It is said that if all the veins of the human body were laid out in a single line, it would stretch over 60000 miles. We don t usually think of our veins or notice them unless an intravenous injection is to be administered or the person suffers from varicose veins. These veins are usually benign and can be described as enlarged veins that rise to the surface, and become prominently visible. The varicose veins can usually be seen on the feet and calves. For most people, it is simply a cosmetic problem but for others it can be the cause of pain and discomfort. The good news is that in either case, varicose veins can be treated.

EVLT refers to Endovenous Laser Therapy, which is also known as EVLA or Endovenous Laser Ablation. This is a type of laser therapy that can be used to destroy veins from within. The procedure is performed while the patient is under local anesthesia and hospitalization is not required. Know the steps in which it is carried out:

The first stage involves mapping the veins and identifying the problem veins. A Duplex Ultrasound is usually used to create this map. It is important to note that this procedure cannot treat bulging veins on the surface of the skin. The veins that can be treated include the Great Saphenous Vein (GSV), Small Saphenous Vein (SSV) and their major tributaries.
Once the veins have been identified a needle is inserted into the vein near the ankle or knee with the help of ultrasound controls. A wire is then passed into the vein and a long sheath is then passed to the top, and positioned with the help of the ultrasound.
Ultrasound is again used to then inject local anesthetic into the area around the vein. This numbs the vein and surrounding tissue. The adrenaline in it also makes the vein contract, so as to fit the sheath perfectly. This technique is called  Tumescent anesthesia .
This is followed by passing a laser fiber inside the sheath and switching the laser on. The laser and sheath are then pulled back simultaneously so as to destroy the vein without damaging any of the surrounding tissues.
Once done, you should be able to get back to work and your normal lifestyle, the day after the surgery. But it is advisable to take good rest for few days, before you get back to your regular routine. Your doctor may advise you to wear compression stockings for up to 2 weeks. You should also avoid letting your legs come in contact with water. To avoid getting varicose veins in future, exercise regularly and have a balanced diet to control your weight.

EVLT Endovenous Laser Treatment For Varicose Veins!

Varicose veins are a painful swelling of the veins of the legs. The raised veins just under the top layer of the skin appear to be purplish blue. It is a common affliction and affects nearly 25% of the adult population all across the world and 10 million people in India are diagnosed with it every year.

What are varicose veins?

Varicose veins are enlarged veins that typically develop in the legs and the feet. This condition is triggered when there is something wrong with the valves of the veins. When the valves do not function properly, blood flow to all parts of the body is disrupted. Since the legs are the farthest part of the body from the heart, gravity makes it difficult for blood to flow up to the heart.

Varicose veins are common in people who are:

  Above 50 years of age
  Lead a lifestyle that requires them to be on their feet for long stretches of time
  Pregnant
  Menopausal
  Obese

If someone in your family has a history of varicose veins, you are quite likely to get it too.

What are the symptoms of varicose veins?

Varicose veins are characterized by the following symptoms-

  The most obvious symptom is the large twisty veins
  Pain all down the length of your legs
  Discolouration of the skin of the legs and feet

Diagnosis of varicose veins:

The doctor usually diagnoses varicose veins by a physical examination. She/he may also suggest an ultrasound to determine if your flow of blood is affected. It is a non-invasive procedure and is done with the help of high-frequency sound waves.

You may even have to undergo a venogram. The doctor injects a coloured dye into your veins and X-rays them. The dye gives an indication of how well your blood is flowing through the veins.

Treatment of varicose veins:

There are several treatment options for varicose veins-

  Compression socks: these socks exert pressure on the swollen veins and make it easy for blood to flow upwards. They also bring down the swelling.

Vascular surgery:

When the other methods do not work, doctors prescribe vascular surgery.

  Ligation and stripping: Through this surgery, the surgeon ties up the vein to prevent pooling of blood in the veins and sometimes the vein itself is removed.
  Sclerotherapy: The doctor injects a chemical right into the varicose vein which closes it.
  Radiofrequency ablation: The doctor uses radiofrequency to heat the varicose vein up, which makes the walls collapse

Lifestyle changes:

A few changes to your lifestyle can help you avoid the menace of varicose veins-

  If your job requires you to stand for extended periods, squeeze out a few minutes so that you can sit down, that allows blood to flow normally up to your legs.

  If you are overweight, lose weight immediately.

  Exercise regularly because that keeps your heart healthy and improves blood circulation.

Varicose veins are a painful condition that can be avoided if you implemented a few changes to how you live your life and even if you do get them, there are ways to cure them.

Varicose Veins - How Does Vascular Surgery Help?

Formation of blood clots in the arteries of the lungs, heart or legs can actually kill a person. In such a case, the immediate medical action is necessary and the only way to deal with blood clots is thrombolysis.
Thrombolysis or thrombolytic therapy is a medical process that dissolves blood clots and facilitates blood flow to all parts of the body. Thus, it protects tissues and muscles from damage.

What are the causes of blood clots in the body?

  Poor blood circulation
  Conditions such as Deep Venous Thrombosis and atrial fibrillation
  Blood clots can also be formed because of dialysis catheters and by-pass grafts

How can you tell if you have blood clots?

  Swelling in one or more legs
  Cramp and tenderness in the legs
  Breathing trouble might indicate that blood clots have travelled to the lungs
  Sweating and frequent chest pain may suggest that blood clots have travelled to the heart

How is Thrombolysis performed?

