Aortic Aneurysm related FAQ
In this condition, aorta is abnormally enlarged predisposing it to rupture and internal bleeding and possibly death.
Aortic aneurysm is an abnormal bulge that occurs in the wall of aorta that carries blood from heart to body. Aortic aneurysms can occur anywhere in the aorta. Abdominal aortic aneurysms often grow slowly and usually without symptoms, making them difficult to detect. Some aneurysms will never rupture. Many start small and stay small, although many expand over time. Others expand quickly.
- Shortness of breath
- A croaky or raspy voice
- Pain in the left shoulder or between shoulder blades
- Sudden and severe pain
- Sudden stomach pain, lower back pain, or flu-like symptoms
- Pain or tenderness below the stomach
- Weight loss
- High blood pressure
- Sex- Men have about double the incidence of aortic dissection.
- Age- The incidence of aortic dissection peaks in the 60s and 80s
- Deep wounds, injuries, or infections of the blood vessels
- Genetic factor
- Narrowing of the aorta at birth (aortic coarctation)
Certain genetic diseases increase the risk of aortic dissection-
- Turner's syndrome
- Marfan syndrome
- Other connective tissue disorders
- Inflammatory or infectious conditions
Treatment may vary from watchful waiting to emergency surgery depending on the size and rate at which aortic aneurysm is growing. Ruptured aortic aneurysms are life threatning thus a close monitoring is essential so that timely surgery can be planned.
There are two types of surgery for aortic aneurysms.
- Open surgery - It involves removing the damaged section of the aorta and replacing it with a synthetic tube (graft), which is sewn into place, through an open-abdominal approach. With this type of surgery, it will likely take you a month or more to fully recover.
- Endovascular surgery is a less invasive procedure sometimes used to repair an aneurysm. Doctors attach a synthetic graft to the end of a thin tube (catheter) that's inserted through an artery in your leg and threaded up into your aorta. The graft is placed at the site of the aneurysm and fastened in place with small hooks or pins. The graft reinforces the weakened section of the aorta to prevent rupture of the aneurysm.
Recovery time for people who have endovascular surgery is shorter than for people who have openabdominal surgery. However, follow-up appointments are more frequent because endovascular grafts can leak. Follow-up ultrasounds are generally done every six months for the first year, and then once a year after that. Long-term survival rates are similar for both endovascular surgery and open surgery.
AV Fistula related FAQ
In chronic kidney disease patients dialysis access is very important. Thus a planned surgery by a specialized vascular surgeon is very crucial for management of chronic kidney disease patients.
An AV fistula is a passage between a vein and an artery. It is required to be formed surgically in chronic kidney disease patients for dialysis access. It requires advance planning because a fistula takes a while after surgery to develop. A surgeon creates an aAV fistula by connecting an artery directly to a vein, frequently in the forearm.
All three types of vascular access av fistula, av graft, and venous catheter can develop complications. The most common complications are access infection and low blood flow due to blood clotting.
Venous catheters are most prone to develop infection and clotting problems that may require medication and catheter removal or replacement.
AV grafts can also develop both these complications. In case of clotting, av graft may require angioplasty ( a procedure to widen the narrowed segment) or replacement.
These complications are less common in av fistulas.
- Make sure your nurse or technician checks your access before each treatment.
- Keep your access clean at all times.
- Use your access site only for dialysis.
- Be careful not to bump or cut your access.
- Don't let anyone put a blood pressure cuff on your access arm.
- Don't wear jewelry or tight clothes over your access site.
- Don't sleep with your access arm under your head or body.
- Don't lift heavy objects or put pressure on your access arm.
- Check the pulse in your access every day.
Carotid Artery Diseases related FAQ
In this disease, carotid arteries get blocked due to fatty plaque deposits. These plaques cause disturbed blood flow predisposing to blood clot formation in brain which can lead to paralysis or loss of vision. Thus, timely treatment of this condition is very crucial.
Carotid artery disease is a condition in which blood supply to a part of brain suffers due to atherosclerosis or fatty plaque deposition in carotid arteries or its branches.
- Sudden numbness or weakness in the face or limbs, often on one side of the body
- Sudden trouble speaking and understanding
- Sudden trouble seeing in one or both eyes
- Sudden dizziness or loss of balance
- Sudden, severe headache with no known cause
- High blood pressure- Excess pressure on artery walls can weaken them and make them more vulnerable to damage.
