Peripheral Artery Disease

Venous Insufficiency

Peripheral artery disease (PAD) is a narrowing of the peripheral arteries to the legs, stomach, arms, and head - most commonly in the arteries of the legs. PAD is similar to coronary artery disease (CAD). Both PAD and CAD are caused by atherosclerosis that narrows and blocks arteries in various critical regions of the body. The most common symptoms of PAD involving the lower extremities are cramping, pain or tiredness in the leg or hip muscles while walking or climbing stairs. Typically, this pain goes away with rest and returns when you walk again. In more severe cases, PAD can lead to pain in your feet at rest, particularly when you are in bed. In the most severe cases, PAD can lead to wounds not healing. Left untreated, PAD can lead to gangrene and amputation. Many people mistake the symptoms of PAD for something else. PAD often goes undiagnosed by healthcare professionals. People with peripheral arterial disease have a much higher risk of heart attack or stroke. Added risks for PAD If you smoke, you have an especially high risk for PAD. If you have diabetes, you have an especially high risk for PAD. People with high blood pressure or high cholesterol are at risk for PAD. Your risk increases with age.

Venous insufficiency is a condition where the flow of blood through the veins is inadequate, causing blood to pool in the legs. It can be caused by several different vein disorders, but it’s most often caused by either blood clots or varicose veins. Your treatment options depend on what’s causing the condition, but your doctor might recommend compression stockings and prescription medications. In more serious cases, you may need surgery. Your arteries carry blood from your heart out to the rest of your body. Your veins carry blood back to the heart, and valves in the veins stop the blood from flowing backward. When your veins have trouble sending blood from your limbs to the heart, it’s known as venous insufficiency. In this condition, blood doesn’t flow back properly to the heart, causing blood to pool in the veins in your legs. Several factors can cause venous insufficiency, though it’s most commonly caused by blood clots (deep vein thrombosis) and varicose veins. Even if you have a family history of venous insufficiency, there are simple steps you can take to lower your chances of developing the condition.

End-Stage Renal Disease

Conditions Treated

When kidney function worsens to the point that dialysis needs to be started, we can place catheters necessary for dialysis to be performed. In addition, we are experienced in maintaining or repairing fistulas which are typically placed in the arm for dialysis and from time to time begin to function poorly.

Chronic Mesenteric Ischemia (CMI)

Chronic mesenteric ischemia (CMI) associated with peripheral vascular disease often presents with insidious symptoms including postprandial abdominal pain, weight loss, food aversion and sometimes diarrhea. Diagnosis often requires CT angiography or MR angiography. Usually, mesenteric ischemia due to atherosclerotic disease requires stenosis or occlusion of two out of the three mesenteric arteries. The gold standard for diagnosis and treatment of CMI is catheter angiography with endovascular revascularization. At Florida Endovascular and Interventional, we have years of experience diagnosing and treating CMI. The vast majority of CMI patients can be diagnosed and treated as outpatients. Patients can safely undergo revascularization of the visceral vessels in our office-based endovascular suites.

Varicocele

Varicocele is the number one cause of male infertility and is caused by gonadal vein reflux. Varicose veins develop in the scrotum and can lead to decreased sperm count and motility. In addition, testosterone levels can decrease and eventually varicocele can lead to testicular atrophy. When symptomatic, varicocele can be treated with outpatient surgical techniques by Urologists or by gonadal vein embolization by the physicians at Florida Endovascular and Interventional. Both treatments have been shown to be equally effective and are viable options to treat this disorder. In the case of recurrent varicocele after gonadal vein ligation, the standard treatment is embolization.

Erectile Dysfunction

Erectile dysfunction can be due to multiple etiologies including psychosocial causes, arterial insufficiency and venous leakage. A thorough workup should be performed by a Urologist to determine if there are any physiologic causes of ED. Often, an ultrasound evaluation can determine that arterial insufficiency can contribute to ED. In the cases in which arterial insufficiency is suspected, referral to the vascular specialists at Florida Endovascular and Interventional should be considered. A thorough examination of the vascular supply to the pelvis would be performed, usually with CT Angiography. If necessary, using minimally invasive treatments, the arterial flow to the penis can often be significantly improved. This, in conjunction with pharmacologic therapy, is often sufficient to improve erectile function and return normalcy to the patient's sexual relationships.

The liver is one of the most common sites of spread of many types of cancer, including colorectal, breast, pancreatic, lung and biliary adenocarcinomas. The treatment of cancers which have spread to the liver include medical, surgical and minimally invasive therapies which aim to improve the survival and quality of the life of patients. Recently, multiple new advanced therapies to treat cancer that has spread to the liver have been developed and are minimally invasive. Studies have shown that these treatments are safe, well-tolerated and can improve both the quality of life and survival of the patients treated.

