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Arterial stents vs. surgical treatment; which is better?

In recent decades; many diseases have increased in prevalence as Diabetes and high blood pressure, the smoking incidence has increased especially in the younger population and unhealthy eating habits are becoming the norm. All of these and other factors have helped in increasing the incidence of arterial diseases and also caused a change in the age group suffering from them. We are seeing more younger patients in our vascular clinic complaining of arterial diseases involving all the blood vessels.
One of the most common questions I get in my practice as a vascular surgeon from the patients is which is better open surgical treatment or endovascular stent placement?
Choosing the best option for a patient depends on so many factors including; age, the artery involved, the length of the narrowing, presence of other diseases. In general in younger patients, we recommend surgical treatment over the endovascular procedure.
Surgical procedures for arterial diseases in general have a longer life and less intervention than endovascular procedures. In vascular surgery, we evaluate the outcome of the procedure according to how long the stent or bypass stays open. Most of the time, the surgical outcome is better than the outcome of the endovascular procedures. That’s why in younger patients we want to choose the procedure that offers the patient the longest time to stay open without doing more frequent procedures.
Always ask your doctor about which procedure is best for you and discuss the outcome and risks of each procedure.

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Can Varicose Veins develop into Varicocele?

Varicose veins are large and dilated superficial veins in the legs, resulting in pain, fatigue, itching, and swelling, which might develop into more sinister venous ulcers. Varicocele is a condition in which the veins surrounding the testicles are dilated and enlarged, causing aching pain and might be related to decreased fertility.

But are these related? And can one lead to another?

Many of my male patients ask me: are varicose veins and varicocele related? Am I going to get varicocele since I have varicose veins?

The straight answer is no; one of these conditions won’t lead to the other. However, they might develop together due to a unique condition. The main vein that drains these areas gets compressed. 

The compression of the Iliac vein in the pelvis might simultaneously lead to varicocele and varicose veins. This is a congenital condition in which the Iliac veins and arteries compress each other, mainly affecting the veins. When veins are compressed, pressure will be built up within the veins, which will help the blood to flow through collateral veins and back to the central veins bypassing the compressed areas. This pressure build-up will result in the veins’ enlargement. As a result, blood will accumulate in the veins causing the symptoms such as pain, fatigue, burning, and itching sensation.

When do we suspect this condition?

If the patient complains of both diseases or when there is recurrence after treatment. Also, if there is a history of previous venous thrombosis in the legs, especially in the iliac veins.

How to diagnose this condition?

The doctor will suspect this condition after a thorough history and physical exam of the patient. Then we confirm the diagnosis by obtaining a CT scan or MRI dedicated to viewing the veins.

What’s the treatment?

After confirming the presence of Iliac vein compression, your doctor might recommend a venous angioplasty with a stent. It is a safe procedure in which the veins are accessed by a small needle. Then a venous metal stent is placed in the vein undergoing the compression. Again, this is done as an outpatient procedure with no need for an overnight stay in the hospital.

For more questions, contact Dr. Omar Hamdallah via phone or WhatsApp at +96265626538


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Venaseal procedure is one of the newest state-of-the-art technologies to treat varicose veins. We perform this procedure in the office under local anesthesia with no incisions. There is no pain after the procedure and no need for a recovery period, patients can resume their routine activities immediately. Patients who underwent regret not having it done earlier.