How to Find a Vascular Surgeon

MelanieS — Tue, 07 Feb 2012 13:23:50 +0000

Finding a doctor can be a daunting task. This is someone with whom you will need to build a deep and rather personal relationship, and for whom the patient must have respect and trust. Often times, people will find a doctor by way of a referral from a friend or family member. Other times people conduct a search online or in the phone book. Some popular sites to search for a physician’s credentials include www.healthgrades.com or www.vitals.com. These are both very effective ways of finding a physician. A combination of credentials, insurances accepted, distance from home, and recommendations from trusted sources should all be taken into account when finding a doctor. Other things to keep in mind are the hospital affiliations for that doctor. You will want to select a doctor who has admitting privileges into a solidly ranked hospital in case of an emergency. Finally, it is wise to double check a specialist with your insurance company to ensure that the doctor accepts your insurance. However, choosing a specialist, such as a Vascular Surgeon, can be a bit trickier if you don’t know what to look for.

At the NYU Vein Center in Morristown, we find that most of our patients have come by a referral from a primary care physician or Cardiologist who noticed that the patient is displaying symptoms of varicose veins or vascular disease. However, varicose veins are often a condition that goes undiagnosed by primary care physicians. It is up to the patient to determine whether or not the discomfort or pain in the legs or the appearance of the veins is significant enough to warrant a visit to a Vascular Surgeon for a duplex ultrasound and proper diagnosis of venous reflux. So how do you know if the local Vascular Surgeon is right for you?

Similarly to finding a primary care physician, when looking for a Vascular Surgeon, it is important to get feedback from others who may have had a procedure performed at the practice. If you don’t know anyone who has had veins treated, searching online for testimonials can be helpful. In addition to the directory websites above, there are other resources for finding a specialist. Specialists such as Vascular Surgeons have gone through extensive training beyond their medical degree in their field of specialty. Most specialties have associations that board-certify these physicians within their specialty. For a Vascular Surgeon, you will typically want to find someone who has completed a fellowship in Vascular Surgery and who is board certified by an organization such as the American College of Phlebology. A Vascular Surgeon should also be board certified by the American Board of Surgery. In the field of diagnosing vascular disease, a new certification has recently been established. This is the Cardiovascular Credentialing International Registered Phlebology Sonographer (indicated as RPhS after the MD). This certificate ensures that you will receive a thorough diagnostic exam. It is important to have such an exam in order for the Vascular Surgeon to determine the best course of treatment for varicose veins or other vein disease.

When you are on your quest to find a doctor, be sure to check for his or her experience, licensures, location, hospital admitting privileges, location, insurances accepted, and most importantly, schedule a consultation to meet with a physician to establish a rapport before you undergo a procedure. Making sure you are comfortable and able to communicate openly will help ensure a successful outcome.

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Solution to treat DVT & PE with better outcomes and reduced costs

MelanieS — Tue, 31 Jan 2012 18:44:38 +0000

The reduction of DVTs and PEs is a core area of focus for CMS cost reductions, and a standard set of guidelines must be developed and adhered to. There must be a team approach to dealing with and treating patients with DVT. This hospital-based team should include multiple physicians and allied health professionals across a variety of specialties, including but not limited to:

• Vascular Surgeons/Vascular Medicine
• Interventional Radiologists
• Cardiologists
• Hematologists
• Internal Medicine
• Oncologists

Additionally, these patients need to be followed across the continuum of care, beyond just the in-hospital encounter.

It is critical for these specialists to come together as key opinion leaders to help shape the government guidelines for treating these patients. Specialists who deal with these patients every day are in the best position to share their knowledge and experience, to determine the best standards of care to treat patients suffering from venous thromboemboli, and to define preventive measures.

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Medicare Costs of Treating DVT and PE

MelanieS — Mon, 23 Jan 2012 19:22:44 +0000

With the healthcare crisis being battled on Capitol Hill and in the news daily, we are being bombarded with statistics of the cost of care increasing while the quality is decreasing. There are a few primary diseases or chronic conditions that account for the majority of Medicare spending. One of these conditions is deep venous thrombosis (DVT). DVT is not only costly at the time the patient is in the hospital being treated, but it becomes even costlier when it’s not treated and resolved. DVTs lead to emboli. When emboli manifest in the lungs (pulmonary embolism) or brain or other critical organs, they become fatal. There is a very high recurrence rate with DVTs and PEs. This recurrence further increases the total financial burden of the patient on the
Centers for Medicare Services (CMS). CMS is evaluating means to reduce the incidence, and therefore the costs, of DVT.

