Category Archives: Treatment

Go For The Best Peripheral Arterial Disease Treatment In Perth

Have you ever felt a sudden cramp calves, thighsor buttocks when you take a brisk evening walk with your pals? You may have noticed that the cramping discomfort usually ceases as soon as you stop walking. Then there might also be cases when the nagging pain, not so subtle anymore, lingers onto you for day in and day out.  If you’re currently going through this, then you might struggle with Peripheral Arterial Disease. Even though for some the symptoms may never show any signs of pain, prolonging this condition may cause dire health consequences in the long run.

Peripheral Arterial Disease Treatment

What exactly is this?

A blockage in the main stream arteries is  a buildup of a plague causing a lack of fresh blood and oxygen below the obstruction causing pain when walking and in a severe cases a limb loss.

How do we know what to look out for?

These are some of the signs you should be watching out for

  • Sudden cramping in the calf, hip or buttock when walking (after certain distance)
  • Persistent pain in the toes or foot
  • Persistent pain growing worse when lying down
  • Formation of ulcers in your foot (or black skin on the toes)

You need to know this-

  • 90% of the time this affects the legs & ever so rarely anywhere else in the body
  • Diabetes and/or cigarette smoking (even a history of smoking) is often linked to this disease
  • Constant neglect will result in gangrene or non-healing ulcers

What we do?

If you’re looking for peripheral arterial disease treatment in Perth, just know putting your faith on A-Vascular will never deem improper repercussions. Our treatment module comes in a two step process.

  • Get over with the preliminary diagnosis-

Prior to treatment the preliminary tests are evaluated. This is basically a confirmation diagnosis prescribed by a consultant where it starts with a

  • Blood test
  • Pressure test
  • U/S or CT scan will be followed
  • On intervention, our qualified base of vascular specialists in Perth will take on the job of performing an angiogram.

Once we follow-up the details with the concerned patient, a brief along with a further step indication letter will be filed to the family doctor on request.

At A-vascular we believe every patient is unique and therefore the treatment procedure adopted will or may vary from one patient to another. Now not every arterial blockage calls for an under the knife treatment but the threatening ones will usually be met with the classical surgical treatment, an open revascularisation or bypass.

That was the worst case scenario beside’s losing a leg. The more narrow or short blockages usually can be very successfully treated with  balloon angioplasty or endovascular treatment (key-hole surgery) requiring only few hours hospital stay and local anesthesia!

The procedures step by step are briefed in our treatments section. If you wish to know more, feel free to contact us anytime.

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Opt for Laser Treatment in Perth to Treat Varicose Veins

Varicose veins are common.Do you notice swollen, twisted veins under the surface of the skin? Yes, they are varicose veins. These enlarged veins are blue or dark purple in colour with a lumpy, bulging appearance. Although the most common place isthelimbs,  it can occur in any part of the body. Most of the times, this condition comes in silence, with very few symptoms. Affecting 3 out of every 10 adults, this is not a rare condition.

The Very Common Symptoms of Varicose Veins

  • Swollen feet and ankles
  • Heavy, aching and uncomfortable legs
  • Burning and throbbing legs
  • Dry, thin and itchy skin over the affected vein
  • Muscle cramps, particularly at night

Varicose Veins

The symptoms worsen during warm weather conditions.

Body Parts Affected by Varicose Veins

  • Legs (most common)
  • Vulva
  • Perineum
  • Gullet (oesophagus)
  • Pelvis

Causes of Varicose Veins

Although there is no real cause that can scientifically prove or declare to be the real reason for developing varicose veins, but the risk factors are plenty.

Risk Factors

  • Gender: The females are more at risk!
  • Genetics: It’s all in the genes. You can be the rightful heir of this condition, coming from your parents.
  • Age: It is a matter of time. Go for regular checkups!
  • Obesity: The extra weight can affect your veins
  • Occupational hazards: Prolonged periods of standing can affect the flow of blood in the veins and result in varicose veins of the legs.
  • Pregnancy: This is a stage where the risk and tendency of developing varicose veins increases significantly.
  • Rare cases: A blood clot, pelvic tumour and abnormal blood vessels can be a reason of developing varicose in the veins.

