provider to protect the well-being of your arteries is a good idea. The experienced team at the Vascular Institute of the Rockies is here to help you prevent, diagnose, and treat RAS.  Conact us today to schedule your appointment and take the first step in living a longer, healthier life.   Thu, 22 Dec 2022 06:00:00 GMT http://vascularinstitute.com/blog/10924/Renal-Artery-Stenosis--Is-It-Common---Life-Threatening- http://vascularinstitute.com/blog/10923/What-Happens-if-Peripheral-Arterial-Disease-is-Left-Untreated-- blog What Happens If Peripheral Arterial Disease is Left Untreated? Maintaining a healthy circulatory system is a critical part of living a long, healthy life. After all, your blood vessels and heart have a direct effect on how the other systems in your body function. Because of this, it is important to address vascular complications as soon as they arise, including Peripheral Arterial Disease (PAD). Here's what you should know about treating PAD before scheduling your next appointment with the trusted team at the Vascular Institute of the Rockies.  What is PAD? PAD is a disorder that occurs when blood is unable to properly circulate through your body. It occurs when arterial blood vessels become blocked, narrowed, or experience spasms. In most cases, PAD is caused by a condition called arteriosclerosis, in which plaque builds up on the inside of one's arterial blood vessels and prevents blood from flowing as it should to different parts of your body. PAD can be quite painful, especially when exercising your legs. However, this discomfort usually subsides with rest.  What Are the Symptoms of PAD? In its earliest stages, the signs of PAD can start slowly and occur sporadically. Many people feel fatigue or pain in their feet or legs with physical activity due to the lack of proper blood flow to their limbs. Other common symptoms of PAD include: Hair loss on legs Skin that feels cold, thin, or brittle on legs Discoloration (reddish or blue) on legs Gangrene Impotence Aching or burning pain Muscles that feel numb, weak, or heavy Limited mobility If you notice one or more of these PAD symptoms, don't wait to seek professional medical care. While PAD may progress slowly, it will only get worse if left untreated. Early detection can lead to a more comfortable and effective treatment plan. What Happens If PAD Goes Untreated? PAD is a serious medical condition that should not be ignored. If left untreated, PAD may progress over time and can lead to more serious health complications. These include: Wounds that won't heal Severe pain, including when at rest Bone and blood infections that could be life-threatening Amputations Impotence Stroke Heart attack Treatment Options for PAD If you are diagnosed with PAD, the good news is that there are treatment options that can help slow down the progression of the disease and help you find relief from your symptoms. Common PAD treatment options include: Making healthy lifestyle changes, such as exercising, quitting smoking, and eating a balanced diet Addressing health conditions that could be contributing to PAD such as diabetes, high cholesterol, and hypertension Taking medicine to improve blood flow, such as blood thinners Angioplasty or stent placement to open the narrowed or blocked blood vessel Surgery to reroute blood flow around the narrowed or blocked blood vessel Treatment options for PAD can vary greatly between individuals. The best treatment plan for you will depend on your particular condition and symptoms. Schedule Your Appointment at The Vascular Institute Your vascular health is worth protecting. If you've been diagnosed with PAD or noticed any of its symptoms, working with an experienced medical team is the best way to keep your symptoms under control and prevent the disease from getting worse. At the Vascular Institute of the Rockies, our friendly team can help you manage your PAD symptoms and create a treatment plan to protect your circulatory health and live your best life. Contact us today to schedule your free consultation and learn more about preventing, treating, and managing PAD.   Thu, 22 Dec 2022 06:00:00 GMT http://vascularinstitute.com/blog/10923/What-Happens-if-Peripheral-Arterial-Disease-is-Left-Untreated-- http://vascularinstitute.com/blog/10177/What-Triggers-May-Thurner-Syndrome- blog What is May-Thurner Syndrome? Also known as Cockett syndrome or iliac vein compression syndrome is a condition that affects the venous blood flow from your legs. As blood flows through your body, your arteries transfer blood away from your heart while your veins return the blood back to it. May-Thurner syndrome occurs when your right iliac artery, which carries blood to your right leg, compresses your left iliac vein, which carries blood from your left leg back to your heart, where they pass each other in your pelvis. How Does it Impact the Body? When a person develops May-Thurner syndrome, it becomes more difficult for blood to travel from their leg back to their heart. Because of this, it is common for blood to pool in the individual's leg or for them to develop deep vein thrombosis (DVT), which occurs when a blood clot forms in the deep veins of the leg. DVT can cause uncomfortable symptoms, such as swollen veins, tenderness, and throbbing in your legs, but can also lead to more serious health concerns, including a pulmonary embolism if the blood clot were to break off and travel to your lung. It is also possible for women with May-Thurner syndrome to develop pelvic congestion syndrome, which can lead to pelvic pain. What Triggers May-Thurner Syndrome? May-Thurner syndrome is a common condition that affects as many as 1 out of every 5 people. It is more common in women and people between the ages of 20 and 50.  May-Thurner syndrome is not a genetic condition. On the contrary, it occurs randomly as a result of the way your blood vessels are positioned. Factors that could make you more likely to develop May-Thurner syndrome include: Being female Recently giving birth Having more than one child Taking hormonal birth control Having a condition that causes your blood to clot Being dehydrated Sitting for long periods of time Symptoms of May-Thurner Syndrome In most cases, symptoms of May-Thurner syndrome only occur in one leg. These could include: Pain Swelling Open sores Varicose veins A heavy feeling Skin discoloration What Are the Treatment Options? Many people who have May-Thurner syndrome don't exhibit any symptoms. This can make it difficult for individuals to get a proper diagnosis and the treatment they need to prevent the condition from progressing into something more serious. If your healthcare provider suspects that you could have May-Thurner syndrome, they will likely use noninvasive imaging studies to diagnose you. These could include: CT scan MRI Ultrasound Venogram Catheter-based venogram Intravascular ultrasound If you are diagnosed with May-Thurner syndrome, your healthcare provider will create a personalized treatment plan based on your condition. They may recommend: Angioplasty and stenting: This entails inserting a tiny alloy mesh tube (otherwise known as a stent) inside the vein via a catheter to hold it open, the vein is further ballooned open and then the balloon is removed. Bypass surgery: This entails making another route for blood to flow around the blocked iliac vein, although this is rare.  This can be done using a vein from another area of your body or a graft made of synthetic material. We Are Here for You At the Vascular Institute of the Rockies, we are eager to help you live a long, healthy life by keeping your cardiovascular system in tip-top shape. If you notice any signs of May-Thurner syndrome or DVT, don't wait to seek medical attention. Being diagnosed as soon as possible can help your recovery go as smoothly and effectively as possible. For more information visit us online today.   Tue, 25 Oct 2022 06:00:00 GMT http://vascularinstitute.com/blog/10177/What-Triggers-May-Thurner-Syndrome- http://vascularinstitute.com/blog/10176/Mesenteric-Ischemia--What-You-Should-Know blog Mesenteric Ischemia: What You Should Know What is Mesenteric Ischemia? Mesenteric ischemia is a condition that occurs when blood flow to your intestines is restricted. There are three primary arteries that deliver blood to your intestines known as the mesenteric arteries. When these arteries become blocked or narrowed, your digestive tract may not be supplied with the amount of blood and oxygen it needs to function properly, which can lead to serious health complications and even death. Symptoms of Mesenteric Ischemia There are two types of mesenteric ischemia: acute and chronic. Acute mesenteric ischemia develops when a blood clot suddenly blocks the flow of blood to the small intestines. Chronic mesenteric ischemia develops slowly over time.  Common symptoms of acute mesenteric ischemia include: Sudden, severe abdominal pain Urgent need to go to the bathroom Nausea and vomiting Fever Common symptoms of chronic mesenteric ischemia include: Abdominal pain that occurs around half an hour after eating Pain that gets worse within an hour Pain that goes away after one to three hours How Can Mesenteric Ischemia Impact the Body? If you experience severe abdominal pain that comes on suddenly, it is important to seek medical attention as quickly as possible. Likewise, if you notice abdominal pain within an hour of eating, it is best to schedule an appointment with your healthcare provider. If left untreated, both acute and chronic mesenteric ischemia can lead to uncomfortable and dangerous health complications.  Not seeking immediate medical care for acute mesenteric ischemia can lead to: Irreversible damage to your bowels: Parts of your bowels can die without an adequate amount of blood flow. Sepsis: If the lack of blood supply leads to bowel death, this could lead to a blood infection or  sepsis, which  could cause other organs to fail. Death: Complications caused by the lack of blood flow to your bowels could put your life in danger. Living with chronic mesenteric ischemia can cause: Fear of eating: Because of the pain that occurs after eating, you may be afraid to eat as often or as much as you need to. Weight loss: Because you are afraid to eat, you could unintentionally lose weight. Acute-on-chronic mesenteric ischemia: The condition can progress, resulting in acute mesenteric ischemia. What Triggers Mesenteric Ischemia? Mesenteric ischemia can happen to anyone, regardless of their age or medical history. While this is true, the condition is more common in individuals with cardiovascular disease. This is because the arteries that bring blood to your intestines come from the heart's primary artery. When plaque builds up on the inside of your arteries as a result of factors such as smoking, diabetes, and high cholesterol, this can lead to both heart disease and mesenteric ischemia. Similarly, heart disease can also contribute to the formation of blood clots that result in acute mesenteric ischemia. Treatment Options for Mesenteric Ischemia If you are diagnosed with acute mesenteric ischemia, you will most likely have to undergo immediate surgery to remove the clot that is blocking blood flow to your intestines. If your arteries are narrowed but not totally blocked, your healthcare provider may recommend that you undergo an angioplasty and stent procedure in order to reopen your artery and allow the blood to flow properly again. Additional steps to treat mesenteric ischemia could include making lifestyle changes such as not smoking, taking antibiotics to treat infections caused by the blockage, and/or taking blood thinners to prevent future blockages.  The Vascular Institute Can Help Protect Your Arteries While cardiovascular complications such as mesenteric ischemia may not always be preventable, there are steps you can take to keep your heart, veins, and arteries strong. The trusted team at the Vascular Institute of the Rockies is eager to help you maintain a healthy cardiovascular system for life. Visit us online today to schedule an appointment or to learn more.   Tue, 25 Oct 2022 06:00:00 GMT http://vascularinstitute.com/blog/10176/Mesenteric-Ischemia--What-You-Should-Know http://vascularinstitute.com/blog/10105/Leriche-Syndrome blog What is Leriche Syndrome? Leriche Syndrome is a condition that manifests symptoms because of a blockage in arterial blood flow. This arterial occlusion is noted at the area of bifurcation, or division, of your aorta and common iliac arteries. Usually, this blockage is due to a plaque buildup, also known as atherosclerosis. Leriche Syndrome can be categorized into three different classifications: Type 1 (atherosclerosis of distal abdominal aorta and common iliac arteries), Type 2 (atherosclerosis of distal abdominal aorta, common iliac arteries, and external iliac arteries), Type 3 (atherosclerosis of aortoiliac segment and femoropopliteal vessels). To diagnose this condition, your physician may perform screening tests, such as an ankle-brachial index test (ABI). An ABI less than 0.9 indicates that your legs and feet are not receiving as much blood flow as required. Also, duplex ultrasonography or CTA may be used to pinpoint the specific location of occlusion. What are the symptoms? Patients with arterial blockage may have no symptoms. However, the most common symptoms for patients with Leriche Syndrome include hip, thigh, and buttock claudication which may be on both sides. Claudication is described as a cramping pain that is exacerbated by exercise. Another crucial aspect of Leriche syndrome is impotence, which is the inability to achieve an erection or orgasm. In fact, sexual dysfunction is so often associated with Leriche Syndrome that the absence of this symptom suggests that another diagnosis should be considered. In addition, muscle atrophy, or breakdown, in your legs may result from this chronic arterial blockage. Your physician may also tell you, after examination, that your femoral pulses are diminished or absent due to the disrupted flow of blood. Who is at risk? Men with atherosclerosis are especially at high risk for Leriche Syndrome. Women are less likely to develop this condition in comparison to men. Patients who have a predisposition to atherosclerosis are generally considered to be at higher risk for this condition, and there are several modifiable risk factors for plaque buildup. Atherosclerosis is potentiated by hypertension, smoking, lower physical activity, obesity, a diet high in saturated fats, and high glucose or lipid levels. What are the treatment options? If no treatment is pursued, a poor prognosis with worsening symptoms is more likely. Treatment is patient-specific and based on age, health, and severity. There are several options for treatment, and these management choices may help slow the progression of symptoms. First, it is recommended that all patients who have risk factors for atherosclerosis treat or alter relating lifestyle choices. Exercise programs have been shown to decrease walking restrictions. Surgical treatments for Leriche Syndrome include aortobifemoral bypass, percutaneous transluminal angioplasty, and thromboendarterectomy. Aortobifemoral bypass, which redirects blood around the blocked blood vessels, has been shown to have the best blood flow rates with patency in patients who are able to tolerate the procedure. Imaging studies may also be ordered and help your physician determine the likelihood of successful surgery and possible complications. Finally, a medication called Cilostazol is occasionally prescribed to help with symptoms of cramping. Tue, 11 Oct 2022 06:00:00 GMT http://vascularinstitute.com/blog/10105/Leriche-Syndrome http://vascularinstitute.com/blog/10104/Hyperbaric-Oxygen-Therapy--Risk---Benefits blog Hyperbaric Oxygen Therapy: Risks & Benefits Oxygen plays a vital role in not only keeping you alive but also in  helping your body heal when it has been infected or injured. In some cases, having access to extra oxygen can give your body the boost it needs to speed up the healing process and restore its overall health. Fortunately, hyperbaric oxygen therapy can do just that. Here's what you should know about the risks and benefits of hyperbaric oxygen therapy before scheduling your complimentary consultation with the trusted team at the Vascular Institute of the Rockies. What is Hyperbaric Oxygen Therapy? Hyperbaric oxygen therapy is a type of treatment that involves a person lying in a special chamber with air pressure that is up to three times higher than normal air pressure. By breathing in this air that has a higher concentration of oxygen, the person's blood can fill up with oxygen more easily, which can help restore normal bodily functions and restore damaged tissues in some cases.  What is It Used For? Your body cannot function without oxygen. When your body becomes infected or injured, it needs more oxygen than normal to heal. Hyperbaric oxygen therapy can assist your body in taking in more oxygen and speeding up its healing process. This type of treatment has been proven to restore normal oxygen levels in damaged tissues with repeated treatments, even after the procedure is complete. Hyperbaric oxygen therapy is used to treat a variety of medical conditions, including: Wounds with delayed healing Gangrene Arterial gas embolism Decompression sickness Carbon monoxide poisoning Crush injuries What Are the Risks Associated with Hyperbaric Oxygen Therapy? Hyperbaric oxygen therapy is considered safe for most people. While side effects are rare, there are some risks associated with this treatment. These include: Lung collapse due to changes in the air pressure Middle ear problems, such as rupturing of an ear drum, due to changes in the air pressure Seizures caused by too much oxygen in your central nervous system Temporary nearsightedness due to temporary changes in your eye lens Low blood sugar, particularly in individuals who have diabetes and take insulin Because of these risks, hyperbaric oxygen therapy may not be an option for people who have lung disease or have recently experienced an ear injury or surgery. What Are the Potential Benefits of Hyperbaric Oxygen Therapy? Hyperbaric oxygen therapy is preferred by medical professionals and patients alike thanks to the many benefits it can provide. Some of these include: Improving blood circulation Reducing inflammation Increasing energy levels Healing injuries and wounds Decreasing muscle aches Boosting immune system What to Expect During Treatment Undergoing hyperbaric oxygen therapy is simple, non-invasive, and virtually painless. During your hyperbaric oxygen treatment, you will lie down on a table inside of a clear plastic chamber. The chamber will be filled with 100% oxygen and the surrounding air pressure will be increased, causing your ears to feel full. Depending on your unique needs, you can expect your treatment to last anywhere from 1 to 2 hours. During this time, you will be closely monitored by your healthcare provider. When your treatment is complete, it is important to drink plenty of fluids. Multiple treatments may be required to achieve the desired results. Schedule Your Free Consultation Today If you are interested in speeding up the healing process of a serious injury or think that hyperbaric oxygen therapy could benefit you, the Vascular Institute of the Rockies is here to help. Our experienced team can help determine if you are a good candidate for hyperbaric oxygen therapy and help you take the first step to live a healthier, happier life. Contact us today to schedule your free consultation!   