arrHitInfo=new Array("000,22,2,24,1","01,23,3","03,21,1","10,19,2,21,1,22,1,23,10","100,22,1","10th,21,1","11,23,5","1149,19,1","1152,19,1","12,19,2,21,1,23,9","1204,19,1","122,21,1","13,23,7","137,21,1","138,19,1","13th,23,1","14,21,2,23,6","140,11,1,21,1","142,19,1","143,21,1","145,19,1","15,21,1,23,3,24,1","16,21,1,23,6","17,21,1,23,2","18,23,1","19,21,1,23,2","1972,23,1","1976,23,2","1980,23,3","1983,23,1","1985,21,1,23,4","1986,21,5,23,6","1987,3,1,21,5,23,7","1988,20,1,21,5,23,9","1989,21,4,23,5","1990,3,1,21,6,23,4","1991,21,2,23,6","1992,19,1,20,2,21,1,23,2","1993,21,1,23,4","1994,21,1,23,8","1995,23,5","1996,20,2,23,6","1997,20,1,23,3","1998,23,3","1999,19,1,23,1","19th,23,1","20,22,1,23,3,24,1","2000,19,3,23,3","2001,19,1,20,2,23,2","2002,2,1,20,3,23,3","2003,19,6,20,3,23,3","2004,1,1,2,1,3,1,4,1,5,1,6,1,7,1,8,1,9,1,10,1,11,1,12,1,13,1,14,1,15,1,16,1,17,1,18,1,19,1,20,2,21,1,22,1,23,3,24,1,25,1,26,1,27,1","201,21,1","21,23,4","22,21,2,23,3","225,2,1,3,1,13,1,15,3","23,21,1,23,5","24,23,5","25,23,5","26,23,2","27,21,2,23,7","28,21,1,23,3","29,21,1,23,2","30,21,2,23,6,24,1","308,21,1","31,21,1,23,4","372,21,1","375,21,1","376,21,1","383,21,1","39,21,1","40,22,1","41,21,1","42,21,1","495,21,1","4e,19,1","500,21,1","5147,15,1","5425,15,1","5479,2,2,3,2,12,1,13,2,15,3","585,19,1","589,19,1","643,19,1","646,19,1","65,19,1","66,19,1","70,21,1","70808,15,1","767,2,2,3,2,12,1,13,2,15,4","79,21,1","808,21,1","80th,21,1","810,21,1","8212,24,2,25,1","8226,1,5,2,5,3,5,4,5,5,5,6,5,7,5,8,5,9,5,10,5,11,5,12,5,13,5,14,5,15,5,16,5,17,5,18,5,19,5,20,5,21,5,22,5,23,5,24,5,25,5,26,5,27,8","877,2,1,3,1,13,1,15,1","90,11,1","911,18,1","aa,21,1","abdomen,24,4,25,1","abdominal,9,1,21,2,24,6","ablation,8,1,19,1,25,1","abnormal,11,2","abnormalities,11,1","abnormality,11,1","abnormally,11,1","abouzeid,21,1","abreo,19,1","absence,11,1","absent,22,1","abshire,21,1","abstract,19,1,21,1","accelerated,24,1","accept,12,1,13,1","accepted,2,1","access,7,1,8,3,9,1,13,1,23,1","accordance,13,1","accuracy,18,1","accurate,9,1","aching,25,1","acquired,26,1","acrobat,13,2","across,3,1,20,1","activity,22,1","actually,11,1,24,1","acute,11,2","add,8,1,13,1","additionally,25,1","administer,26,1","administered,25,1","administrator,5,1","admission,19,1","adobe,13,3","adults,26,1","advanced,20,2,22,1,23,3,24,1","advice,18,3","aedes,19,1","aegypti,19,1","aetna,12,1","affected,22,2,26,1","affecting,11,1,22,1","affiliated,23,1","against,25,1","age,26,2","agent,11,1","agents,11,1","ages,22,1","aid,11,1","air,26,1","akin,19,1","alimentary,23,1","allergic,27,1","allergies,27,1","allow,27,1","allows,2,1,26,1","already,13,1","alternative,21,1","alternatives,1,1,6,1","although,24,2","alton,23,1","always,6,1,18,1","ambulatory,25,1","america,21,1,23,2","american,3,2,16,2,19,4,20,3,21,2,23,15,24,1","americans,22,1","among,25,1","amount,11,1","amp,2,2,3,2,7,1,19,6,20,8,21,6,23,11","ampil,19,1","amputation,22,2","anaheim,23,2","anal,19,1","analyze,9,1","anastomosis,11,1","anastomotic,21,2","anesthesia,25,2,27,1","aneurysm,8,3,11,2,21,4,24,23","aneurysmal,2,1","aneurysms,2,1,7,3,11,1,21,5,24,20","angiogram,9,1,22,1","angiography,9,2,11,2","angioplasty,8,4,19,1,21,1,23,1,26,1","angioscopy,21,1,23,1","animal,11,3","ankle,25,1","ankles,25,2","annual,21,3,23,43","another,11,1,26,1","anticoagulant,11,3,26,1","anywhere,1,1,22,1,24,1","aorta,8,1,9,1,23,1,24,10","aortic,2,1,7,1,8,2,19,2,21,4,24,22","aorticaneurysms,24,4","aorto,21,1","aortobifemoral,21,2","aortocoronary,19,1","aortofemoral,21,1","apologize,14,1","appear,25,3","appearance,25,1","appears,26,1","apply,13,1","appoint,13,1","appointment,2,1,3,1,13,3,15,1","appointments,15,1","appropriate,1,1,25,1,27,1","approximately,27,1","april,5,1,19,1,21,1,23,5","arch,21,1","archived,19,1","archives,19,1","area,3,1,11,1,16,1,22,1,24,4,26,2,27,1","areas,2,1","arizona,2,2,20,3,21,1,23,7","arms,22,1","around,23,1,25,2,27,1","art,2,1,6,1","arterial,2,1,7,4,8,1,9,1,21,3","arteries,11,9,22,3,24,1","arteriogram,22,1","arteriography,8,1,9,1,11,1","arteriovenous,21,1","artery,7,4,8,3,11,14,19,2,24,4,26,1","articles,16,1,23,1","ascending,19,1","asked,25,1","aspirin,22,1","assembly,21,1","assist,12,1","assisted,25,2","associated,11,1,19,1,26,1","association,20,1,21,5,23,15,24,1","atherectomy,21,1","atheromatous,11,1","atheroscleratic,7,1","atherosclerosis,7,1,11,4,22,2,24,6","atherosclerotic,11,2","atlanta,3,1,21,6,23,14","atls,20,1","atria,11,1","atrial,11,1","attach,24,1","attack,11,2","attended,3,1,23,2","attends,23,1","audible,11,1","august,21,2,23,3","automatically,27,1","available,1,1,14,5,25,1","avoid,25,1","award,23,1","aware,19,1,21,1","away,25,2,27,2","axillo,8,1","bachelor,20,1,23,1","bacille,21,1","backward,25,2","bacteria,24,2","bad,24,1","balloon,8,1,26,1","ballooning,11,1","based,24,1","basic,20,1","baton,1,1,3,2,15,1,16,2,21,4,23,1","beach,21,1,23,1","beat,11,1,24,1","beats,11,1","beaver,23,1","because,1,1,11,1,22,2,27,1","become,11,2,25,5,27,1","becomes,24,1,25,1,27,1","becoming,27,1","bed,26,1","beforehand,13,1","began,3,1","begun,11,1","believe,24,1","believed,24,1","beneath,25,1","beneficial,22,1","best,1,1,6,1,9,1,19,1,21,1","better,20,1,23,1,25,1","between,11,1,22,1","beverly,23,1","bifemoral,8,2,21,1","big,27,1","billing,5,1,12,2","biology,19,1","biopsies,22,1","biopsy,22,1","birth,11,1,26,1","blades,25,1","bleeding,11,2,24,2","block,19,1,25,1","blockage,11,3,22,1","blocked,11,1,22,1","blood,9,1,11,49,22,8,24,18,25,13,26,4,27,4","blue,8,1,12,1,25,2,27,1","board,3,1,20,1,23,2","boards,20,1,23,1","body,11,9,24,5,25,5,26,1,27,1","born,25,1","boston,23,4","both,8,1,22,1,23,1","box,17,1","brain,11,8","break,24,2,26,1","breaks,24,1","breast,19,1","brief,11,1","briefs,16,1","bring,6,1","brittany,15,1","brown,19,1,25,1","bruising,24,1","bruits,11,1","buerger,7,1,22,18,26,1","buergers,22,4","build,11,1","bulge,24,3","bulging,24,1,25,1","burning,25,1,27,1","burton,19,1","business,4,1,5,1,15,1","button,17,1","bypass,8,6,19,1,21,4","cadaveric,21,1","calcium,11,2,24,1","calf,22,1,26,1","california,23,6","call,2,1,3,1,12,1,13,1,15,1,18,1","called,11,5,24,8,25,3,26,5,27,3","calmete,21,1","calves,22,1,25,1","camera,25,1","cancer,26,1","cancun,23,1","candidate,20,1","cannot,11,1,13,1,25,1","car,24,1,26,1","carcinoma,19,3","cardiac,11,1,20,1","cardiovasc,21,1","cardiovascular,2,2,11,2,19,1,20,1,23,4","care,3,2,6,1,8,1,19,1,21,1,25,1","caring,4,1","carotid,2,2,7,1,8,2,9,1,11,6,19,2,21,2","carried,11,2","carries,11,2","carry,25,2","carrying,11,1","case,19,2,27,1","cases,22,1,24,2,26,2","cat,11,1,24,1","categorized,7,1","catheter,24,1,25,5,26,1","cause,11,2,21,1,22,3,24,5,25,4,26,1","caused,11,5,22,3,26,1","causes,11,1,22,3,24,5,25,2,26,3,27,1","causing,24,2","cava,8,1","cavity,11,1","cells,11,1,24,1,27,1","center,2,2,16,2,19,2,20,4,21,2,23,2","century,24,1","cerebral,23,1","cerebrovascular,9,1,11,1","certain,11,1,24,1","certificates,23,1","certification,2,1,3,1,19,1,20,5,21,1,23,6","certifications,20,2,23,2","certified,3,1,20,2,23,4","certififed,20,1","cervical,8,1","challenge,21,2","chambers,11,2","chance,11,1","changes,25,2","chapter,19,1,21,1,23,5","characterized,11,1","check,7,1,8,1,13,1,14,1,25,2","chest,24,3","chicago,21,1,23,8","chief,20,1","children,19,1","cholesterol,11,4,24,1","christian,23,1","chronic,7,1,11,3,21,2","cigna,12,1","circulation,22,1","circulatory,24,1","claims,5,1","clammy,22,1","claudication,11,1,22,5","clicking,13,1","clinic,1,6,2,4,3,4,4,5,5,4,6,7,7,5,8,4,9,4,10,4,11,4,12,5,13,5,14,4,15,4,16,4,17,4,18,4,19,4,20,4,21,4,22,8,23,4,24,8,25,8,26,8,27,8","clinical,23,1","close,25,2","closely,12,1","closes,25,1,27,2","closing,11,1","clot,11,6,24,4,25,1,26,6,27,2","clots,11,2,24,1,25,2","clotted,8,2,27,1","clotting,11,5,26,1","clusters,25,1","co,21,1","coast,21,2,23,5","coding,5,1","cold,22,2","collapses,25,1","collect,25,1","college,3,2,16,1,19,3,20,3,21,1,23,2","colorado,23,3","com,6,1,16,1,17,1,18,3","combination,24,1,25,1,26,1","come,6,1,27,1","comes,1,1,25,1","common,22,3,24,2,25,1","commonly,24,1,25,3,26,1,27,1","comorbid,21,1","companies,12,1","competence,3,1","complain,22,1,24,1","completed,2,2","complex,11,1,12,1","complication,21,2,25,1","complications,27,2","component,11,1,25,1","comprehensive,23,2","compression,26,1","computed,24,1","computer,11,1,13,1","concepts,23,1","concern,22,1,25,1","condition,7,1,11,2,18,1,22,2,24,3,25,1,26,1","conditions,1,2,2,1,3,1,4,1,5,1,6,3,7,14,8,1,9,1,10,1,11,1,12,1,13,1,14,1,15,1,16,1,17,1,18,2,19,1,20,1,21,1,22,9,23,1,24,11,25,9,26,10,27,1","conference,23,1","conferences,23,1","confirm,11,1","confusion,24,1","congenitally,25,1","congress,19,3,21,1,23,10","connection,11,1","consciousness,24,1","consent,13,2","consider,1,1,6,1,25,1","considered,2,1,25,1,27,2","constantly,22,1","constriction,11,2","construction,14,5","contact,1,1,2,1,3,1,4,1,5,1,6,1,7,1,8,1,9,1,10,1,11,1,12,2,13,1,14,1,15,10,16,1,17,1,18,1,19,1,20,1,21,1,22,1,23,1,24,1,25,1,26,1,27,1","contain,7,1","content,18,3","contents,18,1","continue,1,1,20,1,23,2","continued,11,1,23,1","continues,22,2","continuing,3,1,21,2","contract,11,1","contractions,11,1","contracts,11,1","contrast,11,1","contribute,25,1","contribution,25,1","contributions,19,2,21,2","control,24,2,25,1,26,1","controlled,23,1,26,1","convenience,7,1","convention,23,1","conventional,26,1","coordinator,5,1","copy,1,1,2,1,3,1,4,1,5,1,6,1,7,1,8,1,9,1,10,1,11,1,12,1,13,1,14,1,15,1,16,1,17,1,18,1,19,1,20,1,21,1,22,1,23,1,24,1,25,1,26,1,27,1","copyright,1,1,2,1,3,1,4,1,5,1,6,1,7,1,8,1,9,1,10,1,11,1,12,1,13,1,14,1,15,1,16,1,17,1,18,1,19,1,20,1,21,1,22,1,23,1,24,1,25,1,26,1,27,1","cords,25,1","coronado,23,1","cosmetic,25,1","coumadin,26,1","country,3,1,20,1","course,23,2","cramps,25,1","crashes,19,1","create,24,1","creek,23,1","critical,22,1,23,1","cross,12,1","cst,5,1","ct,9,1,11,2,24,3","cum,23,1","cure,22,1","current,21,1,23,2","currently,14,5,24,1","custom,19,1","cut,24,1","cystic,24,1","dairy,11,1","dallas,23,1","damage,11,1,24,2","damaged,11,1,24,1","damages,24,1","danger,24,1","dangerous,27,1","danlos,24,1","dark,25,1,27,1","darla,5,1","day,25,1,26,1","dc,23,1"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,5,1","kinds,11,1","knees,25,1","knowledge,1,1","known,3,1,22,2,24,1,26,1","lab,9,1","laboratory,6,1,23,2,24,1","lack,11,1,22,1,24,1","lady,16,1,21,1","lake,16,1,21,1","lance,27,1","lane,21,1","laparoscopy,19,1","large,11,1,19,2,21,1,24,1,25,1,26,1,27,1","largest,24,1","laser,2,1,8,1,19,1,21,1,23,1,25,4","lasers,23,1","last,13,1","lasting,11,1","latest,9,1,19,1,21,1","laude,23,1","lauderdale,23,1","layer,24,1","layers,11,1","laying,25,1","ldquo,21,20,23,1,27,10","lead,22,1,24,4,25,2,26,2","leader,2,1,3,1","leading,24,2","leads,22,1,25,1","leaks,24,1","learn,1,1,25,1","learning,20,2,23,2","leave,27,2","leaves,11,1","lecture,23,1","left,11,1,19,1,27,1","leg,21,2,24,1,25,5,26,8","legitimate,25,1","legs,22,1,25,6","lemoyne,19,2,20,1","less,11,1,24,1","level,19,1","library,16,1,19,1","license,20,2,23,2","licensed,20,1,23,1","licensure,20,1,23,1","life,20,3,23,1,25,1,26,1","ligation,8,3","light,24,1","likely,24,1","limb,11,1,21,1,22,1,26,1","limbs,22,1","limited,25,1","lining,11,2,24,1,26,1,27,1","link,19,1,21,1","linked,8,1","links,1,1,2,1,3,1,4,2,5,1,6,1,7,2,8,2,9,1,10,1,11,1,12,1,13,2,14,1,15,1,16,10,17,1,18,2,19,1,20,1,21,1,22,1,23,1,24,1,25,1,26,1,27,1","linton,8,1","list,19,1,20,1,21,1,23,1","listed,8,1,25,2","literature,19,2,21,1","liver,11,1","lives,24,1","local,25,1","localized,11,1","located,15,1,26,2","location,13,1,24,1","lodges,24,1","logo,3,1","long,11,1,25,2","longer,25,1","looking,1,1","lopez,19,7","loss,24,1","lost,24,1","louisiana,2,3,3,1,15,1,19,1,20,6,21,5,23,21","lower,7,1,8,2,19,1,22,2,24,1","lowest,11,1","lsu,3,1,19,1","lumbar,8,1","lumen,11,2,19,1","lung,26,1","lw,19,1","lymphatic,7,1","magnetic,11,2","major,11,2,12,1,26,1","male,21,1,24,2","malfunction,25,2","malignancy,21,1","malignant,26,1","malperfusion,19,1","management,21,2,23,1","manager,5,1","mansour,21,1","manuscript,19,1","manuscripts,2,1,19,7,20,1","map,1,1,2,1,3,1,4,1,5,1,6,1,7,1,8,1,9,1,10,1,11,1,12,1,13,1,14,1,15,2,16,1,17,1,18,1,19,1,20,1,21,1,22,1,23,1,24,1,25,1,26,1,27,1","march,21,1,23,5","marfan,24,1","marr,19,2","masquerading,21,4","mass,11,1","massachusetts,23,4","maui,23,3","mdash,22,2,26,1","measured,11,1","measurement,11,1","meats,11,1","mechanical,21,1","medial,24,2","medicaid,12,1","medical,1,1,2,4,3,2,4,1,5,1,6,3,7,1,8,1,9,1,10,1,11,2,12,1,13,1,14,1,15,1,16,3,17,1,18,5,19,3,20,6,21,9,22,1,23,9,24,1,25,1,26,1,27,1","medicare,12,1","medication,26,2,27,1","medications,22,1,27,1","medicine,1,1,3,2,6,1,10,1,12,1,16,1,19,1,20,3,21,3,23,4","medline,11,1,16,1","meeting,21,3,23,39","meetings,21,1,23,2","mellitus,11,1","memberships,2,1,3,1,19,1,20,6,21,1,23,7","memorial,3,1,21,1","men,22,1,25,1","meschonat,19,1","mesenteric,7,1,8,1,9,1,21,1","metamorphosis,19,1","metastases,19,1","method,11,1","mexico,23,1","mf,19,1","miami,23,1","middle,24,1","might,13,1","mild,25,1","milk,26,1","mills,19,1","minimally,1,1,2,1,6,1","minority,19,1","minutes,24,1","mirage,23,1","miscellaneous,9,1","misshapen,25,1","mission,1,1","mobley,5,1","modern,24,2","molecular,26,1","monday,15,1","monica,23,2","months,13,1,25,1,26,1","morbid,21,1","morbidity,19,1","mortality,19,1","mosquito,19,1","motor,19,1","mountain,23,2","move,26,1","moved,3,1","mr,9,1","mri,11,1","mt,21,4","multimodal,19,1","multiple,20,1,23,1","murmurs,11,1","murray,21,1","muscle,11,2","mycotic,21,2,24,1","name,8,1,17,1,26,1","naples,23,1","napojaroonsri,19,1","narrowed,11,1,26,1","narrowing,11,1,24,1","nashville,23,1","national,16,1","naturally,27,1","ndash,22,1,23,4","near,22,1","necessary,1,1","neck,11,1","necrosis,24,1","needed,25,2,27,1","needle,27,2","needs,4,1","neovascularization,27,1","neurologic,11,1","neuroprotection,19,1","never,11,1","new,1,1,2,2,3,1,13,3,19,1,20,4,21,4,23,18,25,1,26,1,27,1","newer,25,1","next,17,1","night,25,1","nineteenth,23,1","nj,21,1","nocturnal,22,1","nodal,19,1","non,6,1,7,1,21,1","noninvasive,9,1,11,2","nonsurgical,1,1","normal,11,1,27,1","north,22,1,23,7","notice,13,2","noticeofprivacypolicies,31,8","nov,21,1","november,21,4,23,11","number,21,1,26,1