Complication of Liver Disease 

Metastatic Disease to the Liver

Cancer that arises in the kidneys comes from either the functional tissue of the kidney or from the lining of the collecting system. Renal cell carcinoma arises from the functional tissue of the kidney and is far more common than other types of kidney cancer. Frequently, RCC is found incidentally on imaging for other reasons. Treatments for RCC range from watchful waiting or minimally invasive therapies to open surgery with or without chemotherapy. Some treatments such as surgical resection of all or part of the resected kidney has the potential side effect of causing worsening kidney function or the initiation of dialysis. Stage I RCC (measuring less than 7 cm in diameter) is potentially cured with minimally invasive treatments such as percutaneous ablation with or without transcatheter embolization. This treatment largely avoids the added risk of open surgical procedures and is the treatment most likely to preserve the most kidney function.

The normal liver serves many functions including filtering blood from the gut. Cirrhosis is scarring that develops in the liver in response to various types of injury to the tissue of the liver. Viral infection, alcohol abuse, autoimmune diseases, and other processes can cause the liver to be injured. When the liver develops cirrhosis, several complications can develop, including fluid in the belly called ascites. Another complication is the development of enlarged veins around the stomach or esophagus. These can cause anemia or severe bleeding. Dr. Anderson at Florida Endovascular and Interventional can evaluate and treat complications of liver disease.

Primary Liver Cancer

The liver is one of the most common sites of spread of many types of cancer, including colorectal, breast, pancreatic, lung and biliary adenocarcinomas. The treatment of cancers which have spread to the liver include medical, surgical and minimally invasive therapies which aim to improve the survival and quality of the life of patients. Recently, multiple new advanced therapies to treat cancer that has spread to the liver have been developed and are minimally invasive. Studies have shown that these treatments are safe, well-tolerated and can improve both the quality of life and survival of the patients treated.

Metastatic Disease to the Liver

The liver is one of the most common sites of spread of many types of cancer, including colorectal, breast, pancreatic, lung and biliary adenocarcinomas. The treatment of cancers which have spread to the liver include medical, surgical and minimally invasive therapies which aim to improve the survival and quality of the life of patients. Recently, multiple new advanced therapies to treat cancer that has spread to the liver have been developed and are minimally invasive. Studies have shown that these treatments are safe, well-tolerated and can improve both the quality of life and survival of the patients treated.

Primary Liver Cancer

Cancer that originates in the liver is known as hepatocellular carcinoma (HCC) if it arises from the liver tissue or cholangiocarcinoma if it arises from the bile ducts. The most commonly performed procedure to cure primary liver cancer is surgery to remove the cancerous tissue. Unfortunately, most of the HCC and cholangiocarcinoma is too advanced or in too difficult a location for curative surgery when it is diagnosed. The mainstay of treatment for HCC around the world are minimally invasive therapies to ablate or otherwise treat patients who are not surgical candidates.

Kidney Cancer Renal Cell Carcinoma (RCC)

Compression Fractures

Insufficiency fractures of the spine and pelvis are a major cause of pain and suffering in the elderly patient population. Prompt evaluation and treatment by an Interventional Radiologist can immediately improve the pain and suffering caused by spinal compression fractures. Risk factors for Compression Fractures Metastatic disease to the bone from:

  • Breast, lung, prostate, kidney cancer

  • Multiple myeloma

  • Benign Causes such as

    • Minor trauma

    • Osteoporosis

    • Side effects of medications

Uterine Fibroids

Chronic Pelvic Pain is extremely common, effecting up to one-third of all women during their lifetime.One of the most common causes of chronic pelvic pain is due to hard to detect varicose veins in the pelvis, otherwise known as pelvic congestion syndrome. Pelvic congestion syndrome is similar to the varicose veins that some women develop in the legs instead is caused by enlarged veins that arise from the ovarian veins in the pelvis. These bulging swollen veins can involve the uterus, ovaries and even the vulva, groin and buttocks. These veins are often missed because they collapse when lying down during physical examination. Chronic pelvic pain associated Pelvic Congestion Syndrome is typically dull and achy and involves the belly and back. The pain is usually worse during your periods, after standing all day, and following intercourse.

Pelvic Congestion Syndrome

Fibroids are benign, non-cancerous growths that frequently develop within the walls of the uterus. Fibroids can range in size from less than an inch across to more than six inches. Nearly half of all women have fibroids although not all fibroids cause symptoms. African American women are more likely to have fibroids that cause symptoms. The most common symptoms include:

  • Heavy, prolonged periods, often with clots

  • Fatigue due to anemia

  • Pelvic pain or pain in the back of the legs

  • Pain during sexual intercourse

  • Frequent urination

  • Constipation or bloating

  • An enlarged belly

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