Tue, 11 Oct 2022 06:00:00 GMT http://vascularinstitute.com/blog/10104/Hyperbaric-Oxygen-Therapy--Risk---Benefits http://vascularinstitute.com/blog/10103/Gangrene--What-You-Should-Know blog Gangrene: What You Should Know It is no secret that having good blood circulation is an important part of maintaining good overall health. After all, your body can't function without the help of oxygen-rich blood flowing through its organs and tissues. But what happens when blood flow to a certain part of your body stops? Here's what you should know about identifying and treating gangrene before scheduling your next appointment with the friendly team at the Vascular Institute of the Rockies. What is Gangrene? Gangrene is a serious medical condition that occurs when body tissue dies as a result of a bacterial infection or a lack of adequate arterial blood circulation. It can develop in many areas of the body but is most commonly found in a person's limbs, including on their fingers or toes. It can also affect a person internally, such as on their muscles or organs. What Does Gangrene Look Like? When gangrene develops on an external area of a person's body, common symptoms could include:   Skin discoloration: the area could be a wide range of colors, including red, purple, blue, grey, or even black Blisters Swelling Discharge coming from the wound with an unpleasant odor Skin that is thin, shiny, and/or without hair Skin that feels cold Sudden pain and/or a loss of feeling If gangrene is caused by an infection that spreads to other areas of the body, it may lead to septic shock. If this occurs, you may experience additional symptoms, such as:   Fever Low blood pressure Confusion Lightheadedness Shortness of breath Rapid heartbeat What Are the Health Implications of Gangrene? Gangrene will not go away on its own. It is a serious medical condition that should be taken seriously and requires immediate medical attention. If gangrene is left untreated, other areas of your body could be negatively affected by the spread of bacteria. In some cases, amputation may be necessary. How Does One Get Gangrene? Any event or condition that causes a lack of blood flow to a particular area of your body can lead to gangrene. Common causes of a loss of adequate blood flow include:   Medical conditions that impact your circulation, such as atherosclerosis or peripheral artery disease Infection Severe wounds or injuries What Are the Remedies for Gangrene? Unfortunately, if an area of your body has been affected by gangrene, it typically cannot be recovered. Because of this, it is very important to seek medical attention as quickly as possible if you notice any of the symptoms of gangrene. Early treatment can help prevent the infection from spreading to other parts of your body. Treatments for gangrene depend on where it's located, what is its cause, and how severe it is. These could include:   Medications: Usually antibiotics (used to treat bacterial infections) and pain medications. Surgery: This could be to remove affected tissues, restore blood flow to an affected area, amputate infected body parts, or restore the appearance of scars caused by gangrene. Hyperbaric oxygen therapy: This 90-minute procedure can sometimes help your blood carry more oxygen throughout your body, helping your wounds heal faster and slow down the progression of bacteria that are living in tissue without enough oxygen. While gangrene can lead to serious complications that can have long-term effects on your health, the good news is that it can be successfully treated when caught early. If you notice any unusual signs in the way your skin looks or feels, don't wait to seek professional medical care. Time is of the essence when it comes to preventing the spread of infection and restoring blood flow to the affected area(s) of your body. For more tips on protecting and improving your blood circulation, visit the Vascular Institute of the Rockies online today!   Tue, 11 Oct 2022 06:00:00 GMT http://vascularinstitute.com/blog/10103/Gangrene--What-You-Should-Know http://vascularinstitute.com/blog/9950/Agenda blog Thursday Sept 8, 2022 11:00 -  11:30 am  Registration in Foyer on 3rd Floor by Platte River Ballroom Visit with Sponsors in Confluence Room C (30 mins) 11:30 – 12:15pm   Lunch/Visit with Sponsors in Confluence Room C (45 mins) 12:15 – 12:20pm  Welcome/Introductions in Platte River Room by Barbara Melendez, MD (5 mins) Session 1: 12:20 – 12:50pm     Deep Vein Thrombosis & Pulmonary Embolism by Alex Leung, MD (30 mins) 12:50 – 1:15pm   Aesthetic treatment of lower extremity veins by Sara Montanez, PA and Brittany Macdonald, PA (25 mins) Session 2:   1:15 – 1:35pm    Vascular Care in the Trauma Setting by Lisa Bennet, MD (30 mins) 1:35 – 2:05pm Neuroendocrine Tumors by Eric Liu, MD (30 mins) Break/Visit with Sponsors in Confluence Room C  (20 mins) 2:05-2:25 Session 3: 2:25 -3:05 pm Venous Disease: What to Look For and Why by Omar Mubarak, MD  (40 mins) 3:05 – 3:35pm               Healthcare disparities in vascular care by Barbara Melendez, MD (30 mins) Session 4 3:35 – 4:35pm   Patient Panel and Discussion with 3-5 complex patients  (60 mins) 4:35 – 4:50pm  Questions and Answers: Interactive Audience Trivia with Brittany Macdonald,  PA (15 mins) 4:50 – 4:55pm   Recap of the Days' Topics by (Barbara Melendez, MD (5 mins) 4:55 -5:00pm Sponsor Thank You, Invitation to Reception by Alex Leung, MD (5 mins) 5:00 -7:00pm Reception/Visit with Sponsors in Confluence Room C & Horace Tabor Room   Friday Sept 9, 2022 8:00 – 8:25am  Registration/Visit with Sponsors/Breakfast in Confluence Room C (25 mins) 8:25am – 8:30am Welcome/Introductions in Platte River Room with Barb Melendez, MD (5 mins) Session 5 8:30  – 9:00am Thoracic Outlet Syndrome and Cervical Ribs by Steve Annest, MD  (30 mins) 9:00 – 9:35am Physical Therapy and post-op TOS Surgery by Jenn Kittleson, MSPT  (35 mins) 9:35 – 10:35am Limb Salvage by David Schnur, MD (60 mins) 10:35 – 10:50am Audience Questions and Answers with Brittany Macdonald, PA (15 mins) 10:50- 11:10am Morning Break/Visit with Sponsors in Confluence Room C (20 mins) Session 6 11:10 – 11:40am Pelvic Pain – An Updated Approach by Nel Gerig, MD (30 mins) 11:40– 12:00pm Pelvic Pain Disorders by Ty Garland, MD (20 minutes) 12:00 – 12:45pm Lunch / Visit with Sponsors with Confluence Room C (45 mins) Session 7 12:45 – 1:15pm Pre-op Evaluation and Intraoperative Concerns on Vascular Patients from the Anesthesia Standpoint by Greg Goldenhersh, MD (30 mins) 1:15 – 1:45 Aortic Aneurysms: Diagnosis, Screening and Treatment by Bryan Kramer, MD (30 mins) 1:45 – 2:15pm Aortic Aneurysms and Aortic Debranching by Alex Leung, MD  (30 mins) 2:15- 2:35pm Afternoon Break/Visit with Sponsors in Confluence Room C (20 mins) Session 8 2:35 – 2:55pm Percutaneous AV Fistulas – Technique and Evaluation by Alex Leung, MD (20 mins) 2:55 -3:15pm New Advances in Endovascular Treatment of PAD by Alan Synn, MD  (20 mins) 3:15 - 3:50pm Vascular Quality Measures in the Outpatient Setting by Omar Mubarak, MD (35 mins) 3:50 – 4:05pm Audience Questions and Answers with Brittany Macdonald, PA (15 mins) 4:05 – 4:45pm Emerging Trends in Vascular Surgery by John Hoch, MD  (40 minutes) 4:45pm – 5:00pm End of Day Wrap Up, Check-in with Online Attendees, Thank you to Sponsors with Barbara Melendez, MD (15 mins) 5:00-7:00pm Reception on 2nd Floor Horace Tabor Room and Foyer Prize Drawings at Reception in Horace Tabor Room   Wed, 24 Aug 2022 06:00:00 GMT http://vascularinstitute.com/blog/9950/Agenda http://vascularinstitute.com/blog/9820/Who-Is-Most-at-Risk-for-Fibromuscular-Dysplasia- blog Keeping your blood vessels healthy is one of the most important steps you can take to live a long, healthy life. Along with eating a balanced diet and staying active, it's important to seek professional medical care when you notice any abnormal cardiovascular symptoms. Doing so can make treating your condition easier and more effective, including fibromuscular dysplasia. Here's what you should know about fibromuscular dysplasia before scheduling a free consultation with the trusted experts at the Vascular Institute of the Rockies. What is Fibromuscular Dysplasia? Fibromuscular dysplasia (FMD) is a rare disorder that causes a person's healthy, flexible blood vessels to become less strong and less flexible. Because the blood vessels become stiffer, they're also more likely to experience damage. As a result, FMD can lead to other serious health complications, including stenosis, high blood pressure, aneurysm, and, in some cases, dissection of the arteries.  What Are the Symptoms? The symptoms of FMD depend on which arteries the disease has affected. While some individuals may not experience any symptoms at all, others may notice signs caused by restricted blood flow, such as: Dizziness or vertigo Migraines Bruit (an unusual swishing noise that takes place in your neck or abdomen when your healthcare provider listens to your blood flow through a stethoscope) High blood pressure Poor Kidney function Ringing sound in your ears Neck pain FMD can also lead to serious medical conditions, including: A stroke A brain or abdominal aneurysm when the artery becomes weak and bulges An arterial dissection when the inside wall of the artery tears Who is Most at Risk? Although fibromuscular dysplasia can happen to anyone, there are certain risk factors that could make you more likely to develop this condition. These include: Age: People are most likely to be diagnosed with FMD in their 50s. Sex: Women are more likely to experience FMD than men. Smoking: People who smoke cigarettes are more likely to be diagnosed with FMD. For people diagnosed with FMD, smoking can make the condition worse.  What Are the Treatment Options? The way that FMD is treated depends on your particular symptoms, the location of the affected artery, and any additional health conditions you may have, such as high blood pressure. In its earliest stages, it's possible for your healthcare provider to recommend monitoring the condition before undergoing treatment options. For people with FMD and high blood pressure, medications are often used. These could include angiotensin-converting enzyme (ACE) inhibitors, diuretics, aspirin, and beta blockers, among others. FMD could also require more invasive treatments, including:   Percutaneous transluminal angioplasty (PTA): This is typically done at the same time as a catheter-based angiogram in which dye is injected through a catheter into an artery. X-rays are used to show how the dye travels through your arteries, including the narrow areas. Then, a wire is inserted into the artery and a catheter with a balloon is inserted into the narrow areas. The balloon, and in rare cases a metal stent, is used to support the weakened part of the artery. Surgical revascularization: Surgery is a rare but possible option to treat FMD. If PTA is not an option for you and the narrowing of your arteries is severe, your healthcare provider may recommend surgery to replace the narrow part of your artery. If you experience one or more symptoms of FMD, don't wait to schedule an appointment with the experienced team at the Vascular Institute of the Rockies. Having your FMD diagnosed early is the best way to manage your symptoms and prevent the disease from progressing.  Contac us today to schedule your free consultation.   Tue, 19 Jul 2022 06:00:00 GMT http://vascularinstitute.com/blog/9820/Who-Is-Most-at-Risk-for-Fibromuscular-Dysplasia- http://vascularinstitute.com/blog/9819/What-are-the-Complications-of-Endovascular-Aneurysm-Repair-- blog What are the complications of endovascular aneurysm repair?    When your blood vessels aren't healthy, your overall well-being is put into jeopardy. In fact, many vein and artery conditions can lead to life-threatening complications, such as an aortic aneurysm. The good news is that there are steps you can take to protect the health of your veins and arteries as well as treat them when they aren't strong. Here's what you should know about the complications and treatment of endovascular aneurysm repair. What Requires Endovascular Aneurysm Repair? Sometimes, a blood vessel can bulge out, dilate, or balloon as a result of a weak area of its wall in what is known as an aortic aneurysm. When this occurs, the aneurysm gets bigger and stretches the walls of the artery out until it's too thin, making it impossible for the artery to stretch any further. As a result, the aneurysm could very well rupture and result in life-threatening bleeding, just as if a balloon that was filled with too much air is likely to pop. Fortunately, there are methods to repair an aneurysm, depending on where it's located, how it's shaped, and the overall health of the patient. One of the most effective and minimally invasive approaches to resolving an aortic aneurysm is with a procedure known as endovascular aneurysm repair (EVAR). Your aorta is the largest artery in your body that is responsible for carrying blood from your heart to other parts of your body. If you experience an abdominal aortic aneurysm, EVAR could potentially save your life.  What Is Involved in the Repair? Here's what you can expect during your EVAR procedure:  You will be given general anesthesia to ensure that you are comfortable and pain-free, while a healthcare professional will closely monitor you until the procedure is complete. The surgeon will make a small incision in the region of your groin to access the artery, inserting a thin, flexible tube (catheter) into it. Next, the surgeon will use an X-ray to guide the tube to the location of the aneurysm. Then, a thin, metal mesh stent will travel through the tube to the exact location of the aneurysm. Once it is appropriately positioned, it will be opened and will stay in position so as to allow blood to flow through the graft while preventing the artery from experiencing more damage and thus preventing further growth of the aneurysm. Finally, the tube will be removed, and the incision will be closed. What is the Recovery Time? You can expect your recovery time to take anywhere from 2 to 4 weeks after undergoing an EVAR, depending on your pre procedural condition. During this time, it's common to feel discomfort in the groin area for several days as well as a loss of appetite. What Are the Potential Side Effects of the Repair? While most EVAR procedures go smoothly with little to no side effects, there are risks to any treatment. Potential complications of an EVAR include: Bleeding at the insertion site A graft that moves or breaks Infection Reaction to anesthesia  Blood that flows through the aneurysm location Reduced blood flow to legs, kidneys, or intestines Abdominal compartment syndrome Schedule Your Free Consultation Today No one wants to hear that there may be a problem with the health of their arteries.  If you do, however, it is important to remember that there are effective treatment options that can preserve vessel health and reduce your chances of experiencing serious or potentially fatal complications. If you are diagnosed with an aneurysm, the experienced team at the Vascular Institute of the Rockies is here to help guide you through your treatment journey from beginning to end. Contact us today to learn more about how endovascular aneurysm repair could benefit you.   Tue, 19 Jul 2022 06:00:00 GMT http://vascularinstitute.com/blog/9819/What-are-the-Complications-of-Endovascular-Aneurysm-Repair-- http://vascularinstitute.com/blog/9783/Agenda-2022-Symposium- blog Thursday Sept 8, 2022 11:00 -  11:30 am             Registration in Foyer on 3rd Floor by Platte River Ballroom                                                       Visit with Sponsors in Confluence Room C (30 mins) 11:30 – 12:15pm              Lunch/Visit with Sponsors in Confluence Room C (45 mins) 12:15 – 12:20pm              Welcome/Introductions in Platte River Room by Barb Melendez, MD (5 mins) Session 1:  12:20 – 12:50pm               Deep Vein Thrombosis & Pulmonary Embolism by Alex Leung, MD (30 mins) 12:50 – 1:15pm                 Aesthetic Treatment of Reticular Varices: Adjunct to Symptomatic Vein Therapies  by Sara Montanez, PA and Brittany Macdonald, PA  (25 mins) Session 2:            1:15 – 1:35pm                    Vascular Care in the Trauma Setting by Lisa Bennet, MD (30 mins) 1:35 – 2:05pm                   Neuroendocrine Tumors by Eric Liu, MD (30 mins)                                                 Break/Visit with Sponsors in Confluence Room C  (20 mins) 2:05-2:25 Session 3: 2:25 -3:05 pm                    Venous Disease: What to Look For and Why by Omar Mubarak, MD  (40 mins) 3:05 – 3:35pm                    Disparities in Healthcare by Barbara Melendez, MD (30 mins) Session 4 3:35 – 4:35pm                    Patient Panel and Discussion with 3-5 complex patients  (60 mins) 4:25 – 4:40pm                   Questions and Answers: Interactive Audience Trivia with Brittany Macdonald,  PA (15 mins) 4:40 – 4:50pm                   Recap of the Days' Topics by Barbara Melendez, MD (10 mins) 4:50 -5:00pm                     Sponsor Thank You, Invitation to Reception by Alex Leung, MD (10 mins) 5:00 -7:00pm                     Reception/Visit with Sponsors in Confluence Room C                                                 Grand Prize Drawings at Reception in Horace Tabor Room Friday Sept 9, 2022 8:00 – 8:30am                  Registration/Visit with Sponsors/Breakfast in Confluence Room C (30 mins) 8:30 -8:40am                    Welcome/Introductions in Platte River Room with Barb Melendez, MD (10 mins)                                                 Session 5 8:40  – 9:10am                  Aortic Aneurysms: Diagnosis, Screening and Treatment by Bryan Kramer, MD (30 mins) 9:10 – 9:30am                   Aortic Aneurysms/Aortic Debranching.  Ty Garland, MD  (25 mins) 9:30 – 10:00am                Thoracic Outlet Syndrome and Cervical Ribs by Steve Annest, MD  (30 mins) 10:00 – 10:20am              Physical Therapy and post-op TOS Surgery by Jenn Kittleson, MSPT  (20 mins) 10:20 – 10:35am               Audience Questions and Answers with Brittany Macdonald, PA (15 mins) 10:35- 10:55am                 Morning Break/Visit with Sponsors in Confluence Room C (20 mins) Session 6             10:55 -11:15am                 Pelvic Pain Disorders by Ty Garland, MD (20 mins) 11:15 – 11:35am               Percutaneous AV Fistulas – Technique and Evaluation by Alex Leung, MD (20 mins) 11:35 -11:45am                 Audience Questions and Answers with Brittany Macdonald, PA (10 mins) 11:45 -12:40pm                 Lunch / Visit with Sponsors with Confluence Room C (55 mins) Session 7 12:40-1:10pm                    Limb Salvage by David Schnur, MD (30 mins) 1:10 – 1:40pm                    Pre and Post-Op Cardiology Considerations by Payal Kohli, MD (30 mins) 1:40 – 2:10pm                    Anesthesia Complications: What to Watch For by Sara Chen, MD (30 mins) 2:10 – 2:20pm                    Vascular Quality Measures in the Outpatient Setting by Omar Mubarak, MD (30 mins) 2:20 -2:30                            Audience Questions and Answers with Brittany Macdonald, PA (10 mins) 2:30 – 2:50pm                    Break/ Visit with Sponsors in Confluence Room C (20 mins) Session 8 2:50 -3:00pm                     Venous Flow Hemodynamics by Alan Synn, MD  (20 mins) 3:00 – 3:40pm                    Emerging Trends in Vascular Surgery by John Hoch, MD  (40 minutes) 3:40 – 4:00pm                    Final Questions and Answers, Check-in with Online Attendees with Ty Garland, MD (20 mins) 4:00 – 4:15pm                    Closing Remarks, Recap, Invitation to Reception with Alex Leung, MD (15 mins) 4:15 – 5:00pm                    End of Day Questions and Answers with Sponsors                                                     Grand Prize Drawings in Confluence Room C         5:00-7:00pm                        Reception on 2nd Floor Horace Tabor Room and Foyer      Mon, 11 Jul 2022 06:00:00 GMT http://vascularinstitute.com/blog/9783/Agenda-2022-Symposium- http://vascularinstitute.com/blog/9690/Can-a-DVT-go-away-on-its-own-- blog Can DVT go away on its own?   