Laser treatment in Perth for varicose veins

Are you scared of visiting a doctor for the fear of needles and scissors? Well, do not be, as with the advent of newer technologies, laser therapy is also an effective treatment for getting rid of varicose veins. Yes, with no incision, the laser beam works best. The laser sends a strong beam of light onto the vein, making it disappear. This procedure takes around 30 to 45 minutes in the doctor’s rooms.

Laser treatment for varicose veins

Why Laser is preferable for treating varicose veins?

  • Minimal pain
  • Fast recovery
  • Mild bruising, light skin discoloration and at times a numbing sensation are the only complaints and side effects faced. Thus, relatively, there are no side effects at all.
  • Safe and effective
  • Very high success rate

Experience Counts

Keep in mind, the more experienced your doctor is, the lesser is the risk of it not working out. So, get in touch with renowned vascular specialist in Perth NOW!

Aortic Aneurysm – A Silent Killer

Are you above 60? If the answer is “yes”, then it’s time to ask your doctor for an ultrasound scan of your aorta to find out, whether you are suffering from aortic aneurysm. Men smokers are more often affected and those with a family history of aortic aneurysm should not hesitate. Make sure the scan is assessed by dedicated vascular specialist.

Who killed Lucille Ball,Albert Einstein, John Ritter and George C. Scott? Aortic Aneurysm!

Aortic Aneurysm

Well, more precisely, “the silent killer”. This is because patients suffering from this diseaseusually have no symptoms, until the aneurysm bursts.

What is “Aortic Aneurysm”

Aorta is the largest artery of the body. Abnormal enlargement or bulging of this vessel is called“Aortic Aneurysm”. This bulging of the artery occurs when a segment of the vessel weakens and expands.The bulge is created on the weak spot due to the pressure of the blood flowing through the vessel. The artery can burst causing an internal bleeding.

Aortic Aneurysm

Risk Factors for Aortic Aneurysm

  • Hypertension and high blood pressure.
  • Family History
  • Male gender

Prevention is better than Cure – be proactive

If the “aortic aneurysm”is diagnosed soon enough it can be very successfully treated. A key-hole surgery is safe and effective treatment.

If the aneurysm is small, then proper medication and observation works fine.

Did you know?

Only 50% people who undergourgent surgery after ruptured aneurysms survive, but that too with the perils of kidney failure, leg ischemia or dead bowel to name a few.Survival after planned surgery is 3 times better then after urgent repair for aortic rupture. Its no brainer!

Women’s Woes – The Pelvic Congestion Syndrome

Although there may be numerous reasons for women to suffer from chronic pain, the Pelvic Congestion Syndrome is diagnosed up in to 1/3 of all cases. Only a thorough diagnosis by vascular specialists can enlighten you about the real cause of that chronic pelvic pain if your gynaecologist ruled out other causes.

PCS (Pelvic Congestion Syndrome)

In simple terms, pelvic congestion syndrome is actually the varicose veins in the pelvis around the ovaries, uterus and bladder. Pelvic Congestion Syndrome is quite difficult to detect during pelvic examination. Only with ultrasonography, CT scan or venography doctors can diagnose the problem to ensure the real cause of the pelvic pain.

Pelvic Congestion Syndrome

Varicose veins occur in the pelvic area in the same way, as it can occur anywhere in the body. Due to venous incompetence (or blockage), blood pools in the veins, stretches and bulges causing varicose veins.In normal cases, the blood flow is from the pelvis up towards the heart in the ovarian vein. The valves within the vein prevent it from flowing backwards. But when the ovarian veins dilate, the valves do not close properly, resulting in “reflux”, that is, the backward flow of blood. The pooling of blood within the pelvis results in pelvis varicose veins that cause pain and a general heaviness.

Are you at RISK?

Check out the risk factors that make women susceptible to PCS. Are you susceptible? Read on.

  • Hormonal abnormalities.
  • Retroverted or tipped uterus that is responsible for painful sex.
  • Polycystic Ovarian Syndrome, (PCOS)!
  • Multiple pregnancies.

