An aortogram involves placing a catheter in the main vessel that supplies blood to all your extremities and organs, called the aorta. This is all done through a small incision in one of the groins allowing us to gain access to the vessels. Contrast dye is injected into the vessel which makes it possible to visualize the vessel giving us a roadmap and showing us any blockages or narrowing’s in the vessels. This also allows us to treat these narrowing’s with balloons, stents, and atherectomy devices. This allows the vessel to be opened providing better blood flow to your legs and organs.
These are contrast dye studies through hemodialysis accesses that are used for cleaning the blood for patients with end-stage renal disease. This is done through a small incision and IV placed in the fistula. This also allows us to open narrowing’s that are causing the fistulas to not function appropriately or in some cases have stopped working. This is a critical part of the maintenance for hemodialysis access. It is not uncommon that patients will need some kind of intervention for their hemodialysis access; to keep it working properly so they can get dialysis to maintain a healthy lifestyle.
Venogram is a contrast dye study to evaluate the veins, usually in the arms as well as in the chest, to see if they are adequate for dialysis creation. This helps us to plan dialysis access for the patients; to increase the chance of creating a functioning fistula or graft for patients.
Inferior vena cava filter placement and removal
This is a device that acts as a filter to catch any major clot that would go to the lungs and heart, ultimately leading to the patient’s death. When these are needed, they are placed through a small incision either in the groin or in the neck. When we remove them, they are taken out from a small incision in the neck.
Hemodialysis catheter maintenance
Catheters are placed in the neck through small incisions to help facilitate dialysis for patients when their kidneys have failed. These sometimes need to be removed or new ones placed to keep them functioning appropriately. Most of the time this is done with some local anesthetic and very rarely sedation is needed to make the patient comfortable during placement.
This is a medical procedure that is done through a small incision in the leg, introducing the device into a poorly functioning vein. With local anesthetic this device heats up and seals the vein making it so the dysfunctional vein is not causing a backup of venous blood increasing varicose veins, as well as pressure, and swelling in the lower extremities.
Through a small IV, using ultrasound guidance, a sclerosant solution is introduced through this IV to seal a dysfunctional vein that is leading to venous hypertension and varicose veins. This is done with local anesthetic in the office with very minimal discomfort.
This procedure involves removal of symptomatic varicosities through very small skin incisions. After the areas have been marked in the preoperative area the skin is anesthetized with local anesthetic. The patients would still feel some tugging and minimal pressure but no pain is appreciated. Afterwards the legs are wrapped with dressings and the patient is monitored for a short period to make sure there is no problems with bleeding.
Using a very small needle a sclerosant solution is introduced into spider veins causing an inflammatory reaction and eventually clotting the spider vein. Then over 6-8 weeks the body absorbs the clotted blood and the spider vein disappears.
Renal and mesenteric stenosis treatment
Renal arteries are important to the overall filtering of blood through the kidneys. There are a series of hormones that help to control how much blood as in our circulatory system. If there is a narrowing in these vessels it can cause a problem with blood pressure being too high. Through a small incision in the groin a catheter can be introduced to the vessel allowing us to open it up with a balloon and stent. This allows better flow to the kidneys to help manage blood pressure as well as overall kidney filtering of the blood. A similar build-up of hardening of the arteries can occur to the vessels feeding the intestines. If these are blocked it can cause problems with abdominal pain, weight loss, as well as a fear of eating due to the pain. Through again a small incision in the groin, a catheter is introduced into the artery. These vessels can be opened up with a balloon and stent to help perfuse the intestines.
Mediports are placed beneath the skin through a small incision in the upper chest, most often on the right side. The port connects to a catheter (plastic tube) which then feeds into the vein to deliver medicine, blood products, nutrients, or fluids into the blood stream. This is often used for chemotherapy patients. This is done with local anesthetic; however, sedation can be used if needed for patient comfort.