","numbness,22,1","numerous,24,1","nurse,5,2,27,1","nurses,21,1","obese,24,1","obesity,25,1,26,1","obliterans,22,1","obliterating,27,1","observed,11,1,24,1","obstructed,22,1","obstruction,11,3,22,1","obtaining,20,1,23,1","occasionally,25,1","occlusion,11,1","occlusive,7,1,21,1","occupation,25,1","occupational,21,1","occur,24,2,25,3,26,1,27,2","occurrences,26,1","occurs,11,2,22,2,24,6,25,1,26,1,27,2","ochsner,23,1","october,21,4,23,8","octogenarians,21,1","off,24,3,27,1","offer,2,1","office,4,1,5,7,13,3,25,1,27,1","old,21,2","older,25,1","olsen,19,4","olson,21,1","once,25,1,26,2","oncology,19,1","ongoing,20,1,23,1","online,13,1","open,8,1,11,1,24,1,26,1","opening,11,1","operated,6,1","operation,25,1","operations,3,1,13,2","operative,21,1","opposed,11,2","option,19,1","options,1,1,2,1,6,1,22,2,24,3,25,3,26,2,27,1","oral,26,1","order,9,1,24,1,25,2","organ,11,1","organizations,16,1,20,1,23,1","organized,11,1","organs,24,1,25,2","origin,21,1","orleans,2,1,3,1,19,1,20,1,21,3,23,15","ourselves,1,1","outlet,7,1,8,1","outpatient,25,1,26,1","outside,27,1","overexpression,19,1","overlap,22,1","overlooked,21,2","overlying,27,1","overview,22,2,24,2,25,2,26,2,27,2","own,18,1,27,1","p15,19,1","page,1,5,6,1,7,1,10,1,12,1,13,1,14,5,19,1,20,1,21,1,22,2,23,1,24,3,25,5,26,3,27,2","pages,6,1,12,1,27,1","pain,11,3,19,1,22,8,24,5,25,1,26,2","pam,5,1","paralysis,11,1","parish,23,1","part,11,2,24,5","participates,23,1","particular,1,1,25,1","particularly,22,1,25,1,26,1","partnered,6,1","parts,11,3,22,1,25,1","party,18,3","passing,23,1","pathological,11,1","patient,1,2,2,1,3,2,4,1,5,1,6,1,7,1,8,1,9,1,10,1,11,1,12,1,13,8,14,1,15,1,16,1,17,1,18,1,19,1,20,1,21,1,22,3,23,1,24,3,25,3,26,2,27,1","patientregistration,29,8","patients,6,1,9,2,11,1,12,10,13,2,19,1,21,1,22,2,24,3,25,3","patterns,19,1","paul,1,1,2,6,3,1,4,2,5,1,6,1,7,1,8,1,9,1,10,1,11,1,12,1,13,1,14,1,15,1,16,1,17,1,18,1,19,6,20,6,21,1,22,1,23,1,24,1,25,1,26,1,27,1","payment,13,2","pdf,13,1,29,4,30,4,31,4","pe,19,12","pelvic,26,2","pelvis,25,1","pending,20,1","pentoxyphylline,22,1","people,22,2,25,2,26,1","per,26,1","percutaneous,19,1","perdue,21,5","perforater,8,1","perforator,8,1","perform,8,1","performed,3,1,8,1,24,2,25,1","period,11,1","periods,25,2","peripheral,1,2,2,3,6,1,20,1,23,3","perkowski,1,1,2,14,3,1,4,2,5,1,6,1,7,1,8,2,9,1,10,1,11,1,12,1,13,1,14,1,15,1,16,1,17,1,18,1,19,27,20,11,21,1,22,1,23,1,24,1,25,1,26,1,27,1","permanent,11,1,27,1","persistent,22,1","person,22,5,25,2,26,1","pertaining,11,2","phlebectomy,23,1,25,1","phlebitic,7,1,26,2","phlebology,21,1,23,6","phoenix,2,1,20,1","photographed,11,1","phrase,17,2","physical,24,2","physician,18,1,20,1,23,2,24,1","physicians,4,1,9,1,21,2","piece,24,1","pigment,27,3","pills,26,1","placement,8,2,19,1","plaque,11,6,24,2","plaques,11,1","platelets,11,2","plavix,22,1","pletal,22,1","plethysmography,9,1,26,1","plural,11,2","plus,11,1,16,1","point,1,1","policies,13,2","poor,22,1","popliteal,21,2","population,19,1","possibility,22,1","possible,6,1,9,1,19,1,21,1,22,2,24,2,25,4,26,2,27,2","possibly,25,1","post,1,1,2,1,3,1,4,1,5,1,6,1,7,2,8,1,9,1,10,1,11,1,12,1,13,1,14,1,15,1,16,1,17,1,18,1,19,1,20,1,21,1,22,1,23,1,24,1,25,1,26,3,27,1","postphlebitic,21,4","poultry,11,1","power,1,1","powered,23,1","practice,3,1,19,1,20,1,21,1,23,1","practiced,3,1","pregnancy,21,1,25,2,26,1","pregnant,25,2","premature,24,1","premier,2,1","prescribing,23,1","presence,11,1","present,11,2,13,1,25,1,26,1","presentations,3,1,21,8,23,1","preserve,19,1","pressure,11,9,24,4","pressures,9,1","prestigious,3,1","prevent,1,1","preventing,11,1","prevention,1,1,6,1","prevents,11,2,26,1","previous,24,1,25,1","previously,13,1","print,13,4","privacy,13,2","proactive,6,2","proactivemedical,6,1","probably,1,1","problem,25,1","problems,7,1,23,1","procedure,8,2,11,1,25,1,26,2","procedures,1,1,2,1,3,1,4,1,5,1,6,3,7,1,8,11,9,1,10,1,11,1,12,1,13,1,14,1,15,1,16,1,17,1,18,1,19,1,20,1,21,1,22,1,23,1,24,1,25,5,26,3,27,5","process,24,1","processor,5,1","produce,11,1,24,1","produces,11,1,25,1","producing,24,1","products,11,1","professional,3,1,18,1,20,2,21,1,23,1","professionals,4,1","profile,2,5,3,5,19,1,20,1,21,1,23,1","profuse,11,1","program,2,1,13,3,23,1","progresses,7,1","project,19,1","prolonged,26,1","prompt,26,1","proper,26,1","properly,11,1,25,2","proscribe,9,1","prosthesis,21,2","provide,1,2,9,2,18,2","provider,18,1,23,1","providing,8,1,11,1,19,1,21,1","pseudoaneurysm,19,2","publication,19,1,21,1","publications,2,1,3,1,19,7,20,1,21,7,23,1","publish,19,4,21,4","pubmed,16,1","puerto,21,1,23,3","pulmonary,26,2","pulsating,24,1","pulse,22,1,24,1","punctures,25,1","purple,25,1,26,1","purposes,18,1","puts,24,1","quadrant,19,1","qualified,4,1,18,1","quality,8,1,20,1,23,1","questions,12,1,13,1,18,1","quickly,1,1,13,1,24,1,26,1","quite,27,1","rabalais,5,1","radio,25,1","radiographic,11,1","radiopaque,11,1","ramaiah,19,7","rancho,23,1","range,7,1,11,1","rapid,24,1","rare,22,1,24,4,27,1","rather,22,1,25,1","ravi,19,4","ray,11,1,24,1","raynaud,7,1","rays,11,1,24,1","rb,21,7","rdquo,21,20,23,1,27,10","reach,15,1","reached,1,1","reaction,27,1","reactions,27,1","read,19,1,20,1,21,1,23,1","reader,13,2","reading,23,1","received,3,1,23,1,26,1","recent,26,2","receptionist,5,1","recognizable,26,1","recognize,1,1","recognized,20,1,23,1","recommend,18,1","recurrent,21,2,26,1","redness,27,1","reduced,11,1","referred,11,1","reflux,25,5","regarding,18,2","regional,16,1,21,1","registered,3,1,6,1,23,1","registration,13,4","reimbursement,12,1","related,7,1","relatively,25,1","relatives,24,1","relaxed,11,1","reliable,24,1","remains,25,1","remedial,21,1","removal,8,1,11,1,25,1","remove,25,3","removed,25,1,27,1","renal,7,1,8,2,9,1,19,3","render,25,1","repair,2,1,8,3,19,1,24,1","repeat,27,1","replaced,25,1","report,19,2","reporting,22,1","represent,27,1","representations,18,1","requested,14,4","require,22,2,25,2,27,1","required,24,1,26,1,27,1","requires,26,2","reroutes,27,1","research,2,1,19,2,21,1","researchers,24,1","reserved,1,1,2,1,3,1,4,1,5,1,6,1,7,1,8,1,9,1,10,1,11,1,12,1,13,1,14,1,15,1,16,1,17,1,18,1,19,1,20,1,21,1,22,1,23,1,24,1,25,1,26,1,27,1","residency,2,1,3,1,20,1,23,2","resident,20,2","resistant,27,1","resonance,11,1","resources,1,1,2,1,3,1,4,1,5,1,6,2,7,1,8,1,9,1,10,10,11,1,12,1,13,1,14,1,15,1,16,1,17,1,18,1,19,1,20,1,21,1,22,1,23,1,24,1,25,1,26,1,27,1","respected,3,1","rest,9,1,11,2,22,3,26,1","result,27,2","resulting,24,1","results,9,1","return,19,1,20,1,21,1,22,1,23,1,24,1,25,1,26,1,27,1","revascularization,23,1","reversed,24,1","review,19,1,23,3","rheudasil,21,1","rick,25,1","rico,21,1,23,3","right,11,1,19,1","rights,1,1,2,1,3,1,4,1,5,1,6,1,7,1,8,1,9,1,10,1,11,1,12,1,13,1,14,1,15,1,16,1,17,1,18,1,19,1,20,1,21,1,22,1,23,1,24,1,25,1,26,1,27,1","rio,23,2","ripping,24,1","risk,11,4,18,1,24,1,26,2","risks,26,1","rn,5,1","rocky,23,2","rodriguez,19,7","ron,5,1","room,21,1","rope,25,1","rosemary,5,1","rotating,25,1","rouge,1,1,3,2,15,1,16,2,21,4,23,1","rounds,21,2","routine,24,1","rsquo,21,2,22,13,23,1,26,2,27,1","rule,22,1","ruled,22,1","run,6,1","runs,24,2","rupture,11,1,19