Conditions We Treat

Artery Conditions 

  • Abdominal Aortic Aneurysm
  • Atherosclerosis
  • Beurger’s Disease
  • Blue Toe Syndrome
  • Carotid Artery DiseaseStroke
  • ClaudicationLeg Pain
  • Collagen Vascular Disease
  • Critical Limb Ischemia
  • Fibromuscular Dysplasia
  • Gangrene
  • Mesenteric Artery StenosisIschemia
  • Reno vascular Hypertension
  • Subclavian Steal Syndrome
  • Thoracic Artery Aneurysm

Vein Conditions 

  • Central Venous System
    • Deep Vein Reflux(Internal Iliac Vein Reflux)
    • May Thurner Syndrome
    • Pelvic Vein Congestion (Ovarian Vein Reflux)
    • Portal VeinMesenteric vein thrombosis
    • Restless Leg Syndrome
    • Subclavian Vein OcclusionStenosis
    • Superficial Thrombophlebitis
    • SVC Occlusion Syndrome
    • Thoracic Outlet Syndrome
    • Varicocele
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  • Peripheral Venous System
    • Chronic Venous Insufficiency:


      More than 30 million Americans suffer from varicose veins, or the more serious form of venous disease called chronic venous insufficiency (CVI), yet the majority remains undiagnosed and untreated.

      Venous reflux disease, also known as chronic venous insufficiency, develops when the valves that keep blood flowing out of the legs and back to the heart become damaged or diseased. If venous reflux disease is left untreated, symptoms may worsen over time. As a result, vein valves will not close properly, leading to symptoms such as:

      • Varicose veins
      • Leg pain, aching, or cramping
      • Leg or ankle swelling
      • Leg heaviness and fatigue
      • Skin changes or rashes
      • Ulcers, open wounds, or sores

      Once the valves in the leg stop working properly, they cannot be repaired. Treatment options available include closing or removing the damaged vein so that blood flow can be redirected to healthy veins. In the past surgical stripping was the only method available. Now there are several new non-surgical options available. Vora Vein & PAD Clinic is Owensboro area’s most experienced vein clinic and is at the forefront of non-surgical options and offer state-of-the-art methods to diagnose and treat the vein problems.​

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    • DVT / PE:


      DVT
      Deep Vein Thrombosis occurs when a blood clot develops in the large veins of the legs. A Deep vein thrombosis can be caused by anything that prevents our ability to circulate blood or for our blood to clot normally. Events that can affect our circulation and our ability to clot could be recent surgery, injury sedentary lifestyle, and medication.
      Deep vein thrombosis can cause sudden swelling of one limb, pain, tenderness, change in color of affected extremity, as well as temperature. A deep vein thrombosis can also occur without any symptoms. If you develop signs or symptoms of deep vein thrombosis, contact you doctor. With Prompt diagnosis and treatment, DVT may not be life threatening.
      Diagnostic studies used to identify DVTs could be: Ultrasound, Lab test, Venography, CT or MRI scans. After a diagnosis has been made a physician may take a couple of different approaches to treating a patient, depending on the size, location, and status of the patient. These treatments include blood thinners, clot busters, compression stockings, filters, and other surgical procedures. Treatment varies but the goal is the same, to keep the patient safe. Treatment is aimed at prevention, preventing the clot from growing and/or moving. After the clot is resolved, the focus goes to preventing thrombosis from happening again.

       

      PE
      When a clot forms in a large deep leg vein, breaks free, and begins to travel through the vein it is then called an embolus. This can be very serious, an embolus has the potential to reach and become lodged in a lung artery. If an embolus becomes lodged in a lung artery it is considered a pulmonary embolism (PE) which is a potentially fatal condition.
      Symptoms of a pulmonary embolus include chest pain, shortness of breath, rapid pulse, cough, anxiety, sweating, or fainting. If you were to experience any of these symptoms seeking immediate medical attention greatly reduces the risk of death. By taking steps towards preventing blood clots in your legs, we also protect ourselves against pulmonary embolism.
      In order to diagnose a PE there are many different scans and tests, they include: Chest X-ray, Ultrasound, Blood tests, Spiral CT scan, Pulmonary Angiogram, and MRI.
      Treatments include clot dissolvers which are called thrombolytics may be given through the vein to dissolve clots quickly in life threatening situations. For others, oral pills may be given which keep the clot from getting any bigger and lower the chances of another clot forming.