- Tobacco use- Nicotine can irritate the inner lining of your arteries. Smoking also increases your heart rate and blood pressure.
- Diabetes- Diabetes lowers your ability to process fats efficiently, placing you at greater risk of high blood pressure and atherosclerosis.
- High blood-fat levels- High levels of low-density lipoprotein cholesterol and high levels of triglycerides, a blood fat, encourage the accumulation of plaques.
- Family history- Your risk of carotid artery disease is higher if a relative has atherosclerosis or coronary artery disease.
- Age- Arteries become less flexible and more prone to injury with age.
- Obesity- Excess weight increases your chances of high blood pressure, atherosclerosis and diabetes.
- Sleep apnea- Spells of stopping breathing at night may increase your risk of stroke.
- Lack of exercise- It contributes to conditions that damage your arteries, including high blood pressure
- History and physical examination- A thorough history and physical examination help in making the diagnosis.
- Ultrasound- to assess blood flow and pressure in the carotid arteries.
- Arteriography- This can be used to confirm the findings of ultrasound imaging which can be uncertain in some cases. Arteriography is an X-ray of the carotid artery taken when a special dye is injected into the artery.
- CT or MRI- to look for the ischaemic site or other abnormalities.
- CT angiography or MR angiography- to locate the particular vessel which is thrombosed.
- Don't smoke- Within a few years of quitting, a former smoker's risk of stroke is similar to a nonsmoker's.
- Maintain a healthy weight- Being overweight contributes to other risk factors, such as high blood pressure, cardiovascular disease, diabetes, and sleep apnea.
- Limit cholesterol and fat- Cutting back on saturated fat, in particular, may reduce the buildup of plaques in your arteries.
- Eat a variety of fruits and vegetables- They contain nutrients such as potassium, folate, and antioxidants, which may protect against a TIA or stroke.
- Limit salt- Excess salt may increase blood pressure in people who are sensitive to sodium.
- Exercise regularly- Exercise can lower your blood pressure, increase your level of high-density lipoprotein cholesterol and improve the overall health of your blood vessels and heart. It also helps you lose weight, control diabetes, and reduce stress.
- Limit alcohol.
In this procedure, a stent is placed in the blocked artery thereby restoring the blood supply to the brain.
Diabetic Foot related FAQ
In diabetic foot patients, sugar levels are high. They also have neuropathy and vascular disease, all these factors result in high incidence of ulcers in diabetic patients which require specialized care.
Diabetes is a common chronic condition that can cause a number of serious complications. Ulcers in feet are one of the most common. In many cases serious complications can be prevented if diabetic patients are aware of proper feet care, Diabetic foot treatment in Jaipur.
- Foot infection
- Foot ulceration
They can also develop neuropathy (damaged nerves) or peripheral vascular disease (blocked arteries) of the legs and either can lead to foot ulceration.
- Severe neuropathy
- Severe peripheral vascular disease
- Coexisting abnormalities of the shape of the foot which makes them prone for callus
- In poorly controlled diabetics
- There is a past history of foot ulceration due to diabetes (because the above factors often persist)
Daily foot care to prevent Diabetic FootExamine your feet carefully daily for:
- Cracks in skin
- Soggy skin
- Dry skin
- Corns and calluses
- Ingrown toenails
- Sharp toenails
Check for Corns and Calluses
Corns and calluses can be a problem. They cause pressure and can lead to ulceration. Never trim or cut corn yourself. Never use a corn pad, it can burn the skin and may develop an ulcer from this. Using a pumice stone can also be dangerous, as you cannot feel your feet. The only safe way to treat a corn or callus is to see a podiatrist.
Wash your feet every day with warm water and mild soap. Make sure it is not too hot. Dry your feet, especially between the toes. If the skin between your toes becomes white and soggy apply some methylated spirits using a cotton bud. If the problem doesn't go away in a couple of days, see your doctor. Apply cream or moisturizer into your feet to stop them from getting dry and cracked.
Do not cut your nails too short. Cut your nails straight across. Always check your nails for sharp edges. To smooth sharp edges use a nail file.
