Angioplasty is the procedure of opening a coronary artery blockage with the help of wire balloon and stent. This procedure is done to open the blocked coronary arteries if they are causing symptoms or acute heart attacks.

HOW IT IS DONE?

The procedure is usually done in local anaesthesia. A wrist artery (radial) or a groin artery (femoral) is used to gain access to the coronary artery as is done in angiography. A hollow tube called a catheter is passed upto heart artery and through this, a guidewire is passed across the blockage and over this wire balloon is passed and blockage dilated.

After this balloon is removed and the metallic stent is passed over this wire. The stent is then inflated and it takes its shape of the hollow tube so that the flow in the coronary artery is restored.

WHAT ARE INDICATIONS OF ANGIOPLASTY AND STENTING:

An acute Heart attack is the most definite indication of angioplasty and stenting. At the time of the heart attack, there is an urgent need to restore the blood flow of block coronary artery which is usually not possible with medicines alone. Angioplasty is the most effective and definite way of opening the artery urgently in such situation.

SHOULD ALL BLOCKAGES BE OPENED UP BY ANGIOPLASTY AND STENTING?

NO, all blockages do not warrant this procedure. There is some amount of risk involved in the angioplasty procedure itself. When the risk of blockage is considered more than the risk of opening the artery then the procedure is indicated. Patients who are doing good on medicines may be followed up without angioplasty.

All About Angioplasty!

Varicose veins are enlarged and gnarly veins and they commonly appear in the feet and legs. They occur when veins get filled with blood and they are often red or bluish purple in color.

The main cause of varicose veins is the when the vein dysfunctions. Veins have valves in them that are supposed to keep the blood flowing forward, but if they fail to do so, blood in the vein starts to collect rather than continue towards the heart. Since the legs are furthest from the heart, varicose veins mostly affect the legs. Gravity, too, is a contributing factor as it makes it hard for the blood to flow up the vein.
Out of all the treatments available for varicose veins, sclerotherapy is the most effective.

What is sclerotherapy?
Sclerotherapy is a form of injection therapy that is designed to improve the way the varicose veins appear on your legs.

The Procedure
During the procedure, a solution called sclerosant is injected in the veins that scars and destroys the vein's internal lining which causes the blood to clot. After the solution is injected, pressure over the veins is applied to prevent the return of the blood as you stand up. Compression stockings are worn for maintaining the pressure.

After the Procedure
There is no prolonged recovery time for sclerotherapy. You can move around immediately after the procedure, but do not strain yourself too much. However, bed rest is not recommended as it might stress the vein. You probably have to keep wearing the compression stockings for a few days more.

Reasons for Choosing Sclerotherapy
Sclerotherapy is best for treating the following problems-
1. Small veins and spider veins that do not cause severe damages
2. Smaller varicose veins that might return even after vein stripping surgery (the surgical removal of the superficial saphenous vein with minimal incisions to treat varicose veins).
3. Larger varicose veins
4. Follow up to any other surgery to treat varicose veins

Risks involved
Sclerotherapy, like any other treatment, has certain risks. The risks include-
1. Skin discoloration
2. The varicose veins can still return after the treatment
3. Bruising, itching, blistering and pain in the treated area
4. Mild or severe allergic reaction to the solution (sclerosant) used
5. Blood clots in the deep vein system.

Varicose Veins: Using Sclerotherapy to Get Rid of It

An unhealthy diet is an absolute no in daily life to remain healthy, fit and without any disease. Unhealthy diets fail to give the body the correct amounts and varieties of proteins and nutrients for a maximum proper health.
Too many intakes of calories lead to an unhealthy diet, which also increases blood pressure. It leads to a very poor calorie ratio-to-nutrient that leads to gain weight and also leads to malnutrition along with various health problems. Unhealthy diets cause chronic disease, hypertension, cancer, diabetes, osteoporosis and cardiovascular disease.
Therefore, unhealthy eating habits should be avoided and strongly abandoned.

Why Avoid Unhealthy Diet?

