Carotid Artery DiseaseLearn More ›

What is carotid artery disease?

Carotid artery disease (CAD) is a severe medical condition that describes blockages or narrowing within the main arteries of the neck, known as the “carotid arteries.” These arteries provide blood flow to your brain. As plaque builds up in these arteries, the blood flow to your brain can break off a piece of plaque, which can lodge in your brain - causing a stroke.

What causes carotid artery disease?

Over time, the arteries within the body can become blocked by fatty deposits. This is especially severe within the carotid arteries. While this occurs in some degree to everyone, having some of the risk factors below can speed up the process and cause the disease to become apparent.

Am I at risk for carotid artery disease?

Some of the most common risk factors associated with artery disease (leading to stroke) are the following:

  • Age
  • Family history of CAD or stroke
  • Smoking
  • Obesity
  • Diabetes
  • High blood pressure
  • High cholesterol

What are the symptoms of carotid artery disease?

The gradual build-up of plaque is a silent process. When carotid artery disease becomes symptomatic, it can produce a transient ischemic attack (TIA, or "mini-stroke") or a cerebrovascular accident (CVA, or full stroke). These symptoms include:

  • Slurred speech
  • Facial drooping
  • One-sided vision loss
  • Weakness or paralysis on one side of the body

How can I prevent carotid artery disease?

Avoiding the risk factors, when possible, is the best way to prevent CAD and possibly stroke from occurring. Working with your doctor is the best way to make sure you are doing everything possible to prevent CAD or reduce the impact on your health.

How is carotid artery disease diagnosed?

Carotid artery disease is often picked up incidentally during a physical exam, when a stethoscope is used to listen over the neck area, and a "whooshing" sound is heard. The "whooshing" sound is an indicator of vessel narrowing. To confirm the diagnosis, an ultrasound of the carotid arteries is performed, which can identify the degree of narrowing and the characteristics of the blood flow. Other imaging techniques used include computed tomography angiography (CTA), magnetic resonance angiography (MRA), or carotid angiography.

How is carotid artery disease treated?

Besides avoiding the risk factors mentioned above by quitting smoking, lowering blood pressure, lowering cholesterol and being physically active, medicines can be used to treat blood pressure and cholesterol, and prevent blood clots. Surgery or procedure options include: carotid endarterectomy and carotid angioplasty and stenting.

Aortic AneurysmsLearn More ›

What is an aortic aneurysm?

The aorta is the primary artery of your body that carries blood from your heart to your body. When the aorta develops a dilation, the condition is known as an “aortic aneurysm.” If the aneurysm is left untreated and bursts, serious, and typically fatal, bleeding occurs. Aortic aneurysms are most common in the abdomen, and these aneurysms are known as abdominal aortic aneurysms. Aneurysms may also happen in the chest, and these are known as thoracic aortic aneurysms.

High blood pressure and hardening of the arteries, known as “atherosclerosis,” causes the normally elastic walls of the aorta to weaken. Over time, the weak area begins to stretch, and eventually the walls of the aorta bulge outward to create an aneurysm.

Am I at risk for aortic aneurysms?

Vanguard Vascular & Vein recommends aortic aneurysm screenings for men who are:

  • 65 and older with a history of smoking
  • 60 years of age with an immediate family member who has had an aneurysm, such as a mother, father, brother, or sister

Other risk factors for aortic aneurysms include the following:

  • High blood pressure
  • Smoking
  • High cholesterol
  • Obesity
  • Emphysema
  • Atherosclerosis, or hardening of the arteries
  • Syphilis
  • Marfan syndrome
  • Trauma

Men who have never smoked and women have a lower overall risk for developing aneurysms, but should be screened if they have a family history, or are experiencing symptoms that are related to aortic aneurysms.

What are the symptoms of aortic aneurysms?

As with many vascular conditions, aortic aneurysms do not always cause symptoms. Patients may complain of discomfort or pain in the chest, back, or abdomen. These symptoms can be ongoing or intermittent. When the aortic aneurysm bursts, symptoms are more significant and include severe pain and bleeding, and it can quickly become fatal. An aneurysm can also form blood clots, which have the potential to break off and lodge in other parts of your body, causing a lack of blood flow to the affected area.

How are aortic aneurysms diagnosed?

Your physician will often start with an aortic artery duplex ultrasound to detect an aortic aneurysm. Sometimes, a computed tomography angiography (CTA) or magnetic resonance angiography (MRA) will be ordered to obtain further anatomical information about the aneurysm.

How are aortic aneurysms treated?