Being diagnosed with a blood clot can be a scary experience. While some blood clots are a normal part of your bodily function and will resolve on their own, others are more serious and can even become fatal if left untreated. If you've been diagnosed with a DVT (deep vein thrombosis), you may be wondering if your condition will resolve on its own or if medical intervention is necessary. Here's what you should know before scheduling your consultation at the Vascular Institute of the Rockies. What is DVT? Deep vein thrombosis (DVT) takes place when a blood clot develops in at least one of the deep veins of your body, most commonly your legs. DVT can happen as a result of many factors, including having a medical condition that impacts the way your blood clots or when you don't move your legs for an extended period of time, such as after having surgery or traveling a long distance. DVT can be very dangerous and should be taken seriously because it is possible for these blood clots to break free and travel through your blood to your lungs, resulting in a pulmonary embolism. What Are the Symptoms of DVT? It's estimated that as many as 30% of people with DVT won't exhibit any warning signs or symptoms. While this is true, others may experience these DVT symptoms: •    Tenderness or pain in your arm or leg •    Swelling in your arm or leg •    Red or discolored skin •    Veins that appear larger than usual •    A swollen limb that is warm to the touch Can a DVT Go Away on Its Own? While it is possible for blood clots to be absorbed by your body and resolve on their own without any medical assistance, this is more common in blood clots that are small. If your healthcare provider suspects that you could have DVT, they will likely perform a series of tests to provide you with a diagnosis and personalized treatment plan. Testing for DVT could include: •    Venous ultrasonography: This test is widely used to diagnose DVT because it is non-invasive and easily accessible. It uses ultrasound waves to display the blood flow and identify clots in your blood vessels.  •    Venography: This test injects a special dye into a catheter that is inserted into your posterior knee or neck. This study/procedure can help determine whether blood flow is partially or completely blocked through your veins. •    Magnetic Resonance Imaging (MRI): This method of imaging can be used in patients for whom ultrasound is infeasible.  It can provide an image of the veins in a specific area of your body to display the size and location of blood clots. What Are the Treatment Options for DVT? If you are diagnosed with a DVT, undergoing professional treatment can prevent the clot from getting bigger, prevent it from breaking away and traveling to your lungs, and prevent another DVT from occurring. Your healthcare provider is likely to recommend one or more of the following DVT treatment options: •    Blood thinners to help the clot from getting bigger •    Clot busters •    Filters •    Compression stockings After your DVT treatment is complete, making certain lifestyle changes can reduce your chances of developing another DVT in the future. These include: •    Taking your prescribed medications as directed •    Wearing compression stockings •    Talking to your doctor about what foods to eat or avoid •    Avoiding sitting or standing for long periods of time Promoting good circulation and strong veins is one of the most important steps you can take to live a long, healthy life. If you experience any of the symptoms of DVT, don't wait to schedule an appointment with the experienced team at the Vascular Institute of the Rockies. We are eager to provide you with an accurate diagnosis, personalized treatment plan, and, most importantly, DVT prevention tips to keep your veins clot-free for years to come. Contact us today to schedule your appointment!   Mon, 27 Jun 2022 06:00:00 GMT http://vascularinstitute.com/blog/9690/Can-a-DVT-go-away-on-its-own-- http://vascularinstitute.com/blog/9733/Annual-Vascular-Symposium- blog A 1.5 day discussion and review of medical, interventional, and surgical vascular care.  Designed for internal medicine specilalists, primary care providers, allied and advanced care providers.  Hosted at the Westin Hotel Downtown Denver.  Sept 8-9, 2022.  Free to attend. Industry sponsors will be present!  Free continueing education credits provided.  Fantastic give aways, prizes, nightly receptions, excellent speaker content and much more!    Tue, 21 Jun 2022 06:00:00 GMT http://vascularinstitute.com/blog/9733/Annual-Vascular-Symposium- http://vascularinstitute.com/blog/9689/What-does-claudication-feel-like-and-what-are-the-most-common-causes-- blog What does claudication feel like and what are the most common causes?     When your arteries are not healthy, your overall quality of life can be affected. Having poor circulation or damaged blood vessels can make it harder to perform normal daily activities, such as walking. If you experience pain or discomfort whenever you walk or exercise, it may be a sign of a condition known as claudication. Here's what you should know about claudication before scheduling your consultation with the experts at the Vascular Institute of the Rockies. What is Claudication? Claudication is pain that occurs when you walk or exercise and is alleviated by rest.  It is common in cases of peripheral artery disease (PAD), which causes your arteries to become narrowed or blocked and reduces the blood flow to your legs. Over time, claudication can get worse; this can make it more difficult to walk even short distances if the disease is left untreated. Because individuals with claudication are more likely to have a heart attack or stroke, seeking medical care quickly is important. What Are the Symptoms? If you experience claudication, there are specific symptoms that will present themselves, including: •    Pain in your calves, hips, thighs, buttocks, and/or feet •    Pain, aching, discomfort, or weakness in the same muscles every time you use them •    Pain that goes away quickly after resting The pain caused by claudication can present itself in different ways. While it may feel like muscle cramping to some people, it could feel like dull aching, numbness, or tingling in others.  What Are the Causes? Most people who experience claudication also have PAD. PAD happens when plaque builds up on the inside of your arteries, in a condition known as atherosclerosis. This plaque is made of fat, calcium, cholesterol, and other substances found in your blood. The cells in your body need oxygen carried through your bloodstream in order to perform properly. When you move, your muscles need more oxygen to function than if you were sitting down. If your blood vessels are narrowed or blocked, you may experience pain when you exercise (even if it's a light walk) because your muscles need more oxygen than your blood vessels can deliver. When you rest, the pain goes away because your blood vessels can keep up with the reduced amount of oxygen needed. Not exercising can make claudication worse, which is particularly challenging since the pain from the condition makes it more challenging to stay active.  What Are the Risk Factors of Claudication? Certain risk factors could make you more likely to develop PAD and claudication. These include: •    Family history of PAD and claudication •    Being over the age of 50 and smoking or having diabetes •    Chronic kidney disease •    High cholesterol •    High blood pressure •    Diabetes •    Obesity •    Smoking What Are the Treatment Options? If you are diagnosed with claudication, your healthcare provider will likely create a personalized treatment plan to help relieve your symptoms, reduce pain, and reduce your chances of experiencing other complications, such as heart disease. Staying active is one of the most effective ways to treat claudication. Exercise can help alleviate pain, makes it possible to stay active for longer periods of time in the future, promotes good circulation, and helps you maintain a healthy weight. If you have pain in your thighs, calves, buttocks, or feet when you walk, don't wait to schedule an appointment with the trusted team at the Vascular Institute of the Rockies. We can help determine if claudication is to blame and create an individualized treatment plan to meet your unique needs. Contact us today to schedule your consultation.   Mon, 13 Jun 2022 06:00:00 GMT http://vascularinstitute.com/blog/9689/What-does-claudication-feel-like-and-what-are-the-most-common-causes-- http://vascularinstitute.com/blog/9436/Geniculate-Artery-Embolization--GAE- blog The network of the geniculate arteries comprises six arteries that supply blood flow to the knee. The role of these arteries in various inflammatory processes have received a lot of attention lately, especially in the areas of recurrent hemarthrosis following total knee arthroplasty (TKA) and osteoarthritic (OA) knee pain -- both of which can be effectively treated with geniculate artery embolization. Although recurrent hemarthrosis and osteoarthritic pain are the two most studied conditions, there may be other experimental indications for this procedure (e.g., aneurysms or post-surgical complications). GAE is a newer, minimally invasive, image-guided procedure that can offer benefits and improvement for patients whose symptoms have failed to improve with other conservative measures. Typically, GAE is a short procedure, lasting between 60-90 minutes, and it is performed during an outpatient visit. Most patients are able to go home after a brief period of post-procedural observation and they report significant improvement in their symptoms shorty after the procedure. During the GAE procedure, a small incision is created in the femoral artery in the groin area to provide access for catheterization. Using fluoroscopic visual guidance, a very thin and long catheter is inserted into the artery all the way down to the knee. The catheter may be positioned in one or several of the arteries. Based on an initial angiogram, your physician decides how many of the geniculate arteries need embolization. Once the catheter is in place, an embolizing agent, such as small spheres or surgical glue are injected to either reduce or block blood flow.  Tue, 26 Apr 2022 06:00:00 GMT http://vascularinstitute.com/blog/9436/Geniculate-Artery-Embolization--GAE- http://vascularinstitute.com/blog/9435/Arterial-vs--Venous-Ulcers-of-the-Lower-Extremity blog The two most common types of lower extremity wounds are venous and arterial ulcers.  Although they may look and sound similar, arterial ulcers and venous ulcers represent two distinct sets of concerns, and they require different treatment approaches. Arterial Ulcers: Arteries carry oxygenated blood and nutrients to all organs and tissues in the body. The further away arteries travel from the heart, the smaller they get. Keeping these small vessels in distal body parts open, such as in the feet, are critical to optimal functioning of the surrounding tissues. When arteries get blocked due to atherosclerosis (hardening of the arteries, common with aging) it can result in significant, sometimes even irreversible tissue and skin damage -- especially in areas where the blood vessels are the smallest. The most common cause of poor blood supply to the lower legs is due to atherosclerotic plaque formation in the larger vessels, limiting blood flow to distal areas. Hypertension and smoking are two major risk factors that may damage the most inner part of the arteries called the intima, leading to local inflammation and fibrosis that increase the resistance of the vessels and therefore restrict blood flow. Other risk factors affecting the elasticity and patency of arteries include uncontrolled diabetes, ill-fitting footwear, and advanced age. Arterial ulcers are typically found where the smallest blood vessels supply the feet: in between and at the TIPS OF THE TOES, the tops of the feet, at various pressure points on the soles and the heels, as well as around the lateral ankle. They are sharply demarcated lesions with very little to no discharge that initially appear shallow but become deeper if left untreated. Due to the underlying necrosis, arterial ulcers typically present with a yellowish brown or black discoloration with a thin, pale, and dry border. The area surrounding the wound maybe cool to the touch due to the lack of blood flow. These arterial ulcers can be extremely painful, and elevating the legs can further increase pain. Leg swelling due to arterial disease, in the absence of other medical problems, is uncommon. Venous Ulcers: Veins carry deoxygenated blood away from tissues. Unlike the arterial system, where a pressure gradient is driving the blood forward, veins form a low-pressure network and rely on surrounding muscles squeezing down on them to move blood back towards the lungs. One-way valves inside the veins prevent backflow when the muscles relax. When either the musculature around the veins or the valves inside the veins are damaged, pressure will increase due to volume overload. Unfortunately, veins lack the capacity to withstand high pressure and cannot efficiently contain volume overload. In order to mitigate venous hypertension, fluid begins to leak into surrounding tissues causing gravity-dependent edema, which may damage the overlying skin. Some aspects of chronic venous insufficiency maybe attributable to genetics and hereditary factors that lead to the formation of venous ulcers. However, the vast majority of venous ulcers are secondary to deep venous thrombosis (a blood clot in the vein), which damages the valves and ultimately results in high venous pressures. Symptoms may be exacerbated by obesity, inactivity, metabolic diseases, pregnancy, and aging. An underlying venous hypertension in these cases compromises optimal circulation, and the resulting venous stasis is what causes lengthy healing time or non-healing venous ulcers. Venous ulcers are the most common form of lower extremity wounds. They tend to develop on the CALF AND ANKLE, and are often shallow, but large with irregular shapes and edges. They are typically red and warm to the touch with yellowish sloughing. Venous ulcers often present with moderate to heavy amount of exudate making them appear "weeping" or "wet". The pain associated with venous ulcers is a dull achy pain with mild to moderate intensity. The constant aching characteristic of the pain is thought to be due to the underlying venous congestion and tissue edema, rather than the wound itself. Diagnosis and Treatment: A thorough examination of circulation and inspection of the ulcers are the first steps in making the correct diagnosis. Various imaging modalities such as ultrasound, venous doppler, and serial pressure measurements further aid the diagnostic process. If necessary, vascular studies such as an angiogram or venogram may also be performed as part of the initial evaluation.   Tue, 26 Apr 2022 06:00:00 GMT http://vascularinstitute.com/blog/9435/Arterial-vs--Venous-Ulcers-of-the-Lower-Extremity http://vascularinstitute.com/blog/9434/Lipodermatosclerosis blog Etiology: a chronic form of stasis dermatitis resulting from venous hypertension that causes increased capillary permeability and allows leakage of fibrinogen and erythrocytes into the dermis. Risk factors include age, immobility, obesity, smoking, and history of DVT or trauma to the venous system. Symptoms: - Acute phase: painful erythema, typically at medial ankle region.  HOW TO DIFFERENTIATE FROM CELLULITIS? Lipodermatosclerosis typically presents with indolent development over weeks to months and frequently involves both legs. Cellulitis is most often an acute reaction to a specific trigger. - Chronic phase: hyperpigmented red-brown or violet-brown discoloration and indurated skin that constricts the ankle region, resulting in an "inverted champagne bottle" appearance. Diagnosis: clinical, often seen with other symptoms of venous insufficiency including venous varicosities, pitting edema and hyperpigmentation. Biopsy is NOT recommended due to concerns of poor wound healing in the setting of venous insufficiency. Treatment: CONSERVATIVE MANAGEMENT - Compression therapy: 20-30mmHg knee-high compression stockings - Leg elevation and exercise - Skin care Tue, 26 Apr 2022 06:00:00 GMT http://vascularinstitute.com/blog/9434/Lipodermatosclerosis http://vascularinstitute.com/blog/9420/Symposium-2019 blog Thank you to our past sponsors!  Tue, 19 Apr 2022 06:00:00 GMT http://vascularinstitute.com/blog/9420/Symposium-2019 http://vascularinstitute.com/blog/8746/Symposium-2021-- blog 2021 Hybrid Cardio Vascular Symposium Four Seasons Hotel Denver  September 9-10, 2021  Thank you to our Sponsors    Mon, 04 Apr 2022 06:00:00 GMT http://vascularinstitute.com/blog/8746/Symposium-2021-- http://vascularinstitute.com/blog/8731/Popliteal-Artery-Aneurysms blog Popliteal artery aneurysm (PAA) is the dilation and thinning of the popliteal artery which can occur at any point in the posterior distal thigh or knee. The ballooning of the artery can occur through a variety of etiologies – consider concurrent cardiovascular disease, autoimmune status, or inflammatory state. While not as common as aortic artery aneurysms (AAA), the risk of mortality from PAAs necessitate a familiarity with the correlating clinical signs and symptoms. Patient Presentation: The onset for PAA is typically insidious and asymptomatic. Occasionally patients will report unilateral pain in the lower leg on ambulation similar to peripheral arterial disease. On physical examination, the affected region may be swollen and erythematous though non-tender. Palpation of the artery may present with more pronounced pulsations when compared to the opposite extremity. Risk Factors: Encountering a PAA should lead to suspicion for other arterial aneurysms, especially AAA, and vice versa. Consequently, screening for additional aneurysms upon diagnosis is highly recommended. Initial screening modalities include bilateral ultrasound (US), with CT angiography of the lower extremity if US results are inconclusive. Risk factors associated with PAA include: - smoking - male sex - hypertension - increased age - high cholesterol Potential Complications: As noted above, complications of PAA can be severe. Two of the most common are thrombosis of the popliteal artery (MOST COMMONLY) or rupture of the aneurysm (RARELY). Development of a thrombus may be detected by ultrasound, but may also present symptomatically when occlusion becomes significant. (Note: presence of these signs could be indicative of a medical emergency and patient should be advised to seek help right away.) Signs include: - diminished or absent pulse - pallor of the affected lower extremity - extremity cool to the touch Rupture of the aneurysm is a rare complication of PAA, with an occurrence of 2-5% according to some sources. This can lead to uncontrollable bleeding in the popliteal space, which presents as a massively swollen leg with anemia on laboratory findings. Management: PAA may be treated surgically or conservatively depending on the clinical presentation. Regardless of whether the aneurysm is symptomatic or not, risk factors should be addressed to mitigate worsening of the condition. Patients who may benefit from surgical aneurysmal repair include those who: 1) present with symptoms of acute limb ischemia with aneurysms of any size and 2) those who have aneurysms greater than 2 cm in diameter. For asymptomatic presentations of the disease, regular ultra sound screenings should be planned every 6 to 12 months, with more frequent imaging done in patients with aneurysms greater than 1.7 cm in diameter. While the benefit has yet to be determined, other nonsurgical interventions for patients with thrombi found on imaging may include systemic anticoagulation. While a rare complication of PAA (reported in 2-5% in some sources), rupture of the aneurysm may be life-threatening. IF YOU HAVE A POPLITEAL ARTERY ANEURYSM, YOU NEED TO SEE A VASCULAR SURGEON RIGHT AWAY. YOU WILL NEED LIFELONG FOLLOW-UP WITH YOUR VASCULAR SURGEON. Wed, 30 Mar 2022 06:00:00 GMT http://vascularinstitute.com/blog/8731/Popliteal-Artery-Aneurysms http://vascularinstitute.com/blog/8730/Carotid-Body-Tumor blog What is a Carotid Body Tumor?  