HealthCare Resources Blog


Carotid Artery Disease (Part 3 of 3)

Posted in Doctors,HealthCare Resources by Pam on June 15, 2013
Tags: , ,

If you are receiving this newsletter in error, or would like to be removed from our mailing list – please accept our apologies and notify us – we will remove you immediately. On the other hand, feel free to send this newsletter on to your friends!

We are so proud to work with Dr. Escoto who is a Vascular Specialist. This is Part 3 of a 3 part article written by him on Carotid Artery Disease. Consider participating in our Vascular Clinic, one of our many monthly screening clinics. Upcoming Vascular Clinics are scheduled for June 19 and July 16, 2013. Please email pamela@healthcareresourcespv.com for details or any questions.

TREATMENT AND DRUGS

The goal in treating carotid artery disease is preventing stroke. The method of treatment depends on how narrow your arteries have become.

Mild to moderate blockage

When you have mild to moderate blockage of your arteries, the following recommendations may be sufficient to prevent stroke:

Make lifestyle changes. Healthy changes in your behavior can help reduce the stress on your arteries and slow the progression of atherosclerosis. Such changes include quitting smoking, losing weight, eating healthy foods, reducing the amount of salt you eat and exercising regularly.

Manage chronic conditions. It’s also key to manage any chronic conditions you have, such as high blood pressure, excess weight or diabetes. With your doctor, you can form a plan to specifically address these conditions by managing your blood pressure, maintaining a healthy weight, controlling your blood sugar levels and lowering your cholesterol.

Use medications. Your doctor may ask you to take a daily aspirin or another blood-thinning medicine to avoid the formation of dangerous blood clots. He or she may also recommend medications to control your blood pressure, such as angiotensin-converting enzyme (ACE) inhibitors or calcium channel blockers, or a statin medication to lower your cholesterol.

Severe blockage

When you have severe blockage of your arteries — especially if you’ve already had a TIA or stroke related to the blockage — it’s best to open up the artery and remove the blockage. There are two ways to do this:

carotid endarterectomyCarotid endarterectomy. This surgical procedure is the most common treatment for severe carotid artery disease. The procedure is done under either local or general anesthesia. After making an incision along the front of your neck, your surgeon opens the affected carotid artery and removes the plaques. The artery is repaired with either stitches or, preferably, a graft. Studies have also shown that the surgery is low risk in most otherwise healthy people, has lasting benefit and helps prevent strokes.

Carotid angioplasty and stenting. A carotid endarterectomy isn’t recommended when the location of the narrowing or blockage is too difficult for the surgeon to access directly or when you have other health conditions that make surgery too risky. In such cases, your doctor may recommend a procedure called carotid angioplasty and stenting. While you’re under local anesthesia, a tiny balloon is threaded by catheter to the area where your carotid artery is clogged. The balloon is inflated to widen the artery, and a small wire mesh coil called a stent is inserted to keep the artery from narrowing again.

Carotid Artery Disease (Part 2 of 3)

Posted in Doctors,HealthCare Resources by Pam on June 7, 2013
Tags: , ,

If you are receiving this newsletter in error, or would like to be removed from our mailing list – please accept our apologies and notify us – we will remove you immediately. On the other hand, feel free to send this newsletter on to your friends!

We are so proud to work with Dr. Escoto who is a Vascular Specialist. This is Part 2 of a 3 part article written by him on Carotid Artery Disease. Consider participating in our Vascular Clinic, one of our many monthly screening clinics. Upcoming Vascular Clinics are scheduled for June 19 and July 16, 2013. Please email pamela@healthcareresourcespv.com for details or any questions.

RISK FACTORS

Factors that stress your arteries and increase the risk of injury, buildup of plaques and disease include the following:

High blood pressure. High blood pressure is an important risk factor for carotid artery disease. Excess pressure on the walls of your arteries can weaken them and leave them more vulnerable to damage.

Smoking. Nicotine can irritate the inner lining of your arteries. It also increases your heart rate and blood pressure.

Age. As you age, your arteries become less elastic and more prone to injury.

Abnormal blood-fat levels. High levels of low-density lipoprotein (LDL) cholesterol, the “bad” cholesterol, and high levels of triglycerides, a blood fat, encourage the accumulation of plaques.

Diabetes. Diabetes affects not only your ability to handle glucose appropriately but also your ability to process fats efficiently, placing you at greater risk of high blood pressure and atherosclerosis.

Obesity. Carrying excess pounds increases your chances of high blood pressure, atherosclerosis and diabetes.

Heredity. Having a family history of atherosclerosis or coronary artery disease increases your risk of developing these conditions, as well.

Physical inactivity. Lack of exercise contributes to a number of conditions, including high blood pressure, diabetes and obesity.

Often, these risk factors occur together, creating even greater risk than if they occur alone.

COMPLICATIONS: Stroke

The most serious complication of carotid artery disease is stroke. There are different ways carotid artery disease can increase your risk of stroke:

Reduced blood flow. A carotid artery may become so narrowed by atherosclerosis that not enough blood is able to reach portions of your brain.