Removal of callus on a regular basis. Again this is preferably done by a podiatrist in this group of high-risk individuals.
- Diagnosis & treatment of good blood flow
- Infection control
- Pressure offloading to promote healing
Treatment of poor blood flow
Color Doppler of the blood vessels of the legs is performed to look for blood supply in the foot. If any blockage is found, it can be corrected either by angioplasty and ballooning of blocked vessels or surgical bypass of blocked vessels.
Proper and timely antibiotic treatment is crucial to prevent sepsis. Ulcer if present should be managed by proper dressing and wound care.
Foot Scan is done to map the normal & abnormal pressure areas when we walk. It predicts the areas under stress that are prone to ulceration in the future. Special insoles & footwear are designed to offload the high-pressure areas.
Ischemia related FAQ
In this condition, a blood clot is formed in veins most commonly in the legs, sometimes in the arms, and the patient experiences pain swelling and redness of the affected limb.
Ischemia is any reduction in blood flow resulting in decreased oxygen and nutrient supplies to a tissue.
Ischemia may be reversible or it may be irreversible, resulting in tissue death.
Ischemia can be acute due to a sudden reduction in blood flow or chronic due to slowly decreasing blood flow.
Ischemia can occur anywhere in the body. Heart attacks and strokes can both result from ischemia. Although less well known, ischemia can also affect the intestines, resulting in abdominal pain, bloody stool, and even intestinal rupture or gangrene. Peripheral ischemia can lead to loss of fingers or toes or the need for limb amputation.
- High blood pressure
- High cholesterol or triglycerides
- Increasing age
- Male gender
- Obesity or being overweight
- Physical inactivity
- Tobacco use
- Underlying vascular disease
- Venous thromboembolism
- Abdominal discomfort when eating
- Bloody stools (the blood may be red, black, or tarry in texture)
- Leg pain with walking or climbing stairs
- Nausea with or without vomiting
- Non-healing sores
- Skin changes like pallor, bluish discoloration
- Medications to control pain and dilate blood vessels
- Medications to prevent ongoing clot formation
- Medications to reduce the heart's workload
- Oxygen therapy
- Procedures to expand blood vessels
- Surgery or procedures to remove clots
- Surgery to bypass blocked blood vessels
- Thrombolytic drugs to dissolve clots
- Controlling your blood sugar
- Eating a healthy diet
- Engaging in physical activity
- Maintaining a healthy weight
- Quitting smoking and other tobacco products
- Reducing your stress level
- Taking medications as recommended for heart disease, cholesterol, diabetes, or high blood pressure
Peripheral Artery Diseases related FAQ
In peripheral artery disease patient's legs do not get enough blood due to narrowed arteries. Patient experiences leg pain in such conditions.
Peripheral artery disease is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs. In this your extremities usually legs don't receive enough blood according to demand causing leg pain while walking (claudication).
The cause of PAD may be an injury to a limb or blood clots in arteries or infection or unusual anatomy of ligaments or muscles, or radiation exposure.
- Leg numbness or weakness
- Coldness in leg or foot, especially when compared with other side
- Painful cramps in hip, thigh or muscles after activiry, such as walking or climbing stairs (Intermittent Claudication).
- Sores or wounds on toes, feet or legs that heals slowly
- Hair loss or slower hair growth on feet and legs
- Slower growth of toenails
- Change in color
- Shiny skin
- No pulse or a weak pulse in legs or feet
- Erectile dysfunction in men
- High blood pressure
- High cholesterol
- Old age (>50 years of age)
- Family history of peripheral artery disease, heart disease or stroke
- Physical Examination - There is a weak or absent pulse below a narrowed part of the artery, decreased blood pressure in the legs, or non-healing ulcers.
- Ankle-Brachial Index (ABU) - ABI compares the blood pressure in the ankle with pressure in the arm.
- Ultrasound (Doppler) - Ultrasound is a painless non-invasive procedure that assesses the degree of circulatory impairment by evaluating the blood flow through arteries.
- Angiography - This test involves injecting a dye in arteries and thus blood flow through arteries can be assessed.
Exercise has been proven to create new blood vessels, and restore blood circulation in legs. Thus It is one of the most effective treatments for PAD. Even simple walking regimens, leg exercises and treadmill exercise programs three times a week can result in deceased symptoms in just four to eight weeks.
