Vascular Treatments and Services
The physicians at Arizona Vascular Solutions are committed to providing patients with the highest quality venous treatments and services available. An individual treatment plan is developed for each patient, taking into account his or her medical condition and/or cosmetic requirements.
We are constantly advancing our surgical techniques through innovation. We use cutting-edge technology that empowers us to treat our patients safely, in our unique and intimate environment, and broadens our ability to treat an array of complex diseases.
We deliver value driven results with measurable outcomes and a minimally invasive approach.
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STAT procedure treatments accommodated within 4-6 hours.
We offer the following Vascular treatments & services:
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Angioplasty
An angiogram is commonly used to treat arterial diseases such as peripheral arterial disease and renal artery disease. Depending on the severity and characteristics of the blockage, there are two types of angioplasty that are commonly used.
Balloon Angioplasty
Using imaging for guidance, the interventionalist threads a catheter through a small incision in the groin and guides it to the renal artery–the large blood vessel that carries blood to the kidneys. Then they inflate a balloon to open the blood vessel and compress the blockage. The balloon is deflated and removed while keeping the catheter in place so that contrast dye can be injected to evaluate the result.
If blood flow is improved and less than 30% of the blockage remains, the angioplasty is considered successful. If the vessel is still too narrow, placing a stent may be needed.
Angioplasty with Stenting
When a balloon angioplasty is unable to effectively improve blood flow on its own, a tiny metal cylinder called a stent may be placed to hold the blood vessel open. Stents are considered permanent and cannot be used as a treatment option for patients with a metal allergy.
Both of these procedures are considered minimally invasive outpatient treatments that do not require open surgery. As with an angiogram, the incision is roughly the size of a pencil tip and numbed using a local anesthetic. Patients are usually able to go home the same day.
Angiography
Considered the gold standard for evaluating blockages in the arterial system by the Society of Vascular Surgery, an angiogram is an X-ray procedure used to detect blockages and other blood vessel problems.
An angiogram can show how many of your coronary arteries are blocked or narrowed, pinpoint where the blockages are located and show to what extent blood flow is restricted. This procedure may also be used to evaluate the results of a previous coronary bypass surgery.
During the angiogram, the doctor inserts a thin tube (catheter) into the artery through a small incision in the skin about the size of the tip of a pencil. A substance called a contrast agent (X-ray dye) is injected to make the blood vessels visible on the X-ray.
Medication may be given to help make a patient more comfortable, but he or she will remain awake throughout the procedure. The area where the catheter is inserted will be numbed. Patients may feel slight pressure as the catheter is inserted and some chest discomfort as the dye is administered.
In many cases, the vascular interventionalists can treat a blocked blood vessel without surgery at the same time the angiogram is performed. They treat blockages with techniques called angioplasty and stent placement.
Depending on how difficult the test is and how much treatment is needed, the procedure typically takes between 30 minutes and 2 hours. Patients can generally go home the same day.
Why Angiography May be Recommended
Your doctor may recommend an angiogram if you have any of the following symptoms:
- Unexplained pain in your chest, neck or arm
- New or increasing chest pain
- Heart defect present since birth, such as congenital heart disease
- Symptoms of coronary artery disease, such as chest pain
- Abnormal results from a non-invasive heart stress test
- Injury to the chest
- Heart valve problem that requires surgery
- Other blood vessel problems
Angioplasty with Stenting
The severity and characteristics of the blockage will determine the type of angioplasty needed. When a balloon angioplasty is unable to effectively improve blood flow on its own, a tiny metal cylinder called a stent may be placed to hold the blood vessel open. Stents are considered permanent and cannot be used as a treatment option for patients with a metal allergy.
Stent placement is much less invasive and considered a relatively low-risk, low-cost procedure compared to open surgery. The procedure is performed using local anesthesia using the same incision as for the angiogram, which is roughly the size of a pencil tip and doesn’t require stitches.
Because general anesthesia is not needed for most patients, angioplasty with stenting is commonly performed as an outpatient procedure. Patients are usually able to go home the same day and able to return to normal activities shortly afterward.