 

Symptoms of PCS – THE WARNING BELLS!

Don’t dismiss lower back or abdominal pain as any other ordinary pain. So, check out the symptoms listed below.

  • Sharp, dull pain during or after sexual intercourse.
  • Prolonged lower back pain, aches in the legs and abnormal vaginal bleeding.
  • Clear and watery vaginal discharges.
  • Pain gets worse at the end of the day (after you have been standing or sitting for a long time). By lying down ought to get you much relief.
  • Varicose veins present on the vulva, buttocks and thighs are a sign of PCS.
  • Feeling fatigued, recurrent mood swings, headaches and abdominal bloating with irritable bladder are a few of the other signs.

Diagnosis – The Root Cause

Normal pelvic examinations is common. However, with ultrasonography and CT scan  or angiogram doctors are able to detect the cause of the chronic pelvic pain.

Treatment – The Path to Wellness

The treatment for this painful condition is a safe procedure that is minimally-invasive. It is called ovarian vein embolization.With x-ray technology and a contrast dye, the affected veins are envisioned and a thin, small catheter is first inserted into the blood vessel that passes via the damaged veins. The faulty vein is sealed as a synthetic agent or medication is dispersed from the catheter into the veins which help in clotting the blood and permanently blocking the vein.

When blood does not flow from the varicose veins in the pelvis, the pain subsides.

No Side Effects, All Positive After-Effects

The treatment of Pelvic Congestion Syndrome is simple and effective with a 95% of success rate. Although some patients experiencediscomfort,  it can be controlled with prescribed medication. Depending on the normal healing process, most patients return to work immediately as the procedure is “day-case” with no hospital stay leaving no scar.

Schedule an appointment today and find out the reason behind your chronic pelvic pain. It can be Pelvic Congestion Syndrome!

All you need to know about Venous Leg Ulcers

Symptoms commonly seen with varicose veins include:

  • Dull aching or pain
  • Heaviness or the feeling of leg pressure
  • Swelling
  • Tiredness or fatigue
  • Restless legs at night
  • Nighttime cramping
  • Itching or burning

Patients with chronic venous insufficiency (CVI) develop skin changes resulting from high pressures in the veins that then affect the fat and skin most often around the ankle. It is seen as chronic swelling, more severe skin changes of thickening or fibrosis (lipodermatosclerosis) or dark color changes called hyperpigmentation, or with the most severe condition, venous stasis.After having CVI for a long time, the skin of the lower leg becomes shiny, hard and has a darker color than the surrounding skin. The skin is fixed or anchored to the underlying tissues making the skin tenser and less flexible. They skin may be very dry (dermatitis). White scar tissue (atrophie blanche) may also be present.

 

Venous Leg Ulcers Treatment

Diagnosis

The doctor will want to know of any other medical problems which might show how important or how likely your symptoms are due to venous disease. This includes:

  • A history of blood clots or other vein problems
  • Family history of blood clots or vein problems
  • Previous vein surgery
  • Your job and the need for standing for a long time
  • Any issues you have with weight control and constipation
  • A history of cancer, stroke, recent surgery illness
  • Orthopedic surgery or any injury to the leg.
  • When your symptoms happen and if they are getting worse
  • The use of compression stockings
  • Pregnancies or pregnancy complications
  • Any condition which affects the movement of the foot, ankle or leg

Doppler ultrasound is necessary non-invasive test used to diagnoses “faulty veins”. This allows the physician to directly see the vein and hear blood flow in the vein. This test uses sound waves which can go in to the body, hit the vein and be bounced back to detecting part of the machine. The test usually begins with testing to look for deep vein thrombosis (DVT) or chronic injury resulting from a previous blood clotting. Then the veins are studied with the patient standing to look for reflux (downward flow of the blood) in all of the deep and superficial veins.

In some cases, you may need a CAT scan (computed axial tomography) or MRI (magnetic resonance imaging) to evaluate the veins and make sure there is nothing blocking the blood from getting out of the vein (outflow obstruction).