,1,24,3","ruptured,11,1,24,2","ruptures,24,1","safely,24,1","salam,21,4","saline,27,1","salvage,21,1","same,11,3","santa,23,2","saphenous,8,3,19,1","save,24,1","scab,27,1","scan,11,2,24,5","scar,27,2","schedule,2,1,3,1","scheduled,13,1","schellack,1,2,2,2,3,15,4,3,5,4,6,2,7,2,8,3,9,2,10,2,11,2,12,2,13,2,14,2,15,2,16,2,17,2,18,2,19,2,20,2,21,24,22,2,23,12,24,2,25,2,26,2,27,2","school,3,1,21,2,23,3","schwartzman,21,1","science,20,2,23,1","sciences,2,1,20,2","scientific,21,1,23,1","sclerosant,27,4","sclerosed,27,4","sclerosing,27,1","sclerotheraphy,27,1","sclerotherapy,8,1,25,3,27,14","sconyers,5,1","scottsdale,21,1,23,6","search,1,2,2,1,3,1,4,1,5,1,6,1,7,1,8,1,9,1,10,1,11,1,12,1,13,1,14,1,15,1,16,1,17,12,18,1,19,1,20,1,21,1,22,1,23,1,24,1,25,1,26,1,27,1","second,23,2","section,22,1,24,1,25,1,26,1,27,1","see,10,1,11,2,12,1,22,1,24,2,25,5,26,2,27,2","seek,1,1,18,1","select,4,1","selected,21,1","sense,22,1","sentinel,21,2","september,19,1,23,1","series,11,1,24,1","serve,4,1,6,1","service,6,1","seventh,23,1","several,25,5,27,2","severe,11,1,25,3","severio,5,1","severity,25,1","sexually,24,1","she,25,1","short,11,1","should,11,1,22,1,25,2,26,2","show,20,1,23,1","shows,24,1","shreveport,2,1,20,2","side,11,1","sign,11,1,13,1","signatures,13,1","significant,26,1","similar,25,1","simple,12,1,24,1","since,3,2","singh,19,1","single,19,1","sinus,21,2","site,1,4,2,1,3,1,4,1,5,1,6,2,7,1,8,2,9,1,10,1,11,1,12,1,13,1,14,1,15,1,16,1,17,1,18,3,19,1,20,1,21,1,22,2,23,1,24,1,25,1,26,1,27,4","sites,18,4","sittig,19,1","sitting,25,1","six,13,1,22,1","sixth,23,3","sixty,26,1","skills,3,1,20,1,23,1","skin,22,3,25,5,27,2","sleeps,22,1","slow,24,1,26,1","slowly,27,1","small,25,2,27,3","smaller,25,3","smith,19,1,21,7","smoke,22,1","smokes,22,1","smoking,22,2","snowmass,23,1","societies,16,1,20,1,23,1","society,3,1,19,2,20,4,21,9,23,37","solution,25,1,27,3","solving,12,1","someone,22,1","something,1,1","sometimes,22,1,27,3","somewhere,24,1","soon,7,1,13,1,14,1","sore,27,1","sores,22,1","sorrells,19,1","sound,11,1,20,1","sounds,11,1","source,25,1","sources,1,1,11,1","south,2,1,3,1","southeastern,19,1,21,1,23,1","southern,21,4,23,12","specialist,5,1","specialists,20,1","spent,20,1,23,1","spider,7,1,8,1,25,4,27,7","spontaneous,19,1","spread,24,1","spring,23,1","stabilize,22,1","staff,1,1,2,1,3,1,4,2,5,10,6,1,7,1,8,1,9,1,10,1,11,1,12,1,13,1,14,1,15,1,16,1,17,1,18,1,19,1,20,1,21,4,22,1,23,2,24,1,25,1,26,1,27,1","staining,27,1","standards,3,1","standing,25,2","stands,25,2","start,11,1","state,2,3,6,1,20,4,21,3,23,3","states,20,1,23,1","staying,19,1,21,1","stenosis,11,1,24,1","stent,2,1,8,4,11,1","stenting,2,1,19,2,26,1","stents,23,1","steps,25,1","stewart,21,4","still,25,1","stocking,26,1","stop,11,1,22,1","stops,22,1","stream,11,1,24,1","stress,24,2","stripped,25,1","stripping,8,1,25,1","stroke,11,9","strong,24,1","structure,24,1","structures,11,1,24,1","stuck,26,1","studies,9,1","study,20,1,23,1","subfascial,8,1","subject,18,1","subsides,27,1","substance,11,3,24,1","substitute,18,1","sudden,11,1,24,1","suite,15,1","summit,16,1","suny,2,1","superficial,25,6","supplement,21,1","supply,11,1","support,11,1,20,3,23,1,25,1","supporting,24,1","sure,7,1,8,1,12,1,13,1","surg,21,1","surgeon,19,2,21,1","surgeons,1,1,2,1,3,5,4,1,5,1,6,1,7,1,8,2,9,1,10,1,11,1,12,1,13,1,14,1,15,1,16,2,17,1,18,1,19,3,20,2,21,3,22,1,23,3,24,1,25,1,26,1,27,1","surgeries,8,2","surgery,1,1,2,5,3,2,4,1,5,2,6,2,7,1,8,2,9,1,10,1,11,1,12,1,13,1,14,1,15,1,16,1,17,1,18,1,19,3,20,7,21,12,22,1,23,41,24,2,25,2,26,2,27,1","surgical,3,1,6,1,11,2,19,2,20,1,21,3,23,2,25,1","susceptibility,24,1","svs,23,5","svu,23,3","sw,21,1","swelling,11,2,25,3,26,3","swollen,26,1","symbol,3,2","sympathectomy,8,2","symposium,23,6","symptoms,11,3,22,7,24,5,25,5,26,4","syncope,21,2","syndrome,7,2,8,1,21,7,24,2,26,2","synthetic,11,1","syphilis,24,1","syracuse,2,1,20,2","system,11,1,19,1,24,1","systolic,11,1","take,25,1,27,1","taken,26,1","tampa,23,1","tao,22,3","tcd,11,1","team,4,1","tearing,24,1","technical,11,1","technique,8,2,11,1,19,1","technologies,9,1,24,1,25,1","technologist,3,1,23,1","technologists,6,1","technology,19,1,21,2,23,2,25,1","telephone,15,1","temporarily,11,1","temporary,11,1","tendency,26,1","tenderness,22,1,26,1","tennessee,23,1","tenth,23,1","term,11,1","terms,18,1","test,9,2,11,2,26,2","tested,9,1","testicular,9,1","testing,9,5","tests,1,1,2,1,3,1,4,1,5,1,6,1,7,1,8,1,9,8,10,1,11,1,12,1,13,1,14,1,15,1,16,1,17,1,18,1,19,1,20,1,21,1,22,3,23,1,24,2,25,1,26,4,27,1","texas,23,1","text,17,1,18,1","texts,19,1,21,1","themselves,11,1,24,1","therapeutics,19,1","therapy,2,2,19,4","thick,11,1,25,1,27,1","thickened,11,1","thigh,25,1","think,18,1","thinners,22,1","thinning,24,1","third,18,3","thirty,23,1","thomas,23,1","thompson,19,2","thoracic,7,1,8,1,21,2,24,2","thoracoabdominal,8,1,19,1","thoroughman,23,1","those,25,1,26,1","though,11,1,22,1,24,2","thought,24,1","thousands,3,1,8,2","threads,25,1","threatening,26,1","three,11,1","thrombectomy,8,1,19,1","thrombi,11,1,24,1","thromboangiitis,22,1","thromboembolic,21,1","thrombolysis,8,3,26,2","thrombophlebitis,22,1,25,3,26,1","thrombosis,7,1,8,2,11,1,19,1,25,1,26,6","thrombus,11,2","through,3,1,11,2,15,1,20,1,23,2,24,3,25,1,26,4","tia,11,1","time,3,1,7,1,8,1,9,1,13,2,25,1","timer,26,1","times,25,1","tingling,22,1","tiny,25,2,27,2","tip,25,1","tissue,11,5,22,1,27,2","title,17,1","titles,19,1,21,1","tobacco,22,1","today,24,1","toes,22,4","toll,13,1,15,1","tomography,11,1,24,1","too,27,1","tool,11,1","tools,1,1","top,19,1,20,1,21,1,22,1,23,1,24,1,25,1,26,1,27,1","touch,12,1","tough,25,1","toward,25,1","tract,23,1","trained,8,1","training,2,1,20,2,23,2","transcatheter,19,1","transcranial,9,1,11,1,23,1","transient,11,1","transilluminated,23,1","transmitted,24,1","trapped,27,2","trauma,19,1,20,1,23,1,26,2","traumatic,21,2","travel,26,1","traveling,25,1","travels,24,1","treadmill,9,1","treat,1,1,25,2","treated,25,2,26,1","treatment,1,2,2,1,6,2,9,1,13,2,18,1,19,5,21,2,22,2,24,6,25,6,26,5,27,2","treatments,1,1","trellis,19,1","trips,26,1","true,27,1","tseng,19,1","tubular,11,1","tucson,23,1","tulane,3,1,23,1","tumor,26,1","turbulence,11,1","turn,25,1","turns,27,1","twelfth,23,1","twentieth,23,1,24,1","twenty,11,1,23,5","twice,26,1","twisted,25,2","two,11,1","type,11,3,19,1,22,1,25,1","types,27,1","typically,22,4,24,1,25,2,26,1,27,1","ucla,23,3","ulcer,27,2","ulceration,22,1","ulcers,22,3,25,2,26,1","ultimately,1,1","ultrasound,9,6,11,3,21,1,22,1,24,3,25,2,26,1","ultrasounds,24,1","unable,25,1","uncommon,27,1","uncoordinated,11,1","under,14,1","undergoes,25,1,27,2","undergraduate,3,1,20,1,23,1","underlined,8,1","understand,1,1","united,12,1","universities,20,1","university,2,3,3,2,20,3,23,6","until,24,1","updates,7,1,8,1,13,1,14,1","upper,7,1,11,1,22,1,24,1,25,1","upstate,2,1","use,1,1,9,1,11,1,13,2,18,2,21,1,22,1,25,3,26,3","used,11,4,13,1,22,1,25,3,26,1,27,1","uses,11,1","using,11,1,17,1,24,2,27,1","usnews,16,1","usually,11,4,24,2,26,1","uterus,25,1","va,21,1","vaccine,21,1","vail,23,1","valves,25,7","vanderbilt,23,1","varicose,2,1,7,1,8,2,19,1,25