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Vascular Specialists

At VESA-LA, we are dedicated to providing our patients with the very best vascular care regardless of their condition. If you need assistance in diagnosing or treating a vascular condition, you've come to the right place.

Treatments & Procedures

Venogram

A venogram is a test that lets your healthcare provider see the veins in your body, especially in your legs. A special dye is injected that can be seen on an X-ray. The dye provides a visual contrast that allows your healthcare provider to determine how healthy your veins are.

Endovascular Revascularization

Endovascular Revascularization is a procedure performed to clear any blockages in the arteries and to remove plaque that is causing decreased blood flow to your lower extremities.

Thrombectomy

Surgical thrombectomy is a type of surgery to remove a blood clot or DVT from inside an artery or vein. During the surgery, a surgeon makes an incision or cut into a blood vessel. The clot is removed, and the blood vessel is repaired, and the blood flow is fixed. In some cases, a balloon or other device may be put in the blood vessel to help keep it open.

VENCLOSE Procedure

Tumescent, a diluted local anesthetic solution that numbs the area, is injected in the skin and subcutaneous tissue to prevent the patient from feeling any discomfort. Then, a small catheter is inserted into the diseased vein. The catheter will then deliver heat causing the diseased vein to shrink and close. Once the treatment is completed, blood flow will naturally reroute to nearby healthy veins. After the procedure you can resume normal activities, but it is highly recommended you continue to wear compression stockings.

Fistulogram

A fistulogram is a minimally invasive procedure in which contrast (dye) is injected in the veins or arteries of your AV Fistula which helps identify any clots, narrowing or occlusions of the veins/arteries that may interfere with your dialysis treatment.

Sclerotherapy Injection

Sclerotherapy involves injecting a solution directly into the vein. The solution causes the vein to scar, forcing blood to reroute through healthier veins, the collapsed vein is reabsorbed into local tissue and eventually will fade. Fading of treated veins typically occurs within a few weeks time, and in some cases more to see full results. In some cases, several sclerotherapy treatments may be needed.

Clarivein Procedure

ClariVein is an ultra-thin, sleek infusion catheter with a unique rotating dispersion tip. The entire vein is accessed through one, small, pin-sized entrance point. The physician will then insert the catheter into the targeted vein and the device will administer medication into the vein, which will shrink it. Once the procedure is done you can resume your normal activity. It is important to continue wearing your compression stocking and walk through the day.

Angiogram & Angioplasty

An angiogram uses X-ray and contrast (dye) to help identify any narrowing or blockage in one or more arteries in your leg. If we identify an artery with some narrowing, we will perform an angioplasty to open narrowed or blocked blood vessels. We place a balloon into the artery which presses against the inside wall of the artery to open the space and improve the blood Flow. The balloon is inflated for approximately 2 minutes; at that time the patient may feel the pressure of the balloon but pain medication can be given intravenously by the physician to relieve some of the discomfort. If the artery is completely occluded with plaque, then we will use an atherectomy device utilizing a catheter with a blade in the end which removes any plaque that is blocking the artery or a peripheral laser atherectomy using a catheter that emits high energy light (laser) to unblock the artery. Some patients will sometimes require a stent which is placed across the artery wall to keep the artery open. This procedure usually takes 2 ½ hours or longer depending how complex the case is.

Dialysis Access Procedures

Arteriovenous Fistula (AV Fistula)
An AV fistula is a surgically placed "shunt"; that is, an artery that is directly sutured (sewed) to a vein. An artery is a high-pressure vessel that carries blood away from the heart and delivers nutrients and oxygen to the tissues.

Arteriovenous Graft (AV Graft)
An AV graft is another form of dialysis access, which can be used when people do not have satisfactory veins, or veins that work, for an AV fistula. In this procedure, surgeons connect an artery and a large vein in your elbow or armpit using a graft made of synthetic fabric that is woven to create a watertight tube.

Carotid Endarterectomy

Carotid Endarterectomy is a surgical procedure in which the surgeon makes a small incision in the neck and will remove all the build-up of plaque which is causing narrowing of the carotid artery. This procedure is usually done under General anesthesia and patients are expected to stay in the hospital for 1 to 3 days.

