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!

In our bodies, the vascular system is composed of vessels. This system is comprised of a complex network of veins and arteries. The arteries transport oxygenated blood away from the heart and spread it throughout our bodies and veins brings the deoxygenated blood (oxygen-poor) back to the heart for purification. Whenever this complicated process gets disturbed, pain, dysfunction of the system, and other complications may occur.

Most common complications among all are:
1. Abdominal Aortic Aneurysm: This condition is when there is a  bulge  formed in the weak area of the largest artery in the abdomen and keeps on increasing with each pressure flow of blood from that artery. This condition weakens the artery further and massive internal bleeding may occur.

2. Carotid Artery Disease - Stroke: This condition arises when the main blood vessels flowing blood to the brain develops a plague caused due to hardening of the arteries (atherosclerosis). The continuous increase of plague can cause a stroke.

3. Peripheral Arterial Disease: This condition occurs when the flow of oxygen-rich blood is insufficient to the lower limbs of the body due to hardening of the arteries in that area. This can cause difficulty in walking, foot ulcers, infections and can even lead to amputation.

The complication of these types are corrected by the vascular surgeon with the process is commonly known as vascular surgery. However, this condition is sometimes medically managed by an innovative, less invasive procedure called Endovascular surgery. 

Vascular Surgery-
Vascular surgery is generally the traditional surgery that corrects the diseases outside of the heart and the brain. This procedure is more invasive as it involves incisions that are surgical in nature. Vascular surgery comprises of the surgery of the aorta, carotid arteries, and other small diametric arteries. This surgery also involves surgery of veins for treating various conditions such as varicose veins and May-Thurner syndrome.

Endovascular Surgery:
However, this type of surgery is an innovative way to treat medical conditions related to the vascular system. For instance, during the procedure of treating the Abdominal Aortic Aneurysm, it involves making a small cut near the hip area and inserting the endovascular graft through the arteries and is positioned inside the aorta, in a catheter, which is a flexible, long, and narrow tube. The endovascular graft is a tube device made up of special fiber and is framed within stainless steel self-expanding stents. The grafts expand and seal off the aneurysm. This stops the internal bleeding the system and the graft remain in the aorta permanently.

This method has a short recovery time, smaller incisions, less discomfort, less stress on the heart and has fewer risks. This surgery is appropriate for the patient who is at high
risk of complications. 

Take Away-
Diseases related to artery and veins are now being treated with various methods such as angiography, stenting, sclerotherapy in various countries. These days vascular surgeons have become proficient with the endovascular surgical methods. Endovascular surgery is durable and less painful and stressful when viewed with the context of vascular surgery. However, the cost of staying longer at the hospitals is somewhat got balanced by the high cost of imaging equipment and other high financial expenses in the endovascular surgery.

Endovascular VS Vascular Surgery - Know The Difference!

Varicose veins are bulging blue veins on the legs that can cause leg swelling, skin blackening and even open wounds called ulcers. It is commonly seen in people aged 35 and above who have to stand a lot. Here are a few tips to prevent these:

1. Avoid standing for long periods: standing for long periods of time causes blood to pool in your leg veins and they begin to bulge out like a balloon. Avoid standing desks at your work. If you have to stand, take a 5-minute break every hour and walk around or sit down.

2. Keep weight in check: overweight people have a higher incidence of varicose veins. Keeping your weight in check would also prevent varicose veins.

3. Exercise 30 minutes a day: exercise, especially brisk walking or jogging, will get the blood in your leg veins to circulate and thus prevent varicose veins.

4. Take the stairs: this simple exercise activates your calf muscles and gets blood to circulate in your veins.

5. Be vigilant: calf cramps, swelling, change in colour of skin over foot and open wounds over the feet are a few signs that you need to look out for. Seek medical help to prevent worsening of this disease.

Follow these simple steps and you would be able to prevent varicose veins and have healthy feet.