,35,27,6","varicoseveins,25,4","various,11,2","vasclin,17,1,18,3","vasclinicon,28,8","vascular,1,14,2,11,3,12,4,9,5,7,6,17,7,14,8,13,9,17,10,8,11,9,12,9,13,8,14,7,15,7,16,11,17,7,18,7,19,9,20,10,21,23,22,17,23,63,24,17,25,15,26,18,27,11","vasculitis,11,1,22,1,24,1","vasodilator,22,1","vehicle,19,1","vein,7,1,8,4,11,1,19,1,21,1,25,13,26,13,27,11","veins,2,1,7,2,8,2,11,1,19,1,22,1,25,49,26,2,27,11","vena,8,1","vencor,21,1","venography,9,1,26,1","venous,2,1,7,2,9,1,16,1,19,2,23,4,25,5","vertebral,7,1,9,1","vessel,11,10,24,9,27,3","vessels,11,7,22,4,24,2","vibrations,11,1","video,25,1","viewing,11,1","viii,23,1","villareal,19,1","virgin,23,1","viscosity,22,1","visible,25,1","visit,6,3,12,1,13,2","visited,13,1","visualize,11,1,25,1","vol,21,1","walking,11,1,22,1","walks,22,1","wall,11,6,24,13","walls,11,2,24,1","warfarin,11,1,26,1","warning,11,1","washington,21,1,23,2","waveforms,9,1","waves,25,1","way,25,1","weak,25,1","weaken,24,1","weakening,11,2,24,2","weakens,24,1","weakness,11,2,24,3","wear,25,1","web,6,1,18,3,24,2,26,1","weeks,25,1,27,2","weight,26,1","weiner,5,1","whatwedo,6,4","whether,11,2,24,1","white,26,1","who,1,1,2,1,3,3,4,7,5,1,6,1,7,1,8,1,9,1,10,1,11,1,12,1,13,2,14,1,15,1,16,1,17,1,18,1,19,1,20,1,21,1,22,2,23,1,24,1,25,2,26,2,27,1","whose,11,1","whoweare,4,4","wide,2,1,7,1","widely,3,1,23,1","widens,24,1","winter,23,1","without,24,1,26,1","woman,21,1,25,1","women,25,2","woods,21,1","word,17,1","words,17,2","work,3,1,12,1,25,1","works,11,1","workshop,23,2","world,2,1,23,1","wreck,24,1","wright,19,1","www,6,1","xi,23,1","year,2,1,21,2,24,2","years,3,1,7,1,20,2,23,2,24,1","yolks,11,1","york,2,1,20,3,23,3","young,19,1,21,1","zachary,21,1"); arrFiles=new Array();arrFiles[0]=new Array(1,"","2005-01-24","Vascular Clinic - Home Page","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links The Vascular Clinic of Baton Rouge You probably reached this site because you seek information about vascular disease. This site is here to provide you with the information you need or to point you to other, appropriate sources. It is our goal to provide you with the information necessary to help you understand vascular conditions and treatments. Our Mission The Vascular Clinic is dedicated to the treatment and prevention of peripheral vascular disease. We put the patient FIRST and consider all treatment options, including nonsurgical or minimally invasive endovascular alternatives. We continue to learn about and follow new developments in the field of vascular medicine, so that we can treat and prevent peripheral vascular disease with the best tools and knowledge available. We also recognize that, ultimately, all healing comes from a power higher than ourselves. Looking for something particular? You can use the Search page to find information anywhere on our site, quickly and easily. • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[1]=new Array(2,"perkowski.htm","2005-03-09","Vascular Clinic - Dr. Paul E. Perkowski, M.D. - Profile","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Dr. Paul E. Perkowski, M.D. | Profile | Publications & Manuscripts | Education, Certification, & Memberships | Dr. Perkowski graduated with a medical degree from the SUNY Upstate Medical University in Syracuse, New York. In 2002 he completed a residency in general surgery at Louisiana State University Health Sciences Center in Shreveport, Louisiana. After graduation he was accepted as a fellow in cardiovascular and endovascular surgery at the Arizona Heart Institute of Phoenix, Arizona - a world-wide leader in endovascular therapy, vascular surgery, and cardiovascular research. Dr. Perkowski completed a one-year fellowship in peripheral vascular surgery at Louisiana State University Medical Center in New Orleans. The program is considered one of the premier vascular fellowships in the South. His extensive training allows him to offer state-of-the-art treatment options for peripheral vascular disease, carotid disease, venous disease, and aneurysmal disease. Dr. Perkowski \'s areas of expertise include: Stent graft repair of aortic aneurysms Carotid and peripheral arterial stenting Minimally invasive laser therapy for varicose veins To schedule an appointment with Dr. Perkowski, please call (225) 767-5479 or (877) 767-5479 • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[2]=new Array(3,"schellack.htm","2005-03-09","Vascular Clinic - Dr. Jon V. Schellack, M.D., F.A.C.S. - Profile","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Dr. Jon V. Schellack, M.D., F.A.C.S. | Profile | Publications & Presentations | Education, Certification, & Memberships | Dr. Schellack received his undergraduate degree from Tulane University. He then attended LSU Medical School, New Orleans to earn his M.D.. After five years of residency work through Emory University at Atlanta-area hospitals, such as Grady Memorial Hospital,, he moved to Baton Rouge, where he began to practice vascular medicine. Dr. Schellack has practiced vascular medicine in Baton Rouge since 1987. He has performed thousands of operations at hospitals across South Louisiana since that time and is well-known and widely-respected in his field as a leader in vascular care. In the early 1990 \'s Dr. Schellack was inducted as a Fellow into the American College of Surgeons (F.A.C.S), the country \'s most prestigious surgical society. He is board certified in General Vascular Surgery and is a registered Vascular Technologist. To schedule an appointment with Dr. Schellack, please call (225) 767-5479 or (877) 767-5479. This symbol designates surgeons who are Fellows of the American College of Surgeons. Surgeons who display this symbol are dedicated to the highest standards of patient care and continuing development of professional skills and competence. For more information about F.A.C.S, click on the above logo image. • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[3]=new Array(4,"whoweare.htm","2005-01-24","Vascular Clinic - Who We Are","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Who We Are Our Team The Vascular Clinic is made up of caring, qualified professionals who are in business to serve you and your vascular health needs. Please select one of the links below for more information about us. Physicians: Dr. Jon V. Schellack Dr. Paul E. Perkowski Office Staff • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[4]=new Array(5,"staff.htm","2005-03-09","Vascular Clinic - Office Staff","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Office Staff Kathy Hunter Coding Kathy Hurrell Billing Specialist April Mobley Receptionist Kim Rabalais, CST, AS Surgery Coordinator Darla Severio, RN Office Nurse Katie Schellack Claims Processor Pam Schellack Administrator Ron Sconyers Business Manager Rosemary Weiner Office Nurse • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[5]=new Array(6,"whatwedo.htm","2005-01-24","Vascular Clinic - What We Do","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links What We Do The Vascular Clinic is here to serve