Services

Equipment

Management of Chronic Venous Insufficiency

Superficial and deep venous insufficiency start with leaking valves, leading to venous reflux from deep vessels towards the superficial network and venous dilatation, finally resulting in decompensation. Heaviness, cramps, pains and swellings are some of the common symptoms. Varicose veins of the lower limbs are associated with a hereditary predisposition but develop in response to various triggering factors such as pregnancy, aging, trauma or following deep venous thrombosis.

Management involves use of phlebotonic agents, bandages, gradient stockings, injection sclerotherapy, and surgery.

Management of Leg Swellings

These are due to venous or lymphatic diseases.

Deep venous thrombosis (DVT)s are common in patients confined to bed and is potentially serious. Economy Class Syndrome, in air travel, refers to the same condition.

Pulmonary embolism is a major complication resulting from thrombus formation, often within the deep venous system of the leg & occasionally, from pelvic and subclavian vein thrombosis; it is associated with a high mortality. Deep venous thrombosis not only presents an immediate risk of life but is also associated with late sequelae such as post-thrombotic syndrome (venous ulcer) and varicose veins.

Early management involves anticoagulation (heparin and warfarin), thrombolytic therapy & surgery. In chronic DVT states, filter insertion into the inferior vena vaca prevent pulmonary embolism.

Management of Leg Ulcers

Angioplasty for partially blocked artery

Most of the leg ulcers are of arterial, venous or diabetic in nature. Arterial ulcers are due to insufficiency due to blockage or narrowing of blood vessels. Venous ulcers are due to reflux due to build up of back pressure in blood vessels & valve incompetency. Diabetic ulcers are due to mixture of both arterial and nerve problems.

Management of Acute or Chronic Ischaemic Limbs

Arterial bypass for blocked leg artery

Management of arterial ischemia ulcers or gangrene involves medical therapy with angioplasty, arterial bypass or sometimes amputations. Venous ulcers can be managed in the same way as chronic venous insufficiency while diabetic ulcer is managed non-surgically (conservatively) except when there is occlusion, then, angioplasty or bypass may be needed.

Thrombolytic Therapy

In situ arterial thrombosis is the most common indication for local thrombolytic therapy. In the developed world it causes 40-58% of cases of acute limb ischaemia.

Stenosis is the most common cause of in situ arterial thrombosis in the iliac & femoral-popliteal segments. Thrombolysis offers the opportunity of dissolving the thrombus & unmasking the stenosis, which can then be treated with percutaneous transluminal angioplasty or surgery.

Aneurysm in the popliteal artery, ectasia, bypass graft thrombosis and hyperthrombotic states are other conditions where thrombolytic therapy can be useful.

Management of Abdominal Aortic Aneurysms (AAA) Open Surgical Repair or Endovascular Stenting

AAAs represent a degenerative process that has often been attributed to atherosclerosis because of the elderly age of the patients affected & the universal atherosclerotic changes in their arteries.

If the physician feels there is a risk the abdominal aortic aneurysm may bust, he or she may choose one of these two types of treatment:

Management of Carotid Artery Disease

Stroke or cerebrovascular disease constitutes an important cause of disability among the elderly. Thromboembolic disease accounts for about 75 % of new strokes each year. Of these, carotid artery occlusive disease is probably the single most important causal factor in the development of cerebrovascular ischemia. Transient monocular blindness or amaurosis fugar and transient ischemic attack (TIA) constitute important warning signs of impending stroke. Duplex scanning is an important non-invasive form of investigation to confirm diagnosis. In severe cases of symptomatic disease, apart from medical therapy, carotid endarterectomy is an established modality of treatment where carotid artery stenosis exceeds greater than 70%.

Venous Access Procedures

Arterial venous communications

Repair of Arterial Trauma

Vascular trauma is often part of major motor-vehicle accidents. Common vessels involved are the popliteal, superficial femoral, femoral and brachial arteries and their associated veins. Early referral by 6-12 hours ensures success.

ELVeS : New Treatment For Varicose Veins

Treatment using fine ELVeS laser fibre

Endovenous treatment of reticular veins

Varicose veins are a frequently occuring condition with up to 40% of women & 20% of men likely to suffer from symptoms such as fatigue, pain and swelling of the lower limbs. Soft tissue breakdown (dermatitis), bleeding, ulceration can result if left untreated.

The Endo Laser Vein System(ELVeS) is a versatile system that treats venous incompetence. Treatment can be performed on a Day-Case basis under local anaesthetic with many benefits for the patient including minimal discomfort, short treatment time, excellent aesthetic results and a rapid return to normal activities.

The laser optical fibre is inserted into the vein and closed from the inside by the thermal laser energy. Procedure is approximately one hour. The potential side effects are minor and include thermal injury (burn) to the overlying skin or intervening tissue, perforation of the vein, superficial phlebitis (inflammation of the vein), hyperpigmentation (darkening of the overlying skin) or revascularisation (growth of new veins).

ELVeS is generally well tolerated by patients and shows impressive and convincing cosmetic results. As the procedure is minimally invasive it leaves virtually no scars.

Direct visulization of red aiming beam

Treatment in progress

Before and after comparison

For enquiries call, Tel : 04-222 7727, (DL) : 04-222 7200 ext. 7727