5 Tips To Prevent Varicose Veins and Varicose Ulcers

What is Deep Vein Thrombosis?

Blood clots can arise anywhere in your body. They develop when blood thickens and clumps together. When a clot forms in a vein deep in the body, it's called Deep Vein Thrombosis (DVT). Deep vein blood clots typically occur in the lower leg or thigh. But if your symptoms stem from a blood clot deep in your leg, it can be dangerous. Blood clots can happen to anyone, anytime. But some people are at increased risk. Therefore, they should immediately consult with vein specialist to avoid blood clot forming in the veins which can help avoid potentially serious problems.

DVT Symptoms:

"Deep vein thrombosis has classic symptoms - for example, swelling, pain, warmth, and redness on the leg," says Dr. Rajendra Bansal, a DVT treatment expert in Jaipur.  But about 30 40% of cases go unnoticed since they don't have typical symptoms.  In fact, some people don't realize they have a deep vein clot until it causes a more serious condition.

Deep Vein Clots:

DVT symptoms include deep vein clots - especially those in the thigh - can break off and travel through the bloodstream. If a clot lodges in an artery in the lungs, it can block blood flow and lead to a sometimes-deadly condition called pulmonary embolism. This disorder can damage the lungs and reduce blood oxygen levels, which can harm other organs as well.

Some people are more at risk for deep vein thrombosis than others. "Usually people who develop deep vein thrombosis have some level of thrombophilia, which means their blood clots more rapidly or easily," Dr. Bansal says, a DVT specialist in Jaipur. Getting a blood clot is usually the first sign of this condition because it s hard to notice otherwise. In these cases, lifestyle can contribute to a blood clot forming if you don t move enough, for example. Your risk is higher if you ve recently had surgery or broken a bone if you re ill and in bed for a long time, or if you're traveling for a long time (such as during long car or airplane rides).

Other Symptoms:

Having other diseases or conditions can also raise your chances of a blood clot. These include a stroke, paralysis (an inability to move), chronic heart disease, high blood pressure, surgical procedure, or having been recently treated for cancer. Women who take hormone therapy pills or birth control pills are pregnant, or within the first 6 weeks after giving birth are also at higher risk. So are those who smoke or who are older than 60. But deep vein thrombosis can happen at any age.

Chronic vs Acute DVT:

Chronic DVT refers to long-standing venous thrombosis present for more than 28 days.  It can either permanently block the vein or it can adhere to the wall of the vein.  Chronic DVT that doesn t block the vein can still cause long-term problems known as Post Thrombotic syndrome which occurs due to pooling of blood in legs by gravity as the protective valves are damaged or destroyed. Patient symptoms are:

Leg swelling after standing for long periods
Aching pain
Varicose veins
Skin ulcers in severe cases.
Acute DVT refers to venous thrombosis for which symptoms have been present for 14 days or less. The symptoms of acute DVT are sudden limb swelling and pain. During this period the clot is soft and easily treated with clot-dissolving drugs. The period between 14-28 days is called Sub-acute DVT.

Clues of a Clot:

Seek DVT treatment if you have these symptoms. They may signal a deep vein clot or pulmonary embolism:

Swelling of the leg or along a vein in the leg
Pain or tenderness in the leg, which you may feel only when standing or walking
Increase in warmth in the area of the leg that s swollen or painful
Red or discolored skin on the leg
Unexplained shortness of breath
Pain with deep breathing
Coughing up blood
A prompt diagnosis and a proper DVT treatment can help prevent the complications of blood clots. See your doctor immediately if you have any signs or symptoms of deep vein thrombosis or pulmonary embolism. A physical exam and other tests can help doctors determine whether you ve got a blood clot.

Your doctor will diagnose deep vein thrombosis (DVT) based on your medical history, a physical exam, and the color Doppler ultrasound or sometime may require CT or MRI. He or she will identify your risk factors and rule out other causes of your symptoms. After analyzing the risk factors, the doctor will tell you whether you need an immediate DVT treatment or not.