A carotid body tumor is a growth in your neck located next to the carotid artery, which is the vessel that carries blood to parts of your brain and face. This type of tumor is also known as a paraganglioma or chemodectoma. It grows right at the point where your carotid artery bifurcates or splits into two branches, your internal carotid artery and your external carotid artery. This is often the location of the carotid body, a group of sensors that is responsible for sending chemical signals to your brain based on levels of oxygen, carbon dioxide, and acidity in your blood. Carotid body tumors are usually not cancerous, but they do grow and can become large enough to compress important structures in your neck What are the Symptoms? Carotid body tumors are often asymptomatic and unnoticed by the patient. However, you can start to have symptoms as the tumor grows larger. These symptoms include difficulty swallowing, hoarseness, loss of sensation in the tongue, high blood pressure, and others. It may just be a painless mass that you can feel on the side of the neck. Who is at Risk? There are three types of carotid body tumors: sporadic, familial, and hyperplastic. The majority are sporadic, meaning they can occur randomly in a patient without cause. Some patients may have a familial risk factor as a smaller percentage of these tumors have a genetic inheritance. The hyperplastic type of carotid body tumors are seen more frequently in patients in chronic states of low oxygen such as those that live at high altitudes or those with medical conditions like cyanotic heart disease or chronic obstructive pulmonary disease (COPD). What are the Treatment Options? Treatment of carotid body tumors is based on the age and heath of the patient, the size of the tumor, whether the tumor is bilateral (on both carotids), and patient preference. Due to the ability of these tumors to grow and compress vital structures in the neck, the treatment of choice is usually surgical removal of the tumor. Radiation therapy is rarely used, mostly for patients who are poor surgical candidates or have other specific circumstances. The effectiveness of radiation is debated, so it is not recommended as an alternative for patients that have surgery as an option. The risks of the operation are directly related to the size of the tumor and the degree that other structures like nerves and blood vessels in the neck are involved. Extensive imaging is done prior to the surgery to assess a patient's risk and help them prepare for the success and possible complications of the surgery.   Wed, 30 Mar 2022 06:00:00 GMT http://vascularinstitute.com/blog/8730/Carotid-Body-Tumor http://vascularinstitute.com/blog/8719/Subclavian-Steal-Syndrome blog Definition Subclavian steal syndrome is defined by neurologic symptoms such as dizziness, vertigo, or syncope and arterial disease symptoms such as arm claudication. caused by retrograde flow in one of the vertebral arteries. The retrograde flow usually develops as a result of stenosis or occlusion of the proximal subclavian or brachiocephalic artery. The neurologic symptoms may worsen with exercise of the upper extremity. Risk Factors Risk factors for subclavian steal syndrome include: • Age • Sedentary lifestyle • Smoking • Hypertension • Dyslipidemia • Diabetes • Cardiovascular disease Symptoms and Clinical Signs Patients with subclavian steal syndrome will present with symptoms of dizziness, syncope, or loss of coordination typically in association with exercise of their arms. Signs of subclavian steal syndrome include the presence of diminished brachial or radial pulses in the affected arm with interarm differences in blood pressures. A difference greater than 40 mmHg is associated with development of the syndrome. Others include typical peripheral arterial disease signs such as arm or hand pallor and finger ulcers or necrosis. Pathogenesis Subclavian steal syndrome results from hemodynamic changes due to stenosis or occlusion of the subclavian artery. More than 80% of symptomatic cases involve the left subclavian artery. The main cause is atherosclerosis with plaques formed proximal to the origin of the vertebral arteries. Less common causes are inflammation, fibromuscular dysplasia, or congenital disorders. Subclavian steal syndrome may be classified into 3 grades based on severity. Type I – Antegrade vertebral flow is reduced Type II – Antegrade flow during diastolic phase and retrograde flow during systolic phase Type III – Permanent retrograde vertebral flow Diagnosis Diagnosis can be made using imaging such as duplex ultrasound of the subclavian and vertebral arteries. CT angiography can be used to determine the underlying cause and develop a treatment plan. Treatment Options Conservative management includes lifestyle changes such as smoking cessation, weight loss, and regular physical exercise. Medications to use include controlling dyslipidemia, hypertension, and diabetes along with antiplatelet therapy. Patients with burdensome symptoms and occlusive disease can be managed by a vascular surgeon, either with open surgery or percutaneously. Percutaneous balloon angioplasty and stenting can be achieved in 90% of cases when stenting will not compromise the vertebral circulation. Surgical revascularization typically consists of a carotid-subclavian bypass with a success rate of greater than 80%. Sat, 26 Mar 2022 06:00:00 GMT http://vascularinstitute.com/blog/8719/Subclavian-Steal-Syndrome http://vascularinstitute.com/blog/8654/Lymphedema blog Lymphedema The lymphatic system is a system of lymph vessels and lymph nodes that carries lymph fluid from soft tissues throughout the body. This lymph fluid is comprised of a watery mixture containing immune system byproducts. When the lymph system flow becomes dysfunctional, the fluid builds-up in the soft tissue of an extremity and is called lymphedema. This usually occurs in a single extremity but can be bilateral. Signs and Symptoms: Swelling of an arm or leg Feeling of fullness or heaviness in an arm or leg Tight feeling in the skin Itching of the skin of the extremity Non-pitting of the skin when pressed Loss of hair Risk Factors: BUT......VERY OFTEN A CAUSE IS NOT SPECIFICALLY IDENTIFIED Prior Surgeries Trauma Hx of radiation Scar tissue Cancer Detection: An appropriate history and physical are usually sufficient for diagnosis. Unfortunately, there isn't a great imaging study or test to diagnose lymphedema yet. If referred to a vascular surgeon, appropriate vascular studies can be done to conclude that the vessels of the extremity are intact and functioning correctly but are not necessary. Treatment Options: Treatment for lymphedema is mainly compression through compression stockings or a compression device. This will decrease the pooling of lymph in the extremity, which will improve the swelling. Typically patients get a lymphatic pump, which is a sleeve that goes over the leg and pushes the fluid from the toes back to the center of the body. This is usually used for an hour or two, EVERY DAY. Compression stockings are worn from waking up in the morning and removed at bedtime to control the swelling. Exercise and massage therapy can also help push the lymph out of the extremity. MOST PATIENTS will improve with weight loss. Fri, 11 Mar 2022 06:00:00 GMT http://vascularinstitute.com/blog/8654/Lymphedema http://vascularinstitute.com/blog/8653/Peripheral-Artery-Disease--PAD--vs--Peripheral-Venous-Disease--PVD-- blog PAD vs PVD - Differences Explained   Maintaining a strong vascular system is an important part of living a long healthy life. If you're diagnosed with a disease that affects your vessels (veins & arteries) organs including your heart and lungs can be affect.  Even your legs and feet can feel the effects of an unhealthy circulatory system.  Early diagnosis and treatment can help prevent more serious complications from developing. Here's what you should know about PAD and PVD before scheduling your first visit with the trusted team at the Vascular Institute of the Rockies.   PAD vs PVD: What's the Difference? Both peripheral artery disease (PAD) and peripheral venous disease (PVD) are conditions that affect the circulatory system, however, there are key factors that differentiate the two. PAD occurs when the arteries that carry blood away from your heart to your brain and extremities have either narrowed or been blocked as a result of plaque buildup. Alternatively, PVD occurs when cholesterol or tissue builds up along the internal lining of the vessel and causes your arteries to harden as a result of a condition called atherosclerosis. Both conditions are very serious and can increase your chances of experiencing heart disease, a stroke or limit mobility.   Symptoms of PAD & PVD While many people with PAD do not exhibit any signs until the problem worsens, some there are common symptoms that many people will experience in both PAD and PVD. These include:   Claudication (Pain or tightness in the lower leg due to inadequate blood flow) Numbness, weakness, or tingling in feet or lower legs Pain or burning in feet or lower legs when resting Color change (purple/blueish)  or coldness in feet or lower legs Pain that wakes you while you're sleeping Shiny, smooth skin on lower legs Wounds that won't heal Diagnosing PAD & PVD  PAD and PVD can exhibit many of the same indicators of other circulatory conditions. If your doctor suspects that you have either condition, they will likely perform a CT Angiogram or an ankle blood pressure measurement, or Ankle-Brachial Index (ABI), to determine the cause of your symptoms. An ABI is a painless test that uses an ultrasound to measure your blood pressure reading in your ankle and arm. It can measure any fatty plaque buildup in your leg arteries as well as the plaque buildup in the other blood vessels in your cardiovascular system. Diagnosing PAD and PVD as early as possible is critical to preventing further plaque buildup that can lead to serious complications, including heart disease and stroke.    How to Treat PAD & PVD Managing your symptoms and preventing the progression of PAD and PVD is possible. Depending on your diagnosis, condition, and medical history there are a variety of PAD and PVD treatment options, including:   Angioplasty and stenting: This is a nonsurgical option in which a balloon is placed in a narrowed or blocked artery to stretch it and allow blood to flow more easily through it. A small metal stent may also be inserted into the artery to keep it open after the balloon is removed.  Endarterectomy: This is a minor surgical procedure that is used to remove plaque buildup from inside of a narrowed or blocked artery when a balloon or stent may not be an option. Bypass surgery: This is an open surgery that uses another vein or synthetic tube to make a path around a blocked or narrowed section of an artery. While this requires a longer recovery time than other treatment options, it may be the best long-term solution depending on your particular needs. Amputation: In rare cases, amputating your foot or lower leg may be recommended, especially if gangrene is present. This treatment option is always a last resort. To learn more about keeping your arteries and heart strong and healthy, the friendly team at the Vascular Institute of the Rockies is here for you. Contact us today to schedule an appointment. Fri, 11 Mar 2022 06:00:00 GMT http://vascularinstitute.com/blog/8653/Peripheral-Artery-Disease--PAD--vs--Peripheral-Venous-Disease--PVD-- http://vascularinstitute.com/blog/8652/Foods-to-Improve-Blood-Health blog 8 Foods For Clearing Your Arteries and Veins Your arteries and veins have a critically important job: bringing nutrient and oxygen-rich blood to and from your heart and other organs and tissues of your body. Because of this, keeping your arteries and veins healthy should be a top priority. Unfortunately, clogged arteries are all too common among Americans, which can lead to other serious health complications, including vascular and heart disease, heart attacks, and strokes. The good news is that there are steps you can take to keep your arteries and veins strong which including eating certain foods. Here are 10 smart foods that can help clear out your arteries and blood vessels naturally. Berries Blueberries, blackberries, and strawberries may be little, but they can make a big impact on the health of your blood vessels. Thanks to the polyphenol compounds they contain, including quercetin and anthocyanin, berries can provide antioxidant and anti-inflammatory effects on your arteries and veins. This can help lower your cholesterol and maintain a healthy blood pressure, both of which benefits your heart and blood vessels.  Fatty Fish Sardines, salmon, mackerel, and other fish high in omega-3 fatty acids can protect your vascular system from inflammation and conditions, such as atherosclerosis. They also can lower your risk of developing blood clots, increase your levels of good cholesterol, and lower triglyceride levels. Avocado Avocados are a great option to maintain a healthy blood sugar and cholesterol, which is important for artery and vein health. Surprisingly, avocados are also an excellent source of fiber (with half an avocado containing around 6.5 grams), which can also reduce your cholesterol. Dark Chocolate Believe it or not, dark chocolate has been attributed to improving healthy blood flow, preventing blood clots, reducing inflammation, and lowering blood pressure thanks to its high content of polyphenol compounds. Choosing an option that is low in sugar and eating it alongside walnuts is a great way to keep your blood vessels strong while maintaining a healthy blood sugar. Spinach Leafy greens, such as spinach, are a good source of fiber and other micronutrients, including folate. Folate, in particular, is responsible for lowering the levels of the amino acid homocysteine in your blood, which can damage the lining of your veins and arteries if it gets too high. Green Tea Drinking green tea regularly can make you blood less likely to clot in your arteries and reduce inflammation. In fact, research suggests that drinking one cup of green tea a day can lower your risk of dying from a cardiovascular problem by up to 5%.  Walnuts While all nuts are beneficial to good heart and blood vessel health, walnuts provide the highest levels of omega-3s that can prevent heart disease and promote healthy blood flow. Best of all, walnuts are also a great source of protein, healthy fats, and fiber, which can also support a strong cardiovascular system. Legumes Beans, lentils, and chickpeas are high in soluble fiber can help lower your cholesterol, blood pressure, and inflammation, all of which can damage your arteries and veins over time. While most legumes are low in sugar, be sure to pair your legumes with a lean source of protein and healthy fat to prevent a potential blood sugar spike. Keeping your veins and arteries in good shape for life may seem like an impossible feat, but it doesn't have to be. By incorporating more heart-healthy foods, such as walnuts, dark chocolate, and berries, you can keep your cardiovascular system healthy and strong naturally. For more tips on caring for your heart, arteries, and veins, the knowledgeable team at the Vascular Institute of the Rockies is here to help. Contact us today to see how simple keeping your blood vessels healthy can be. Fri, 11 Mar 2022 06:00:00 GMT http://vascularinstitute.com/blog/8652/Foods-to-Improve-Blood-Health http://vascularinstitute.com/blog/8519/Acute-Limb-Ischemia- blog Definition Ischemia is a term used to describe decreased blood flow to bodily tissues. This results in decreased oxygen delivery to the tissue, leading to damage and even tissue death. When ischemia happens very quickly and affects the blood vessels supplying an arm or a leg, it is called acute limb ischemia. Acute limb ischemia is a very serious medical problem that can cause loss of limb. It is very important to treat acute limb ischemia as soon as possible, so patients who believe they have acute limb ischemia should be evaluated emergently by a vascular specialist. Every minute matters! Treatment includes the use of both medications and surgical procedures. Causes Overwhelmingly, the most common causes of acute limb ischemia involve blockages of arteries that deliver blood to the limbs. Decreased blood flow results in decreased oxygen delivery to active tissues, leading to injury and tissue death. Many events can cause the blockage of an artery, with the most common causes discussed here: Arterial thrombosis: the formation of a clot within the arterial system itself. These clots are most likely to occur at the site of a pre-existing cholesterol (atherosclerotic) plaque. Clots can form at cholesterol plaques in two different ways. If the plaque becomes large enough, it may slow down blood flow to the point that clots are allowed to form. Alternatively, the plaque can rupture from within, leading to the formation of a clot. Other causes of arterial thrombosis include arterial aneurysm, arterial dissection, and hypercoagulable states. Embolism: a clot forms somewhere else in the body and is carried by blood flow to an artery, where it gets stuck. Arterial emboli typically form in the heart due to conditions such as atrial fibrillation. Arterial emboli most commonly affect the lower limbs. Injury: direct injury to an artery can cause the formation of a clot, blocking the artery. This most commonly occurs following posterior knee dislocation. Thrombosis following intervention: when a clot forms in an artery after a medical procedure, most commonly after stent or graft placement. This is a rare occurace, but still a cause of acute limb ischemia. Symptoms Symptoms typically include: Pain  Pale appearance of the limb The limb feels cold A change in sensation in the limb, often a "pins-and-needles" feeling aralysis of the limb Decreased strength in the limb Decreased pulses in the limb Diagnosis Many physicians can diagnose acute limb ischemia simply by asking the patient questions about his or her symptoms and then performing a physical exam. Additional tests may be run to ensure that the correct diagnosis is made, including: Ankle-brachial index: blood pressures are taken in both arms and both legs and then compared. This can give the physician an idea of how much blood flow is reaching each limb.  