Tobacco smoking increases risk for PAD, heart attack and stroke. Smokers are four times more prone of developing PAD than nonsmokers.
High blood pressure and high cholesterol levels are usually managed through medications in order to prevent progression of disease. Antiplatelet medications may also be prescribed to help prevent blood clots.
Surgical options - Angioplasty and surgery
In this procedure, a small hollow tube (catheter) is threaded through a blood vessel to the affected artery. There, a small balloon on the tip of the catheter is inflated to reopen the artery and flatten the blockage into the artery wall, while at the same time stretching the artery open to increase blood flow. Your doctor may also insert a mesh framework called a stent in the artery to help keep it open. This is the same procedure doctors use to open heart arteries.
Surgical options - Bypass surgery
Your doctor may create a graft bypass using a vessel from another part of your body or a blood vessel made of synthetic fabric. This technique allows blood to flow around or bypass the blocked or narrowed artery.
Surgical options - Thrombolytic therapy
If you have a blood clot blocking an artery, your doctor may inject a clot dissolving drug into your artery at the point of the clot to break it up.
Thrombosis related FAQ
In this condition, blood clot is formed in veins most commonly in legs, sometimes in arms and patient experiences pain swelling and redness of the affected limb.
A deep vein thrombosis (DVT) is the formation of a blood clot in a deep vein, most commonly in the leg but it can also occur in the arm. The vein can be either partially or completely blocked.
- Reduced blood flow through the veins- Any situation which reduces mobility like accident, surgery or illness or long-distance travel (air, car, coach or train) reduces the blood flow through veins making it prone for clot formation.
- Changes in the clotting mechanism of the blood caused by pregnancy, some drug treatments and some inherited conditions causes clot formation in veins.
- Damage to the lining of the blood vessel wall in certain conditions like surgical procedures, trauma or inflammation makes blood cells prone to stick to lining of veins causing clot formation.
- Inheriting a blood-clotting disorder
- Prolonged bed rest, such as during a long hospital stay, or paralysis
- Injury or surgery
- Birth control pills (oral contraceptives) or hormone replacement therapy.
- Being overweight or obese
- Heart failure
- Inflammatory bowel disease
- A personal or family history of deep vein thrombosis or pulmonary embolism.e
- Age. Age more than 60 increases your risk of DVT
- Sitting for long periods of time, such as when driving or flying.
- Swelling in the affected leg
- Pain in leg starting in calf
- Cramps or soreness in legs
- Red or discolored skin on the leg
- A feeling of warmth in the affected leg
- Unable to bear the weight
- DVT nearly always affects one leg only
This is the most commonly used test for diagnosing DVT. If a clot is present, your doctor will be able to see the interrupted blood flow and make the diagnosis.
If the ultrasound is inconclusive, a venogram is done. During this test, a dye is injected into the vein then an X-ray is taken over the area where your doctor suspects DVT. The dye makes the vein more visible, so interrupted blood flow would be easily seen.
It measures the presence of a substance that's released when a blood clot breaks apart. If levels of the substance are high and you have risk factors for DVT, you likely have a clot.
Blood thinners are medications that thin your blood like heparin, warfarin (Coumadin), enoxaparin (Lovenox), or fondaparinux (Arixtra) are given to stop the progression of thrombus formation. If blood thinners don't work then thrombolytic drugs are intravenous to break the existing clot.
Compression stockings can prevent swelling and might lower the chance of developing clots. Compression stockings reach just below your knee or right above it.
Filters are usually put inside the large abdominal vein called the vena cava if the patient is not able to take blood thinners. This form of treatment helps prevent pulmonary embolisms by stopping clots from entering the lungs. But filters if left inside for too long, can actually cause DVT. Filters should be used for a short-term period until the risk of thromboembolism is reduced and blood-thinning medications can be used.
Surgery is recommended in very large blood clots or clots that are causing serious issues, like tissue damage. During a surgical thrombectomy, the clot is located and removed through an incision into a blood vessel. Complications in surgery include infection, damage to the blood vessel, and excess bleeding.
There are certain exercises to be done by individuals who are more prone to developing a blood clot. If you have to be seated for long periods, there are exercises you can do while sitting to keep your legs moving and help circulate blood.