DVT Treatment

There are many ways in Deep Vein Thrombosis treatment. DVT treatment process includes medicines, certain devices, and therapies. The main goals of DVT treatment include:

Stopping the blood clot from getting bigger
To dissolve the already formed clot
Preventing the blood clot from breaking off and moving to your lungs
Reducing your chance of having another blood clot
To prevent long-term complication known as Post Thrombotic Syndrome.
Anticoagulants (Blood Thinners):

These are the most common medicines in DVT treatment. These medicines decrease your blood s ability to clot. They also stop existing blood clots from getting bigger. However, blood thinners can t break up blood clots that have already formed. (The body dissolves most blood clots with time.)

Blood thinners are taken either as a pill, an injection under the skin, or through a needle or tube inserts into a vein (called intravenous or IV injection). There are different types of  Blood thinner. The choice of anticoagulant depends upon multiple factors, including the preference of the patient and the healthcare provider, the patient s medical history and other conditions, and cost considerations.

Initial anticoagulation is continued for 5 to 10 days. After that, long-term anticoagulation is continued for 3 to 12 months depending upon the patient profile, length of vessel involvement and risk of recurrence. In some patient where permanent risk factor like a congenital cause or cancer lifelong anticoagulation may require.

Other available treatments, which are for specific situations, include thrombolytic therapy or placing a filter in a major blood vessel (the inferior vena cava).

Thrombolysis (Clot-Busting DVT Treatment):

Minimally invasive procedures in DVT treatment are performed by an interventional radiologist under X-ray Guidance, if a patient has severe pain, difficulty in walking, significant swelling while on blood thinners, or if there is clot blocking the pelvic veins (iliac veins).  When performed early, thrombolysis is highly effective at dissolving a clot and preserving the valves in the veins.

It is designed to rapidly break up the clot, restore blood flow within the vein, and potentially preserve valve function to minimize the risk of post-thrombotic syndrome. The interventional radiologist inserts a tiny tube called catheter into the vein behind the knee or other leg vein and threads it into the vein containing the clot using x-ray guidance. The catheter tip is placed into the clot and a  clot-busting  drug is infused directly to the thrombus (clot) followed by clot removal by special devices. The fresher the clot, the faster it dissolves   one to two days. Clinical resolution of pain and swelling and restoration of blood flow in the vein is greater than 85 percent with these invasive techniques.  In patients in whom thrombolysis or blood thinners are not medically appropriate, an interventional radiologist can insert a vena cava filter, a small device that functions as an umbrella to capture blood clots that would float to the lung, but allows normal liquid blood to pass.

DEEP VEIN THROMBOSIS PREVENTION:

You can take simple steps to lower your chances for a blood clot:

Exercise your lower leg muscles if you re sitting for a long time while traveling.
Get out of bed and move around as soon as you re able after having surgery or being ill.
The more active you are, the better your chance of avoiding a blood clot.
Take any medicines your doctor prescribes to prevent clots after some types of surgery.
Wear compression stocking to prevent complication or recurrence as per instruction.
Keep regular follow-up with your doctor to avoid or prevent post DVT complication.
SPECIAL PRECAUTIONS FOR PEOPLE WITH DEEP VEIN THROMBOSIS:

Patients being treated for venous thrombosis are at an increased risk for developing another blood clot. The patient should watch for new onset leg pain or swelling. If these symptoms occur, the patient should speak to his/her health care provider or seek medical attention as soon as possible.
Risk of bleeding is high with anticoagulant so dose should not change unless the provider or clinic directs the patient to do so.
Patients may bleed easily from anywhere while taking anticoagulants. In some cases, bleeding can develop inside the body and can t notice immediately. Bleeding inside the body can cause a person to feel faint, or have pain in the back or abdomen. A healthcare provider should be notified immediately if there is any sign of this problem.