Imaging: depending on the severity of the limb ischemia, the physician may choose to order a medical imaging test, such as a CT scan, to try to find the cause of the limb ischemia. Treatment The treatment of acute limb ischemia is very complex. Physicians use many factors, including the severity of arterial blockage and the patient's history, when deciding what treatment choice is best for each individual patient. Most patients will be treated with a combination of surgery and medications (such as heparin, a blood thinner). Many surgical strategies exist, and they can be combined to suit a patient's individual needs. Patients who are treated for acute limb ischemia should been seen regularly by a vascular surgeon in office for the rest of their life. Surgical strategies for treating acute limb ischemia include: Catheter-based thromboembolectomy: the physician will insert a catheter into the artery and removes the obstruction Bypass grafting: the physician uses a graft to bypass the blockage so that blood can get to the limb tissues Thrombolytic therapy: the physician injects a drug onto the clot to dissolve it Percutaneous transluminal angioplasty: the physician uses a small, inflatable balloon to smash the obstruction and open the artery Limb amputation: if all other opttions have been explored, amputation may be necessary   Mon, 14 Feb 2022 06:00:00 GMT http://vascularinstitute.com/blog/8519/Acute-Limb-Ischemia- http://vascularinstitute.com/blog/8518/Restless-Leg-Syndrome blog Definition Restless leg syndrome (RLS) is a common sleep-related movement disorder marked by an uncomfortable urge to move the legs that occurs during periods of inactivity, especially in the evenings, and is transiently relieved by movement. Causes Although the pathophysiologic basis has yet to be fully understood, there are several correlates that have been found. Neurodegeneration has not been implicated, however, there are a few CNS correlates to include: Reduced CNS Iron stores  Increased CNS Dopamine metabolism  Other neurotransmitter abnormalities (endogenous opioids, glutamate, glutamine, adenosine, histamine, and gamma-aminobutyric acid (GABA)  Resting state CNS network connectivity disorders between: Thalamus, Pons, Red nucleus, and Brainstem Some peripheral pathophysiologic correlates include:  Afferent nerve central sensitization leading to hyperalgesic neuropathic pain  Abnormalities of microvascular function in the legs (altered leg intramuscular blood flow, peripheral hypoxia, and reduced endothelial function) Risk Factors Common risk factors for RLS include: • Family history of RLS • Low iron stores • Uremia (Chronic kidney disease) • Neuropathy • Spinal cord disease/trauma • Pregnancy • Multiple Sclerosis • Parkinson's Disease Symptoms and Clinical Signs The hallmark symptom is an uncomfortable ache or tension deep in the calf muscles with an urge to move the legs with a kick or repetitive motion. Symptoms usually present in the evenings when the patient is lying down to sleep or during other periods of rest. Transient symptomatic improvement can be achieved by walking, stretching, massage, or by applying heat or cold presses. RLS may exacerbate or precipitate other disorders such as insomnia, depression, or anxiety. Sleep partners may report leg movements while the patient is asleep. Patients may find that medications including antihistamines (especially 1st generation), dopamine receptor antagonists, and select antidepressants worsen or even cause their RLS symptoms Diagnosing RLS Restless Leg Syndrome is a clinical diagnosis requiring all five of the following clinical features. 1. An urge to move the legs, often accompanied or caused by uncomfortable sensations in the legs. 2. Symptoms begin or worsen during periods of inactivity such as lying or sitting. 3. Uncomfortable features are relieved by movement, such as walking or stretching as long as the activity continues. 4. Symptoms are worse in the evening. 5. Symptoms are not accounted for by another medical or behavioral condition Treatment Iron replacement therapy has shown mixed results for efficacy in trials and should only be initiated in patients whose fasting serum ferritin levels are below 75ng/mL. Nonpharmacologic therapies have been shown to be effective in mild cases of RLS and have been shown to help reduce the medication requirements in severe cases. These therapies include behavioral strategies such as: • Mental alerting techniques during times of rest Avoidance of aggravating factors such as Sleep deprivation Precipitating medications               ▪ Antidepressants               ▪ Neuroleptics               ▪ Dopamine-blocking antiemetics               ▪ Sedating antihistamines               • Regular exercise               • Reduce caffeine intake   Mon, 14 Feb 2022 06:00:00 GMT http://vascularinstitute.com/blog/8518/Restless-Leg-Syndrome http://vascularinstitute.com/blog/6892/Vein-Health-for-Older-Adults blog Vein Health: 5 Exercises for 65+ It's no secret that as people age, they're more likely to develop varicose veins in their legs and feet. That's why eating a balanced diet, avoiding tobacco, and breaking up long periods of sitting are so important, especially if you're over 65. While varicose veins cannot be prevented entirely, promoting good vein health with regular low-impact exercise can keep your vascular system in tip-top shape. Here are 5 exercises that are both simple and effective at maintaining healthy veins for people 65+. Walking Walking may not seem like a vigorous workout routine, but it is one of the best things you can do to improve blood circulation in your legs. While walking for 30 minutes a day is ideal, there are other ways to get your blood pumping freely through your legs, such as: Taking the stairs instead of the elevator Parking farther away in the parking lot of a store Walking your dog in the morning and evening Swimming Gravity can play a major role in developing vascular disease. This is because veins are responsible for returning blood back to your heart, which is often easier said than done when they have to work uphill. However, gravity doesn't affect your leg veins when you're submerged in water. Because of this, swimming is an excellent way to promote circulation, improve flexibility, and work your calf muscles without the risk of injury that some more strenuous exercises, such as running. Water aerobics, in particular, is a great way to build muscle and incorporate cardio into your routine without putting undue stress on the veins in your legs. Resistance Bands When it comes to preventing the pain and aesthetic concerns that are caused by varicose veins in your legs, building strong calf muscles is a must. When your calves are healthy, blood can freely flow from your lower legs back to your heart. Luckily, working your calf muscles is easy enough for people of all ages to do. With resistance bands, you can improve the circulation in your legs and adjust the difficulty of each workout to suit your specific needs in the comfort of your own home. Biking Going for a spin around the neighborhood may be more than you realize. Riding your bike is a great way to maintain healthy veins. Cycling not only increases circulation and relieves stress, but it also requires you to use your calf muscles and can help manage a healthy weight. Wearing compression socks during a cycling session can also be beneficial by keeping your veins in the proper position.  Lightweight Lifting Exercises Lifting weights may not seem like the best exercise to undertake if you're striving to prevent varicose veins, but when done properly, weight lifting can actually be a proactive part of promoting good vascular health. After all, exercise increases circulation, which is important for circulation and combating the negative effects of varicose veins. Just be sure to choose weights that aren't too heavy, hire a trainer to assist you if you're just starting out, and incorporate plenty of rest days to let your muscles adjust. Healthy veins are an essential part of living a healthy lifestyle for many years. No matter what your age may be, maintaining healthy veins is possible with a few simple steps. For more tips on how to keep your vascular system healthy and strong for a lifetime, the experienced team at the Vascular Institute of the Rockies is here to help you every step of the way. Visit us online or contact us today to learn more about preventing varicose veins, treating vascular problems, and keeping your heart healthy. Wed, 27 Oct 2021 06:00:00 GMT http://vascularinstitute.com/blog/6892/Vein-Health-for-Older-Adults http://vascularinstitute.com/blog/6887/Hyberbaric-Oxygen-Therapy- blog What is Hyperbaric Oxygen Therapy and How it Helps Heal Wounds Hyperbaric oxygen (HBO) therapy involves treating patients with 100% oxygen (O2) at elevated atmospheric pressures in a specially designed chamber. The chambers are about 3 feet in diameter and 8 feet long, so they are big enough for people to enter and exit easily. Most patients lie on their backs or sit up just slightly. During the treatment they can watch TV, take a nap, read a book or listen to music to keep themselves entertained during the treatment, which can last up to two hours. How HBO Therapy Works During the treatment, the chamber is filled with 100% pure oxygen and the atmospheric pressure is increased to up to three times higher than normal. Transparent walls allow the clinical staff to monitor the patient closely and minimize discomfort for those with claustrophobia. Some chambers are the size of small rooms that can treat multiple people at the same time. There is always a trained professional monitoring the oxygen levels and observing patients throughout the treatment cycle. Benefits of HBO Therapy The benefit of increased pressure includes improved oxygenation to damaged tissues by increasing the amount of O2 in the blood plasma which can reduce inflammation and swelling by improving circulation. Increased oxygen levels also help the body build up white blood cells which help fight off infection. HBO therapy has been shown useful in limb preservation by improving oxygen flow to complex diabetic foot and ischemic limb ulcers as well as osteomyelitis, and necrotizing fasciitis. Increased oxygen supply can also help individuals suffering from air embolism, decompression sickness, burns, cerebral edema, diabetic wounds, gas gangrene, stroke, and many others. With a rise in oxygen rich blood cells, affected tissues throughout the body are able to stimulate a process called angiogenesis. Angiogenesis is the formation of new blood vessels. This developmental process involves the growth and maturation of endothelial cells, which are the main type of cell located inside blood vessels, lymph nodes, and the heart. Most sessions in the chamber are 90 minutes, several times a week, for several weeks. Typical treatment protocols for leg ulcers involve one or two treatments daily for a total of 20 to 40 treatments. Risks though rare, can be serious, including seizures, collapsed lung, and ear pain due to the increased air pressure. HBO is covered by most insurance plans and is considered a cost-effective tool to treat limbs that may otherwise be destined for amputation. However, access to hyperbaric chambers may be limited in some areas and involves a time commitment for patients and their families. Wound care centers are increasing in popularity and offer coordinated multispecialty management of complex wound problems. Due to the size of hyperbaric oxygen chambers, most physician's do not have them in their offices, though the chambers are used by a variety of specialists including vascular, plastic, general and orthopedic surgeons. Proper coordination of care is essential for the evaluation and treatment plan of wound care patients. Wed, 27 Oct 2021 06:00:00 GMT http://vascularinstitute.com/blog/6887/Hyberbaric-Oxygen-Therapy- http://vascularinstitute.com/blog/6698/8-Signs-You-May-Be-Suffering-from-Thoracic-Outlet-Syndrome---VIR blog What is Thoracic Outlet Syndrome? Thoracic Outlet Syndrome (TOS) refers to disorders that take place when injury, irritation, or compression affect the nerves and/or blood vessels (veins and arteries) in the area of the lower neck and upper chest area. It gets its name from the Thoracic Outlet that is located between the lower neck and upper chest and this collection of blood vessels and nerves can be found. TOS can affect virtually anyone, regardless of their age or gender. It's particularly common, however, in athletes who perform repetitive motions with their arms and shoulders, including volleyball, baseball, and swimming. What Are the Types of Thoracic Outlet Syndrome? There are three main types of TOS. These include: Neurogenic thoracic outlet syndrome: This type makes up to 95% of TOS cases and affects primarily middle-aged women. It occurs when the nerves leading from the neck to the arm, also known as the brachial plexus, become compressed.  Venous thoracic outlet syndrome: Also known as vascular TOS, this type makes up around 5% of TOS cases. It occurs when a vein becomes compressed, causing upper body thrombosis. Arterial thoracic outlet syndrome: This is a rare but serious form of TOS that occurs as a result of a congenital bony abnormality in the lower neck and upper chest. While it's not always clear what causes TOS, a number of lifestyle factors can increase a person's likelihood of developing it, such as: Poor posture Sleep disorders Weightlifting Sports that require repetitive arm movements Injury to one's back or neck Whiplash Stress Tumors in the lower neck or upper chest area Signs That You May Have Thoracic Outlet Syndrome Regardless of what type of TOS a person may be suffering from, there are several tell-tale symptoms that could indicate that they have TOS, including: Pain, numbness or tingling in the arm, forearm or fingers Loss of pulse in the wrist Swollen, bluish arm Clumsiness of the affected arm Band-like tightness around the bicep muscle Cold hand or arm Waking during the night with pain, aching, or numbness of the arm Headaches, neck pain, shoulder and back muscle tightness or chest discomfort How is Thoracic Outlet Syndrome Treated? While TOS cannot be cured, it is treatable. When left untreated, TOS can cause more serious complications, including permanent arm swelling and pain, blood clots, pulmonary embolism, and permanent nerve damage. Because of this, it's best to seek treatment sooner rather than later when you first notice the symptoms of TOS. With the primary goals of reducing your pain and symptoms, treatment for TOS include: Physical Therapy Medications Surgery After being examined and diagnosed, your doctor can make a personalized treatment plan to help you manage your TOS and reduce your symptoms. Tips to Prevent Thoracic Outlet Syndrome  Certain lifestyle factors can make a big difference in terms of a person developing TOS over time. Keep these tips in mind to reduce your chances of forming TOS: Avoid lifting heavy objects or carrying heavy items over one shoulder, which can put pressure on your thoracic outlet Maintain a healthy weight Stretch regularly Keep your shoulder muscles strong through exercise Get enough sleep Vascular Institute Can Help Manage Your Thoracic Outlet Syndrome If you are suffering from one or more symptoms of TOS, now is the time to seek professional treatment. At the Vascular Institute of the Rockies, we are well-equipped to help diagnose and treat your TOS with professional, compassionate care. To learn more about TOS and caring for your vascular system, visit us online today. We can't wait to help you take the first step in living a happy life with healthy veins.     Fri, 20 Aug 2021 06:00:00 GMT http://vascularinstitute.com/blog/6698/8-Signs-You-May-Be-Suffering-from-Thoracic-Outlet-Syndrome---VIR http://vascularinstitute.com/blog/6697/5-Tips-For-Healthy-Arteries blog When it comes to living a healthy life for years to come, taking care of your heart matters. After all, in the U.S. alone, more than 30 million people have heart disease, making it the leading cause of death for both men and women. Fortunately, with a few simple steps, you can keep your arteries healthy and prevent heart disease from developing. Check out these tips to help you do just that. Eat a Balanced Diet Few things affect your arteries quite like the foods you eat. Rather than choosing foods that are highly processed or contain a lot of cholesterol, be sure to pick foods that are high in fiber and nutrients. High cholesterol foods, such as greasy meats, can lead to build-up along the walls of your arteries, while nutrient-rich foods, such as fruit, vegetables, whole grains, and lean meats promote healthy digestion and will keep your arteries clean and clear. It's also important to take in the recommended dose of your daily vitamins. If you're uncertain that your diet alone is providing you with enough vitamins, it's wise to incorporate a multivitamin into your daily routine. Stay Active Getting enough exercise on a consistent basis is one of the most effective ways to maintain healthy arteries. That's because when you get your body moving, your arteries carry oxygen-rich blood around your body. Luckily, you don't have to hit the gym every day to keep your arteries healthy through exercise. Simply going for a walk around the block can make a big difference in terms of your artery and heart health. Likewise, it's important to stay active throughout the day. If you work at a desk or find yourself sitting for extended periods of time, try to take hourly breaks where you get up and walk around. Your heart and arteries will thank you! Avoid Cigarettes It's no secret that smoking cigarettes can have damaging effects on nearly every system of your body, including your cardiovascular system. Along with causing cancer, smoking can cause your arteries to contract, making it harder for blood to flow freely throughout your body. You don't have to be a smoker to have your heart affected by cigarette smoke. Secondhand smoke can also have devastating effects on one's heart and arteries. With this in mind, stop smoking cigarettes and avoid inhaling secondhand smoke whenever possible. Manage Stress Like smoking, stress can have a huge impact on virtually every part of your body, including your heart. To protect your arteries from the negative effects of stress, try these tips to help you relax and feel your best: Get plenty of sleep Make time for yourself Journal Meditate/pray Take up a new hobby Practice Good Oral Hygiene Did you know that your oral health and heart health are connected? It's true. Poor oral hygiene can cause gum disease that can lead to atherosclerosis. The good news is that gum disease is preventable. By brushing your teeth twice a day and flossing thoroughly one time a day, you won't just be protecting the well-being of your smile, but of your heart as well. Bottom line? Don't forget to floss! Vascular Institute Can Help You Maintain Healthy Arteries Striving to maintain healthy arteries can help you live your best life possible. By eating a nutrient-rich diet, exercising regularly, avoiding cigarette smoke, managing your stress, and practicing good oral hygiene, you will be well on your way to keeping your arteries healthy and strong. For more information on how to protect your heart and arteries, the Vascular Institute of the Rockies is here for you. Visit us online today to schedule your free consultation.   Fri, 20 Aug 2021 06:00:00 GMT http://vascularinstitute.com/blog/6697/5-Tips-For-Healthy-Arteries http://vascularinstitute.com/blog/6630/Signs-You-Might-be-Suffering-from-a-Pelvic-Venous-Disorder- blog Varicose veins occur as a result of faulty valves which allow blood to fall with gravity and pool in abnormal veins (reflux) or by blockages in the veins not allowing the blood to leave the pelvis (obstruction). Although varicose veins typically occur in lower extremities, such as your lower legs and feet, varicose veins can also occur in your pelvis. Pelvic venous disorders are a painful condition that can occur in both men and women, but it is commonly referred to varicocele in men. Approximately, 13-40% of women that suffer from chronic pelvic pain for more than six months have a pelvic venous disorder.  Signs and symptoms commonly associated with pelvic venous disorders: Pelvic pain and heaviness Pain around the time of menses Backache Depression Fatigue Unusual varicose veins around the vulva, buttocks and in between the legs Swelling of the labia Tenderness of the abdomen Burning pelvic pain Pelvic floor spasm Hip pain Feeling of fullness in the legs Worsening of stress incontinence Worsening irritable bowel syndrome symptoms Pain usually affects one side but can affect both Pain is worse standing, lifting, during pregnancy or during/after sexual intercourse Risk Factors  Younger women ( Multiple pregnancies (2-3 pregnancies) Men with a history of varicocele If you suffer from many of these symptoms for six months or more, it's important to schedule an appointment with your OBGYN who can refer to you to a vascular specialist for a proper work up and diagnosis which involves a physical exam and a trans abdominal duplex ultrasound. In most cases, a transvaginal ultrasound is not necessary, but it may be requested following a CT scan or MRI, if necessary.  Treatment Options Your gynecologist may start with hormonal medications to reduce the blood flow and engorgement of varicose veins within the pelvis. If the patient does not see improvement, nonsurgical embolization, an outpatient, minimally invasive procedure where a small catheter or plastic tube is inserted into a central vein and guided to the problem veins using X-ray, may be an option. The veins are plugged with foam or coils to prevent abnormal blood flow. Recovery is quick and no stitches are required. Most patients leave the treatment facility/hospital in about four hours and resume normal activities within a few days. Other treatment options include open or laparoscopic surgery to tie the veins. This procedure is more invasive, requires the use of general anesthesia and entails a longer recovery period.  