It causes obesity. Increased intake of nutrient-dense foods like fruits, sugar, processed carbohydrates and animal fat leads to obesity.
Nutrient deficiency is another harmful effect of following an unhealthy diet.
Illness is another factor. Poor intake of nutrition leads to diseases like heart disease, diabetes, and cancer. Lack of calcium weakens the bones, lack of vitamin A and C suppress the body immune system leaving a person vulnerable to diseases.
Increases the risk of coronary artery disease as unhealthy diet contributes to building up of plaque in the coronary arteries which can cause heart attacks.
Coronary Heart Disease - A Serious Issue!
It is a disease which leads to plaque building inside the coronary arteries, which supply rich oxygen blood to the human heart muscle. Over time the plaques either hardened or get ruptured and hardened plaque restricts the coronary arteries, which reduce the oxygen flow to the heart. On the other hand, if the plaque is ruptured blood is formed on its surface which also narrows the coronary artery and restricts the blood flow. And if the blood flow is blocked or reduced, then it might lead to Angina and heart attacks leading to loss of life. Angina causes chest pain it can also cause pain in the neck, back or arms. It is a state where one gets a feeling of indigestion.

Outlook
Changes in lifestyle, eating habits, intake of medicines and its procedures helps to prevent this disease. These steps can also reduce the chances of health problems. Therefore, a proper healthy diet is a must in a person s routine because it serves as one of the links to coronary heart diseases. In order to live long, live healthily and live happily one needs to adopt a good eating habit, take care of the medicines they intake, certain input time of exercise, change the monotonous lifestyle to lessen down the chances of their occurrence. Adopting healthy food habits also enables the body to fight against diseases and infections, reducing the rate of illness. It also reduces stress and provides a good healthy and happy life.

Unhealthy Diet - How It Is Related With Coronory Heart Disease?

Dialysis is a very important and life-saving procedure. It is performed to replace kidney function in case of renal failure. Wastes and extra fluids in the blood are filtered out during this process. To be able to perform Dialysis, the connection between the patient s bloodstream and the equipment for performing Dialysis (dialyzer) outside the body is established. This connection is created through Dialysis Access Surgery. It is a type of Vascular Surgery which forms the vascular opening for access during Dialysis. Thus, Dialysis Access Surgery is the lifeline for the survival of the patient.

Types of Vascular Access for Dialysis- 
There are three types of Vascular Access for Dialysis: Arteriovenous (AV) Fistula, Arteriovenous (AV) Graft, and Venous Catheter.

  Arteriovenous (AV) fistula is a surgical connection of an artery to a vein. An AV fistula is usually placed in the upper arm or in the forearm. It causes extra blood to flow into vein making it grow large. A larger vein hence provides easy access to blood vessels. An AV fistula is preferred over other methods as it lasts longer than other methods of access and provides a good flow of blood. Moreover, it is less prone to infection and blood clots than other methods. Before an AV Surgery, a Vessel Mapping Test is sometimes performed for assessing the blood vessels most suitable for Dialysis. An AV fistula is performed under local anaesthesia and requires two to three months for maturation before hemodialysis. If it fails to mature, the procedure is repeated.

  Arteriovenous (AV) graft is performed when AV fistula fails to mature. It is hence the second most preferred choice for long-lasting access to vascular tissues for Dialysis. An AV graft is a looped plastic tube which establishes a connection between an artery and a vein. Like AV fistula, AV graft is also performed under local anaesthesia. It is slightly more difficult to maintain than an AV fistula.

  A venous catheter is used for short- term hemodialysis. It is a tube which is inserted into chest, neck, leg, or near groin for vascular access. After exiting the body, the tube splits into two halves. In the case where a renal disease has made quick progression leaving little or no time for the AV fistula or AV graft to mature, a venous catheter is used to establish the required vascular connection. This procedure is also performed under local anaesthesia. It is a tool for emergencies but is not suited for long- term use. It can cause narrow vein due to an infection,
scarring, or blood clot. If long- term venous catheter is used, it is tunnelled under the skin which has fewer problems associated with it and is more comfortable. 

How to Care for a Vascular Access?
  Get checked for infections and other problems before each hemodialysis session;
  Use the operated site for access only for the intended use;
  Always keep the access clean;
  Prevent cutting or bumping the access;
  Check for thrill/ vibration in the access and inform the doctor if any;
  Do not put pressure on the access site;
  Do not put blood pressure cuff around the access arm;
  Do not wear jewellery or tight-fitting garments over the site;
  Do not lift a weight.

Take Away-
Vascular Surgery for Dialysis is performed to provide vascular access for the procedure. AV fistula is the most preferred type followed by an AV graft. A venous catheter is recommended to be used only in case of an emergency when there is not much time left for the other two options to mature.

Vascular Surgery - Can It Help For Dialysis?