Thrombolytic drugs are injected into the body intravenously. They make their way to where the blood clots exist and dissolve them. If there is a medical emergency, the drugs are delivered to the exact location of the blood clots and immediately start dissolving them. Another method is inserting a device into the blood clot infested region to break the clots up. The drugs which on entering the body dissolve blood clots are called thrombolytics. There are many varieties of thrombolytics such as the following-

  Streptokinase - It is a kind of enzyme. It is used when a person has just suffered a heart attack or pulmonary embolism. Doctors do not usually prescribe the second usage of this drug. It is injected into a vein and can be administered to pregnant women.

  Tenecteplase - Also an enzyme, it is a plasminogen activator. When it binds to the surface of the blood clot, it makes the clot degenerate.

  Reteplase - It is actually extracted from E-Coli. It is a sterile intravenous bolus injection

The leading cause of heart attacks and ischemic heart disorder is the formation of blood clots in the arteries that connect the heart and the brain. Thrombolysis is often employed as an emergency treatment for this purpose. Thrombolysis is also effective against blood clots formed in the lungs (which lead to acute pulmonary embolism). Sometimes blood clots are formed in the legs, upper extremities of the body, the pelvic region (deep vein thrombosis). These clots may travel to the lungs and heart.

Consult your doctor before undergoing the treatment.

Thrombolysis - Causes, Symptoms & Treatment Of It!

Varicose veins are a condition marked by enlarged or gnarled veins. This typically affects the veins in the feet and legs. In most cases, varicose veins are a mere cosmetic concern but in some cases, it can be quite uncomfortable and painful. If left untreated, it can also lead to further complications.

Varicose veins may be caused by a lack of elasticity in the veins causing blood to pool in them and flow backwards. This blood is deoxygenated and hence the veins appear blue. Women have a higher risk of suffering from varicose veins as compared to men. This risk also increases with age and weight. Pregnancy can also cause varicose veins. 

The most common symptoms of this condition are:

Visible veins just under the surface of the skin
Veins that appear blue and gnarled
A dull ache in the legs
Throbbing or burning sensation in the calves
Pain in the legs that worsens after standing or sitting in the same position for a long time
Itching around the veins
Bleeding veins
Inflammation of the skin or ulcers around the ankles
Red or blue spider veins
What steps to maintain once you have undergone the sugery

Keeping the legs raised or wear compression stockings can relieve the pain associated with varicose veins and prevent the condition from worsening. 
Exercise can also help improve blood circulation. If these home remedies are not effective, the patient may need to consult a doctor.
Women with a family history of varicose veins should also avoid wearing high heels and tight stockings.
Complications caused by varicose veins are rare. However, some people may experience bleeding on the surface of the skin. There are chances that the veins deep inside the muscle may get twisted which may lead to the swelling of the calf muscles. Varicose veins may also cause painful ulcers around the ankles and is a result of the buildup of fluid around the ankles.

All the complication must be reported to the doctor at the earliest to prevent the condition from worsening.

Varicose Veins - Know The Signs Of The Condition!

Peripheral Artery Disease (PAD) is a disease of blood vessels that are located outside the heart and brain. The condition develops due to fatty deposits in the arteries and veins that stops the blood flow to the heart and mind as the case may be. It narrows the artery and restricts the blood flow, which causes problems to other organs of the body such as kidney, liver, and stomach.


Symptoms of Peripheral Artery Disease-
Peripheral Artery Disease is the most common type of condition in people. Some people may not even notice the symptoms. The symptoms include:

Pain in the hips and lower leg area.
Brittle toenails.
Short breath while taking stairs.
Pain in the calf.
Numbness and coldness in the leg around a calf
Hair loss on legs and feet
Erectile dysfunction in men
Repeated sores and ulcers in legs
Causes of Peripheral Artery Disease-
The most common cause of Peripheral Artery Disease is the deposit of fatty substances inside the arteries. The fatty deposits build in the arteries gradually with a process called Atherosclerosis. Most of the time people do not know that they are facing the problem of Atherosclerosis. With time deposits increase and the arteries become narrow. It restricts the blood flow and causes problems for other organs.
Another cause for Peripheral Artery Disease is clot created in the arteries due to diabetes. Also, this problem is common in diabetic patients and increases with old age.

The risk factors that contribute to the development of Peripheral Artery Disease are high blood pressure, bad cholesterol, obesity, and diabetes.

Diagnosis of Peripheral Artery Disease-
The primary way to test and diagnose Peripheral Artery Disease is to check the blood pressure in the arm and ankles. If the pressure is low as compared to arm in the ankles, one might be facing Peripheral Artery Disease. It is commonly known as the ankle-brachial index. Other ways to determine Peripheral Artery Disease are CT scans, angiography, and blood tests. Since the disease is prevalent and gradually progress, most of the time it remains undetected.

It is essential that Peripheral Artery Disease gets detected and treated well in time. If the condition persists for a more extended period of time, it may result in loss of leg, increased chances of coronary artery disease and carotid atherosclerosis.

Treatment for Peripheral Artery Disease-
The only way to treat Peripheral Artery Disease is to indulge in physical activity. A regular regime of exercise and physical work will help a person to burn fat and makes the arteries fat free. Doctors suggest that daily 30 minutes of walking or gyming will help treat Peripheral Artery Disease with significant effects. One may notice the signs in just a couple of months.

Along with exercise, one also needs to monitor the weight and eating habits. Foods that are rich in fats and bad cholesterol should be avoided. Make changes in the lifestyle and eat a healthy balanced diet. Include fruits and fresh vegetables in the diet and follow a low carb diet for regular food intake. If a person is addicted to smoking and alcohol, then he/she should consider leaving the bad habits for their own good health.

Take Away-
Above are some of the common and tried treatments. However, it is advisable to consult a doctor before opting for any of these options as these treatments are depended upon the condition of the patients.


Learning In depth About Peripheral Artery 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?

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