Over the past two weeks, I have described the blood thinning medications that vascular surgeons use to treat patients: Anticoagulant and Antiplatelet medications. This week, I want to spend time talking about another important medication that primary care physicians and vascular surgeons both agree helps to improve patient outcomes: Statins. Statins refer to a general class of drugs that inhibit a special enzyme involved in the production of cholesterol within the body: 3-hydroxy-3-methylglutaryl-Coenzyme A, otherwise known as HMG-CoA.  HMG-CoA catalyzes the first ..read more

Last week I began a description of the medications that vascular surgeons use with a blog post on drugs used for anticoagulation.  This week, I want to describe a group of medications that also thin the blood, albeit through a different mechanism.  As discussed last week, the coagulation cascade works to turn the blood from a liquid to a solid.  A special group of cells in the blood mixed with red blood cells called platelets works simultaneously with the coagulation cascade to serve as the glue so to speak between clumps of red blood cells.  This bond that platelets facili ..read more

Last week I wrote the first part of a four-part series about foot pain at night.  Specifically, I talked about venous disease as a cause of foot pain. Today, I want to talk about another common cause of foot pain at night: Raynaud’s Syndrome.  As a quick review, last week we talked about the two main types of blood vessels in our bodies: arteries and veins.  Arteries bring blood from the heart to the feet under high pressure.  Veins bring blood back from the foot to the heart under low pressure. Raynaud’s Syndrome is a disease of the arteries, particularly the small arterie ..read more

One of the many questions I receive as a vascular surgeon is why do my feet hurt at night?  Though this question may seem simple, every person is different. Before I can provide you with “real” solutions to what’s causing this pain and what can be done to stop it, I need to evaluate multiple factors to understand “Why” this pain exists.  Over the next few weeks, I am going to explore the most common reasons for foot pain at night and why people can have pain in their feet at night caused by venous disease. For the majority of patients Raynaud’s syndrome, Arterial disease, and Diabeti ..read more

Of the many reasons that a patient can be referred to a vascular surgeon, one is that their referring physicians believes that their patient may have developed an aneurysm.  Aneurysms, typically speaking, form in arteries which are the specialized vessels that carry blood from the heart to the rest of the body under high pressure.  When the wall of an artery weakens, it can develop into a balloon-like dilation called an aneurysm. (See below). This most commonly occurs in the main blood vessel in your abdomen, which is called the abdominal aorta. When the blood vessels dilate to 50% g ..read more

As a vascular surgeon, I perform two very different types of surgery: Open Surgery and Endovascular Surgery. Open surgery is just as you might think!  It involves making an incision with a scalpel and using various tools like forceps, scissors, electrocautery, and needle drivers to expose and then repair specific structures.  Since the beginning of surgery itself, all surgeons, not just vascular surgeons, have been practicing open surgery. Endovascular surgery is a recent development that only began in the 1990s.  Motivated by the desire to perform minimally invasive and less h ..read more

As a vascular surgeon, one of the more common questions I receive from patients and from friends and family alike is what do I actually do?  I find the question interesting because before I went to medical school, I did not even know that the field of vascular surgery existed!  Vascular surgeons operate on the blood vessels all around the body including the chest, arms, neck, abdomen, and legs. One key thing to remember is that Vascular surgeons do NOT work on a person’s heart. Heart doctors are more commonly known as cardiologists and cardiac surgeons. There are two different types ..read more

One of the most common consultations that we as vascular surgeons receive is for deep vein thrombosis, otherwise known as blood clots.  Deep veins refer to the location of the vein that has the problem.  In the legs we have two main sets of veins: Deep and superficial.  Deep veins are within the muscle and close to the bones whereas superficial veins are close to the skin; hence their names! Thrombosis refers to the process of the blood turning from a liquid into a solid form.  Normally, thrombosis occurs in response to an injury to stop bleeding from a wound.  However ..read more

One of the most gratifying problems we help treat for patients is carotid artery disease.  The carotid arteries supply the brain with blood.  In patients with high blood pressure, high cholesterol, diabetes, and a history of smoking, the carotid arteries can become narrowed and form blood clots that then go into the brain and cause strokes.  Traditionally, vascular surgeons have fixed this carotid artery narrowing’s with a surgery called a carotid endarterectomy.  The carotid artery is dissected out and cut open.  The plaque is then removed, and the carotid artery is s ..read more

Hello. Dr Lau here again. Today I wanted to share some information about Varicose Veins.  Almost daily, my patients ask me “Dr Lau, what causes varicose veins and associated swelling in the legs and what can I do about them?” Although every patient I meet is different, varicose veins are one of the most common conditions that I treat as a vascular surgeon and relate to a disruption of structures within the veins called valves. Normally, veins have valves that allow blood to go from the feet to the heart and prevent the blood from pooling in the legs. When these valves become damaged ..read more