Endovascular Aneurysm Repair (EVAR)

Endovascular aneurysm repair (EVAR) is a minimally invasive procedure in which the surgeon will make an incision through the artery in the groin. A thin, flexible tube (Catheter) is threaded up through the artery to the site of the aortic aneurysm. A stent graft is sent along the catheter to the aneurysm. The stent graft is then opened inside the aorta and fastened in place. The stent graft will stay in place, and blood flows through it. It protects part of the aorta and prevents the aneurysm from bursting. Endovascular repair has lower risk of complication and has faster recovery. The patient usually will stay in the hospital for 1-3 days.

Diagnostic Ultrasounds

Intravascular Ultrasound (IVUS)

Intravascular ultrasound (IVUS) is an imaging technique that utilizes a specially designed catheter or thin tube, with a miniaturized ultrasound probe attached to the end of the catheter. The end of the catheter is attached to computerized ultrasound equipment. It allows the ultrasound technology to see from inside blood vessels out through the surrounding blood column, visualizing the endothelium or inner wall of the blood vessels.

Arterial Ultrasound study

A Doppler ultrasound is a test that uses high-frequency sound waves to measure the velocity (the measurements of how fast your blood is flowing in one direciton) of blood flow through the arteries in the upper and lower extremities (arms and legs).

Venous Ultrasound Study

A venous Doppler ultrasound is a diagnostic test used to check the circulation in veins in the legs and arms. This exam can detect any blockage through the vein by a blood clot (DVT). It also helps to evaluate the deep and superficial venous system in your legs for evidence of valvular incompetence (blood leaking through the veins).

Carotid Ultrasound

A carotid ultrasound uses sound waves to examine the blood flow through the carotid arteries (blood vessels in your neck). It can detect any narrowing or blockage in the carotid arteries.

AV Fistula Ultrasound

An ultrasound to identify characteristics and measures connection between vein and artery to confirm if fistula (device placed under the skin) is ready to use for dialysis. The Doppler also measures the volume of blood flowing in the lumen.

Vascular Conditions

Varicose Veins

Varicose veins are a common condition where veins become enlarged and twisted. They most commonly appear in the legs and feet, just below the skin and are caused by weak or damged vein walls. Many people experience no symptoms, but in some cases, varicose veins can cause pain and discomfort. Sclerotherapy and vein ablation are common treatments.

Carotid Stenosis

Carotid Stenosis is narrowing of the blood vessels in the neck that carry blood from the heart to the brain. If there is not enough blood flow to the brain a patient can have a TIA or Stroke. Symptoms include sudden numbness or weakness, trouble speaking, sudden headaches, and fainting.

Deep Vein Thrombosis (DVT)

A DVT is when blood moves too slowly through your veins, causing a clump of blood cells called a clot. When a blood clot forms in a vein deep inside your body, it causes what doctors call deep vein thrombosis, or DVT. This is most likely to happen in your lower leg, thigh, or pelvis. But, it can occur in other parts of your body as well.

Abdominal Aortic Aneursysm (AAA)

An Abdominal Aortic Aneurysm is a bulge in the wall of the aorta. The bulge is caused by a weak section in the artery wall. If the Abdominal Aortic Aneurysm is greater than 5cm in diameter and symptomatic, pain in the back and abdomen, you may need a procedure done to prevent the aneurysm from bursting.

Peripheral Arterial Disease (PAD)

Peripheral Arterial Disease, PAD, is a disease in which plaque builds up in the walls of the arteries in the lower extremities (legs). If your plaque hardens, it will narrow or block your arteries which will limit the needed blood flow down to your legs and feet. Symptoms of PAD include pain and cramping in the thigh and calf area during activities, poor hair growth on the legs, and sores or ulcers on your legs or feet that won't heal

Venous Reflux Disease

Inside the veins we have valves, which prevents blood from flowing back down through the veins. When the valves do not function adequately, this can lead to a reversal of blood flow through the valves during standing or sitting, which is called Venous Reflux disease or venous insufficiency disease.

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