Vascular Procedures in Danville
Vascular procedures treat diseases affecting the vascular system, also called the circulatory system. At East Bay Cardiovascular & Thoracic Associates, our surgeons perform vascular procedures for Danville, Pleasanton, Concord, Walnut Creek, and San Ramon patients.
What Is the Vascular System?
The vascular system comprises veins, arteries, and lymphatic vessels. It carries blood, oxygen, nutrients, and lymphatic fluid throughout the body. When circulation issues arise, they can result in several problems, from varicose veins to heart attacks and strokes. Vascular procedures are used to address or prevent these problems.
Dialysis Access
Dialysis is short for hemodialysis, a blood treatment procedure for patients with chronic kidney failure. The kidneys filter waste from the blood, but when they fail, dialysis is necessary to take over that filtering.
Dialysis is necessary when 85-90% of kidney function is lost. During dialysis, blood is removed from a vein and circulated through a filtering machine before being returned to the body.
Vascular Access for Dialysis
Veins tend to have weak blood flow that is not durable enough to provide the necessary output of dialysis. Because of this, a doctor will often surgically connect a vein to a nearby artery to strengthen the vein and allow for heavier circulation. The increased strength allows long-term dialysis to be possible.
Types of Vascular Access
The needs of dialysis patients vary, and therefore, there are three main types of vascular access for treatment that may be recommended:
- Arteriovenous Fistula
An arteriovenous, or AV, fistula is the surgical connection of an artery to a vein. It is created during a minor outpatient procedure under local anesthesia. Fistulas typically take some time to mature, but they are usually the preferred method for dialysis access due to the lower risk of complications over artificial grafts and catheters and their higher durability. - Arteriovenous Grafts
If a patient has small veins that will not properly develop into a fistula, they typically require a synthetic tube graft to connect the artery and vein. This graft can be used for needle access during hemodialysis. Unlike fistulas, a graft does not need ample time to develop and is, therefore, a better option when access is needed more urgently. - Venous Catheters for Temporary Access
For quickly progressing kidney disease, patients may need a venous catheter for temporary but immediate access. Catheters are not ideal for permanent access.
Complications of Vascular Access
As with any procedure or treatment, there are risks. Most often, the complications are associated with venous catheters. Risks associated with all three types of vascular access, although uncommon, may include:
- Infection
- Low circulation
- Blood clots
Sclerotherapy
Sclerotherapy is a minimally invasive procedure that treats varicose and spider veins, most often in the legs. The injection of a solvent into the veins causes the vessels to collapse and restore proper blood flow.
Reasons for Spider Vein Treatment
Those affected by varicose veins, either for cosmetic reasons or because of painful/dangerous symptoms due to the diseased veins, can undergo sclerotherapy. Some symptoms include:
- Swelling and redness at the site
- Cramping of the legs
- Scaly, discolored, and dry skin at the site
- Discomfort after standing or sitting for long periods
- Pain, burning, or aching in feet and legs
The Sclerotherapy Procedure
The procedure includes injecting saline and a sclerosant into the affected veins. These substances cause the veins to collapse and eventually be reabsorbed into the body so that other healthier veins can take over and provide proper circulation.
The procedure is safe and effective, and can be performed as an outpatient procedure in less than an hour. There is little to no discomfort during the process, even without anesthesia. Typically, only a mild burning sensation is reported.
Risks of Sclerotherapy
Although sclerotherapy is a safe and successful procedure, certain possible risks may include:
- Inflammation
- Bruising and discoloration (temporary)
- Blood clots
- Air bubbles in the bloodstream
- Nerve damage
- Allergic reaction to sclerosant
Recovery from Sclerotherapy
Patients can return home the same day, and most can return to work and regular activities the next day. Exercise and strenuous activities should be avoided for about a week or two. Compression bandages should be worn for about a week after the procedure.
Some improvement might be seen immediately, but full results may take about a month to be apparent. It is recommended that patients maintain healthy lifestyles by controlling weight and regularly exercising to promote vascular health and preserve the effects of their sclerotherapy.
Endovenous Laser Therapy
Endovenous laser therapy, or EVLT, is a minimally invasive procedure for treating varicose veins. EVLT has both cosmetic and health benefits and is considered safe, quick, and effective. The outpatient procedure takes less than an hour and can be performed in the doctor’s office. EVLT instantly relieves symptoms without scarring or a long recovery and is FDA-approved with a 98% success rate.
The EVLT Procedure
During the procedure, the physician marks the affected veins and uses an antiseptic and local anesthetic. A laser probe is then inserted into the vein and positioned properly, and the procedure is confirmed with imaging and ultrasound.
The laser energy targets the damaged veins and causes them to collapse so blood can no longer flow through. Healthier vessels will take over the blood flow that the disease’s veins were previously circulating. The probe is removed, and compression bandages are applied.