you We are dedicated to the treatment and prevention of Peripheral Vascular Disease. Our patients always come FIRST, and we will consider all treatment options, including non-surgical or minimally invasive endovascular alternatives to surgery. Our state-of-the-art clinic is run to bring you the best possible vascular care. For more information on the vascular conditions, procedures, and diagnostic exams with which we are experienced, please visit one of the following pages: Vascular Conditions Vascular Procedures Vascular Diagnostic Exams Please also visit the General Resources page for more information on vascular medicine. The Vascular Clinic has partnered with ProActive Medical, a full-service laboratory operated by Registered Vascular Technologists. Visit ProActive Medical \'s web site for more information: www.proactivemedical.com • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[6]=new Array(7,"conditions.htm","2005-01-24","Vascular Clinic - Vascular Conditions","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Vascular Conditions At the Vascular Clinic, we have years of experience with a wide range of vascular diseases. As time progresses, this page will contain links with more information on each of the following conditions, so please be sure to check back again soon for updates. The following conditions have been categorized for your convenience: Arterial Conditions Occlusive Arterial Diseases Atherosclerosis-Related Diseases Carotid Artery Disease Vertebral Artery Disease Renal Artery Disease Mesenteric (intestinal) Artery Disease Lower & Upper Extremity Arterial Disease Non-Atheroscleratic Arterial Diseases Raynaud \'s Disease Buerger \'s Disease Aneurysms Aortic Aneurysms Other Aneurysms Venous Conditions Varicose Veins Spider Veins Deep Vein Thrombosis Chronic Venous Insufficiency Post-Phlebitic Syndrome Thoracic Outlet Syndrome Hemo Access Problems Lymphatic Condition • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[7]=new Array(8,"procedures.htm","2005-01-24","Vascular Clinic - Vascular Procedures","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Vascular Procedures Dr. Schellack and Dr. Perkowski are well-experienced at providing the highest-quality vascular care. Both surgeons have trained for thousands of hours and performed thousands of surgeries. Some of the surgeries that they perform are listed below. Click on the linked procedure name for more information (links are blue and underlined ). Over time we will add information about many of these procedures to our site, so be sure to check back for updates. Access placement for dialysis Aorta Bifemoral Bypass Aortic Aneurysm Repair with endovascular technique Aortic Aneurysm Repair with open technique Axillo-Bifemoral Bypass Balloon Angioplasty Carotid Endarterectomy Carotid Stent Angioplasty Cervical Dorsal Sympathectomy Embolectomy for lower extremity embolism Endoscopic Subfascial Perforator Ligation Femoral-femoral bypass Laser Ablation of Saphenous Vein Lower Extremity Bypass Lumbar Sympathectomy Mesenteric Artery Bypass Perforater Ligation (Linton Procedure) Removal of Varicose Veins Renal Artery Bypass Renal Artery Stent Angioplasty Saphenous vein ligation Saphenous vein stripping Sclerotherapy for Spider and Varicose Veins Stent Angioplasty Stent Graft Thoracoabdominal aneurysm repair Thrombectomy of clotted access graft Thrombolysis for clotted access graft Thrombolysis for deep vein thrombosis Thrombolysis for arterial thrombosis Vena Cava Filter Placement Surgery for Thoracic Outlet Syndrome Arteriography • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[8]=new Array(9,"diagnostic.htm","2005-01-24","Vascular Clinic - Vascular Diagnostic Tests","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Vascular Diagnostic Tests In order to provide the best possible treatment of vascular diseases, we proscribe and evaluate the following vascular diagnostic exams for our patients. We use the latest technologies, as well as time-tested exams, to analyze our patients health. Our physicians provide expert interpretations of lab and test results so that an accurate diagnosis can be made. Noninvasive Vascular Tests Abdominal Vascular Ultrasound Testing Aorta and Iliac Duplex Testing Mesenteric Duplex Testing Renal Duplex Testing Arterial Evaluation of Extremities Direct Ultrasound Studies Indirect Doppler Pressures and Waveforms At Rest After Treadmill Exercise Dialysis Access Duplex Testing Venous Evaluation of Extremities Doppler Ultrasound Exam Plethysmography D-dimer Blood Test Cerebrovascular Evaluation Carotid Duplex Ultrasound Vertebral Duplex Ultrasound Transcranial Doppler Miscellaneous Erectile Dysfunction Evaluation Testicular Ultrasound Invasive Vascular Tests Arteriography (Angiogram) MR Angiography CT Angiography Venography • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[9]=new Array(10,"resources.htm","2005-01-24","Vascular Clinic - General Resources","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links General Resources Please see the Glossary page for helpful information about Vascular medicine. • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[10]=new Array(11,"glossary.htm","2005-01-24","Vascular Clinic - Glossary","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Glossary A B C D E F G H I J K L M N O P R S T U V W X Y Z Acute: Severe; of short duration, as opposed to chronic . Anastomosis: The surgical or pathological connection of two tubular structures. Aneurysm: A ballooning out of the wall of an artery or of the heart due to weakening of the wall by disease, injury, or an abnormality present at birth. Angiography: A diagnostic procedure in which a dye is injected into blood vessels that are then photographed using X-rays. Angiography is used to visualize the condition of arteries and veins and to confirm the presence of blood clots or other abnormalities. Anticoagulant: An agent that prevents blood from clotting. Arteriography: A method of X-ray viewing the inside of the arteries by injection of radiopaque contrast substance into the lumen of the arteries. Artery: A blood vessel that carries blood from the heart to the various parts of the body. Atherosclerosis: A type of artery disease in which the inner layers of artery walls become thick and irregular because of deposits of cholesterol and calcium. The arteries become narrowed and the flow of blood through them is reduced. A localized area of this build up is called an atheromatous plaque and is often referred to as hardening of the arteries. Atherosclerosis is frequently observed in the artery wall of aneurysm patients, though there is much debate as to whether or not atherosclerosis actually causes most aneurysms. In atherosclerosis, a substance called plaque forms on the lining of the blood vessel wall, weakening the wall. See plaque for more information. Atrial fibrillation: The uncoordinated contractions or individual heart muscle fibers in the upper chambers of the heart. These chambers, called the