The veins are a type of blood vessels which collect impure blood from all parts of the body and return it to the heart. The veins in the legs especially are quite thick and need to exert extra pressure to pump blood against gravity towards the heart. In quite a few people, these veins could be engorged, swollen, and twisted, which are known medically as varicose veins.

Causes:
Defective or damaged valves in the blood vessels. Normally, the blood flow is controlled by valves which ensure blood flows in the desirable direction. When these valves are not able to control the flow of blood, then varicose veins can return
Thin vein walls can lead to improper flow of blood, resulting in varicose veins

Risk factors:

Prolonged standing
Obesity
Pregnancy
Smoking
Surgery in the leg, which could have hampered the values or veins
Age, as the elasticity of the vessels, reduces with age and can impede normal blood flow
Family history
Symptoms:

Blue, swollen veins in the legs which are thin and ropy
Pain with prolonged standing followed by pain and tenderness
Itching and heaviness in the legs
Cramping in the night
Blood clots in the superficial vessels
Severe varicose veins can cause bleeding
The area around the leg feels firm and/or hard
There could be skin changes like scaling, dryness, and color changes
Increased propensity to bleed in the affected leg
Diagnosis:

Usually easily diagnosed in clinical examination
The above-listed features are very characteristic and help in identifying them
Further testing may be done to identify the problematic valve, usually using a tourniquet
Doppler ultrasound, scanning, and MRI may be required to confirm diagnosis, which are quite rarely used
Prevention/Treatment:

Keep the legs elevated as much as possible. During working hours, take short breaks where you are able to elevate the legs
Even in prolonged journeys, try to take a break which will improve circulation
Quit smoking
Compression stocking (Ted hose or Jobst stocking) can be used to improve circulation. They also help in controlling pain and are very commonly recommended to treat varicose veins
Avoiding alcohol, which leads to venous dilation
Weight management, as being overweight is a big risk factor
Do not cross legs when sitting, as it puts constant pressure on the valves
Avoid tight clothing which can put pressure on the veins and/or valves
Keep a regular exercise regimen like walking to improve blood flow
Surgical treatment options include sclerotherapy, laser treatment, and stripping off the vein, but are not usually required.

Varicose Veins - 9 Signs You Are Suffering From It!

Varicose veins is a medical condition where the veins become large and swollen and begin to appear so especially on the legs and feet though any vein can become varicose. This happens when the valves do not function properly and allow the blood to flow in the opposite direction or to pool. Due to this, the veins enlarge, and they begin to appear blue or dark purple on the skin. Legs and feet are the most commonly affected areas because standing or walking increases the pressure on the veins in the lower part of the body.

Symptoms of Varicose Veins
Apart from the twisted and bulging appearance like cords in blue and dark purple, varicose veins may include other painful symptoms as well such as-

Throbbing feeling and aching, heavy feeling in the legs.
Muscle cramping and swelling in the legs.
Severe pain after sitting or standing for a long period of time.
Bleeding varicose pains.
Treatment for Varicose Veins
In severe cases, varicose veins may rupture and form varicose ulcers on the skin. To avoid complications, it is best to get varicose veins treated before it worsens. Varicose veins can be treated in two ways- either by surgeries or by non-surgical methods, that is, by home remedies, medicines or non-invasive methods.

Surgical methods to treat Varicose Veins
Vein Stripping - Under general anesthesia, two cuts are made one below the groin and one behind the knee joint. The affected vein is then tied or clamped off at the top incision using a technique called vein ligation
Phlebotomy is another method where smaller incisions are made along the vein and using surgical instruments, the vein is pulled out.
Though treating varicose veins by surgeries is the most effective method, it involves several risks. Patients take a longer time to recover from surgeries than non-surgical methods. The sedation may cause complications. Chances of nerve injuries cannot be negated which may lead to fatal conditions such as deep vein thrombosis.

Non-surgical methods to treat Varicose Veins

Radiofrequency ablation is a method in which heat generated electromagnetic waves are used to close off the veins.
Endogenous laser ablation- in this case, lasers are used to close off veins.
Sclerotherapy is another method where a liquid or foam is injected into the affected vein to close it off.
Although big veins cannot be treated by these methods or additional treatments may be required, these methods are not only effective but also free from cuts and stitches or anesthesia. Performance of these treatments need not always take place in hospitals, special clinics can cure varicose veins using these methods. It is always advisable to consult doctors for treating varicose veins who can suggest the best treatment needed to cure varicose veins.


Surgical & Non-Surgical Treatment Options For Varicose Veins - Which Is Better?

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