What is Deep Vein Thrombosis (DVT) - Symptoms,Treatment & Prevention

Varicose veins are known to be a very common problem, which result in the inflammation of veins in the body. Veins are the blood vessels, which are responsible for the transfer of deoxygenated blood from the different parts of the body to the heart. Because the blood does not contain oxygen, it has a bluish tinge. As a result varicose veins are most likely to appear bluish when swollen. 
This condition is quite common in old people and some are even likely to develop slight ulcers in the vein. 
Homeopathic treatment for varicose veins
Certain homeopathic drugs are said to work wonders for this condition, as they not only offer pain relief, but also make the veins more elastic. This helps with effective circulation and thus, the swelling reduces. The following is a list of some homeopathic medicines that work best to cure varicose veins.
1. Hamamelis
It is known to be the best cure for varicose veins. It effectively stops any sort of bleeding from the veins. It also offers relief from pain and from a sensation of heaviness of the legs. 

2. Pulsatilla
This medicine is greatly recommended for women who develop varicose veins during the course of their pregnancy. It immediately does away with the pain. The medicine especially works well for swollen veins of the legs and the hands. Application of a cold pack also helps relieve the pain and reduce swelling. 

3. Calcarea
It is generally recommended to patients who have varicose veins, but do not suffer from any pain. In case the patient feels chilly and suffers from various other symptoms like some sort of burning sensation in the veins or cold hand and feet, calcarea is a good cure. 

4. Graphites
It is known to be a great cure for varicose veins that is accompanied with some amount of itching and cramping. 

5. Arnica
This homeopathic medicine effectively deals with varicose veins accompanied with symptoms like soreness and bruising.

5 Best Homeopathic Remedies for Varicose Veins Ulcers

Varicose veins and chronic venous insufficiency both affect the veins of the legs. The veins in the legs are equipped with one-way valves, which direct the flow of blood from the legs to the heart. If these valves malfunction, the blood may flow backwards. This blood may collect in small pools somewhere in the veins or the veins may become enlarged and swollen. This causes immense pain that makes it difficult to go about your everyday activities.

What are the complications linked with varicose veins and chronic venous insufficiency? 

Usually, both disorders cause a lot of discomfort and pain. But sometimes the varicose vein may rupture and cause varicose ulcers on the skin of your legs. The blood clot may travel to your heart and it may lead to cardiac complications.

Who is susceptible to varicose veins and chronic venous insufficiency?

Although anyone can get varicose veins or chronic venous insufficiency, women are more likely to develop these venous disorders than men. The chances go up if you are-

  Older than 50
  Obese
  If someone in the family has varicose veins or chronic venous insufficiency
  Pregnant or if you have been pregnant before
  If you have been diagnosed with blood clots
  If you consume alcohol or smoke

Diagnosis of varicose veins and chronic venous insufficiency-

As interrupted blood flow leads to both varicose veins and chronic venous insufficiency, your doctor will conduct a blood flow test through a duplex ultrasound. The sound waves can help determine in which direction the blood is flowing and the speed of the flow.

Treatment of varicose veins and chronic venous insufficiency-

The doctor will ask you to implement lifestyle changes-

  You need to lose weight because being overweight is the chief contributing factor towards both these disorders. Besides regular exercise can improve blood flow through your veins
  Do not sit for long stretches of time. Go for small walks and stretch those legs.
  Medications that can target the pain and the swelling

Surgery:

If medication and lifestyle changes do not work, you might have to undergo surgery. The surgery is performed under general anaesthesia. You can leave on the same day. Not much follow-up care is required.

Sclerotherapy: Another popular option is sclerotherapy . A chemical is injected into the vein that closes it. The scar it produces will disappear within 4-5 days.

Laser therapy: Painless small procedure to close diseases vein.

Open surgery: Small cuts over skin to remove diseases vein.

Both varicose veins and chronic venous insufficiency are accompanied by pain. Medication can help keep the pain and discomfort under check but in severe cases surgery is necessary.

Varicose Veins & Chronic Venous Insufficiency!

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