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    • Lymphedema:

      Most people associate lymphedema with cancer but it can also occur due to untreated chronic venous insufficiency.
      Untreated chronic venous insufficiency can lead to edema(phlebo-lympho-dynamic insufficiency )in lower extremities. Without appropriate intervention at this stage, if blood vessels and lymphatic capillaries have to keep working at their maximum capacity over an extended period, they suffer damage. The constant high pressure in the lymphatic system leads to the valves becoming inefficient. Also the walls of the veins become fibrotic. This causes damage so severe that results in accumulation of not only fluid but also proteins. This is called phlebo-lympho-static inefficiency.
      Initially the lymphedema is smooth and pitting(when the indention remains after pressing) but it can progress to more fibrotic stage without proper intervention that is why early diagnosis and treatment are of utmost importance.
      Diagnosis is usually based on good history and physical examination. Lower-extremity duplex ultrasound can be used to measure ankle-brachial index.
      The intervention at this stage would be leg elevation, compression, and exercise. But the main treatment focuses on treating the underlying problem.
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    • Post Thrombotic Syndrome:


      Post-thrombotic syndrome (PTS), sometimes called post-phlebitic syndrome is a long-term condition that occurs as a result of a deep vein thrombosis (DVT).   More than one third of people who have DVT then develop PTS. It is most common for a DVT to occur in the legs but could occur in other deep veins as well.

      When a thrombus (clot) stays in the vein for a long time or when DVT is not completely treated, the blockage can lead to increased venous hypertension. Inflammation associated with the process causes scarring of the vein walls and valves. Scarred veins do not expand as normal veins do, so when the flow of blood increases and they cannot expand, it causes a throbbing pain and swelling in the lower part of our legs.

      The most usual symptoms of PTS are aching, swelling, cramps and pain in the leg, which is usually worse can after standing for long periods or walking and is typically relieved by resting or raising the leg

      If you develop any of these symptoms, particularly if you know you’ve had a recent DVT, you should see your doctor as soon as possible.

      PTS can be diagnosed by getting good medical history. Venous duplex and IVUS could be used based on the area affected.

      PTS is a long term chronic condition and can affect your mobility, so it’s best to take preventative measures. The person should wear a compression stockings  if you have had recent DVT. Sleeves (“gauntlets”) for post-thrombotic syndrome in the arm also exist and should be worn if there is arm swelling or pain. The other treatments may include leg elevation, pain medication, anticoagulant medication,  angioplasty or stent depending on the extent of the problem.

       
    • Spider Vein:

      Telangiectasia, commonly called spider veins, are web like networks of tiny red, blue or purple vessels that are seen commonly on legs or face. They are a very common problem that develop from a range of factors including age, heredity, lifestyle and diet. These unsightly blemishes can appear on several visible areas on your lower legs or face.
      Spider veins are harmless and do not cause much pain but they are of cosmetic concern and may make someone self conscious. Hence they need to be treated.
      If you are looking to get rid of spider veins, Rejuve Medical Spa at Owensboro Medical Practice offers two treatment options - Sclerotherapy and Vein Gogh.
       
    • Stasis Dermatitis:

      Stasis dermatitis also called gravitational dermatitis, venous eczema, and venous stasis dermatitis is skin inflammation that develops in people with poor circulation. Typically, poor circulation is the result of a long-term condition called chronic venous insufficiency. Venous insufficiency occurs when your veins have trouble sending blood to your heart. It most often occurs in the lower legs because that’s where blood typically collects. Very rarely, Stasis dermatitis may involve the upper limbs in patients with artificial arteriovenous (AV) fistulas for hemodialysis, or congenital AV malformations. It is seen more in female population and it may be most likely due to the fact that pregnancy results in significant stress on the lower-extremity venous system.

      Stasis Dermatitis is usually a precursor to more problematic conditions, such as venous leg ulceration. At first, symptoms seen are those affecting the ankles. There may be swelling that appears toward the end of the day and lessens after sleeping overnight.  Eventually it leads to heavy or aching legs when standing for a prolonged period.

      In the early stage, the skin may become red, swollen, which may later turn weeping and crusty. This can be made worse by bacterial superinfection or by contact dermatitis caused by the many topical treatments often applied.

      When the red blood cells breakdown from the pooled blood, it leads to deep dermal deposit of hemosiderin (a protein from hemoglobin). This causes diffuse, red-brown discoloration. These spots can also be itchy. Sometimes, loss of hair may also accompany.

      A number of diseases and conditions can increase your risk for developing stasis dermatitis but main factors are venous insufficiency, obesity, multiple pregnancy for females.

      Diagnosis is usually based on good history and physical examination. Lower-extremity duplex ultrasound can be used to measure ankle-brachial index.

      Treatment includes leg elevation, compression, and dressings.  Sometimes topical or oral antibiotics may be recommended. Petroleum jelly or fragrance free creams can help reduce dry skin.

