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!

Peripheral vascular disease (PVD) is a circulation issue that affects the veins and blood vessels outside of the brain and heart. PVD commonly strikes the veins that supply blood to the arms, legs, and organs situated beneath the stomach. These are the veins that are located away from the heart. They are known as peripheral vessels.

In PVD, the width of the veins get limited. Narrowing is normally created by arteriosclerosis. Arteriosclerosis is a condition where plaque develops inside a vessel. It is additionally called 'solidifying of the arteries'. Plaque acts towards reducing the amount of blood and oxygen that is supplied to the arms and legs. As the plaque development advances, clumps may develop, which may further affect the vessel.

There are two main types of PVDs:

    Functional PVD: This doesn't include physical issues in the veins. It causes accidental side effects. Typically,these fits happen suddenly.
    Organic PVD: This includes changes in the vein structure. This sort of PVD causes irritation, tissue harm, and blockages.

The most well-known reasons for functional PVDs are as follows:

    Emotional stress
    Smoking
    Cold temperatures
    Operating Vibrating machinery

The common causes of such natural PVDs are given below:

    Smoking
    High circulatory strain
    Diabetes
    High cholesterol

The symptoms include the following:

    Cramps
    Achiness
    Fatigue
    Burning

Diagnosis:

PVD can be diagnosed using interventional radiology (IR).

IRis a sub-claim of radiology that gives an image-guided diagnosis, and if required, includes treatment of the organs as well.It has developed as a first-line treatment in the administration of PVD.

Advantages:

IR medications are for the most part less demanding for patients than surgery, since they include no surgical cut.They are less painful and have shorter stays at the hospital. By and large, the patients are discharged on the same day the procedure is done. This mainly includes angioplasty and stenting. The procedure is as follows:

    Utilising imaging for direction, the interventional radiologist puts a catheter through the femoral artery in the crotch to the blocked vein in the legs.
    At that point, the interventional radiologist expands a balloon to open the vein that is blocked.
    Sometimes it is opened with a tiny metallic cylinder called astent.
    This is a treatment that does not require surgery; only a scratch in the skin the extent of a pencil tip.

Alternative measure:

Angioplasty and stenting have totally replaced invasive surgical methods. Early trials have proven IR to be as successful as surgery for some blood vessel and artery impairments. Earlier, extensive clinical experience demonstrated that stenting and angioplasty are favoured as first-line treatments for more procedures all through the body .

Doctors as well as patients who have been through the same, believe that IR is much better for PVD than invasive surgery, since it reduces the risk of infection.

Diagnosing Peripheral Vascular Diseases With Interventional Radiology

Coronary artery disease is characterized by accumulation of plaque in the coronary artery that chokes blood supply to the heart. This plaque buildup usually starts with cholesterol accumulation and gradually other particles such as calcium and lipoproteins get deposited as well. Over time, the plaque accumulates, making the blood vessels narrow and choking the supply of blood. In some cases, if the plaque ruptures, it may lead to formation of blood clots resulting in stroke.

The symptoms of coronary artery disease are:

1. Breathing difficulties: This disorder may lead to shortness of breath as the blood pumping mechanism of the heart is impaired; this usually results in fatigue and exertion. It is advised to avoid advanced cardio exercises such as the high intensity interval training.

2. Chest pain: Stress related activities may cause intense pressure or tightness in your chest, resulting in pain in the middle or left portion of your chest. If you discontinue the activity, the pain would usually subside. In some cases, you may feel the pain in the arm and the neck.

3. Heart attack: If the level of plaque accumulation is excessive, then it may result in a heart attack. It is characterized by breathing difficulties, pain, tightness in the chest and sweating. You may also experience pain in the neck and the jaw.

The causes of coronary artery disease are:
1. Smoking and alcohol consumption
2. Leading a sedentary lifestyle ups the risk of coronary artery disease
3. Hypertension
4. High cholesterol levels in the body
5. Blood sugar problems

Treatment
1. Get your blood pressure under control: If you suffer from high blood pressure, then it is recommended to get it under control to prevent coronary artery disease.
2. Quit smoking: If you are a habitual smoker, then it is time to nip the habit in the bud. Smoking is known to constrict blood vessels as it is a vasoconstrictor.
3. Eat healthy: Eat a well balanced diet consisting of vegetables and fruits so that your body receives the essential nutrients to function well.
4. Beat stress: You need to control your stress levels through exercise or meditation. Take time off work and do activities that make you happy.

Coronary Artery Disease: Causes and Treatment

Varicose veins are large veins that appear on the legs of some patients. Usually, blood travels to the legs from the heart through the arteries, and the veins take it back to the heart. The valves in the veins allow the blood to travel from the legs to the heart against gravity. During this process, the valves may leak and blood may collect in the veins, making them appear enlarged.
EVLT (Endovenous laser therapy) is the latest method for curing varicose veins without surgery. It heats the affected veins them through a laser instead of removing them.
Process
In this process, at first, an ultrasound scan is carried out to locate the veins that have to be treated. After marking them, the doctor applies local anaesthetic on the skin and a needle is inserted into it. A wire is then passed through the needle up to the target vein. Over this wire, a catheter is passed after removing the needle. After that, the wire is removed.
Through the catheter, a laser fibre is placed whose tip usually reaches up to the groin crease. Using tiny needles, a large amount of local anaesthetic solution is applied in the region surrounding the vein. The laser is then applied for 5 minutes on the veins. You might hear a buzz or feel a burning sensation but won t feel any pain. The catheter and the laser are then removed and the incision is covered.
The process takes about 30 minutes to complete. After the treatment, you will be advised to wear compressions stockings and can go back to your normal routine immediately.
Benefits
The different benefits of the surgery are:
The skin does not have to be stitched 
There is no pain in the process and patients can go back to work right after the treatment
The process is free from complications 
No scars are left after the treatment

Common uses of the process
EVLT is also used for treating the following:
Swelling of the veins 
Discolouration of the skin
The heaviness of the leg
Skin ulcers and irritation
Precautions
These are the precautions that you must take:
A week before the process, avoid taking arthritis medications, aspirin, and Ibuprofen as they can increase the chances of bruising 
Avoid alcohol and tobacco 2 days before the procedure
After the treatment, ask someone to drive you back home and do not use public transport
Avoid activities like swimming, running, jogging and weightlifting for at least 2 weeks after the procedure

The varicosities fade away after the process but rarely disappear completely. You might require further treatment for improving the appearance of the veins. 


EVLT Varicose Veins Treatment!

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?

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!

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