The Risks of an EVLT
Although EVLTs are considered safe, there are certain risks associated with any surgical procedure. Some risks may include:
- Numbness
- Vein inflammation
- Deep vein thrombosis
- Infection
- Ineffectiveness of the procedure
- A drawing sensation
Recovery from EVLT
Most patients experience temporary tightness in the legs and mild bruising, but these symptoms will subside within a few days. Patients can go home immediately after the procedure and resume normal activities on the same day. Strenuous activities should be avoided for a time suggested by the physician.
Results are typically visible immediately. Because of the fast recovery and pain-free results, most patients enjoy more attractive legs and are satisfied with the procedure. EVLT is becoming the new standard treatment for varicose veins.
Microphlebectomy
Microphlebectomy, or stab phlebectomy, is a minimally invasive procedure for treating varicose veins. It is performed when the veins are too large for sclerotherapy but too small for laser ablation. The procedure uses small punctures to remove damaged veins and divert blood flow to healthy ones.
The Procedure
The procedure will take place in your doctor’s office under local anesthesia. A microphlebectomy usually has a very short recovery time. Patients can typically return to regular activities the same day, but should avoid strenuous activity for a week. They are usually required to wear compression bandages for the week following the procedure to minimize bleeding and swelling.
Risk of Microphlebectomy
Although this procedure is considered safe, there are certain risks associated with any surgical procedure. There is a possibility of bruising and discomfort for a few days, and in rare instances, a skin nerve injury.
Deep Vein Thrombosis
Deep vein thrombosis, or DVT, is a condition in which a blood clot or thrombus occurs in a deep vein in the body. Most commonly, DVT occurs in the legs.
Causes of DVT
Most patients with DVT are over the age of 60, but the condition can occur at any age. Some causes that result in DVT may include:
- Long periods of bed rest or inactivity
- Pressure from pregnancy or obesity
- Inherited conditions
- Vein damage
- Reactions to medication
- Hormone replacement or birth control
- Smoking
- Certain cancer treatments
Symptoms of DVT
About half of all DVT cases are present without symptoms. If symptoms do occur, they may include:
- Pain at the site
- Swelling in the legs, ankles, and feet
- Swelling along the vein
- Redness or discoloration of the skin
- Warmth to the touch
Diagnosis of DVT
Your physician will check your blood pressure, breathing, and heart sounds and thoroughly examine the legs. Some other diagnostic tests for DVT may include:
- Ultrasound
- Venography
- CT scan
- MRI scan
- D-dimer test
- Blood tests
Treatment of DVT
Most treatments focus on preventing the thrombus from growing in size and developing another clot. They will also focus on avoiding an embolism, which occurs when a clot or a segment of plaque breaks off and travels elsewhere in the body, creating a dangerous blockage.
This can occur in the lungs, heart, or brain, and therefore can cause life-threatening strokes or heart attacks. The best course of treatment for DVT will likely be a combination of compression and medication.
Compression Stockings
Special elastic stockings that put pressure on the veins will be prescribed to keep the blood from clotting and pooling. In less severe cases, these stockings may keep the condition under control on their own.
Anticoagulants
Blood thinners are medications that cause easier circulation. Heparin (injection or intravenous tube) and warfarin (pill form) are common anticoagulants.
Thrombin Inhibitors
These medications interfere with the blood clotting process by inhibiting the enzyme thrombin.
Vena Cava Filter
This filter is placed inside the vena cava, which carries blood from the lower half of the body back to the heart. It prevents a pulmonary embolism by catching blood clots before they can reach the lungs.
Symptoms of DVT
Some symptoms of an embolism may include:
- Sudden shortness of breath
- Sharp chest pain
- Pain worsened by deep breathing or coughing
- Dizziness
- Cough with pink, foamy mucus
Prevention of DVT
Improvement of vascular health will lessen the risk or slow the progression of DVT. Some methods of improving vascular health are:
- Losing weight
- Quitting smoking
- Managing blood pressure
- Regular exercise
- Not sitting or standing in one place for too long
Endovenous Laser Ablation
Endovenous Radiofrequency Ablation, or RFA, is a minimally invasive treatment of varicose veins. As blood pools in the veins, the walls of the vessels become damaged and appear raised and visibly twisted. Varicose veins can be a cosmetic problem, but they can also become dangerous and painful.
Reasons for RFA
Varicose veins result from venous reflux or the backward flow of blood in the veins. Symptoms may include:
- Feeling of heaviness in the legs
- Bleeding, ulceration, and discoloration along the veins
- Pain while sitting or standing
- Swelling and distension along the veins
Patients with small varicose veins, called spider veins, may not be candidates for RFA, and sclerotherapy may be a better option.