The Centers for Medicare Services has established core quality measures upon which care providers will be evaluated to determine whether optimal quality of care and reduced costs have been met. These core measures include evaluating DVT incidence and hospital readmissions (DVT and PE are leading causes of costly hospital readmissions). Initially providers will be financially rewarded to reduce or eliminate hospital readmissions within 30 days. Eventually, every hospital and provider will become financially accountable for the outcomes of patients with DVT according to the national guidelines and benchmarks against the quality measures. To ensure they receive their incentives and prevent a reduction in pay down the road, providers are closely evaluating how patients with venous thromboemboli or who are susceptible to DVTs are being treated.

In my next post on the topic of deep vein thromboses and pulmonary emboli, I will present a strategy to treat these conditions in such a way that we can reduce costs while also improving patient outcomes.

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Overview of Deep Vein Thrombosis and Pulmonary Embolism

MelanieS — Mon, 16 Jan 2012 19:38:53 +0000

What are DVT and PE, and why should patients care?

Deep Vein Thrombosis (DVT) is one of the most prevalent medical problems today. DVT, while in some cases life-threatening, can lead to an even more serious condition called pulmonary embolism (PE). In fact, death occurs in about 6% of DVT cases and 12% of PE cases within one month of diagnosis.1 DVT and PE are caused by blood clots in the veins. A pulmonary embolism occurs when one of these clots travels to the lungs where it may obstruct air flow. Annually, it is estimated that 600,000 patients will be diagnosed with venous thromboembolism, and anywhere from 50,000-200,000 will die from PE. PE is stated to be the leading cause of preventable death in hospital patients, responsible for approximately 10% of all hospital deaths.

Who is at risk?

People with varicose veins are more prone to thrombosis and embolism; other factors that contribute to increased risk are advanced age, obesity, and cardiac problems, among other conditions. If you are at risk of DVT, there are preventive measures you can take, such as wearing compression stockings during air travel or for prolonged periods of standing or sitting. Be sure you discuss this with your physician. You should consider asking for a referral to a Venous Specialist if you have any symptoms of varicose veins, leg spider veins, restless leg syndrome, heavy or aching legs, venous ulcers, or if you have a family history of DVT or PE.

1 http://circ.ahajournals.org/content/107/23_suppl_1/I-4.full

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Highlights from the 38th Annual VEITHsymposium

MelanieS — Thu, 05 Jan 2012 17:59:22 +0000

This past November, I attended and presented at the 38^thannual VEITHsymposium. The symposium is a five day event filled with the world’s leading vascular specialists presenting and educating others on the most current methods of diagnosing and treating patients who suffer from vascular disease. With vascular disease being a leading cause of death and disability for a large percentage of Americans, treating these patients effectively is an important initiative. It was encouraging to see that Venous and Endovenous Diagnosis and Treatment topics monopolized the opening day for the sixth consecutive year. Of the 57 talks given by 41 speakers, topics ranged from the basic anatomy to more advanced discussions, such as Chronic CerebroSpinal Venous Insufficiency: Is This a Real Syndrome? There were two very intriguing debates. The first was whether Hypercoaguable Testing is Needed in Most Cases and the second was We Should Treat Calf Vein DVT with Standard Anticoagulation.

A fellow member of American Venous Forum and the American College of Phlebology (ACP), Dr. Jose Almeida, opened the session with a look forward to new therapies being tested and discussed for the treatment of venous disease in the future. Some of the new therapies discussed include those that don’t require tumescent anesthesia such as glue, foam sclerotherapy, and pharmacomechanical treatments. He also highlighted deep venous pathology with a focus on venous outflow obstruction, intravascular ultrasound, and stents.

Dr. Mauriello, President of the ACP, lectured on the significance of venous anatomy knowledge in order to avoid injury to the saphenous, sural, or peroneal nerves while performing vein ablation or other venous treatments. This highlights the significance of selecting a certified and qualified vascular surgeon to diagnose and treat a venous or vascular condition.

I have been evaluating treatment for Endothermal Heat Induced Thrombosis (EHIT2) post ablation, and am still undecided on whether or not anticoagulation is necessary. I will continue to gather more data and to work with my peers to determine the best method of treatment. It is apparent that more data is needed to ensure the best standard of care based on the fact that 50% of the audience in attendance did anticoagulate with EHIT2 and 50% did not. I also presented a conclusion from my recent pilot studies that both wavelength of a laser and non-contact fibers are important factors in postoperative recovery.

