What is Atherosclerosis?

Atherosclerosis is a disease where plaque, comprised of fat, cholesterol, calcium and other substances found in the blood, builds up inside your arteries. Remember that your arteries carry blood away from your heart to the rest of your body. The narrowing of your arteries caused by atherosclerosis, limits the flow of oxygen-rich blood to your organs and the rest of your body.

Atherosclerosis can affect any artery on the body. This includes the brain, heart, legs, kidneys, pelvis and arms. Different diseases may develop depending on which arteries are affected, and can lead to serious problems.

As vascular surgeons, we treat atherosclerosis that affects the vascular system, including carotid artery disease, peripheral artery disease and the vascular impact of kidney disease.

The carotid arteries are located on either side of your neck. The carotid artery supplies oxygen-rich blood to your brain. If blood flow to your brain is reduced or blocked, you could suffer from a stroke. Screening for carotid artery disease is a quick and painless ultrasound, performed in our ultrasound lab.

Peripheral artery disease can occur in your legs, arms or pelvis. If blood flow to these areas is reduced or blocked, you may experience numbness, pain and sometimes wounds that will not heal, or infections. Again, ultrasound testing is a simple, and painless diagnostic tool. In some cases, further testing may be necessary to confirm location and severity of disease.

Another area of concern are the renal arteries. The renal arteries carry oxygen-rich blood to your kidneys. The main function of your kidneys is to remove waste and extra water from the body. If the renal arteries become narrowed or blocked by atherosclerosis, your kidneys will be unable to function, and you may develop chronic kidney disease.

There are certain factors that are believed to raise your risk for the disease, like smoking, lack of physical activity, an unhealthy diet and family history. Making some life changes, like quitting smoking, eating a healthy diet, and exercising regularly, may help you avoid atherosclerosis, and live a long and healthy life.

For more information about vascular diseases, please visit our website at: www.sfvvg.com

What is a Vascular Surgeon?

A vascular surgeon is a medical doctor who has completed additional, extensive training in the vascular system and its diseases. The vascular surgeon has expertise in the diagnosis and treatment of patients with vascular disorders and disease. Vascular surgeons focus on the part of the vascular system that includes the arteries, arterioles, veins, venules and capillaries. For example, a vascular surgeon may perform a procedure on the carotid artery in the neck, or they may treat an abdominal aortic aneurysm. They also treat varicose veins, or peripheral arterial disease, which often occurs in the legs and feet. The vascular surgeon does not treat the vessels in the brain or heart.

The vascular surgeon is trained to perform open surgery, as well as endovascular procedures. The vascular surgeon decides which approach is the best approach for his patient, based on physical examination, tests, medical history, risk factors, age, and lifestyle. The vascular surgeon is oftentimes a lifelong partner with his patients, with the goal of improving their quality of life.

What are some of the conditions and diseases that vascular surgeons treat? Vascular diseases and conditions can occur in our arteries, veins and capillaries. Some of these diseases are caused by narrowing of our blood vessels, which can cause lack of blood flow or blockages, and some are caused by aneurysms or “ballooning” of our blood vessels. We also have valves in our legs, and faulty valves can cause varicose veins or peripheral artery disease.

When should you see a vascular surgeon? You may visit a vascular surgeon if your primary care doctor refers you for swelling or pain in your legs. You may also establish a relationship with a vascular surgeon if you have risk factors for vascular disease, such as diabetes, or kidney disease, high blood pressure or if you are a smoker. And sometimes your first encounter with a vascular surgeon, may be because you end up in the hospital.

A vascular surgeon’s goal is to treat vascular diseases, so that patients can lead their best life possible. Lifestyle changes can have positive effects on your health, and your vascular surgeon may offer you advice and counsel you to make changes to improve your health.

For more information, please visit our website, www.sfvvg.com

Did you know that March is National Kidney Month?

The kidneys are a very important organ, so important that they have a month dedicated just to them! So, let’s talk about your kidneys! We’ll start with where your kidneys are located and what your kidneys do.

There are two kidneys about the size of a normal fist, located on either side of the spine, at the lowest level of the ribcage. Most of us know that kidneys are responsible for the life sustaining job of filtering waste from our bodies to the tune of about two quarts every 24 hours, in the form of urine. But did you know that the kidneys filter and return to the bloodstream about 198 quarts of fluid every day?! That’s astonishing!