Smaller aortic aneurysms typically require only regular monitoring. Larger aortic aneurysms are typically treated through surgery. Your surgical plan depends on your anatomy and the extent of the aneurysm. The options that exist include open repair to remove and replace the damaged section of the aorta, or a less-invasive procedure known as an EVAR (endovascular aneurysm repair).

Dialysis AccessLearn More ›

Who needs dialysis access?

According to the latest U.S. Renal Data System Annual Data Report, more than 660,000 Americans are being treated for kidney failure, also called end stage renal disease, or ESRD. Of these, 468,000 are dialysis patients, who need direct access created to the bloodstream to be able to undergo dialysis, which does the job of the failing kidneys and cleans the blood.

Am I at risk for needing dialysis?

The greatest risk factors for kidney failure are the following:

  • Age, with older adults being at greater risk
  • Chronic health problems such as diabetes, high blood pressure, heart failure, or obesity

Other factors that may place you at risk for kidney failure are as follows:

  • Conditions that cause a significant decrease in blood flow to the kidneys, such as heavy blood loss, injury, sepsis, and dehydration that damages the kidneys
  • Long-term use of medications, such as certain antibiotics, pain medications, and blood pressure medications
  • Blockages in the kidneys that keep urine from efficiently leaving the kidneys

What are the symptoms of kidney failure?

Most people with kidney failure do not experience symptoms. Others experience one or more symptoms, such as the following:

  • Production of very little or no urine
  • Swelling, especially of the legs and feet
  • Loss of appetite
  • Nausea and vomiting
  • Feelings of confusion or anxiety
  • Restlessness or fatigue

What are my options for dialysis access?

There are both short-term and long-term dialysis access solutions. One or the other may be preferable depending on your unique situation. For short-term dialysis access, a catheter is placed into one of your major veins, most often in the neck or chest. Long-term dialysis access consists of constructing a fistula, which is a connection between your own artery and vein, or a graft, which uses a synthetic graft as a bridge between your artery and vein.

Peripheral Arterial DiseaseLearn More ›

What is Peripheral Artery Disease?

Peripheral artery disease (PAD), also known as atherosclerosis, poor circulation, or hardening of the arteries, is a common problem, especially among the older population. This build-up of plaque makes it difficult for blood to circulate through the arteries. PAD primarily affects the legs, but can affect the arms as well.

What causes Peripheral Artery Disease?

Peripheral artery disease most often occurs after a buildup of fatty deposits in the arteries. This is called atherosclerotic plaque. Over time, this buildup becomes more severe, and blood flow is reduced—especially in the extremities. Much less often, peripheral artery disease occurs after an accident or injury that reduces circulation to the arms or legs.

Am I at risk for Peripheral Artery Disease?

Some of the most common risk factors associated with peripheral artery disease are the following:

  • Smoking
  • Diabetes
  • Obesity
  • High Blood Pressure
  • High Cholesterol
  • AGE (Those 30 and older are most susceptible)
  • Family history of heart disease

What are the symptoms of Peripheral Artery Disease?

Some people may have PAD and be completely symptom-free. However, the most common symptoms are pain, cramping and discomfort in the legs, calves, thighs or buttocks when walking. The pain usually goes away with rest, but then restarts once activity is resumed. Other symptoms may include severe pain in your feet at night that wakes you up, or wounds on your feet that won't heal. Often times, the leg will become discolored and dark, and the skin can become shiny and hair-free.

How can I prevent Peripheral Artery Disease?

While you may not be able to change your family history, some of the risk factors can be avoided or minimized. Controlling weight, blood pressure and cholesterol through diet and exercise are key. Additionally, those who smoke are encouraged to quit. Taking care of other health problems may also help prevent PAD from occurring or worsening.

Varicose VeinsLearn More ›

What are varicose veins?

Varicose veins are large, distended veins that appear on the surface of your legs. In the U.S., roughly half of all adults age 50 and older suffer from varicose veins. These veins are more than a cosmetic concern; they often cause great discomfort, pain, itching, aching, and cramping in the legs.

What causes varicose veins?

Veins carry blood from the legs back to the heart. There are one-way valves in the veins that close off and prevent gravity from pushing the blood flow back down the leg. When the valves in the leg veins become weakened or damaged, blood can "reflux" back into the leg veins and collect there. Over time, the veins will distend, forming varicose veins.

Am I at risk for varicose veins?

The most common risks associated with varicose veins are the following:

  • Family medical history
  • Professions that require long periods of standing
  • Advanced age
  • Obesity
  • Hormonal changes that result from pregnancy, puberty, and menopause
  • Birth control medications
  • Hormonal replace therapy
  • History of blood clots

How are varicose veins diagnosed?