Treatment

There is wide range of treatment options available and most are “key-hole surgery”. It will depend on the severity of patients venous disease and patients may choose from variety of options from open surgery to sclerotherapy. The modern and very efficient treatment for advanced venous disorders are clot dissolving, clot debulking, angioplasty or stent of the affected veins and laser surgery. Most are “day-case” treatment requiring NO hospital stay at all.

 

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Diagnosis & Treatment of Post Thrombotic Syndrome (PTS)

Incidence and Prevalence of PTS

Deep Vein Thrombosis (DVT) affects 1 to 3 of 1000 people in the general population annually (1,2)Between 20% to 50% of patients with DVT develop post thrombotic syndrome (PTS)(3-8). PTS usually develops within a few months to a few years after DVT. Incidence of PTS continues to increase, even 10 to 20 years after DVT diagnosis and up to 10% of patients develop severe PTS, which may include venous ulcers (9-10).

Signs and symptoms

Post-thrombotic syndrome symptoms and signs include swelling, heaviness, fatigue, itch, pain or cramps and also skin discolouration (pigmentation, redness, eczema) and skin breakdown (ulcers). Symptoms usually get worse at the end of the day or after standing, and improve with rest or limb elevation.

Post Thrombotic Syndrome

Pathophysiology of PTS

It is believed that that major trigger is venous hypertension(high pressure in the venous not arterial system). Normally, when an individual isat rest in the supine position, venous pressure is low. When a personstands up and remain motionless, venous pressure is highest. While an individual is walking, venous pressure is reduces asblood is ejected by contraction of the calf muscles. Well working venous valves then help out to keep blood moving towards the hart. Any damage to the venous valves impedes venous return.This leads to venous hypertension. Any obstruction in the venous system again works against the flow and increases venous pressure in the leg and foot. Combination of reflux and obstruction causes usually the worst symptoms 11).

Diagnosis

Clinical assessment, venous ultrasound scan and CT or MRI are usually necessary to correctly diagnose the problem.

In selected patients in whom iliac vein obstruction is suspected on also invasive imagining is needed and includes contrast venography with or without intravascular ultrasound (IVUS). In those cases where obstruction or compression was verified an endovascular techniques can be used at the same time to correct the problem.

Treatment

Compression should be used to treat all patients with venous ulcers. A number of reports describe the technical success rate and short-term outcome after percutaneous relief of iliac vein obstruction. The largest, most carefully studied cohort was that of Neglen et al,150 who reported results of venoplasty and stenting in 464 limbs of patients with PTS followed up for at least 5 years. Ulcer healing occurred in 55%. Resting arm-foot pres- sure differential and QoL significantly improved after venoplasty and stenting. Procedure-related thrombosis occurred in 2.6% (10). There are however number of other procedures to help to get the venous pressure under control. These include sclerotherapy, laser saphenous vein ablation, stripping, phlebotomy and other techniques. These have to be taken into account as every patient is different and all interventions have to be “tailored” individually.