Why Angioplasty with Stenting May be Recommended
Angioplasty with or without stenting is commonly used to treat conditions that narrow or block blood vessels causing disruption to blood flow. These conditions include:
- Peripheral artery disease
- Renal vascular hypertension
- Narrowing in dialysis fistula or grafts
Atherectomy
Atherectomy is a minimally invasive procedure similar to angioplasty. It is performed to cut away plaque that has built up in the arteries. After the plaque is removed, a stent may be placed to keep the artery open.
Catheter Access / Placement / Removal
Catheter Placement
Most often, the physicians at ACS use a venous catheter to give temporary access to patients that need to start hemodialysis treatment immediately. The catheter is inserted into a vein in the neck or chest directly into the heart. The extensions hang outside of your chest or neck so that blood can flow to and from the dialysis machine.
Catheters are not ideal for the long-term access that dialysis patients generally require. However, for patients whose kidney disease has progressed quickly, a catheter can be used for several weeks or months while permanent access develops.
Catheter Removal
For most dialysis patients, catheters are temporary until permanent access develops, at which point the catheter will be removed.
Permanent access options include:
Fistula: Considered the gold standard for dialysis access, an arteriovenous fistula involves a direct connection between an artery and a vein. A fistula takes approximately 6-8 weeks to mature before it can be used for dialysis.
Graft: A graft, or synthetic tube, can also be used to create a direct connection from an artery to a vein. Grafts are not suitable for all patients, but those that are can typically begin dialysis within 2-4 weeks of placement.
Once permanent access has been established patients should never try to take a catheter out themselves or put a catheter back that has come out prematurely. If you feel that your catheter is not working properly, call your doctor right away.
Dialysis Access
Also known as Arteriovenous Fistula, Arteriovenous Graft, Shunt
A tunneled catheter in your neck—temporary, because the possibility of infection is high.
An AV fistula—taking a piece of a vein from your arm or leg and sewing it into a nearby artery, and allowing the sewn-in vein to enlarge and become thicker, like an artery. Considered the best option because it has the lowest risk of infection.
An AV graft—the sewing of a prosthetic graft between an artery and vein in your arm or leg. The preferred option if your veins are too small for an AV fistula. AV grafts tend to close more quickly and are more prone to infection because they are not formed from natural tissue.
Peritoneal dialysis—placement of a small tube, called a cannula, in your abdomen to allow the use of the lining of the abdomen (peritoneum) to filter your blood. It requires several “exchanges” every day: you introduce and remove fluid through the tube. A convenient option because you perform the dialysis therapy at home, but infections sometimes occur and the tube can become clogged.
Embolization’s and Stents
Restricting Vascular Access
In some cases, vascular access may need to be restricted such as to control or prevent abnormal bleeding, cut off blood supply to a tumor or eliminate abnormal connections between arteries and veins.
What is an Embolization?
Embolization is a highly-effective, minimally invasive method to restrict vascular access. At Arizona Vascular Solutions, we commonly use embolization to treat pelvic congestion syndrome (PCS)–a chronic condition that occurs in women when varicose veins form within the pelvic region below the abdomen.
IVC Filter Access / Placement / Removals
Your inferior vena cava (IVC) is one of your body’s major blood vessels that delivers deoxygenated blood back to your heart after it’s delivered oxygen to your lower body. In order to prevent blood clots in your legs from traveling up into your heart or lungs, an IVC filter can be placed in the IVC, directly beneath your kidneys.
About the Procedure
IVC Filter placement and removal is a minimally invasive surgery. The implantation of the IVC filter involves a local anesthetic and numbing medication injected in your skin in the area that the IVC filter will be inserted, preventing discomfort during the surgery.
Once the anesthetic has begun to take effect, a catheter will be inserted into your body through your leg or neck, where it can then be guided into the IVC in your abdomen area. With the use of an x-ray dye, x-rays will be taken so that the catheter can be moved to the correct location within the IVC.
After the catheter has been correctly placed, the filter will be threaded through the catheter where it will attach to the wall of your IVC and remain in place until a later surgery to remove it. After the filter is placed, the catheter will be removed and the incision area will be bandaged.
While the filter is in your body, it will filter the blood passing through the IVC on the way back to your heart, catching clotted blood as it flows through the filter. Once your doctor has determined that the filter is no longer necessary, it can be removed in a procedure similar to the procedure involved in placing the filter.