Varicose veins are diagnosed during a physical exam. If there are additional symptoms such as aching, heaviness, or swelling, an ultrasound scan may be ordered, which is used to evaluate for the presence of venous reflux, or leaky valves.

How are varicose veins treated?

Varicose veins are first treated through conservative measures, which include compression stockings, leg elevation, and exercise. If these do not resolve the symptoms, then there are a variety of different ways that varicose veins, and venous reflux, are treated. Vanguard Vascular & Vein strives to offer the latest and most cutting-edge technology to treat this disabling problem.

  • Endovenous laser ablation (EVLA) is a technique where laser energy is delivered into the vein via a small laser fiber. This in turn causes the vein to be sealed. EVLA is performed under local anesthesia in the office. This is an outpatient procedure ,which means you can resume your normal activities almost immediately. Recovery time is very minimal.
  • Endovenous Radiofrequency Ablation (EVRFA) is another technique for delivering heat energy into a refluxing vein for purposes of sealing off the vein. It is very similar to Endovenous Laser Ablation (EVLA) in that a small catheter is inserted into the vein, and then under ultrasound guidance, heat energy is then delivered into the vein in cause the vein to close. Like EVLA, EVRFA is an outpatient procedure performed under local anesthetic.
  • Endovenous mechanicochemical ablation (MOCA) is a technology that combines 2 different methods to seal off veins. Firstly, it mechanically irritates the inside of the vein through a rotating wire at the end of the device. Secondly, an infusion of a sclerosant (a solution that irritates the vein and causes it to close) is injected through the tip of the catheter as it is slowly withdrawn.
  • Ambulatory Phlebectomy is a surgical technique that employs a series of small incisions to remove varicose veins. It is a minimally invasive option that is carried out in the office with a local anesthetic. Ambulatory Phlebectomy may be performed together with vein ablations or sclerotherapy, depending on how much vein there is to remove. Most individuals are able to return to their daily routine soon after the procedure, as down time is very minimal. This results in excellent clinical and cosmetic results.
  • Transilluminated power phlebectomy (TIPP or Trivex) is a minimally invasive way to remove a large amount of varicose veins in a short amount of time. The Trivex procedure uses a thin lighted wand inserted under the skin to illuminate the veins, while a second minimally invasive instrument is used to remove the problem vein. It is ideal for large clusters of varicose veins. It is performed at a hospital as an outpatient procedure. Down time is minimal. This also results in excellent cosmetic results.
  • Injection sclerotherapy is a technique that is used for spider and small varicose veins. During this procedure, a sclerosant (an irritating agent) is injected into the abnormal vein. The sclerosant causes the walls of the vein to constrict and seal shut. This form of treatment can be conducted independently or in conjunction with other procedures. This is an office procedure that can be done with little to no downtime.

How can I prevent varicose veins?

While you may not be able to avoid varicose veins completely, especially if you have a family history, you should rest your legs frequently when you are required to stand for long periods of time. Physical activity, including regular exercise, helps your body circulate your blood efficiently. Wearing compression stockings can also be preventative.

Spider VeinsLearn More ›

What are spider veins?

Spider veins, also referred to as telangiectasias or reticular veins, are clusters of dilated, tiny blood vessels that develop close to the surface of the skin. They are often red, blue, or purple, and may have the appearance of a spiderweb. They are commonly found on the face and legs. Unlike varicose veins, spider veins are harmless and usually do not have much of a medical consequence, but they can cause some discomfort and be unsightly.

Spider Veins

What causes spider veins?

The same risk factors that put you at risk for varicose veins (Link to varicose vein page here) will put you at risk for developing spider veins. These include:

  • GeneticsProlonged standing/sittingObesity
  • Hormonal influences
  • A history of blood clots
  • Age

How are spider veins diagnosed?

These veins are diagnosed with a simple, thorough physical examination of the skin.

How are spider veins treated?

  • Injection sclerotherapy - With this method, a sclerosant (irritating solution) is injected into into the affected veins. The injection irritates the inside of the vein, and over time the vein will shrink and disappear. If you have multiple spider veins, the treatment will require multiple injections to collapse all the veins. Bright light and magnification may be used to ensure maximum precision while injecting the sclerosing solution.
  • Laser therapy - Using this, an intense beam of light is directed at the spider vein, which obliterates it through the skin. More than one laser session may be needed to obtain the desired results. Sometimes, laser therapy is used in combination with injection sclerotherapy.

How can I prevent spider veins?

  • Avoid prolonged standing/sitting
  • Exercise regularly
  • Maintain a healthy weight
  • Compression socks
  • Elevate legs when resting