But that’s not all the kidneys do. The kidneys release hormones that regulate your blood pressure and calcium metabolism. They also regulate salt, potassium and acid. Healthy blood pressure is essential, as hypertension contributes to many diseases. The kidneys also play an important role in making vitamin D. The kidneys convert the vitamin D from supplements or the sun, to the active form needed by the body. Kidneys also control the production of red blood cells, without enough red blood cells, we can become anemic.

“Of the 24 million American adults estimated to have kidney disease, most do not know that they have it,” states Dr. Joseph Vassalotti, National Kidney Foundation Chief Medical Officer. That’s why it is vitally important to take care of your kidneys. You should get tested for kidney disease if you have risk factors such as; diabetes, high blood pressure, or a family history of kidney disease.

There are other simple things we can do to protect our kidneys:

  • Reduce the amount of NSAIDS (non-steroidal anti-inflammatory) drugs you take. NSAIDS can harm the kidneys, particularly if you already have kidney disease, and never go over the recommended dosage without consulting your physician.
  • Control blood pressure and diabetes. High blood pressure and diabetes are the leading causes of kidney disease and kidney failure. Managing high blood pressure and diabetes can slow the progression of kidney disease.
  • Cut processed foods. Processed foods contain high amounts of sodium, phosphates and nitrates, which have been linked to kidney disease and cancer.
  • Exercise! It’s not just your heart and vascular system that benefit from regular exercise, your entire body benefits! Regular exercise can help regulate blood pressure and blood sugar, and your kidneys will reap the rewards too!
  • Quit smoking! Smoking damages your heart and vascular system leading to poor blood flow to the kidneys, causing damage over time.

Follow these simple things and start protecting your kidneys.

For more information, please contact our website at: www.sfvvg.com

What is the Vascular System?

The vascular system is part of the circulatory system, which also includes the heart (cardiovascular) and lymph system. Today, we will just talk about the role of the blood vessels.

The vascular system consists of blood vessels, aptly named, because they transport blood throughout our body.

Fun Fact * If you lay out all of our blood vessels in a line, it would stretch for nearly 60,000 miles! That means, they could circle the globe more than twice!

 The blood vessels that make up the vascular system are:

  • Arteries – Oxygenated blood travels from the heart through the arteries, which branch into smaller and smaller vessels, eventually becoming arterioles.
  • Arterioles – Arterioles connect with even smaller vessels called capillaries.
  • Capillaries – Capillaries pass the oxygen and nutrient rich blood into the tissues. Waste products and deoxygenated blood then pass from the tissues back into the blood in the capillaries.
  • Venules – From the capillaries, the blood passes into the venules.
  • Veins – The venules then pass the blood onto the larger vessels called veins, and the veins take the deoxygenated blood back to the heart, and the process begins all over again.

The vascular system also plays other vital roles in other body systems too, like the respiratory system. As blood flows through the capillaries in the lungs, oxygen is picked up to be taken to the rest of the body’s tissues, and carbon dioxide is expelled. Our digestive system also gets help from our vascular system. As food is digested, blood flows through the intestinal capillaries and picks up nutrients like vitamins and minerals and sugar (glucose) and delivers them through our blood vessels to body tissues.

Fun Fact * Blood vessels act as a shield for the brainBlood vessels are part of an important defense system known as the blood-brain barrier. A network of blood vessels and tissue comprised of closely-spaced cells, helps keep harmful substances from reaching the brain.

Our vascular system is susceptible to disease. Most often, vascular disease affects the blood flow of our arteries and veins, either by blocking or weakening blood vessels or by damaging the valves that are found in veins. Organs and other body structures may become damaged by vascular disease as a result of decreased or blocked blood flow.

To learn more about vascular disease, please visit our website at: www.sfvvg.com

Be well!

What is deep vein thrombosis?

Deep vein thrombosis or DVT is a serious medical condition that requires immediate attention. DVT is when a blood clot forms in a deep vein. This usually develops in the lower leg, thigh or pelvis, but can also occur in the arm. DVT is often dismissed by patients, or misdiagnosed.

DVT can lead to pulmonary embolism. Pulmonary embolism occurs when a part of the clot breaks off and travels through the bloodstream to the lungs, causing a blockage. If the clot is small, treatment can be administered and people can recover, however, there may be damage to the lungs. If the clot is large, it can stop blood from reaching the lungs. This is a fatal condition.