Bend your leg, and raise your knee toward your chest. Wrap your knee with your arms for a greater stretch. Hold this position for several seconds, then do the same exercise on the other side. Repeat these stretches several times.
Place your feet flat on the floor. Keeping the balls of your feet on the floor, raise your heels. Hold for a few seconds, then lower the heels. Raise the balls of your feet off the floor, keeping your heels in place. Hold for a few seconds, then lower the balls of your feet. Repeat these pumps several times.
Lift both feet off the floor. Draw circles with your toes in one direction for a few seconds. Switch directions, and draw circles for a few seconds. Repeat this exercise several times.
Traumatic Vascular Repair related FAQ
In trauma sometimes major vessels supplying blood to the limb gets injured, therefore to salvage the limb it is necessary to repair the injured vessels vascular treatment in jaipur.
The term vascular treatment in jaipur trauma refers to injury to a blood vessel either artery or vein. These injuries are categorized by the type of trauma that caused them- blunt or penetrating injury.
- A blunt injury occurs when a blood vessel is crushed or stretched.
- A penetrating injury occurs when a blood vessel is punctured, torn or severed.
- Either type of vascular repair treatment in jaipur trauma can cause the blood vessel to clot and interrupt blood flow to an organ or extremity, or cause bleeding which can lead to life-threatening hemorrhage.
A vascular injury can sometimes be diagnosed by physical examination alone.
Ultrasound is non-invasive, safe, repeatable, and very flexible, in contrast with other imaging modalities. Blood flow velocities and waveforms are displayed in real-time, revealing pathologic changes such as arterial thromboses and occlusions.
This helps in locating the site of vessel injury.
Angiography has a role when noninvasive methods yield inconclusive results.
Surgical BypassOpen surgical repair of a blood vessel often requires a surgical bypass.
- In this procedure, a prosthetic graft or a natural graft formed from a portion of a vein obtained from another location in your body, usually from your thigh or calf ios used for vascular repair treatment in jaipur.
- If the injured vessel is a vein, it may be repaired with a graft, but sometimes can simply be tied off (ligated).
Endovascular treatmentIt is less invasive than open surgery and may be an option for some vascular injuries in jaipur.
- Balloon stenting is done to widen the injured vessel to restore blood flow.
- A stent graft can be placed to provide internal support to help keep the vessel open.
Varicose Veins related FAQ
- Increasing age
- Family history
- Pregnancy and hormonal changes
- Prolonged standing
- Prior deep venous thrombosis
- Aching pain
- Leg swelling
- Leg cramps
- Numbness in the legs
- Leg heaviness
- Darkening of the skin
- Rash on the legs
- Skin ulcers
- Skin shrinking
- Prominent and visible veins
- Telangiectasia in the affected leg (spider veins)
- Swollen ankles
- Venous eczema - skin in the affected area is red, dry, and itchy
Radio frequency ablation (RFA)
Radio Frequency Ablation involves the passage of RFA probe inside a vein. This technique uses radiofrequency energy (instead of laser energy) to heat up and damage the wall inside a vein. This usually closes off a varicose vein in the leg.
RFA is a minimally invasive procedure with minimal risk of scarring & post operative infection. It is generally performed under local anesthesia.
It is a simple day care procedure which takes less than an hour and you will be discharged the same day. You may resume your regular activities and routine immediately.
Endo venous laser ablation (EVLA)
Laser surgery closes and shrinks the varicose vein and causes scar tissue within the vessel. This seals off the vein. Blood then flows through other nearby veins instead.
In this process, a sclerosing solution is injected into the varicosed vein that stops the flow of blood, and the vein turns into scar tissue. Subsequently, the vein fades away and the disease subsides completely.
Compression stockings are elastic socks to be worn in affected leg. It reduces the pooling of blood and pumps blood from veins causing an increase in blood flow velocity and valve effectiveness. Compression therapy decrease venous pressure and relieves heavy and aching legs. Now a days graduated compression stockings are used which are tightest at the ankle and gradually loosen upwards. They are to be worn during day time only.
Varicose vein open surgery in Jaipur
This is an invasive surgery that involves removing the varicose veins in jaipur. The procedure involves ligation & stripping of vein.