There was also a significant amount of time spent on discussions of treating and diagnosing deep vein thrombosis (DVT). Momentum is gaining in new pharmacomechanical treatments for acute DVT, though there do appear to be some device limitations for now.

Overall, the VEITHsymposium remains one of the leading conferences for the discussion and progression of treatment for venous disease, and I am proud to have been a part of the faculty once again.

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The Grandma Disease that Strikes Young Men

MelanieS — Sat, 03 Dec 2011 22:04:22 +0000

Dr. Lowell Kabnick’s patient, Ronald Sprofera or Jersey City, New Jersey, tells Men’s Health magazine that his procedure to eliminate his painful varicose veins was easier than going to the dentist.

http://news.menshealth.com/varicose-veins-in-young-men/2011/11/27/

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An Introduction

admin — Thu, 01 Dec 2011 23:00:36 +0000

Greetings. I’m Lowell Kabnick, MD, RPHS, FACS, FACPh, Director of the NYU Vein Center, and I would like to personally welcome you to my new blog.

I am a vascular surgeon with over 30 years of experience in treating patients who suffer from vein disease, varicose veins, and other vascular issues, and advising medical device companies in the design of the most cutting-edge technologies to advance the treatment of these diseases. I am a professor and practitioner with various editorial positions on renowned journals and with council or board positions in multiple medical societies and medical device companies, all geared toward advancing the treatment of vascular disease. I practice medicine in New York City at the NYU Vein Center and from my Morristown, NJ office. Read more about my background.

Through this new venue, I hope to provide you with information on vein disease, advances in treatment technologies, thoughts on the political climate of healthcare and what it may mean for patients suffering with varicose veins and other related illnesses, and to respond to user comments or questions.

By watching, reading, and subscribing to this blog, you will learn more about where I believe medicine is headed and learn about multiple treatment options for a variety of vascular conditions. Please stop by often.

Best regards,
Lowell S. Kabnick, MD

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Dr. Lowell S. Kabnick First to Use New VenaCure® 1470nm Laser

admin — Wed, 08 Jun 2011 13:15:16 +0000

NYU vascular surgeon pioneering AngioDynamics’ latest offering for varicose vein treatment

Morristown, NJ (June 8, 2011) – Dr. Lowell S. Kabnick, MD, RPhS, FACS, FACPh, Director of NYU Vein Center and internationally recognized authority and pioneer in the field of vascular surgery, is once again leading the way with breakthrough techniques, being the first in the country to use the new VenaCure® 1470nm laser to treat varicose veins. The new laser uses a lower power output compared with other lasers resulting in effective vein closure.

The VenaCure 1470nm laser’s light energy is accurately delivered through the NeverTouch® gold-tip fiber, and is more readily absorbed by the water in the blood and endothelial lining than with other wavelengths. The specially engineered fiber tip has a low power density that maximizes effectiveness and minimizes postoperative pain and bruising. The VenaCure 1470nm lasers are manufactured in AngioDynamics’ Cambridge, U.K., facility, and have received the CE mark and 510k clearance.

Ongoing research studies have found excellent vein closure rates, minimal postoperative discomfort and bruising, and a clear reduction in symptom severity over the follow-up period.

“The 1470nm laser enables us to be more efficient during a procedure, we are able to treat veins much more efficiently, which ultimately improves the patients procedure experience,” stated Dr. Kabnick. “That translates into quicker recovery for patients.”

About Lowell S. Kabnick, MD, RPhS, FACS, FACPh
Lowell S. Kabnick, MD, RPhS, FACS, FACPh, a New York University Surgeon with offices in Manhattan and Morristown, NJ and Director of NYU Vein Center, is a world-renowned surgeon-teacher whose patient-centered approach to vein care has enabled the creation and improvement of many of today’s most advanced noninvasive vascular surgery techniques. Recognized by his peers as an international leader in the diagnosis and treatment of venous disease, Dr. Kabnick was the first vascular surgeon in the United States to perform the VNUS Closure™ (radiofrequency) procedure and the VenaCure EVLT® (laser) procedure – two FDA-approved breakthrough technologies for treating the underlying causes of many varicose vein problems. For more information, please visit www.lowellkabnickmd.com.