Deep vein thrombosis is a condition that anyone can get. In the United States, DVT accounts for about 900,000 cases, and approximately 100,000 deaths per year. One third of survivors suffer from long term complications caused by the damage the clot does to the valves in the vein. This is called post-thrombotic syndrome (PTS). People with PTS have symptoms such as pain, discoloration, swelling, and in some more severe cases, scaling of the skin and ulcers in the affected part of the body.

There are certain factors that increase the risk of developing a DVT. Some of them may include:

  • Reduced blood flow which can be caused by confinement to bed during an illness or medical condition, or after surgery. Sitting for long periods of time, or limited movement due to having a cast on to heal an injured bone.
  • Injury to a vein caused by a severe muscle injury, or a fracture. Also, major surgery, particularly in the abdomen, pelvis, hip or legs. 
  • Increased estrogen, birth control pills, hormone replacement therapy used after menopause, and pregnancy, for up to 3 months after giving birth.
  • Chronic illness such as heart and lung disease, treatment for cancer, Crohn’s disease or ulcerative colitis.
  • Other factors include, previous DVT, or PE (pulmonary embolism), family history of DVT or PE, age (risk increases with age), obesity, a catheter in a central vein, or inherited blood disorders.

Symptoms of DVT can develop silently. Symptoms may include:

  • Pain or tenderness in a leg or arm that get worse over time.
  • Swelling in one leg or one arm.
  • A leg or arm that feels warm to the touch.
  • A reddish or bluish tinge to the skin of one leg or arm.

If you experience any of these symptoms, you should notify your doctor as soon as possible.

Symptoms of PE (Pulmonary embolism). You can have PE without any symptoms of a DVT. The symptoms of a PE, can include:

  • Difficulty breathing
  • Pain in the chest area, which may worsen when taking a deep breath or coughing
  • Irregular or faster than normal heart beat
  • Lightheadedness, or fainting. Lower than normal blood pressure
  • Coughing up blood

If you experience any of these symptoms, you should seek medical attention immediately!

Are there things you can do to prevent DVT? Yes there are! The following tips can help prevent DVT:

  • If you must sit for prolonged periods of time, get up and walk around every 2-3 hours. While seated, you can exercise your legs by keeping your toes on the floor and raising and lowering your heels. Reverse, and keep your heels on the floor and raise and lower your toes. Tighten and release your leg muscles.
  • Wear loose-fitting clothing.
  •  If you are confined to bed due to an illness or surgery, move around as soon as you are able.
  • If you are at risk for DVT, ask your doctor about compression stockings or medication to prevent DVT.
  • Maintain a healthy weight. Consult your doctor about an exercise program, such as walking or swimming.

For further information, please visit our website: www.sfvg.com

Lifestyle Choices May Decrease Stroke

Did you know that there are things you can do to decrease your risk of stroke? Some are simple lifestyle choices, and others, depending on any pre-existing medical conditions, may require the help of a physician.

To understand a stroke, it helps to understand how the brain works. The brain controls everything from our movements and digestion, to our emotions and breathing. In order to perform properly, the brain needs oxygen. Interestingly, the brain takes up only about 2% of our body weight, yet it uses about 20% of the oxygen we breathe.

A stroke occurs when a blood vessel in the brain ruptures and bleeds, or where there is blockage to the blood supply to the brain. The rupture or the blockage, prevents blood and oxygen from reaching the brain tissue causing damage to the cells, and within minutes the cells in the brain begin to die.

Depending on the type of stroke and the severity, a stroke can cause brain damage, long term disability, or even death.

These risk factors can increase your risk of a stroke:

Diet: A diet that is high in salt, trans fats, cholesterol and saturated fats.

Lack of exercise: Exercise has numerous health benefits. Even a brisk walk a few times a week can make a difference.

Tobacco: Using tobacco of any kind, causes damage to your blood vessels and your heart. Smoking further increases the risk as your blood pressure is raised when you use nicotine.

Alcohol Consumption: Alcohol consumption should be done in moderation, as excessive drinking also raises blood pressure and can increase triglycerides which are attributed to atherosclerosis (hardening of the arteries).

