Even though he was wearing a helmet when riding his motorcycle, in the Emergency Room the CT scan of Dick’s head showed some bleeding around his brain. He was a safe driver and was coming home from work when he was hit from behind while stopped at a light. After brain surgery to remove the blood, Dick was in the hospital bed recovering and not moving around that much. Ten years later he is doing fine but his left leg swells as the day progresses.
He wears compression stockings that help a little bit. John has chronic DVT.
Jane was always an athlete. Running was her main activity but in her 50’s Jane’s left knee was painful during and after running. After much physical therapy and medication, Jane had a knee replacement. Three years later she is back competing in triathlons. Her left leg is always more swollen than the right. It feels heavy and throbs by the end of the day. Jane has chronic DVT.
What happened to Dick and Jane? What is their problem? Can they be helped? March is National DVT Awareness Month. Dick and Jane both had a DVT in the past that was unrecognized and untreated. They now have symptoms due to the DVT and the damage that occurred to their veins. People get blood clots for many reasons: immobility from accidents or surgery, inherited clotting disorders, hormone therapy, long air or car travel, etc. Usually a DVT is diagnosed early and it is treated with blood thinners. Usually the blood clots don’t damage the veins but sometimes the veins develop scarring and narrowing and don’t work correctly. This is what happened to Dick and Jane.
The veins bring the blood back to the heart. When we walk the muscles in our legs pump the blood up the veins back in the direction of the heart. If the veins are scarred and narrowed (blocked), the blood can’t flow back as quickly as it should. Blood backs up and patients experience symptoms of: swelling, pain, pressure, throbbing in their legs. This is usually worse by the end of the day. Sometimes they even develop ulcers or skin discoloration around their ankles. Until recently patients were told that there really wasn’t much that could be done. All they could do was to wear compression stockings and elevate their legs. Now things are different. Now many times we can help by using procedures that stretch and widen the veins so that the blood can flow back to the heart more normally.
Angioplasty and stenting are what these procedures are called. Many of you may be familiar with the terms from treating blockages in the blood vessels of the heart. Veins are different, they are bigger. They may get blocked by previous blood clots or phlebitis (inflammation). Treating them is much less risky than treating the heart arteries. Once the diagnosis is made by either: ultrasound, MRI, CT scan or venography patients can have the narrowed parts of their veins made wider by stretching these areas with balloons (angioplasty) and then keeping them open by placing stents in the stretched veins. All of these procedures require no incisions or stitches, only a needle stick. Most patients return to normal activity in a day or so.
If you’ve had a DVT, if you have a leg ulcer, if you have symptoms that affect your quality of life then you should seek out a vein specialist that can help you. The diagnosis is non-invasive and the treatments are minimally invasive. Not every patient is a candidate for these procedures but many are. It depends on each individual’s anatomy and level of vein damage. Most patients can be helped. Hundreds of these procedures are done yearly, hundreds of people are helped. If you’ve had a DVT or know of someone who has had one, take advantage of March being National DVT Awareness Month. Seek out a vein specialist, find out your options, there is hope.
About Dr. Steven Elias: Steve Elias MD FACS FACPh, is the Director of the Center for Vein Disease at Englewood Hospital.. Dr. Steve Elias was recently named by VEIN Magazine as one of the 25 most influential professionals in vein care worldwide and voted “Best Doctor” in 2009, 2010 and 2011 by New York Magazine. In 2011, Dr. Elias was listed in The U.S. News & World Report Top Doctors in America. Castle Connolly as Top Doctor in the New York Metropolitan Area has named him for the last 9 years. He has been Visiting Professor at Yale University and has given keynote speeches at the Turkish Asian Vascular Society meeting and at the International Congress on Endovascular Interventions.
Dr. Elias lectures, publishes, and teaches nationally and internationally about minimally invasive vein care and surgical procedures. As Founder and Course Director of the Annual Vascular Fellows Course in Venous Disease, he trains young vascular surgeons in the treatment of vein problems. He is also the Course Director for the Expert Venous Management Course held at Englewood Hospital that teaches advanced vein care. His clinical interests encompass all aspects of vein care: spider veins, varicose veins, perforator and deep venous incompetence, and venous ulcers. Dr. Elias performs and teaches most minimally invasive vein procedures. His work also includes the prevention and treatment of DVT (Deep Venous Thrombosis).
Dr. Elias is a fellowship-trained vascular surgeon and is board certified in Phlebology and Surgery. Societal memberships include: The American Venous Forum, The American College of Phlebology, The Society for Clinical Vascular Surgery, American Venous Forum Foundation, American College of Phlebology Foundation, American College of Surgeons and the International Society of Cardiovascular Surgery. In addition, Dr. Elias is a member of The New York Society of Vascular Surgery and The New Jersey Vascular Society. He is a recipient of the Dardik Research and Education Award and The Fellows Education Award.