Contact:
Lowell S. Kabnick, MD, RPhS, FACS, FACPh, lowell.kabnick@nyumc.org

New Jersey:
95 Madison Ave
Suite 415
Morristown, NJ 07960
Phone: 973-538-2000

New York:
NYU Vein Center
530 First Avenue
Suite 6D
New York, NY 10016
Phone: 212-263-8346

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Dr. Lowell S. Kabnick Announces New Website Launch

admin — Thu, 05 May 2011 20:14:28 +0000

New website focuses on providing quality patient-centric information

Morristown, NJ (May 05, 2011) – Dr. Lowell S. Kabnick, MD, RPhS, FACS, FACPh, internationally recognized leader and pioneer in the field of vascular surgery, has recently launched a new website that features comprehensive information on vein anatomy and varicose vein treatment options. The website provides visitors with specific information about the latest advances in minimally invasive techniques for the treatment of varicose and spider veins.

Features of the new website, www.lowellkabnickmd.com, include:

Vein disease information – symptoms, risks and associated complications
Treatment – overview, options, side effects and recovery
Video testimonials – actual patients describing their experience with treatment, recovery and results
Before and after gallery – real life imagery of successful procedures
Consultation scheduling – the ease of requesting a consultation online at either the New Jersey or New York location

The website is designed to educate the patient population that seeks to better understand venous disease, procedures and treatments as well as recovery and potential risks, side effects and insurance coverage. “We’ve worked hard on this website to ensure it will have the technical ease as well as timely and useful content that is relevant to individuals who suffer from chronic venous insufficiency, which if left untreated, will worsen over time,” said Dr. Lowell S. Kabnick. “I feel it’s vitally important to provide patients with the most up-to-date, accurate information concerning the disease and options for care.”

Contact:
Lowell S. Kabnick, MD, RPhS, FACS, FACPh, lowell.kabnick@nyumc.org

New Jersey:
95 Madison Ave
Suite 415
Morristown, NJ 07960
Phone: 973-538-2000

New York:
NYU Vein Center
530 First Avenue
Suite 6D
New York, NY 10016
Phone: 212-263-8346

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Dr. Lowell S. Kabnick Performs Revolutionary Technique To Eliminate Spider Veins

admin — Tue, 19 Apr 2011 10:05:38 +0000

Internationally renowned physician is one of first in the U.S. to offer Veinwave™

Morristown, NJ (April 19, 2011) – Dr. Lowell S. Kabnick, MD, FACS, FACPh, internationally recognized leader in the diagnosis and treatment of venous disease, has pioneered the use of several innovative and minimally invasive techniques in the treatment of varicose and spider veins. Approved by the FDA for use in the U.S. in June 2009, Veinwave™ is the latest of these procedures which enables patients to see immediate results. Dr. Kabnick provides services at both his Morristown, NJ facility and at NYU Vein Center in New York City.

For the treatment of fine thread veins, known as telangiectasia, small vascular blemishes in the face and hands, and for spider veins in the legs, Veinwave™ is the only treatment of its kind to receive 510k clearance by the FDA. Having been used successfully to treat patients in the UK and throughout Europe since 2001, Veinwave™ utilizes the principle of thermocoagulation, or high-frequency energy, to heat the fine blood vessels causing them to immediately disappear. A sterile, single-use needle delivers these waves. The ultra-fine needle allows for accurate application of the treatment, protecting the skin and tissue, also aiding in the prevention of scarring.

Veinwave™ has become the solution of choice for physicians and patients alike for veins that are too fine to be treated endovenously like varicose veins. Dr. Kabnick explained, “Veinwave™ is a safe and effective, out-patient procedure with minimal pain and does not require bandages.” Dr. Kabnick added, “Typically, patients are able to resume normal activity immediately following treatment.”

About Lowell S. Kabnick, MD, FACS
Lowell S. Kabnick, MD, RPhS, FACS, FACPh, a New York University Surgeon with offices in Manhattan and Morristown, NJ and Director of NYU Vein Center, is a world-renowned surgeon-teacher whose patient-centered approach to vein care has enabled the creation and improvement of many of today’s most advanced noninvasive vascular surgery techniques. Recognized by his peers as an international leader in the diagnosis and treatment of venous disease, Dr. Kabnick was the first vascular surgeon in the United States to perform the VNUS Closure™ (radiofrequency) procedure and the VenaCure EVLT® (laser) procedure – two FDA-approved breakthrough technologies for treating the underlying causes of many varicose vein problems.

Contact:
Lowell S. Kabnick, MD, FACS, FACPh
lowell.kabnick@nyumc.org

New Jersey:
95 Madison Ave
Suite 415
Morristown, NJ 07960
Phone: 973-538-2000

New York:
NYU Vein Center
530 First Avenue
Suite 6D
New York, NY 10016
Phone: 212-263-8346

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