References

  1. White RH. The epidemiology of venous thromboembolism. Circulation. 2003;107(suppl 1):I4–I8.
  2. Cohen AT, Agnelli G, Anderson FA, Arcelus JI, Bergqvist D, Brecht JG, Greer IA, Heit JA, Hutchinson JL, Kakkar AK, Mottier D, Oger E, Samama MM, Spannagl M: VTE Impact Assessment Group in Europe (VITAE). Venous thromboembolism (VTE) in Europe: the number of VTE events and associated morbidity and mortality. Thromb Haemost. 2007;98:756–764.
  3. Prandoni P, Lensing AWA, Cogo A, Cuppini S, Villalta S, Carta M, Cattelan AM, Polistena P, Bernardi E, Prins MH. The long-term clinical course of acute deep venous thrombosis. Ann Intern Med. 1996;125:1–7
  4. Kahn SR, Shrier I, Julian JA, Ducruet T, Arsenault L, Miron MJ, Roussin A, Desmarais S, Joyal F, Kassis J, Solymoss S, Desjardins L, Lamping DL, Johri M, Ginsberg J. Determinants and time course of the post-throm- botic syndrome after acute deep venous thrombosis. Ann Intern Med. 2008;149:698–707.
  5. Ginsberg JS, Hirsh J, Julian J, Vander LaandeVries M, Magier D, MacKinnon B, Gent M. Prevention and treatment of postphlebitic syn- drome: results of a 3-part study. Arch Intern Med. 2001;161:2105–2109.
  6. Stain M, Schonauer V, Minar E, Bialonczyk C, Hirschl M, Weltermann A, Kyrle PA, Eichinger S. The post-thrombotic syndrome: risk factors and impact on the course of thrombotic disease. J Thromb Haemost. 2005;3:2671–2676.
  7. Schulman S, Lindmarker P, Holmstrom M, Larfars G, Carlsson A, Nicol P, Svensson E, Ljungberg B, Viering S, Nordlander S, Leijd B, Jahed K, Hjorth M, Linder O, Becknam M. Post-thrombotic syndrome, recur- rence, and death 10 years after the first episode of venous thromboembo- lism treated with warfarin for 6 weeks or 6 months. J Thromb Haemost. 2006;4:734–742.
  8. Aschwanden M, Jeanneret C, Koller MT, Thalhammer C, Bucher HC, Jaeger KA. Effect of prolonged treatment with compression stockings to prevent post-thrombotic sequelae: a randomized controlled trial. J Vasc Surg. 2008;47:1015–1021.
  9. Kahn SR, Partsch H, Vedantham S, Prandoni P, Kearon C; Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Definition of post-thrombotic syndrome of the leg for use in clinical investigations: a recommendation for standardization. J Thromb Haemost. 2009;7:879–883.
  10. Kahn, S. The Postthrombotic Syndrome: Evidence-Based Prevention, Diagnosis, and Treatment Strategies A Scientific Statement From the American Heart Association. Downloaded from http://circ.ahajou1r6n3a6ls.org/ by guest on February 3, 2016.
  1. Prandoni P, Frulla M, Sartor D, Concolato A, Girolami A. Vein abnor- malities and the post-thrombotic syndrome. J Thromb Haemost. 2005;3:401–402.

Chronic Venous Insufficiency and Post-thrombotic Syndrome (PTS)

Every year,large number of people suffer from acute Deep Vein Thrombosis (DVT; blood clots in a vein). Many of them, later on, develop symptoms affecting their legs. Chronic complications of DVT affecting legs is called “Post-thrombotic Syndrome” (PTS).

Venous blood is normally being pushed through healthy vein to the heart but in cases of PTS when veins are blocked with old or fresh clots the blood is “sitting” in the veins increasing venous pressure (high blood pressure in the veins). This has long-term consequences on the leg resulting in skin pigmentation, skin hardening, eczema, inflammation, and ultimately a skin defect or ulcer which are difficult to heal. Some DVT sufferers can’t walk, have chronic swelling and many people spend hours getting their ulcers re-dressed by their GPs. We also know that even if the ulcer heals eventually it often reoccurs and this can happen in up to 70% of people.

The DVT itself is also major issue as the clot can travel up to the lungs and can cause a permanent damage or death.

In order to prevent complications after DVT we recommend (for suitable candidates) urgent appointment (within days) with vascular specialist to discuss an intervention that can help avoid PTS. The idea is to remove the clot early so it does not cause vein damage and allow the blood to return back to heart. It also can prevent recurrent DVT which happens more often to those who already had one before.

Part of every assessment is a scan (ultrasound or CT – “cat scan”). Treatment traditionally only consisted of wearing elastic compression hosiery (bandages or stockings) but this was not optimal management as the veins remained untreated. Technology has advanced during last 5-10 years therefore we have new safe treatment options available. Most patients can be treated with keyhole surgery (“through a needle” ) and usually only under local anaesthetics. There are number of techniques that can be used to improve quality of life and in many cases it helps to get rid of elastic stockings for good.

Results of such mini invasive treatment are very encouraging and it is now more then ever before obvious that these interventions improve quality of life of people with acute and chronic Deep Vein Thrombosis.