Family History and Health History: You may be more at risk for a stroke if your family has a history of high blood pressure. Sex may also play a role, as incidence and mortality rates of stroke tend to occur more often in men. Age, race and ethnicity, can also put you at a higher risk.

Age: The older you are, the more likely you will suffer from a stroke.

Medical Conditions: Certain medical conditions increase the risk of stroke: Previous stroke or TIA (Transient Ischemic Attack), high blood pressure, High cholesterol, diabetes, heart disorders, such as coronary artery disease, obesity, enlarged heart, sickle cell disease, to name a few.

The good news is, there are things you can do every day to decrease your risk of stroke:

Maintain a healthy weight

Reduce salt and fat intake

Eat more fresh vegetables and fruit and whole grains


Limit alcohol consumption

Get out and exercise!

Before beginning any exercise routine, consult with your doctor about what the best type of exercise is right for you.

These simple lifestyle changes, can make a huge difference and you can get started today!

For more information, visit our website at: http://www.sfvvg.com

What Causes Varicose Veins

You may have or suspect you have varicose veins, or know someone who does. Even if you don’t, you’ve seen them and are familiar with their appearance. Often bluish, bulging, and twisted, varicose veins can be painful and cause you to feel subconscious.

Your veins are vessels that carry blood from your body’s tissues to your heart and lungs to pick up oxygen which gets re-circulated throughout your body. Valves in your deep veins aid in this process by helping to pump the blood upward toward your heart. These valves keep the blood from flowing backward. Sometimes the vein wall is weakened and valves become damaged. When that happens, blood can no longer be pumped up to the heart efficiently, which can cause a variety of symptoms, such as pain and swelling, to large, bulging veins, skin discoloration, skin sores or ulcers. A shower or minor trauma can cause a varicose vein to burst and bleed. Skin tears or ulcerations indicate a very severe case.

Sometimes, varicose veins clot and become painful, hot, hard and discolored. This is called phlebitis, an uncomfortable but temporary condition that will get better on its own in 2-3 months. Clots associated with phlebitis are limited to surface veins, and are not dangerous, unlike clots in the deep veins (deep vein thrombosis or DVT) that are dangerous because they can travel to the heart or lung and require prompt treatment with blood thinners.

Diagnosis will usually include a physical exam, and an ultrasound to see if your veins are functioning normally. Your doctor will also want to see if there is any evidence of a blood clot and to rule out any other serious problems. Your evaluation will determine the cause and extent of the problem. Oftentimes, varicose veins are inherited. Your risk of developing varicose veins increases if a close family member has the condition. Pregnancy can also cause varicose veins, although they often resolve on their own within a year of delivery.

After your evaluation, you will work with your doctor to develop a treatment plan. Your treatment plan may include, compression stockings, injections, minimally invasive procedures, and surgery. Fortunately, treatment doesn’t mean a hospital stay or a long uncomfortable recovery. Thanks to less invasive procedures, varicose veins can generally be treated on an outpatient basis. Please visit our website at www.sfvvg.com for treatment options.

In the meantime, there are things that you can do on your own to try to ease the pain of varicose veins and to prevent them from getting worse.

Wear Compression Stockings – Compression stockings assist in the upward circulation of blood. They also may help when your legs are feeling tired or achy. Ask your doctor what pressure stocking is best for you and make sure they fit properly.

Exercise – We know you’ve heard this before! Consult with your doctor to find out which type of exercise is best for you, and try to exercise every day. Walking is great because your calf muscles expand and contract when you walk and this movement encourages your leg valves to open and close.

Lose Weight – Excess weight is not only hard on your joints, but the extra weight is hard on the valves in your legs.

Don’t wear tight fitting clothing – Try not to wear clothing that is tight around your waist or upper thighs. It’s important to keep your circulation flowing freely.

Elevate your legs when possible – Avoid standing for long periods of time and when possible, put your legs up and give them a rest. If you have to stand for any length of time, try to put one foot up on a stool, and then alternate legs. You can also flex your ankles when you are sitting to keep the blood moving.

If you recognize these symptoms and would like more information, please visit our website at www.sfvvg.com

Best to you and your health!

Are varicose veins during pregnancy dangerous?