      Stasis dermatitis tends to come back until the underlying cause (damaged veins) is addressed. Hence venous interventions like varicose vein closure or treatment for DVT –are needed to address the underlying cause.

      Primary prevention involves adequate anticoagulation after DVT and use of compression stockings for up to 2 years after DVT or lower extremity venous trauma. Lifestyle changes (eg, weight loss, regular exercise, reduction of dietary sodium) can decrease risk by decreasing lower extremity venous pressure.
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    • Swollen Leg (Edema):

      Veins have lower pressure than arteries as they rely on the pumping mechanism of surrounding muscles to help send the blood back to the heart. Due to damaged valves in vein because of Chronic venous insufficiency, the veins have to work hard to force the blood towards heart (against gravity).  This is called ambulatory venous hypertension. The deficient valves also fail to prevent the backward flow of blood in the vein. This causes the pressure in veins to elevate.

      This increased pressure subsequently affects the blood capillaries and more fluid is filtered from venous blood into the tissue. This extra fluid causes increased work for the lymphatic drainage system. The lymphatic system in spite of working to its full capacity, is not able to cope with the additional fluid which leads to edema in the lower leg.

      During initial stages, the lymphatic system is able to 'catch up' with the excess fluid at night (when legs are rested and gravitational forces are inactive) so the venous pressure comes back to normal after the night rest. This is called phlebo-lympho-dynamic insufficiency (edema).

      Diagnosis is usually based on good history and physical examination. Lower-extremity duplex ultrasound and ankle-brachial index are also useful.

      The intervention at this stage would be leg elevation, compression, and exercise. But the main treatment focuses on treating the underlying problem.  

       
    • Varicose Vein:

      Varicose veins are like twisted veins that may be blue or purple in color close to the skin’s surface. These can occur anywhere in the body but are mostly seen in legs and feet because of the pressure from the upper body and gravity.
      Most people associate veins as being a cosmetic issue but a deeper problem may exist.
      Varicose veins occur due to faulty valves, the blood in our body is pumped through veins back to our heart. Since the blood is running in an upward direction there are valves that prevent backflow, when these valves are faulty we experience excess volume and therefore increased pressure. Chronic pressure causes damage to our vessels which causes the varicose veins.
      Varicose veins may not show any symptoms or they may cause some pain. Pain, burning , lower leg swelling, dry skin and itching near vein may be associated with varicose veins.
      A venous duplex ultrasound is used to diagnose varicosities of the vein.
      In the past, vein stripping (removal of vein by surgery)was the only procedure available to remove varicose veins. With advances in medical care, non-surgical procedures like compression therapy, Endo Venous LASER Ablation (EVLT), VenaSeal and Foam sclerosant (Varithena) became available. Vora Vein & PAD clinic is the first one in the Owensboro area to offer these procedures as they became available. The type of treatment is decided based on the symptoms and extent of the problem.
      If you have symptomatic varicose veins, you should get them evaluated and treated immediately. Untreated varicose veins may lead to venous reflux getting worse and complications like bleeding varicose veins, stasis dermatitis, and venous ulcers.
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    • Venous Ulcer Wound:

      Venous ulcers or venous stasis ulcers are ulcers that usually appear on the inner part of the leg, near the ankle. When the valves in veins of legs do not function properly, the blood that is supposed to flow upwards towards heart may flow back a little (retrograde) and get pooled (stasis). If this continues, it can lead to increased pressure in the veins. As the venous hypertension gets worse, fluid may leak from the veins and get pooled in tissue (edema). This mainly occurs near ankle area. Chronic venous insufficiency makes this worse where protein may accumulate in the tissue as well. At some point the circulation becomes so restricted that proper nutrient exchange does not take place. In addition to the lack of Oxygen and nutrients in the tissue, the fibrin (which normally plays a role in clotting) from the fluids adds to the insult and leads to necrosis and ulceration.
      The venous ulcers start small but may grow in size. They are shallow with irregular edges and may have clear, yellow or red drainage. If they are not properly cared for, they have potential to get infected.
      Diagnosis is usually based on good history and physical examination. Lower-extremity duplex ultrasound can be used to measure ankle-brachial index.
      Although not usually fatal, these chronic wounds severely affect patients & quality of life because of impaired mobility and substantial loss of productivity. The treatment focuses on improving blood flow to the affected area. The wound needs to be dressed regularly. Unna boot application is a great dressing with Zinc and Calamine. But the main treatment focuses on treating the underlying problem. Hence proper diagnosis by a vein expert is the key to treating and preventing venous ulcers.

 

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