Ruptured plaques. A piece of a plaque may break off and flow to smaller arteries in your brain (cerebral arteries). The fragment may get stuck in one of these smaller arteries, creating a blockage that cuts off blood supply to the area of the brain that the cerebral artery serves.

Blood clot blockage. Some plaques are prone to cracking and forming irregular surfaces on the artery wall. When this happens, your body reacts as if to an injury and sends platelets — blood cells that help the clotting process — to the area. A large blood clot may develop in this manner and block or slow the flow of blood through a carotid or cerebral artery, causing a stroke.

A stroke can leave you with permanent brain damage and muscle weakness. In severe cases, it can be fatal.

TEST AND DIAGNOSIS

In addition to taking a thorough medical history and recording risk factors and any signs or symptoms, your doctor may conduct or request several tests to evaluate the health of your carotid arteries:

Physical examination. Your doctor may hear a “swooshing” sound (bruit) over the carotid artery in your neck, a sound that’s characteristic of a narrowed artery. Your doctor may perform a neurological evaluation to test your physical and mental status such as strength, memory and speech capabilities.

Ultrasound. A common, noninvasive test used to check for carotid artery disease is a Doppler ultrasound. This variation of the conventional ultrasound assesses blood flow and pressure — and possible narrowing of the blood vessel — by bouncing high-frequency sound waves (ultrasound) off red blood cells.

Computerized tomography angiography (CTA). This imaging test uses a contrast dye to highlight your carotid arteries in the pictures taken. The dye is injected into a blood vessel. When it travels to your carotid arteries, a computerized tomography (CT) scan gathers X-ray images of your neck and brain from many angles.

Head computerized tomography (CT). This imaging looks at the brain tissue, without giving dye, to rule out bleeding or other abnormalities.

Magnetic resonance angiography (MRA). Like CTA, this imaging test uses a contrast (noniodine) dye to highlight the arteries in your neck and brain. A magnetic field and radio waves are used to create cross-sectional, 3-D images.

Magnetic resonance imaging (MRI). Like CT, this imaging test looks at the brain tissue for evidence of early stroke or other abnormalities.

Cerebral angiogram. A more traditional, and more invasive, imaging procedure called a cerebral angiogram may sometimes be done, but its use is less common as it carries a slight risk of stroke. In this procedure, contrast dye is injected with a catheter that’s been threaded directly into your carotid arteries. Detailed X-ray images are then taken.

Carotid Artery Disease (Part 1 of 3)

Posted in Doctors,HealthCare Resources by Pam on June 1, 2013
Tags: , ,

If you are receiving this newsletter in error, or would like to be removed from our mailing list – please accept our apologies and notify us – we will remove you immediately. On the other hand, feel free to send this newsletter on to your friends!

We are so proud to work with Dr. Escoto who is a Vascular Specialist. This is Part 1 of a 3 part article written by him on Carotid Artery Disease. Consider participating in our Vascular Clinic, one of our many monthly screening clinics. Upcoming Vascular Clinics are scheduled for June 19 and July 16, 2013. Please email pamela@healthcareresourcespv.com for details or any questions.

DEFINITION

Carotid artery disease occurs when fatty, waxy deposits called plaques clog your carotid arteries. Your carotid arteries are a pair of blood vessels that deliver blood to your brain and head. The buildup of plaques in these arteries blocks the blood supply to your brain and increases your risk of stroke. Because carotid artery disease develops slowly and often goes unnoticed, the first outward clue that you have the condition may be a stroke or transient ischemic attack (TIA), sometimes referred to as a ministroke. Treatment of carotid artery disease usually involves a combination of lifestyle changes, medications and, in some cases, surgery or a stenting procedure.

In its early stages, carotid artery disease often doesn’t produce any signs or symptoms. You and your doctor may not know you have carotid artery disease until it’s serious enough to deprive your brain of blood, causing a stroke or TIA — an early warning sign of a future stroke.

SYMPTOMS

You may not have any symptoms of carotid artery disease. Plaque builds up in the carotid arteries over time with no warning signs until you have a transient ischemic attack or a stroke.

Signs of a stroke may include:

  • Sudden loss of vision, blurred vision, or difficulty in seeing out of one or both eyes
  • Weakness, tingling, or numbness on one side of the face, one side of the body, or in one arm or leg
  • Sudden difficulty in walking, loss of balance, lack of coordination
  • Sudden dizziness and/or confusion
  • Difficulty speaking (called aphasia)
  • Confusion
  • Sudden severe headache
  • Problems with memory
  • Difficulty swallowing (called dysphagia)

When to see a doctor

Dr. Escoto, a wonderful, bilingual vascular surgeon

Dr. Escoto, a wonderful, bilingual vascular surgeon

Talk to your doctor if you have risk factors for carotid artery disease. Your doctor may do some tests to see what shape your arteries are in. Even if you don’t have any signs or symptoms, your doctor may recommend aggressive management of your risk factors to protect you from stroke.