atria, cannot contract in an organized fashion. Blood clot: A mass of thickened blood formed by clotting factors in the blood. This clot can stop the flow of blood from an injury. Blood clots can form inside an artery whose walls are damaged by atherosclerotic plaques and can cause a heart attack or stroke. A blood clot and thrombosis are the same. Bruits: Abnormal sounds or murmurs caused by turbulence and heard over blood vessels. Cardiac: Pertaining to the heart. Carotid artery: The major artery in the neck carrying blood to the brain. The body has a left carotid artery and a right carotid artery. Carotid endarterectomy: Surgical removal of atherosclerotic plaque deposits from the carotid arteries. Cerebrovascular occlusion: The obstruction or closing of a blood vessel in the brain. Cholesterol: A type of fatty substance found in animal tissue. Cholesterol is present only in foods from animal sources, such as dairy products, meats, fish, poultry, animal fats, and egg yolks. Chronic: Having a long duration, as opposed to acute . CT (computer tomography): A radiographic diagnostic test often used for evaluating brain tissue and identifying whether a stroke was due to bleeding or a blockage in an artery. Also called a CAT scan. For more information, please see the Medline Plus entry for CT scan . Diabetes mellitus: A disease in which the body does not produce or properly use insulin. Diabetes increases the risk of developing cardiovascular disease. Diastolic blood pressure: The lowest blood pressure measurement in the arteries. It occurs when the heart muscle is relaxed between beats. Edema: Swelling due to an abnormally large amount of fluid in body tissue. Embolic stroke: A stroke caused by obstruction in a brain artery cause by a clot that has formed elsewhere, usually in the heart or in the carotid arteries, and has been carried through the blood stream to the brain. Embolus: A blood clot that forms in a blood vessel in one part of the body and then is carried to another part of the body. The plural of embolus is emboli. Hematoma: A tissue swelling filled with blood. Hemiplegia: A paralysis of one side of the body. Hemorrhage: Profuse bleeding from a ruptured blood vessel. Heparin: A type of anticoagulant drug that prevents clotting by affecting the blood component fibrinogen. High blood pressure: A chronic blood disease in which blood pressure is above its normal range of 140/90. High blood pressure increases the risk of heart disease and kidney disease and is a major risk factor for stroke. A technical term for high blood pressure is hypertension. Hypertension: Same as high blood pressure. Infarction: Death of tissue due to a lack of blood, usually caused by a blockage of an associated artery. Intermittent claudication: A complex of symptoms characterized by absence of pain in a limb when at rest. The start of pain and weakness when walking is begun, intensification of the pain and weakness if exercise is continued, and the disappearance of symptoms after a brief period of rest. Ischemia: Decreased blood flow to an organ, usually due to constriction or obstruction of an artery. MRI (magnetic resonance imaging): A noninvasive diagnostic tool, which produces a magnetic field for examining the brain and other parts of the body. Plaque: Plaque is formed when cholesterol, fibrous cells, and/or calcium deposit themselves in the inner lining of a blood vessel wall. Platelets: One of the three kinds of formed elements found in the blood. Platelets aid in the clotting of the blood. Risk factor: A condition that increases the chance of developing cardiovascular disease or stroke. Stenosis: Narrowing or constriction of an opening or lumen, such as blood vessel. Stent: A device used to hold a vessel open by providing support. Stroke: The sudden interruption of the blood supply to the brain, caused either by blockage or a rupture of blood vessels. Systolic blood pressure: The highest blood pressure measured in the arteries. It occurs when the heart contracts with each heart beat. Thrombus: A blood clot that forms inside a blood vessel or cavity of the heart. The plural form of thrombus is thrombi. Transcranial doppler ultrasound: A noninvasive diagnostic test that uses ultrasound technique to generate information about intracranial blood vessels. Also called TCD. TIA (transient ischemic attack): An abnormal neurologic episode that is caused by a temporarily blocked blood vessel and leaves no permanent brain damage. Symptoms are the same as for a stroke, but are temporary, usually lasting twenty-four hours or less. They are now an important warning sign of an impending stroke and should never be ignored. Ultrasound: Fast-frequency sound vibrations, not audible to the human ear, used in medical diagnosis. Vascular: Pertaining to blood vessels. Vasculitis: Inflammation of the blood vessels. Vein: Any one of a series of blood vessels of the vascular system that carries blood from various parts of the body back to the heart. Warfarin: A synthetic anticoagulant that works by preventing certain blood clotting agents from forming in the liver. • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[11]=new Array(12,"patients.htm","2005-01-24","Vascular Clinic - Information for Patients","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Information for Our Patients Please see the Contact Us page for how to get in touch with us. Also be sure to visit our Glossary and What We Do pages for more information on Vascular Medicine. Billing Information We at the Vascular Clinic work closely with our patients to assist them in solving simple and complex reimbursement issues. We accept all major insurance companies, including Medicare and Medicaid, Blue Cross, United, Cigna, and Aetna. Call us at 767-5479 if you have any questions about billing or insurance. • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[12]=new Array(13,"forms.htm","2005-05-02","Vascular Clinic - Forms","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Forms Below are links to forms that you can fill out and print. If you have an appointment scheduled, feel free to download any forms you might need and fill them out beforehand to help make your office visit go more quickly. We will add more forms to this page over time, so be sure to check back again soon for updates. If you have any questions about these forms or how to fill them out, please call us at (225) 767-5479 or, toll free, at 877-767-5479. All forms are in the Adobe Acrobat (PDF) file format. You will need to download and install the Adobe Acrobat Reader program if your computer does not already have the program installed. You can download the program for free by clicking on Get Adobe Reader Patient Registration If any of the following apply to you, then you will need to fill out the Patient Registration form before or when you visit us for an appointment: If you are a new patient If you have not visited us at our present office location If you have not previously had an in-office