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Venous Access / Other Procedures

At the Vascular & Interventional Pavilion in Pinellas County, Hillsboro County, and Polk County, our surgeons have performed numerous venous access procedures, including dialysis access, IVC filter placement, thrombectomy, and renal artery stenting. These procedures may be performed in the Vascular & Interventional Pavilion outpatient surgery center in St. Petersburg, Florida, or in a nearby hospital facility, if needed.

In Vena Cava (IVC) Filter Placement

An in vena cava (IVC) filter is placed in the inferior vena cava (the large vein that carries blood to the heart) to protect patients from a pulmonary embolism if they are unable to take medicinal anticoagulants.

An IVC filter prevents clots from travelling to the lungs in patients who are at high risk after surgery or trauma, or in patients who suffer deep vein thrombosis (DVT) . Using image guidance, one of VIP's board certified vascular surgeons will place a catheter (a long, thin tube) into a blood vessel through a catheter in the leg, arm, or neck, and he places a tiny filter into the inferior vena cava to trap any potential clots.

Thrombectomy

An endovascular thrombectomy is intended to break up a clot, restore blood flow, potentially preserve valve function, and minimize the risk of post-thrombotic syndrome. Vascular surgeons at the Vascular & Interventional Pavilion have performed many endovascular thrombectomies under imaging guidance.

During this procedure, the surgeon inserts a catheter into a leg vein and threads it into the vein containing the clot. The catheter tip is placed into the clot and a “clot busting” drug is infused directly to the thrombus (clot). The fresher the clot is, the faster it dissolves. Any narrowing in the vein that might lead to future clot formation can be identified by venography, an imaging study of the veins, and we can then treat it with balloon angioplasty or stent placement.

Renal Artery Stenting

The renal arteries are those that supply the blood to the kidneys. Renal artery stenting is an endovascular, or minimally invasive technique, used to re-open a partially or completely blocked renal artery. Vascular surgeons at VIP have successfully placed many renal artery stents.

To perform this procedure, the surgeon inserts a catheter through a small puncture site and guides it through the blood vessels to the renal artery. The catheter carries a tiny balloon that inflates and deflates, flattening the plaque against the walls of the artery. Then the doctor inserts a tiny metal tube called a stent into the artery to hold it open.

Deep Venous Thrombosis (DVT)

This is a serious condition in which a deep vein (the deep veins that are in our muscles and you cannot see) is partially or completely blocked by a clot. Goal of treatment is to prevent the blood clot from breaking off and traveling to other parts of the body, such as the lungs.

What Causes DVT?

  • Prolonged bed rest
  • Decreased activity over a long period of time
  • Recent major surgery
  • Injury to the veins of the arms or legs
  • Obesity
  • Pregnancy

Signs and Symptoms

  • Unusual sudden swelling of an arm or let
  • Pain, cramping, or an aching feeling in the legs

Treatment

  • You may need to be admitted to the hospital and be on bed rest.
  • Bed rest and elevation will decrease swelling and prevent the clot from breaking loose from the vein wall.
  • An intravenous catheter will be inserted into an arm vein so you can receive a blood thinning medication called Heparin.
  • After receiving Heparin for a few days, you will begin taking a blood thinner by mouth called Coumadin. You will need to be on Coumadin for six months or for life. For more information on Coumadin, see below.
  • Blood tests will be done on a daily basis while you are in the hospital and periodically once you are discharged. This is to check the clotting of your blood and to keep your medications at a safe and therapeutic level.
  • An elastic stocking will be ordered for the affected arm or leg once you are able to get out of bed, in about three or four days. This should be worn at all times except when bathing or sleeping. It should be put on in the morning and taken off at night when you go to sleep.

Coumadin (Warfarin)
Coumadin prevents your blood from clotting normally. Many people refer to it as a blood thinner. Its goal is to prevent blood clots from forming or moving to other areas.

Important Points to Remember

  • You will need to have periodic blood work done to evaluate the clotting of your blood and to keep your medication at a safe and therapeutic level.
  • The blood test is called a protime (PT, prothrombin time), or INR. It is best to keep your INR between 2-3.
  • Your physician will monitor your INR
  • Take your Coumadin at the same time each day. This will keep your INR at a consistent level.
  • If you miss a dose do not take an additional dose – call your physician for instructions.
  • DO NOT take aspirin or aspirin products unless instructed by your physician. This increases the effect of Coumadin
  • Watch for signs of bleeding, such as blood in urine or stool, tarry black stools, bleeding gums, joint, back, or abdominal pains, coughing up blood, severe nose bleed, vomiting “coffee ground” material. If any of these symptoms occur, DO NOT take your Coumadin until you consult your physician.
  • Carry an identification card or medical alert bracelet stating you are taking Coumadin.
  • Tell all doctors and dentists you are on Coumadin
  • Use an electric razor
  • If you get cut, apply pressure for 5 to 10 minutes. If it continues to bleed, call your doctor.
  • Do not take vitamins containing Vitamin K. The reason is food high in Vitamin K have the reverse effect on Coumadin causing the blood to clot.
  • Your diet can affect Coumadin. Food rich in Vitamin K (green leafy vegetables, cauliflower, vegetable oils, etc.) should not be taken in excess but at a consistent level. Alcohol should be used in moderation. It increases the effect of Coumadin making your blood thinner. Therefore, it should be taken carefully.
  • Notify your physician for any hair loss, itching, rash or fever.
  • Notify your physician if you have persistent vomiting or diarrhea. This will affect your response to Coumadin.
  • Certain medications interact with the effect of Coumadin. It is important to contact your physician or pharmacist regarding any new medications to avoid interaction.
  • It is very important that you follow your doctors instructions regarding your blood work and have it drawn on a regular basis.

To become a VIP patient or refer a patient to VIP surgeons, contact us today. You may also request a free consultation using our secure online form. Our offices are located in Tampa, Lakeland, and Largo, Florida.