Seek emergency care if you experience any of the signs or symptoms of a transient ischemic attack (TIA) or stroke.

Even if the signs and symptoms last only a short while — usually less than an hour but possibly longer — and then you feel normal, tell your doctor right away. What you may have experienced is a TIA, a temporary shortage of blood flow to a region of your brain. A TIA is an important sign that you’re at high risk of having a full-blown stroke, so don’t ignore it.

Seeing a doctor early increases your chances that carotid artery disease will be detected and treated before a disabling stroke occurs. It’s also possible that a TIA can be due to lack of blood flow in other blood vessels. Your doctor will determine which testing is necessary.

Make sure your close friends and family know the signs and symptoms of stroke and understand that it’s critical to act fast in the event of a possible stroke.

Spider Veins!

If you are receiving this newsletter in error, or would like to be removed from our mailing list – please accept our apologies and notify us – we will remove you immediately. On the other hand, feel free to send this newsletter on to your friends!

Spider Veins are quite common, more in women than men. HealthCare Resources interviewed Vascular Specialist/Surgeon, Dr. Hector Escoto to learn a bit more about this condition.

HCR: What is the medical term for “spider veins”?

Dr. Escoto: Spider veins are a common, mild variation of varicose veins. This condition is medically called “telangiectasias”.

HCR: What are the causes?

Dr. Escoto:

  • Age: The development of spider veins may occur at any age, but usually occur between the ages of 18 and 35 years, peaking between 50 and 60 years.
  • Gender: Females are affected approximately four to one over males.
  • Pregnancy: Pregnancy is a key factor contributing to the formation of varicose and spider veins.  The most important factor is circulating hormones that weaken vein walls.  There is also a significant increase in the blood volume during pregnancy, which tends to distend veins, causing valve dysfunction which leads to blood pooling in the veins.  Later in pregnancy, the enlarged uterus can compress veins, causing higher vein pressure leading to dilated veins.  Varicose veins that form during pregnancy may spontaneously improve, or even disappear a few months after delivery.
  • Lifestyle/Occupation: Those who are involved with prolonged sitting or standing in their daily activities have an increased risk of developing spider or varicose veins.  The weight of the blood continuously pressing against the closed valves causes them to fail, leading to vein distension.
  • Family History: If other family members had varicose veins, there’s a greater chance you will too.
  • Obesity: Being overweight puts added pressure on the veins.

HCR: Are they dangerous? Or are they usually removed only for cosmetic purposes?

Dr. Escoto: Spider veins alone are not a dangerous condition but a cosmetic issue. If you have spider veins, plus varicose veins it is important to rule out an underlying condition (such as venous valve deficiency).

HCR: How can they be prevented?

Dr. Escoto: There is no way to completely prevent this condition. But improving circulation and muscle tone can reduce the risk of developing varicose veins/spider veins or getting new ones. The same measures taken to treat the discomfort of varicose veins at home, can help to prevent varicose veins, including: Exercising, watching your weight, eating a high fiber/low salt diet, avoid high heels and tight hosiery, elevating your legs, changing your standing/sitting position frequently.

HCR: How can they be removed?

Dr. Escoto: There are two options for this medical condition.
1) Sclerotherapy: This is the “gold standard” and is preferred over laser for eliminating spider veins and smaller varicose leg veins. A sclerosant medication is injected into the diseased vein so that it hardens and eventually shrinks away.
2) Skin Laser: This is a new technology. With this treatment, we close of smaller varicose veins and spider veins. Laser surgery works by sending strong bursts of light onto the vein, which causes the vein to slowly fade and disappear. No incisions or needles are used.

Each month, HealthCare Resources and Dr. Escoto have a Vascular Clinic. This is a screening clinic for circulation, blood flow, vein evaluation. If you would like further information, please contact us at pamela@healthcareresourcespv.com

A New Vascular Clinic!

Posted in Clinics,Doctors,HealthCare Resources by Pam on October 4, 2011
Tags: , , ,

If you are receiving this newsletter in error, or would like to be removed from our mailing list – please accept our apologies and notify us – we will remove you immediately. On the other hand, feel free to send this newsletter on to your friends!

HealthCare Resources is proud to present a new Vascular Clinic!

Dr. Escoto, a wonderful, bilingual vascular surgeon

Dr. Escoto, a wonderful, bilingual vascular surgeon

HealthCare Resources is proud to present a new Vascular Clinic! This is a screening clinic to check on your leg and feet circulation. (We still have space for the October 17, 2011 clinic and will be repeated on November 21 and December 28, 2011). This will be done with Dr. Escoto, a wonderful, bilingual vascular surgeon. And exciting news! He now is able to do the varicose vein procedure via Laser! Non-invasive, no overnight stays in the hospital! The article below was written in conjunction with Dr. Escoto.

What are varicose veins? (more…)