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Venous
Ulcers and Skin Changes Successfully Prevented
and Treated at JVAI
- Signs
and Symptoms of Venous Disease
- What
is Venous Disease and How Does it Lead
to Ulcers that Don't Heal?
- The
Solution and Permanent Answer for Venous
Disease
- The
SEPS Procedure
- Complex
Vascular Reconstructions
1.
Signs and Symptoms of Venous Disease
The symptoms of venous
disease are varied but generally include
one or more of the following: aching,
burning, swelling, tired legs, skin discoloration,
difficulty healing leg wounds, excessive
bleeding from leg injuries and ulceration.
Symptoms are generally less in the morning
and increase throughout the day or after
long periods of standing. Patients often
have difficulty sleeping at night due
to pain and discomfort of their legs.
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2.
What is Venous Disease and How Does it
Lead to Ulcers that Don't Heal?
There are two systems
of veins in the leg. The main system in
the middle of the muscles is called the
deep system. The other system is made
up of all the veins you see under the
skin, the superficial veins. Veins called
perforator veins connect these two systems.
The superficial veins are at low pressure
and the deep veins are at high pressure.
When perforator veins malfunction, each
leg movement causes blood to flow backward
at high pressure into the superficial
system, causing damage to the delicate
superficial veins and skin. This is called
chronic venous insufficiency.
High blood pressure of
the surface veins (chronic
venous insufficiency) produces
major negative changes. It causes the
veins to distend over time producing varicose
veins. It also increases the pressure
in the smaller veins causing these to
stretch and become very prominent. When
these are just under the skin, they are
known as spider veins. The increase pressure
causes the small veins to leak fluid into
the surrounding tissues resulting in swelling
or edema followed by discoloration. The
high pressure is also transmitted to the
smallest veins that lie near the capillary
beds. This makes it difficult for blood
to flow across the smallest vessels or
capillaries, thus disrupting the exchange
of nutrients and wastes in this area.
The tissues of the leg respond by thickening
of the skin and finally by ulceration.
A serious consequence of this type of
vascular disease is infection of the skin
or cellulitis.
Historically doctors have
had to resort to telling patients that
they will simply have to "live with
the problem, alleviating symptoms somewhat
by wearing compression stockings. Painful
debilitating ulcers that don't heal make
the situation almost unbearable leading
some patients to undergo skin grafts,
painful vein stripping procedures, and
even the daily wearing of a "soft
cast" to attempt to get the ulcers
to heal—all of this is to no avail.
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3.
The Solution and Permanent Answer for
Venous Disease
The answer
to chronic venous insufficiency with all
its related symptoms is to remove the
dysfunctional perforator veins. The procedure
called Subfascial Endoscopic
Perforator Surgery or SEPS,
is a minimally invasive outpatient procedure
that is performed by Dr. Joyce on a regular
basis. Dr. Joyce was one of the first
physicians to meet and train with the
developers of the SEPS Procedure when
it was just becoming known about seven
years ago. At that time, Dr. Joyce had
approximately 30 patients with chronic
venous insufficiency with unhealed leg
ulcers. He contacted them, performed a
specialized ultrasound exam and determined
that most were good candidates for the
SEPS Procedure. Post-operatively, over
90% of those patient's ulcers healed completely
within several months. Today Dr. Joyce
is one of only five physicians in the
United States who perform a significant
number of SEPS procedures each month.
He performs the highest volume of SEPS
surgeries in Florida and one of the two
highest volumes in the entire country.
Dr. Joyce trains doctors from all over
the United States in the SEPS procedure
and is regarded as a leader in the vein
treatment field. >>Learn
more about Dr. Joyce
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4.
The SEPS Procedure
For many
patients, the SEPS procedure is done in
Dr. Joyce's office under local anesthesia.
Some may require a brief hospital stay.
The procedure involves advancing a small
camera or endoscope through a one-inch
incision made just below the knee. This
allows Dr. Joyce to view the compartment
where the perforator veins are located.
Tiny titanium clips are placed around
the malfunctioning veins, closing them
and enabling healthy veins to take over.
Of the approximate 140 perforator veins
in a normal adult, Dr. Joyce will generally
close 5-7 of them. Afterwards, he places
a tiny stitch under the skin and a small
bandage on the leg and the patient goes
home in about an hour and a half. Patients
with untreatable ulcers in their legs
for years begin to heal almost immediately.
It gives Dr. Joyce great satisfaction
to help these people through this technology.
Patients now come from all parts of the
country to benefit from Dr. Joyce's knowledge
and experience in performing the SEPS
Procedure.
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5.
Complex Vascular Reconstructions
Dr. Joyce
also specializes in reconstruction of
the arteries of the legs. These operations
are performed using the latest minimally
invasive techniques and equipment. Many
patients have had successful outcomes
after being told, prior to visiting JVAI,
that there is nothing more to do for their
condition. Dr. Joyce has helped some of
these patients avoid previously recommended
and scheduled leg amputation. Advanced
techniques such as endovascular microsurgery,
where tiny video cameras and instruments
are utilized to operate directly inside
the arteries and veins, are often employed
to facilitate these challenging operations.
Dr. Joyce
approaches each case individually. Patients
who will benefit from these complex procedures
are offered surgical treatment. Other
patients are managed with the latest medical
therapies. The majority of these patients
have had excellent functional outcomes.
Call today
for a consultation and experience state-of-the-art
vein treatment that cures venous disease.
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