Benefits of RFA
Some benefits of an RFA include the following:
- Small incisions with no scars or sutures
- Little to no pain or discomfort
- Short recovery time
- Immediate relief
- Successful removal of damages vessels
The RFA Procedure
The skin will be numbed with a local anesthetic, and a radiofrequency catheter will be inserted into the vein. Ultrasound images confirm proper placement, and the vein will be exposed to RF energy to seal off the vein. Healthy veins will take over blood flow and restore proper circulation.
Risks of RFA
While RFAs typically have a low incidence of complications and are considered safe, all surgical procedures have associated risks. These risks may include:
- Thrombophlebitis
- Deep vein thrombosis
- Nerve damage
- Skin burns
- Bruising
- Infection
Recovery from RFA
Patients can return to regular activities the very same day after their procedure, but should avoid strenuous activity for a few weeks. If pain occurs, it is usually mild and only lasts for a few days.
Compression stockings should be worn for about a week after the procedure to prevent swelling and bruising. Making healthy lifestyle changes will prevent future vascular damage and ensure the longevity of the RFA’s results.
Ultrasounds
Ultrasounds at East Bay Cardiovascular and Thoracic Associates are done at our Vascular Ultrasound Lab:
- Concord, CA
2350 Pacheco Street
Monday: 9 am-2:15 pm
Tuesday: 9 am-2:15 pm
Wednesday: 9 am-5 pm
Thursday: 9 am-2:15 pm
Friday: 9 am-3 pm
- Danville, CA
1320 El Capitan Dr.
Suite #120
Monday: 9 am-5:00 pm
Tuesday: 9 am-2:00 pm
Wednesday: 9 am-2:00 pm
Thursday: 9 am-5:00 pm
Types of Ultrasounds Offered
- Carotid
- Peripheral Arterial Duplex
- Venous Duplex
- Abdominal/Mesenteric
- Vein mapping
- Exercise Ankle-brachial index (ABI)
Vascular Conditions Treated
Peripheral Artery Disease (PAD)
Peripheral Artery Disease (PAD) occurs when the arteries that supply blood to the limbs become narrowed or blocked. This can cause symptoms such as leg pain, numbness, and cramping. Left untreated, PAD can lead to severe complications, including limb loss.
Carotid Artery Disease
Carotid Artery Disease involves the narrowing or blockage of the carotid arteries, which supply blood to the brain. This condition increases the risk of stroke and requires careful management to prevent severe neurological damage.
Aortic Aneurysm
An aortic aneurysm is an abnormal bulge in the wall of the aorta, the largest artery in the body. If an aneurysm ruptures, it can cause life-threatening bleeding. Early detection and management are crucial to prevent complications.
Varicose Veins
Varicose veins are swollen, twisted veins that often appear on the legs. They can cause discomfort, pain, and cosmetic concerns. Treatment can alleviate symptoms and improve the appearance of affected veins.
Deep Vein Thrombosis (DVT)
Deep Vein Thrombosis (DVT) is when a blood clot forms in a deep vein, typically in the leg. If the clot travels to the lungs, it can lead to serious complications, such as pulmonary embolism. Prompt treatment is essential.
Lymphedema
Lymphedema is the swelling of limbs due to the accumulation of lymphatic fluid. It can result from damage to the lymphatic system, often due to surgery or radiation therapy. Managing lymphedema involves reducing swelling and preventing infections.
Vascular Treatments Offered
Angioplasty and Stenting
Angioplasty uses a balloon to open narrowed or blocked arteries, and stenting involves placing a small mesh tube in the artery to keep it open. These procedures restore blood flow and relieve symptoms associated with artery blockages.
Atherectomy
Atherectomy is a minimally invasive procedure that removes plaque from the inside of an artery. This treatment improves blood flow and is often used with angioplasty and stenting.
Bypass Surgery
Bypass surgery creates a new pathway for blood to flow around a blocked artery by grafting a vessel from another part of the body. It is commonly used for severe cases of PAD or coronary artery disease.
Venous Ablation
Venous ablation is a minimally invasive procedure that treats varicose veins. It involves using heat or chemicals to close off the affected veins, which are then reabsorbed by the body. This procedure alleviates symptoms and improves vein appearance.
Benefits of Choosing East Bay Cardiovascular and Thoracic Associates
Our team consists of highly experienced, board-certified surgeons who are experts in treating vascular conditions. Their extensive training and expertise provide our patients the highest level of care. We are equipped with the latest technology and advanced medical equipment, enabling us to perform cutting-edge vascular procedures. Our practice is designed to provide our patients a safe and comfortable environment.
At East Bay Cardiovascular and Thoracic Associates, we prioritize compassionate care. Our team is dedicated to providing personalized treatment plans and supporting patients throughout their healthcare journey.
Cost of Vascular Procedures
There are many types of vascular procedures, and every vascular conditions and treatment we perform is tailored to the patient’s needs. The price of your vascular procedure will depend on the condition being addressed and the complexity of your treatment. We will review the details of your procedure with you, including the associated cost, during your consultation.