Why an IVC Filter Placement and Removal May Be Recommended
IVC filters are a common treatment method for people who have been diagnosed with a pulmonary embolism or deep vein thrombosis who also cannot take blood-thinning medications for various medical reasons.
A pulmonary embolism is a clump of material, usually a blood clot that becomes lodged in an artery in your lungs. The clump of material or blood clot from a pulmonary embolism usually originates in the deep veins in your legs. When this occurs, it is referred to as deep vein thrombosis. If the blood clot was able to travel all the way back to your heart, it could form a larger clot in your heart, preventing blood flow to or from your heart, causing a serious medical emergency.
Thrombectomy
Surgical thrombectomy is a type of minimally-invasive surgery to remove a blood clot from inside an artery or vein. During a surgical thrombectomy, a surgeon makes an incision into a blood vessel. Using fluoroscopy, or continuous x-ray, the doctor guides instruments through the patient’s arteries to the clot, extracting the clot all at once to restore blood flow. In some cases, a balloon or other device may be put in the blood vessel to help keep it open.
What Thrombectomy Treats
Your doctor may recommend a thrombectomy for the following conditions:
- Deep Vein Thrombosis (DVT): a blood clot (thrombus) that forms in one or more of the deep veins in your body, usually in your legs. DVT is considered a serious condition because there is a risk of the clot breaking off and traveling to the lungs (pulmonary embolism).
- Ischemic Stroke: a condition that occurs when a blood clot forms in an artery leading to the brain, or in an artery in another area of the body that then moves to a brain artery, causing the blood supply to the brain to slow or stop.
Blood clots can cause a variety of symptoms including swelling, pain, numbness or tingling. Left untreated, they can lead to serious problems such as tissue or organ damage. They can also cause long-term problems with your veins.
Wound Care
Chronic non-healing wounds:
Without proper investigation research which includes vascular testing, advanced treatment methods, non-healing wound can lead to difficult and long-term health complications. These include severe pain, secondary infections, damage to body organs and systems, loss of limbs. Chronic non-healing wounds impact more than 6 million people in the United States, 1-2% percent of people will experience a non-healing wound in their expected lifetime. Unfortunately, they are difficult to treat requiring specialized care. We at Arizona Vascular treat a variety of patients with advanced non-healing wounds, and recommend best practices for their plan of care.
Things you should know DIABETES AND NON-HEALING WOUNDS:
Due to the correlation between diabetes and non-healing wounds, chronic wounds may happen, most particularly in the feet, and lower extremities most commonly found in people with diabetes due to damaged nerves in the legs or feet which affects cellular function. If you are diabetic, experiencing warmth, tenderness in one of limbs it is important you are examined by a specialist urgently.
Process to Healing
Healing a chronic wound occurs through a process of engagement between the patient and the specialists. The greatest factors which limit recovery from non-healing wounds are:
- Diabetes, preventing the body from healing appropriately
- Infection, causing wounds to become worse instead of better
- Arteriosclerosis, varicose veins, and other conditions associated to blood flow
- Age, older individuals have more non-healing wounds than younger people
- Obesity, places tension on the body, increasing the risk of infection
- Alcohol or tobacco use, impacts the body, interfering with healing
- Stress, limits the body’s natural ability to heal quickly
- Medication, although necessary for other health issues, contributes to chronic non-healing wounds
If a wound does not make improvement in healing within 4 weeks and/or persists beyond 8 weeks, it is defined as a non-healing wound.
Commonality of non-healing wounds:
- Venous Ulcers
- Arterial Ulcers
- Diabetic Foot Ulcers
- Pressure ulcers
- Wounds from inflammatory or autoimmune disease
- Surgical wounds
- Wounds from tumors, including cancerous lesions
The apparent fact these wounds do not heal easily, patients will often notice other symptoms early on in their development such as: increasing or throbbing pain, redness or discoloration beyond the edges of the wound, a feeling of warmth around the wound, oozing, or an odor.
It’s important to determine the causes behind non-healing wounds before treating them. Always consult a wound care specialist or vascular surgeon and not self-diagnose a non-healing wound, this can lead to a very serious outcome.
Our physicians are committed to providing patients with the highest quality treatments and services available.
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