If you are experiencing these symptoms for a period of 6 months or more, please contact your gynecologist today to learn more about a treatment option that works well for you.  To learn more about PVD from Vascular Institute of the Rockies, watch our video here.   Mon, 02 Aug 2021 06:00:00 GMT http://vascularinstitute.com/blog/6630/Signs-You-Might-be-Suffering-from-a-Pelvic-Venous-Disorder- http://vascularinstitute.com/blog/6577/Raynaud-s-Phenomenon blog What is Raynaud's Phenomenon? Raynaud's phenomenon, also known as Raynaud Syndrome, is an exaggerated response to a normal physiologic process. This means that the body reacts as it is supposed to, but in an exaggerated way. Normally, when a healthy individual is exposed to cold temperatures the blood vessels in the fingers and toes vasoconstrict or narrow. This diverts blood to the body's core, which ensures blood flow is going to the body's vital organs. In Raynaud's phenomenon this vasoconstriction occurs, but to a more dramatic extent to the point of causing a change in skin color and symptoms such as aching, numbness and tingling in response to cold. This usually includes a sudden onset of cold in digits on hands or toes followed by a three-color change from white to blue to red. Vasoconstriction of the digits can also occur due to emotional stress. Raynaud phenomenon is more common in young women and in those with a family history. What causes Raynaud's Phenomenon? The cause is not completely clear. Most commonly occurs due to exposure of cold temperatures, which causes an exaggerated vasoconstriction of the blood vessels to the fingers and toes. This results in decreased blood flow to those areas. In addition, emotional stress can cause an attack due to the stimulation of the sympathetic nervous system. This is the "fight or flight" part of the nervous system. What do patients with Raynaud's Phenomenon experience? Commonly, symptoms occur from low blood flow to fingers and toes. Patients can experience numbness, aching, pain, clumsiness of motor skills of the hand, and sensations of "pins and needles". Normally when the fingers and toes warm again the symptoms will completely go away and leave no residual effects. Very rarely, when blood flow is severely impeded tissue ischemia results in ulcerations of the skin, which occurs at the very tips of the fingers and toes. What is the difference between primary and secondary Raynaud's phenomenon? Primary Raynaud's phenomenon is idiopathic, which means we do not know what causes it. It is not considered to be a pathologic or a disease process. It is simply an exaggerated vasoconstriction of the digits, which affects the normal blood supply. Secondary Raynaud's phenomenon includes patients whom an associated disease or cause is responsible for the disruption of blood flow to the digits and surrounding skin. Some of these diseases include: autoimmune rheumatic diseases such as systemic lupus erythematosis, amphetamines and chemotherapeutic agents like cisplatin and bleomycin, and hematologic abnormalities including cryoglobulinemia and cold agglutin disease. Additionally, causes of secondary Raynaud phenomenon include vascular trauma, frostbite, carpal tunnel syndrome, overuse of vibrating hand tools, vasculitis, and hypothyroidism. How is Raynaud's Phenomenon diagnosed? Evaluation begins with three screening questions: Are your fingers or toes unusually sensitive to cold? Do your fingers or toes change color when they are exposed to cold temperatures? Do your fingers or toes turn white, blue, or both? If a patient answers yes to all three of these questions, then they most likely have Raynaud phenomenon. It is not always necessary to induce an attack, such as a coldwater challenge or inducing an emotional stress attack due to the responses to those challenges being inconsistent for those patients with Raynaud phenomenon. What is the treatment for Raynaud's Phenomenon? The initial treatment of Raynaud syndrome is to avoid things that trigger an attack. This includes avoidance of cold temperatures and sudden temperature changes, which can even occur when entering the frozen food section at the supermarket. Maintaining whole body warmth is important as well. Avoid repeat trauma of fingertips, vasoconstrictive drugs, and encourage smoking cessation when appropriate. Educating patients on the link between emotional stress and Raynaud's phenomenon is important and attention to mental health disorders should be considered. Unless there is another disease that is causing the Raynaud's, Raynaud's itself is rarely harmful and usually doesn't require treatment beyond avoiding inciting causes. If the symptoms are extremely debilitating, or cause ulceration of the tips of fingers or toes, pharmacological therapy and referral to a rheumatologist to look for autoimmune disease causes may also be considered. Very few patients with Raynaud's should be offered drug treatment, because the side effects of the medications are more dangerous than the Raynaud's they are used to treat. Mon, 12 Jul 2021 06:00:00 GMT http://vascularinstitute.com/blog/6577/Raynaud-s-Phenomenon http://vascularinstitute.com/blog/6576/Varicose-Veins blog Varicose veins are abnormally enlarged blood vessels due to faulty valves in your veins. While this is not a serious condition, many people find varicose veins uncomfortable and not aesthetically pleasing to look at. Veins normally have one-way valves that prevent blood from flowing backwards. When these become faulty this results in blood flowing backwards and pooling, most commonly in the legs. Symptoms of Varicose Veins: A lot of people do not have any symptoms Leg pain Itching Soreness Swelling in legs Heaviness Cramping Discoloration of the skin Risk Factors and Causes of Varicose Veins: Family history Pregnancy Obesity Age Sitting or standing in one place for a long period of time Previous blood clot Treatment: Before treating varicose veins you will get a full workup including an ultrasound of your veins to assess the blood flow in your legs. This will determine what kind of treatment is best suited for you Conservative treatment includes compression socks, weight loss, elevating legs, and exercising. After trying conservative treatment options next line are minimally invasive procedures, which are usually done in the office as an outpatient. These include venous ablation (sealing off the veins that had bad valves using laser or radio waves) and removing the varicose veins directly through tiny incisions that can be closed with a bandaid. If you have varicose veins that are CAUSING SYMPTOMS, ask to see a vascular surgeon. Almost all insurance plans cover symptomatic varicose veins. Treating varicose veins for cosmetic reasons is usually not covered and the results of treatment is usually not worth doing it. Mon, 12 Jul 2021 06:00:00 GMT http://vascularinstitute.com/blog/6576/Varicose-Veins http://vascularinstitute.com/blog/6488/Treating-Varicose-Veins-At-Home--What-You-Should-Know blog .blog h2 { margin-top: 1.25rem; } With more than 40 million people suffering from the pain and embarrassment that comes from living with varicose veins, you may be wondering: can anything be done to manage these negative effects at home, or is professional intervention the only solution for varicose veins? Fortunately, the knowledgeable team at Vascular Institute can help. Here's what you should know about treating varicose veins at home before scheduling a consultation with one of our trusted providers.  What Causes Varicose Veins? Varicose veins are enlarged, twisted veins that can be located anywhere on a person's body, but are most commonly visible on one's legs. They occur when a vein becomes over-filled with blood and, as a result, appear swollen. For most people, varicose veins are merely a cosmetic concern, however, they can sometimes cause pain, discomfort, or more serious complications.  Varicose veins can indicate that veins aren't working as they should. While healthy veins perform as one-way valves that prevent blood from flowing in the opposite direction, blood collects in varicose veins rather than continuing to push it to the heart. When this occurs, the veins enlarge and become visible. Because of the combination of gravity's pull as well as their location being the farthest away from the heart, the veins in one's legs are more prone to develop varicose veins than other areas of the body. Some factors that can contribute to the formation of varicose veins include: Pregnancy Jobs that require you to stand all day Age (people over 50 are more likely to develop them) Obesity Lifestyle Genetics While varicose veins cannot always be prevented, eating a well-balanced diet, staying active, and maintaining a healthy weight can reduce your chances of developing varicose veins. Symptoms of Varicose Veins Varicose veins can present several common symptoms, including: Visible veins that are blue, purple, or dark red Veins that appear to be bulging, twisted, or misshapen A heavy feeling in one's legs Aching, throbbing, or swelling in one's lower legs Increased pain after prolonged periods of sitting or standing Skin discoloration around the vein Itching around the vein Can You Treat Varicose Veins at Home? In some cases, managing and improving the negative effects of varicose veins can be achieved at home. To reduce the appearance and discomfort caused by varicose veins, try these simple tips: Exercise: Incorporate low-impact exercises, such as swimming, yoga, and walking, into your routine to promote healthy blood circulation through your legs. Compression: Wear compression socks or stockings with a pressure of 200 to 30 mmHg to reduce the aches and pains in your lower legs. Elevation: Break up long periods of sitting or standing by elevating your legs to the same height as your heart to promote efficient blood circulation. While living an active lifestyle is the best way to prevent and manage varicose veins at home, in some cases seeking professional assistance is necessary, particularly if your symptoms get worse over time. When to Seek Professional Help  While at-home remedies may reduce the discomfort of varicose veins temporarily, varicose veins won't get better or go away on their own for most people. If you're suffering from the pain or embarrassment of living with varicose veins, the trusted team at Vascular Institute can help. With our state-of-the-art vascular treatments and surgical options, our experienced providers can create a personalized treatment plan to overcome your varicose veins safely and effectively. To learn more about how you can regain your quality of life by treating your varicose veins or to schedule a free consultation at one of our two convenient locations in Denver and Junction, visit us online today.   Mon, 28 Jun 2021 06:00:00 GMT http://vascularinstitute.com/blog/6488/Treating-Varicose-Veins-At-Home--What-You-Should-Know http://vascularinstitute.com/blog/6487/Common-Myths-about-Varicose-Veins blog .blog h2 { margin-top: 1.25rem; } Varicose veins are quite common and often lead to pain, embarrassment and possibly further health issues. According to the American Society for Vascular Surgery, 20-25 million Americans have varicose veins.  Varicose veins often present as blue, rope-like vessels under the skin usually in the legs and feet. Varicose veins are often painful and unsightly. Usually caused by reflux or valves not working properly, the reversal of blood flow and venous stasis (slow blood flow or pooling) may result in leg swelling (Edema), skin changes and in more severe cases, venous ulcers, if left untreated.  Given the prevalence of varicose veins, many myths continue to surround them. The physicians at the Vascular Institute of the Rockies, the largest vascular group in the Rocky Mountain region, will debunk some of these top myths.  Myth #1: Varicose veins are only cosmetic. While varicose veins are certainly visible on your legs, they can significantly impact your health and well-being. People may experience heaviness/fatigue in their legs, leg swelling, Restless Leg Syndrome, leg cramping while sleeping, color changes in skin, pain, itching, burning, and an increased risk of blood clots.  Myth #2: Only women get varicose veins. While it is more common for women to have varicose veins, men certainly have them as well. According to the American Society for Vascular Surgery, 17% of men and 33% of women have varicose veins. Myth #3: Varicose veins only occur with elderly people. Although varicose veins become more common as you age, people may get varicose veins at any age.  Myth #4: There are no risk factors to varicose veins. They just occur over time. A variety of risk factors may lead to an increased risk of varicose veins including heredity, excess weight or obesity, prolonged periods of standing or sitting, pregnancy and older age. Women are also more likely than men to get varicose veins.  Myth #5: Varicose veins are simply detected by seeing blue, rope-like vessels on legs or feet. For proper diagnosis, a vascular specialist will complete a comprehensive evaluation that includes an ultrasound to detect varicose veins, evaluate blood flow and determine the efficiency of vein valves. Myth #6: There is nothing that will alleviate pain caused by varicose veins. Small, habits or lifestyle changes may help to reduce the pain caused by varicose veins: In order to decrease the pressure in the veins, elevate legs to the level of the heart for 30-minute increments, 4 times a day. People carrying extra weight may benefit from losing some weight. Keeping your blood circulating with regular exercise or physical activity may alleviate some pain.  Wearing compression stockings will help to keep blood from pooling. Reducing salt intake since a high salt diet may lead to hypertension or narrowing of arteries. Minimally invasive procedures or surgery may also be an option if these measures do not help. Talk to your doctor to determine the best option for you. Myth #7: Surgery is the only option to permanently treat varicose veins. While surgery used to be the only option, there are now a range of options including quick, minimally invasive, outpatient procedures. Vein Ablation: This minimally invasive technology uses ultrasound guidance to position a catheter through a small opening in the skin. Using radiofrequency, the vein is heated causing veins to close so blood is re-routed to other healthy veins. This outpatient procedure results in minimal to no scarring, bruising or swelling and patients can typically resume normal activities within a few days. Sclerotherapy: Sclerotherapy is an outpatient procedure used to treat varicose and spider veins. A tiny needle injects a solution directly into the vein to damage the lining of the vessel so it is absorbed into the body. Patients may feel a mild discomfort during the procedure. Depending on size and location of the veins, patients will respond to treatment in 3 to 6 weeks or 3 to 4 months for larger veins. Multiple sessions may be required. Phlebectomy: An outpatient procedure to surgically remove varicose veins using tiny incisions. Minimal scarring and discomfort are experienced.  Myth #8: Working on hard surfaces leads to varicose veins. Working on hard surfaces, such as cement, does not lead to varicose veins but may contribute to musculoskeletal problems.  Myth #9: Sitting for long periods of time causes varicose veins. While is it true that venous pressure does increase with little to not activity, such as standing or sitting for long periods of time, it does not necessarily lead to varicose veins. Taking short walks, stretching or doing calf pump exercises may help to alleviate some pain and symptoms.  Myth #10: If you cross your legs, you'll get varicose veins. This popular myth has been passed down through generations but fortunately has no merit. Varicose veins occur as a result of damaged or weakened veins. Crossing your legs does not lead to damaged or weakened veins.  Myth #11: Spider veins and varicose veins are the same. Both are merely cosmetic.  Spider veins, or Telangietasias, are small, dilated capillary veins that are bluish-red in color and often appear in weblike patterns typically on legs or around the nose and lips. Spider veins are typically more cosmetic than symptomatic.  Varicose veins are common and often present as rope-like blue vessels typically in the legs or feet. Varicose veins are oftentimes painful presenting with symptoms such as heaviness/fatigue in legs, leg swelling, restless leg syndrome, leg cramping while sleeping, pain, itching and burning. If left untreated, varicose veins may results in leg swelling, skin changes or venous ulcers in more severe cases.  Myth #12: Treating varicose veins is expensive and painful. Varicose veins are oftentimes covered by insurance whereas spider veins typically are not since they tend to be cosmetic only. Patients may feel a very mild discomfort during the treatment and downtime is usually minimal afterwards depending on the size and severity of your veins.  Myth #13: Varicose Veins always come back even after treatment. This may have been true years ago but with today's technology and treatment options, this is no longer the case. Vein ablation, Sclerotherapy and Phlebectomy are all effective treatment options and typically few patients require follow up treatments on the same veins.  Myth #14: Exercise is bad for varicose veins. To the contrary, exercise is great for varicose veins as it gets your heart pumping and your blood moving. Please note, limited exercise and compression socks may be recommended right after a varicose veins treatment to ensure blood does not pool in the legs. Myth #15: Pregnancy causes varicose veins. Although pregnancy does not cause varicose veins it can exacerbate them. Typically harmless, varicose veins may occur when the uterus applies pressure to the large vein (inferior vena cava) which transports blood back to the heart from your lower extremities (feet or legs). Oftentimes, varicose veins will fade after delivery. Myth #16: Varicose veins are hereditary. Varicose veins run in the family for only 50% of all people who have them. So, if your parents and grandparents had them, your likelihood is higher but it does not guarantee that you will have them. Other risk factors such as age, excess weight, prolonged sitting/standing, pregnancy and gender may increase your likelihood as well.  Myth #17: Massages can cure varicose veins. While massaging your achy legs or feet may provide temporary relief of swelling or discomfort, it does not make varicose veins go away. Advanced treatment options such as vein ablation, sclerotherapy and phlebectomy are all proven, effective treatment options. Myth #18: Compression stockings are not required/recommended before or after treatment.  Most insurance companies require patients to wear compression stockings before treatment. Compression stockings are oftentimes required post treatment, sometimes up to six weeks. Myth #19: Woman should wait until they are done bearing children to seek treatment for varicose veins. There is no medical reason to wait until after women are done bearing children to treat varicose veins. In fact, women may benefit from having varicose veins treated before even becoming pregnant. However, if your varicose veins are treated before pregnancy, they are more likely to recur.  Myth #20: Tattoos negatively affect varicose veins. There is actually no correlation between tattoos and varicose veins. If you have questions or concerns about varicose veins or your lifestyle is being negatively impacted by the pain and discomfort of varicose veins, talk to your doctor today. A primary care physician can recommend you to a vascular specialist that can quickly and easily treat your varicose veins today.  