Varicose veins are a fairly common, although unpleasant occurrence during pregnancy. Are they something to worry about? Short answer, not usually. Barring any underlying conditions, or risk factors, varicose veins will normally disappear within a few months to a year after delivery. If they persist, or are causing pain and swelling, there are several treatment options available which you can view on our website www.sfvvg.com.

What causes varicose veins during pregnancy? Several factors come into play. The main reason is reduced blood flow to the legs from pressure on the large blood vessels in the pelvis from the growing baby. Veins have valves that open and close to keep blood flowing to the heart. Pressure or weakened valves, allows blood to back up and pool in the veins resulting in swelling of the veins.

Another factor is the increased volume of blood. Did you know that a women’s blood volume increases during pregnancy anywhere from 20% and up, with an average of 45%! The extra blood is needed to support the uterus and the growing baby. The extra blood puts extra pressure on the vascular system, making it harder to pump the blood back up to the heart, causing blood to pool and veins to enlarge.

All pregnant women are aware of hormonal changes during pregnancy. But, what you may not know are the reasons for some of the changes. During pregnancy one hormone that is increased is progesterone. Progesterone helps the fertilized egg implant in the uterus to establish pregnancy by thickening the endometrium so it can receive an embryo. Progesterone continues to keep the environment healthy in order to maintain pregnancy.  Progesterone also keeps the muscles in the uterus relaxed to prevent contractions. However, progesterone can also weaken vessel walls, causing veins to expand, which increases the chance of developing varicose veins.

Is there anything you can do to prevent varicose veins? Yes, there are some proactive things that you can do every day. These tips will not only be beneficial for lessening the chances of varicose veins, but they are helpful tips for a healthier pregnancy too.

First and most important, exercise! After consulting with your doctor to find out which form of exercise is safe and right for you, try to do some sort of exercise each day. Walking is great as it is good for the valves in your calves, and it gets you outside for fresh air too! Your calf muscles expand and contract when you walk, which encourages your leg valves to open and close. Swimming is also great too, and the buoyancy will feel great!

Watch your weight. It’s important to gain a healthy amount of weight during pregnancy. Remember you have a being growing inside you which requires adequate nutrition. Again, consult with your doctor about what is the appropriate weight gain for you. Excess weight however, is not only hard on the veins in your legs, but it is hard on your other organs and joints as well.

Elevate your legs! When possible, put your legs up and give them a rest. Even when standing, try to have one foot up on a stool and then alternate legs. You can also flex your ankles when you are sitting to keep the blood moving.

Wear compression stockings. Ask your doctor what pressure stocking is best for you, and make sure they fit properly. Compression stockings help with blood flow and if your legs feel tired or ache, they can help alleviate those symptoms.

Avoid high heels. High heels don’t work your calf muscles like flats do, so if you have a choice, go for the flats! Flats tend to tone your calf muscles and encourage blood flow back up to the heart.

Wear loose fitting clothing. Try not to wear clothing that is tight around your waist or upper thighs. It’s important to keep your circulation flowing freely.

Eat healthy! It’s always important to eat a well-balanced diet, rich in fruits and vegetables, fiber to prevent constipation, and vitamins, but it’s even more important when pregnant. Try to limit salt intake too, as salt makes you retain fluid. Always make sure to drink plenty of water to stay hydrated, as it is important for the health of your organs and your baby!

If you do everything you can do to prevent varicose veins, but you get them anyway, wait a while after delivery to see if they resolve on their own. Oftentimes they will. But if they don’t, there are several options for you to eliminate them. Consult with a board-certified vascular physician to discuss which treatment would be best for you. Treatment has advanced over the years, and procedures are less invasive than they used to be. Depending on the cause, your treatment may be covered by your insurance. Visit our website at www.sfvvg.com for treatment options.

If you have spider veins, those small blood vessels that can been seen beneath the surface of the skin, you can receive treatment which is done on an outpatient basis and is simple and fairly painless. Sclerotherapy and Laser are two options that we offer that can be very effective at eliminating spider veins. More than one treatment may be needed to completely eliminate them, and because they are cosmetic in nature, the treatment is not covered by insurance.

As we have stated, most varicose veins during pregnancy are harmless, but if you have pain, or redness, swelling, or your skin feels warm to the touch, see a vascular surgeon for evaluation, as you may have an underlying condition that needs attention.

Please feel free to share this post, and best wishes to you and your baby!