If you'd like more information about varicose veins, please refer to your FAQ or watch our video. Feel free to reach out to us if you'd like to speak directly to a vascular specialist.    Mon, 28 Jun 2021 06:00:00 GMT http://vascularinstitute.com/blog/6487/Common-Myths-about-Varicose-Veins http://vascularinstitute.com/blog/5147/Aneurysms--An-Overview blog What is an aneurysm? Definition: A weakness in the wall of an artery that causes an abnormal dilation. When most people hear the word "aneurysm" they tend to think of the many complications associated with aneurysms listed below: Rupture This would be a surgical emergency. This hemorrhage (excessive escaped blood flow from a vessel) can cause significant hypotension (low blood pressure) and can lead to death if not treated. Thrombosis (aka formation of a blood clot) When the artery is dilated so much this allows for blood in the aneurysmal area to become slow moving and more prone to forming clots. Embolization  An embolus is a blood clot that has broken off and is now free moving throughout the arterial system. This free blood clot can be transported throughout the arteries until it becomes lodged in a narrowed artery away from its original location. This can result in blockage of blood flow to certain parts of the body. This blockage of blood flow is called ischemia. Symptoms of ischemia due to embolization can cause numerous symptoms dependent on what artery the emboli is in. For example, if an artery supplying one of the limbs is occluded the affected limb can lose sensation, motor function, and become cold, pale, and painful. What are risk factors for aneurysm formation? While the exact cause of aneurysm formation is not known, any process that weakens or destroys blood vessel integrity can contribute to aneurysm formation. A few risk factors are listed below: Smoking Hypertension Family history Advanced age How many types of aneurysms are there? There are many different types of aneurysms depending on the artery affected. Abdominal aortic aneurysms and intracranial saccular aneurysms are two of the most common. Further information on abdominal aortic aneurysms can be found here https://vascularinstitute.com/blog/1161/APatient-s-Guide-to-Abdominal-Aortic-Aneurysm-AAA-. As intracranial aneurysms are within the head, they do not fall under general vascular surgery, but would rather be treated by a neurosurgeon. Peripheral artery aneurysms are a broad category that include aneurysms of most any artery excluding the abdominal and thoracic aorta, coronary arteries or cerebral arteries. An aneurysm of any artery outside the brain is treated by a vascular surgeon. Treatment Options: The treatment for aneurysms vary, again, depending on the artery affected. The most common treatment methods for aneurysms are: Conservative management with observation In this method, once the aneurysm has been identified there will be regular repeat imaging to monitor the size of the aneurysm. If the aneurysm becomes enlarged to a certain point, then surgical interventions are considered. Endovascular repair (minimally invasive) Endovascular repair usually requires placement of a stent graft to stabilize the blood vessel at the point of the aneurysm. While this can be done with minimal or no incisions, the downside is that stents require lifetime follow up with imaging, and there is a small chance of needing another procedure to keep the aneurysm fixed. More information on this can be found here https://vascularinstitute.com/blog/5055/A-Patient-s-Guide-to-Endovascular-Aneurysm-Repair-EVAR-. Open surgery Open surgery is when an incision is made and the involved artery is replaced directly. This is more invasive that a stent, but it is more durable, in that it usually is the only procedure you will need for that aneurysm. Citations: DynaMed [Internet]. Ipswich (MA): EBSCO Information Services. 1995 - . Record No. T1604421653652, Peripheral Artery Aneurysm; [updated 2020 Nov 30, cited 2020 Dec 12]. Available from https://www-dynamed-com.proxy.rvu.edu/topics/dmp~AN~T1604421653652. "Aneurysm." Johns Hopkins Medicine, 2020, www.hopkinsmedicine.org/health/conditions-anddiseases/aneurysm. Stather PW, Sidloff DA, Rhema IA, et al. "A review of current reporting of abdominal aorticaneurysm mortality and prevalence in the literature." Eur J Vasc Endovasc Surg 2014; 47:240. Mon, 21 Dec 2020 06:00:00 GMT http://vascularinstitute.com/blog/5147/Aneurysms--An-Overview http://vascularinstitute.com/blog/5059/Lower-Extremity-Bypass-for-Peripheral-Artery-Disease---Indications-and-What-to-Expect- blog There are several indications for surgical intervention for peripheral artery disease. Some cases may be treated with minimally invasive techniques such as endovascular stenting and angioplasty. Other more complicated cases may require open interventions such as endarterectomy and/or bypass. While bypass surgery is a "real" operation, in many cases it can solve the patients problem for many years or forever, compared to angioplasty and stenting which may need to be repeated frequently to keep the blood flow open.  Indications for intervention include pain at rest in the affected limb as well as non-healing wounds from the decreased blood supply. Some may even have a black toe from the lack of blood flow. Patients with peripheral artery disease often have a history of limb claudication, which refers to pain with exertion. For example, when you take a walk down the block, your muscle is consuming oxygen brought to it by the arterial system. When the arteries become narrowed by atherosclerotic plaque, the artery can no longer deliver oxygen to the muscle as it demands. Over time, the patient will complain of pain when walking a certain distance. As the artery narrows more, this can turn into pain at rest at which there is now an indication for surgical intervention. Sometimes we recommend intervention for claudication alone, but not everyone who has a walking limitation needs an intervention. People with claudication alone are not at any risk of limb loss if we do not intervene.  Prior to the peripheral artery bypass procedure, the surgeon will identify a superficial vein from which the bypass graft can be created. Your own veins work best, but sometimes an artificial material such as Dacron or PTFE will be used. Primary patency (the bypass is still open and working) rates at 5 years for saphenous vein grafts are 85.2% vs. PTFE (a prosthetic graft) at 64.5%.1 This is the reasoning for choosing a native vein as the first choice for grafting material. Typically, the great saphenous vein, that runs along the front and inside of the thigh, is the most common choice. This vein is easily accessed by the surgeon during surgery because its location and path can be easily tracked with ultrasound. Additionally, its location makes it an ideal choice for bypassing some of the large arteries in the leg as they descend down toward the feet. Once the vein of choice has been identified, the surgery team will carefully dissect the vein away from the surrounding superficial tissue. From there, the areas of viable artery will be identified so that the vein graft can be connected to the arterial supply. The goal is to use the vein as a conduit for arterial blood and oxygen delivery to the limb. In order for the vein to act like an artery, we must "arterialize" the vein by removing the venous valves, or take the vein out and reverse its direction of flow. Removing the valves provides a clear path for forward moving  blood and further decreases the risk of venous hypertension. Once the vein is arterialized, it can then be placed in its new location with inflow and outflow connections to the artery being bypassed. The flow through the graft is then checked using doppler, which utilizes sound waves to ensure that blood is readily moving through the newly placed graft. Overall, this procedure may seem quite complicated, but a large team of medical experts are involved in the care of each patient. From the ultrasound technologists, to the anesthesiologist, to the surgeons as well as the  resident doctors and medical students, there will be a team-based approach to your care. -Onilia Zorio MS III, Eugenia Jernicks MS III, Garrett Fante MS III 1. Comparisons between prosthetic vascular graft and saphenous vein graft in femoro-popliteal bypass Thu, 03 Dec 2020 06:00:00 GMT http://vascularinstitute.com/blog/5059/Lower-Extremity-Bypass-for-Peripheral-Artery-Disease---Indications-and-What-to-Expect- http://vascularinstitute.com/blog/5058/Trans-Carotid-Artery-Revascularization- blog Carotid Artery Stenosis (CAS), or blockage in the carotid artery, is a considerable risk for strokes or TIAs. Trans Carotid Artery Revascularization, or TCAR, is a novel technique to treat CAS by accessing the common carotid artery via a small incision just above the collar bone. The older stenting technique requires access to the carotid artery via the femoral artery in the upper leg and navigating a metal wire going upstream of the blood flow to the carotid artery in the neck. In both techniques, a metal umbrella-like stent opens up to keep blood flowing through the artery. The TCAR procedure also utilizes a special tool that reverses the blood flow that usually goes from the aorta to carotid and to the brain. The back flow of blood brings pieces of plaque back through a filter and then plaque-free blood returns to a vein in the leg to be recycled by the heart. In the transfemoral approach, there is a risk that using this tool to reverse blood flow would cause lack of blood flow to other arteries. The brain is unique because even if one artery is blocked, there are 3 others that continue to supply the brain with oxygenated blood. Therefore, even with the decreased blood flow in the carotid artery that is being operated on, the brain will continue to receive plenty of blood. An advantage of TCAR over the transfemoral stent is a decreased risk of having a piece of plaque travelling up to the brain and causing a stroke, though the risk of this varies with patient's risk factors1. TCAR and the surgical removal of the plaque (Carotid Endarterectomy) are equally as efficacious in one-year follow-up2. In-hospital complications for either procedure are rare ( The following video is a representation of the procedure: TCAR (Transcarotid Arterial Revascularization) References 1. Schermerhorn ML, Liang P, Eldrup-Jorgensen J, et al. Association of Transcarotid Artery Revascularization vs Transfemoral Carotid Artery Stenting With Stroke or Death Among Patients With Carotid Artery Stenosis. JAMA. 2019;322(23):2313-2322. doi:10.1001/  jama.2019.18441. 2. Malas M, Dakour-Aridi H, Kashyap V, et al. Outcomes of TransCarotid Revascularization with Dynamic Flow Reversal (TCAR) Versus Carotid Endarterectomy (CEA) in the TCAR Surveillance Project. European Journal of Vascular & Endovascular Surgery. 2019;58:e638. https://search-ebscohost-com.proxy.rvu.edu/login.aspx? direct=true&db=edo&AN=141107250&site=eds-live&scope=site. Accessed March 10, 2020. Thu, 03 Dec 2020 06:00:00 GMT http://vascularinstitute.com/blog/5058/Trans-Carotid-Artery-Revascularization- http://vascularinstitute.com/blog/5056/May-Thurner-Syndrome---Venous-stenting blog .blog .blog-desc img { width: 307px !important; max-width: 40% !important; height: auto !important; float: left; margin: 0 20px 10px 0; } What is May-Thurner Syndrome? May-Thurner Syndrome is an anatomical abnormality in which the Left Iliac Vein is compressed by the Right Iliac Artery. Why does May-Thurner Syndrome Matter? Veins carry blood at much lower pressures than arteries. With the Right Iliac Artery so close, the Left  Iliac Vein can be easily obstructed. Even partial obstructions can cause issues. Partial obstructions of the Left Iliac Vein increase the risk of clot formation, particularly for patients who are immobilized (Post-operative, long plane flights, casts). Treatment for May-Thurner Syndrome Most May-Thurner patients are asymptomatic and neither diagnosed nor treated. If a patient develops a deep venous thrombosis, they may be referred to a vascular surgeon for further evaluation, which is usually when May-Thurner is diagnosed. Sometimes it is found when evaluating a patient for chronic LEFT leg swelling. Deep Venous Thrombosis Treatment in May-Thurner Syndrome A deep venous thrombosis or DVT is a blood clot in the venous system. DVTs can be much more serious in May-Thurner patients, as they are larger, cause more swelling, and may be more likely to cause Pulmonary Embolism. In addition to hospitalization and anticoagulation treatment with Heparin (A blood thinner), these patients often require a stent to be placed in their Left Iliac Vein. The reason they  eveloped a DVT was due in large part to their unique anatomy. The stent helps keep the vein open and prevents the formation of future DVTs. Sometimes a patient receiving a stent will be put on an anti-platelet medication like Plavix for three months, and often is maintained on baby aspirin (81mg) for life. Lifetime followup of the stent with yearly ultrasound is also recommended to make sure the vein is not narrowing down again for any reason.  Thu, 03 Dec 2020 06:00:00 GMT http://vascularinstitute.com/blog/5056/May-Thurner-Syndrome---Venous-stenting http://vascularinstitute.com/blog/1372/Peripheral-Arterial-Disease-and-Foot-Wounds blog Peripheral Arterial Disease and Foot Wounds By Lauren Molchan, DPM R2  What is peripheral arterial disease (PAD)?  ·  Peripheral arterial disease or PAD refers to the buildup of plaques on the arterial wall that cause narrowing or blockage of arteries that carry blood to the limbs, most commonly affecting the legs. PAD may occasionally affect the upper extremities as well.  ·  If symptoms do arise, the most common symptom is leg pain that is brought on by activity and goes away with rest. Other symptoms include: cuts or sores on your feet that don't heal or a toe that turns black and doesn't heal. ·  Narrowing of the arteries places patients with PAD at a high risk for stroke, heart attack and limb loss. For this reason, if you suspect PAD, it is important to talk to your doctor.  Are diabetic patients more likely to have PAD?  ·  Yes, diabetes is a risk factor for developing PAD. In diabetic patients, the risk of PAD is increased by: duration of diabetes, age, smoking status, and presence of peripheral neuropathy.  ·  According the American Diabetes Association, 1 in 3 diabetic patients over the age of 50 have PAD, versus 1 in 20 Americans in the general population over the age of 50.  ·  PAD is a major risk factor for amputation in diabetic patients. It is important to establish care with vascular and wound care specialists to treat PAD symptoms and prevent limb loss.  Why does PAD increase the risk for foot wounds and limb loss?  ·  When the vessels that carry blood to the legs and feet narrow or become completely blocked, patients' risk of developing non-healing wounds on the lower extremities greatly increase. This is because the blood carries oxygen and other nutrients that are required for wound healing and tissue regeneration. Without adequate blood flow, the body is unable to heal small cuts or breaks in the skin. ·  Additionally, the risk of infection in these wounds is also increased. The body's natural defenses to bacteria and immune cells are carried to cuts and wounds through the blood. If the vessels are narrowed and blood flow is blocked, the immune cells are unable to reach the wound and fight off infection causing bacteria.  How can wounds associated with PAD be managed and treated?  ·  There are important steps patients can take to help in their own treatment and improve blood flow and wound healing such as smoking cessation, exercise, maintain a healthy diet, monitor of blood glucose levels and blood pressure.  ·  However, non-healing wounds and symptomatic PAD require treatment from specialists. A visit to the vascular surgeon to properly evaluate the health of blood vessels is important for patients with PAD and foot wounds. Treatment may be required to improve blood flow before healing can be achieved.  ·  It is also important to see a foot or wound specialist such as a Podiatrist to aid in the  treatment. It is also important to maintain close follow up with your general doctor for diabetes management, blood pressure control, cholesterol monitoring and overall health management.    Mon, 24 Feb 2020 06:00:00 GMT http://vascularinstitute.com/blog/1372/Peripheral-Arterial-Disease-and-Foot-Wounds http://vascularinstitute.com/blog/1371/What-is-a-Vascular-Surgeon- blog What is a Vascular Surgeon? Vascular Institute of the Rockies 5-7 years of training after medical school specializing in learning about all aspects of peripheral vascular disease. Vascular Surgeons treat all arteries and veins EXCEPT the ASCENDING AORTA and the HEART, which are the areas of expertise of cardiac surgeons. Vascular Surgeons are the ONLY doctors who are experts in all methods of treatment of vascular disease- Medical therapy, MINIMALLY INVASIVE balloons and stents, and open blood vessel replacement surgery along with LIFETIME FOLLOWUP.  Because vascular surgeons have the skills to provide every treatment of vascular disease, they can help individualize the treatment of each patient to what will work best for them. Other specialties have expertise in SOME types of vascular treatment, but only vascular surgeons are experts in ALL TREATMENTS, from the least invasive to the most complex. Interventional Radiologist- similar expertise to vascular surgeons in balloons and stents ONLY- If long term medical management or open surgery is a better option for the patient, they refer them to a vascular surgeon.   Interventional Cardiologist- some have expertise in ballooning or stenting peripheral arteries and veins, but their primary training is on treating the heart arteries.  Can also provide medical management, but if open surgery is the best option, they will refer the patient to a vascular surgeon. Other Surgeons- General Surgeon, Cardiac Surgeon- some can perform open surgery on arteries and veins, but have no training in minimally invasive techniques or medical management. Vein Doctors- Many specialties have learned how to treat veins AFTER their formal training.  Usually this is a 2-5 day training course, compared to 5-7 years of training for a vascular surgeon. All other doctors who treat vascular disease REFER THEIR PATIENTS TO A VASCULAR SURGEON WHEN THEY HAVE COMPLICATIONS FROM THEIR INTERVENTIONS. Primary Referral to a Vascular Surgeon eliminates all of these issues- Vascular Surgeons are the only true experts in all treatment methods for peripheral arteries and veins and provide comprehensive lifetime vascular care. Mon, 24 Feb 2020 06:00:00 GMT http://vascularinstitute.com/blog/1371/What-is-a-Vascular-Surgeon- http://vascularinstitute.com/blog/1369/Peripheral-Arterial-Disease-and-Foot-Wounds blog Peripheral Arterial Disease and Foot Wounds By Lauren Molchan, DPM R2  When do you suspect PAD in patients with wounds?  ·    On physical exam, findings that would indicate PAD include wounds located on the tips of the toes or foot, wounds covered by black eschar or gangrenous changes, shiny atrophic skin, lack of pedal hair or weak or absent pedal pulses.  ·    Past medical history indicators of PAD include: history of smoking, age 65 or greater, diabetes history, CAD or stroke, or history of renal, carotid or mesenteric ischemia.  What does the PAD workup include?  ·    Detailed history including claudication symptoms, rest pain, diabetes and smoking history, history of renal, carotid or mesenteric ischemia. On physical exam, evaluate pedal pulses, temperature of distal extremities, pedal hair presence, wounds, and if available perform a Doppler exam (a normal result is a strong, triphasic waveform; patients with PAD often have weak and monophasic waveforms).  ·    Keep in mind patients with significant neuropathy may not have typical claudication symptoms. They may describe feelings of their legs "giving out" or "feeling like jelly" that is brought on after walking certain distances and relieved by rest.  ·    If pulses are weak or absent, the next step would be to order non-invasive exams such as ABIs or skin perfusion pressure. Patient's have an abnormal ABI if the value is lower than 0.9. If the ABI is higher than 1.2 this is an indicator that the vessel is calcified and unable to compressed. In this case, TBIs can be useful since the small vessels in the toe often are unaffected.  What lifestyle changes and recommendations can I make to my patients with wounds associated with PAD?  ·    Diabetic management is important in preventing the progression of disease. Encourage patient to take an active role in their care and monitor their blood glucose levels and remain compliant with prescribed medications.  ·    Encourage smoking cessation and help provide smoking cessation resources. Smokers have four times the risk of developing PAD as nonsmokers. Smoking cessation not only will help with PAD progression but also reduce risk of other cardiac diseases such as stroke, CAD, MI.  ·    Encourage an active lifestyle. Simple walking or treadmill programs tree times per weeks can reduce claudication symptoms in few as 4-8 weeks.  ·    Monitor patients cholesterol and prescribe statin medications when appropriate. Recommend diets low in trans fats, saturated fats and cholesterol with plenty of fruits and vegetables. Referrals to nutritional programs or specialists can be beneficial.  ·    Ensure appropriate hypertension management and medication. In one study published in JAMA showed patients on appropriate antihypertensive management, specifically an ACE inhibitor, had 60% pain free walking compared to pre-treatment symptoms.  ·    In patients with neuropathy, encourage patients to wear shoes even in the home and perform daily foot exams so they may catch wounds in their earliest stages.  When should I refer to a specialist?  ·    Patients with non-healing wounds, absent or weak pulses, abnormal ABIs ( ·    One study found that more than 50% of lower extremity amputations occur without prior vascular testing of any type (including noninvasive testing such as Doppler, PVRs or ABIs). With adequate examination, referral and intervention, many of these limbs could have been saved. (1)  ·    The vascular surgeon can help restore blood flow giving the wound a chance to heal; however, the patient would also benefit from a referral to a wound specialist such as a Podiatrist.  (1)     Allie DE, Hebert CJ, Lirtzman MD, et al. Critical limb ischemia: a global epidemic. A critical analysis of current treatment unmasks the clinical and economic costs of CLI. Euro Intervention J. 2005; 1(1):75-84.   Mon, 24 Feb 2020 06:00:00 GMT http://vascularinstitute.com/blog/1369/Peripheral-Arterial-Disease-and-Foot-Wounds http://vascularinstitute.com/blog/1366/Peripheral-Artery-Disease--PAD- blog Peripheral Artery Disease (PAD) By Grace Kim MSIII, Kameron Black MSIII, Rutit Pak MSIII, Andi Garcia MSIII and Bryan C. Kramer, MD Peripheral artery disease (PAD) is the narrowing and restriction of blood flow to all parts of the body excluding the heart and brain. The mechanism of PAD is similar to coronary artery disease and cerebrovascular disease, with the majority of cases caused by atherosclerosis. Thus, all pa-tients with PAD symptoms should be assessed for risk of cardiovascular disease. (4) If PAD is suspected, initial evaluation consists of taking an ankle-brachial index (ABI), the ratio of lower and upper extremity blood pressures. Ultrasound and CTA can also be utilized to evaluate blood flow through vessels and narrowing of arteries.   PAD can remain asymptomatic for many years, but initial presentation may include various de-grees of intermittent claudication, or limb pain with exertion. It is completely relieved by rest and most commonly affects the calf, buttock, hip, and thigh. (1) Mild symptoms should be managed conservatively with lifestyle changes, risk factor modifications (e.g., tobacco cessation, control of blood pressure, glucose, and cholesterol), and exercise. (1, 3) Primary care providers should consider referral to a vascular specialist when the severity of symptoms become lifestyle debilitat-ing or progress to critical limb ischemia (CLI), which is defined as the presentation of rest pain, non-healing wounds, or gangrene. (1, 2)   Rest pain is usually described as a burning pain in the lower extremities that is worse with leg elevation. Patients usually complain of worsening pain at night that is only relieved by hanging the affected leg over the side of the bed or with ambulation. The positional pain relief can create a vicious cycle that can eventually cause the extremity to become edematous from a decrease in lymphatic return. This edema can cause further worsening of the tissue damage.   Non-healing wounds can be acute or chronic and are due to major disruptions in blood flow. This decreases the likelihood of a wound to heal properly in an appropriate amount of time. If a wound fails to heal in several weeks or is getting worse, the patient should be evaluated for arterial dis-ease.  Surgical intervention may be considered when non-healing wounds fail treatments includ-ing debridement, antibiotics, proper wound dressing, negative pressure wound therapy, and hy-perbaric oxygen therapy. Healing or excision of the wound is imperative as it can progress to even more serious conditions such as infection or gangrene.   There are three types of gangrene: dry, wet, and gaseous. Dry gangrene causes skin to fall off, wet will cause blistering and swelling, and gaseous will cause bubbling due to bacterial infection. Gangrene can be a life-threatening condition if it is allowed to progress. The tissue will show changes in texture, color, smell and have pain as a consequence of lack of blood.   If conservative methods fail (Statin, hypertensive medications, glucose control, pain relief, exer-cise, careful foot care) and patient presents with severe signs of limb ischemia (described above), you may need to refer to a vascular surgeon for surgical options. Surgical options that may be considered are endovascular repair with angioplasty and stent, bypass of affected segment, or amputation if it cannot be fixed (very unusual).  The only doctor who is an expert at all the treat-ment modalities is a vascular surgeon, and they can individualize the treatment for each patient to find the best solution.   Mon, 24 Feb 2020 06:00:00 GMT http://vascularinstitute.com/blog/1366/Peripheral-Artery-Disease--PAD- http://vascularinstitute.com/blog/1365/Non-Healing-Foot-Wounds blog Peripheral Artery Disease (PAD) Non-Healing Foot Wounds      If you have a wound or opening in the skin on your toes or foot, and it does not heal in 4 weeks, you need to see a vascular surgeon immediately.      Wounds are usually on toes or the front part of the foot, but can be in other places.      Usually the wounds start with minor trauma to the foot.      Most important is to notice that the wound is NOT HEALING normally or getting worse.      The wound may not be healing because your arteries are blocked, and cannot deliver enough blood flow and oxygen to heal the injured tissue.      If this happens to you, please see a vascular surgeon right away.      This is a limb threatening situation- you can lose your leg above or below the knee without treatment.      Treatment-  Includes both minimally invasive and open surgical treatment to restore enough arterial blood flow to heal the wound.  Only a vascular surgeon has the expertise to perform all possible treatments for this, and they can help choose the right one for your individual situation.                                                          Bryan C. Kramer, MD   Mon, 24 Feb 2020 06:00:00 GMT http://vascularinstitute.com/blog/1365/Non-Healing-Foot-Wounds http://vascularinstitute.com/blog/1159/Lower-Extremity-Chronic-Venous-Disease blog Definition: spectrum of lower extremity vein abnormalities that may be morphologic and/or functional in nature that lead to venous dilation  May or may not be symptomatic  Causes:  Inadequate muscle pumps  Incompetent venous valves (reflux) Venous thrombosis (clotting) Non-thrombotic venous stenosis  Risk Factors:  Advanced age  Family history of venous disease  Smoking Sedentary lifestyle Lower extremity trauma  Prior venous thrombosis  Pregnancy  Symptoms and Clinical Signs:   Symptoms: calf pain, leg heaviness and aching, swelling of the calves, muscle cramps, and skin irritation (tightness, dryness, itching)  Clinical signs: Telangiectasias: dilated intradermal and subdermal veins (spider veins) Most prevalent clinical sign Varicose veins: dilated, elongated, tortuous, dilated subcutaneous veins >/= 3 mm in diameter  Often concerning to patients for cosmetic reasons Signs of more advanced disease: Edema (swelling) Skin changes Hyperpigmentation (discoloration) and induration (hardening) Ulceration Mon, 30 Dec 2019 06:00:00 GMT http://vascularinstitute.com/blog/1159/Lower-Extremity-Chronic-Venous-Disease http://vascularinstitute.com/Testimonials testimonial Everyone in the office provided stellar care!? They're all very caring yet professionals. They're excellent in what they do. I'm so excited to have found someone who is actually able to provide help for my legs. Mon, 06 May 2024 12:47:06 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial From the moment I stepped into the office I felt cared for. The staff was very attentive to my needs. They explained in detail the procedures, and what to expect afterward. I would recommend anyone with vein concerns to this office. I am so thankful to have my legs back. Sat, 06 May 2023 08:36:16 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial Your Grand Junction team is first class. I have been there several times and your crew from the front desk to the ultrasound technician, to the nurses up front, procedure nurses and doctors are extremely helpful and truly care about what they are doing. They truly care about the patient. I have been going to the local vascular clinics for several years and hands down VIR surpasses its competitors. I would highly recommend VIR services to anybody needing vascular care. Wed, 21 Dec 2022 03:23:09 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial Dr Synn did an absolutely amazing job on some very large and ugly varicose veins. He was so kind and patient and very respectful to the staff. Bandage from one leg removed today and it feels great. Thank you!!! Sat, 17 Dec 2022 01:36:00 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial Ty Garland is the best doctor we have ever encountered. He's personable, knowledgeable and patient. He can explain things in a way you can understand. He never makes you feel rushed. Getting in to see him can take awhile, but he's worth the wait. Fri, 28 Oct 2022 08:48:22 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial The doctors went out of their way to perform emergency surgery. All of the doctors, nurses etc. were wonderful. I feel fortunate to have found this practice. Fri, 29 Jul 2022 05:34:01 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial Great staff, easy parking, compassionate professional physician's. Tue, 19 Jul 2022 04:17:58 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial In 2019, I had an unfortunate mountain biking accident in which the handlebar severed my femoral artery. Dr. Kramer was there to save my leg and possibly my life, and I will be forever grateful. The people at VIR have been there for me ever since in my follow-up visits, and I feel confident that because of their support for my journey, I can live a long and healthy life, doing the things I love such as running and hiking. Sun, 17 Jul 2022 04:14:14 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial everybody is friendly and I always get my answers quickly Sat, 16 Jul 2022 05:12:18 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial Excellent service! Sat, 16 Jul 2022 01:43:44 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial Although carotid artery surgery is not a great way to start summer, my experience with Dr. Garland was excellent in every way. Quick full recovery. Sat, 16 Jul 2022 01:19:34 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial The care I received was excellent and very professional, this time and every time. Starting from the ultrasound techs that are always willing to go above and beyond to help me and keep me calm. The same goes for all the nurses that assisted me. I could not ask for better doctors and surgeon. I truly got lucky with the Vascular Institute. I would also like to thank Sara the physician Assistant - she always take the extra time to answer all my questions. And ease my anxiety. Thank you Fri, 15 Jul 2022 04:54:11 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial Everyone was very nice, professional. Everyone made a bit of a scary procedure for me easier to deal with. They all made sure I was comfortable. Fri, 15 Jul 2022 04:39:52 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial Dr. Melendez listened to me in a way that no doctor has listened to me in 3 years of chronic pain. She made me feel like there's hope of solving this for once. Fri, 15 Jul 2022 04:08:39 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial VIR and Doctor Synn along with his PA has always been upfront with my condition and has always explained my operations and procedures. I fully trust all VIR staff, I have experienced professionalism and caring people. My stay at Lutheran Hospital was excellent by caring people. The trust you have in caring people overrides all negatives. Thank you very much for taking care of me. Fri, 15 Jul 2022 03:29:55 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial Everyone was courteous, quick and listened to my concerns. They squeezed me in for an afternoon ultrasound as I did not want to make the drive the next day. Thank You for taking such good care of me. Tue, 05 Jul 2022 11:54:48 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial Professional, communicative — appreciate the care and service! Tue, 05 Jul 2022 11:25:14 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial I've been seeing Dr. Kramer for over 9 years. He is the best doctor I've ever had. He is caring, thorough, thoughtful and can still be funny. I never feel rushed and he always takes as much time with me as I need. He always has an bunch of students following him around which I think is great. They are learning how to be good doctors and have people skills. I feel like we have become friends besides being doctor and patient. I sometimes wonder if I would still have my leg if I hadn't happened on to Dr. Kramer when I did. Sun, 05 Jun 2022 10:45:29 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial When I went for my initial appt. everyone made me feel comfortable. Dr. Mubarak explained everything and set up the referrals for me to get the care I need. He got straight to the point; I like that about him. I would recommend Vascular Institute to everyone. Fri, 03 Jun 2022 04:46:39 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial Great staff, great doctor and awesome result. Fri, 27 May 2022 10:21:09 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial I had such a wonderful experience with the Vascular Institute of the Rockies in Grand Junction! I had my renal ultrasound done at this location and the radiologist was fantastic and knowledgeable. I could not have asked for a better experience at a medical practice as everyone there is kind and helpful. Overall really nice atmosphere and I so appreciate this amazing experience. Thank you so much for making such a great difference for me! Thu, 26 May 2022 10:54:03 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial My experience with VIR was with Dr. Horner (his office is located there) who conducted several procedures on my back vertebrae to stabilize fracturing and to biopsy for potential tumor development. Dr. Horner was awesome. Pre-procedures, he explained in very understandable terms what he wanted to do and why. He insisted that I have a new MRI to better guide his planned procedure. That MRI was critical in identifying new areas of concern that he recommended be addressed. The procedures were very successful in greatly reducing back pain associated with the vertebrae fracturing and confirming cancer as the cause of the fracturing. I'm now addressing the cancer issue with an optimistic outlook as it hadn't advanced substantially. Dr. Horner also asked for a post-procedure appointment about two months after his work. He clearly did not have to do this, but from my point of view it was useful and demonstrated his concern for his patients. I would give Dr. Horner 6 stars if possible. Mon, 16 May 2022 08:51:22 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial The staff was efficient and explained the purpose of the procedure. Mon, 16 May 2022 12:13:44 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial We were at two locations and were treated in a timely and professional manner. The medical staff kept us informed and made certain we were comfortable with the procedures and follow ups. We would recommend the practice without hesitation. Sun, 15 May 2022 09:00:30 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial I was seeing a different vascular practice for some claudication I was experiencing in my right leg. The surgeon kept wanting me to "wait and see" as my symptoms got increasingly worse. I did some homework and found Dr. Garland at VIR. He saw me right away for a consult, and I was quite impressed with his professionalism and his actual empathy. He was able to do a popliteal arterial bypass which instantly relieved me of the painful symptoms I had been experiencing. I would highly recommend Dr. Garland for anyone needing some vascular intervention. Wed, 27 Apr 2022 02:47:53 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial I recently had my 7th procedure done at VIR. I could not be more pleased. Dr. Mubarak is a life saver - literally. He and his team take time to find out what is really going on with my arteries and veins and then go about to treat the issues. I am very thankful for VIR. Mon, 18 Apr 2022 07:41:35 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial Very professional, efficient and friendly. Nice, pleasant staff. Sat, 16 Apr 2022 07:04:02 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial Dr. Mubarak and Brittany McDonald his PA are the best 2 specialists that I have in my life right now. Brittney is thorough and takes her time to answer all my questions. Long ,long ago and far away, Dr. Mubarak saved my life what can I say... I adore him! Sat, 16 Apr 2022 05:04:19 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial I'm not a person who trusts very easily but somehow I was quite convinced that my surgery would fix my problems and it actually did. Dr. Kramer answered all my questions and delivered results. I had almost given up but knew when I woke up from surgery that it was successful. My feet are no longer cold and my legs aren't numb anymore. I was very well taken care of by Dr. Kramer as well as his very fine staff. St. Joseph's staff took excellent care of me and I can't thank them enough. I am sincerely humbled and will never be able to repay my new lease on life. I'm also in awe of the skill that is required to be able to actually fix something like this. I have the highest respect for these wonderful folks. Mon, 11 Apr 2022 09:50:33 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial Nice facility and very short wait times. Sat, 09 Apr 2022 02:15:17 GMT http://vascularinstitute.com/Testimonials http://vascularinstitute.com/Testimonials testimonial Great service from X-ray technician, doctor and staff. Thank you! Fri, 08 Apr 2022 03:29:56 GMT http://vascularinstitute.com/Testimonials