appoint with us If you have not been to the Vascular Clinic for an appointment in the last six months Click HERE for the Patient Registration form. You can fill out and print the registration form, or print it and then fill it out by hand. Notice of Privacy Policies This document describes how information about you (our patient) may be used and disclosed, and how you can get access to this information. Click HERE for the Notice of Privacy Policies. New Patient Consent to Use and Disclosure of Health Information F or Treatment, Payment, of Healthcare Operations In accordance with governmental HIPAA guidelines, all new patients or patients who have not filled out this form will need to do so. You can fill in some of the information online and then print it out, but you will have to initial and sign the document by hand. We cannot, at this time, accept electronic signatures for this document. Click HERE for the HIPAA Patient Consent form (to use and disclose health information for treatment, payment of healthcare operations) • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[13]=new Array(14,"construction.htm","2005-01-24","Vascular Clinic - The requested page is not currently available","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Under Construction We apologize for the incovenience, but this page is not currently available. Please check back again soon for updates. • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[14]=new Array(15,"contact.htm","2005-01-24","Vascular Clinic - Contact Us","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Contact Us Where We Are Located: 5425 Brittany Drive Suite B Baton Rouge, Louisiana 70808 click here for map How to Reach Us: Telephone: (225) 767-5479 Toll-Free: 877-767-5479 Fax: (225) 767-5147 Appointments: To make an appointment, call us at (225) 767-5479 during business hours, Monday through Friday. • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[15]=new Array(16,"links.htm","2005-03-10","Vascular Clinic - Links","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Links Your Vascular Health: USNews.com - Vascular Health Briefs Vascular Societies and Organizations: Vascular Disease Foundation American Venous Forum American College of Surgeons Baton Rouge Area Hospitals: Our Lady of the Lake Regional Medical Center Baton Rouge General Medical Center Summit Hospital US Government Health: MedLine Plus Health Info National Library of Medicine \'s PubMed Health Articles • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[16]=new Array(17,"search.htm","2005-05-02","Vascular Clinic - Search","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Search VasClin.com To search for a word or phrase, enter it in the box next to the Search button, below. within All text Title Keywords Descriptions File name using All words Any words Exact phrase • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[17]=new Array(18,"disclaimer.htm","2005-01-24","Vascular Clinic - Disclaimer","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Disclaimer THIS SITE DOES NOT PROVIDE MEDICAL ADVICE. The contents of the Vasclin.com site, such as text, graphics, and images, are for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Vasclin.com may provide links to third-party web sites. Vasclin.com and its employees do not recommend and do not endorse the content on any third-party web sites, and do not make any representations regarding their content or accuracy. Your use of third-party web sites is at your own risk and subject to the terms and conditions of use for such sites. • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[18]=new Array(19,"perkowski_publish.htm","2005-01-24","Vascular Clinic - Dr. Paul E. Perkowski, M.D. - Publications & Manuscripts","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Dr. Paul E. Perkowski, M.D. | Profile | Publications & Manuscripts | Education, Certification, & Memberships | For any doctor, staying aware of and educated about the latest medical technology and research is essential to providing the best possible care and treatment for patients. Dr. Perkowski \'s list of publications and manuscripts illustrate his contributions to the field of vascular surgery, and to the practice of medicine at large. We hope to link some of the following publication and manuscript titles to their full texts so that, in the future, you can read some of Dr. Perkowski \'s contributions to medical literature. Publications Trellis thrombectomy system for the treatment of iliofemoral deep venous thrombosis. V Ramaiah, P DelSanto, J Rodriguez-Lopez, R Gowda, P Perkowski , EB Diethrich. Journal of Endovascular Therapy 2003; 10(3):585-589. Emergent endovascular treatment of a spontaneous internal carotid artery dissection with pseudoaneurysm. A Tseng, V Ramaiah, J Rodriguez-Lopez, P Perkowski , P DelSanto, R Gowda, EB Diethrich. Journal of Endovascular Therapy 2003; 10(3):643-646. Morbidity and mortality of children following motor vehicle crashes. EC Thompson, PE Perkowski , D Villareal, E FJ Block, MF Brown, L Wright, S Akin. Archives of Surgery 2003; 138:142-145. Anal duct carcinoma; case report and review of the literature. PE Perkowski , DL Sorrells, JT Evans, C Napojaroonsri, LW Johnson. American Surgeon 2000; 66(12):1149-1152. Diagnostic laparoscopy as an option for evaluation of right lower quadrant pain in young females: the LSU experience. PE Perkowski , K Sittig. American Surgeon 1999; 65(12): 1204, abstract P15. An investigation into the metamorphosis of the mosquito, Aedes aegypti . Research in Biology and Integral Honors Project, PE Perkowski . LeMoyne College, 1992. Archived in LeMoyne College Library. Manuscripts Endovenous laser ablation of the saphenous vein for treatment of venous insufficiency and varicose veins; a large single-center experience. PE Perkowski , R Ravi, R Gowda, D Olsen, V Ramaiah, J Rodriguez-Lopez, ED Diethrich. International Congress of Endovascular Interventions . February 2003 Initial experience with carotid angioplasty and stenting with neuroprotection devices. V Ramaiah, R Gowda, J Rodriguez-Lopez, R Ravi, PE Perkowski , EB Diethrich. International Congress of Endovascular Interventions . February 2003. Renal artery stenting to preserve renal function. K Singh, J Rodriguez-Lopez, V Ramaiah, R Gowda, P Perkowski , D Olsen, EB Diethrich. Transcatheter Cardiovascular Therapeutics . September 2003. Treatment of an ascending aortic pseudoaneurysm from aortocoronary bypass with a custom-made endoluminal graft; a case report. PE Perkowski , J Rodriguez-Lopez, D Olsen R Gowda, V Ramaiah, R Ravi, EB Diethrich. Endovascular repair of thoracoabdominal aortic dissection (Type IIIB) with infrarenal false lumen rupture and left renal malperfusion. R Gowda, PE Perkowski , J Rodriguez-Lopez, V Ramaiah, R Ravi, D Olsen, EB Diethrich. Journal of Endovascular Therapy . Multimodal therapy for esophageal carcinoma in an indigent minority population. PE Perkowski , FL Ampil, GV Burton, GM Mills, B DL Li. Southeastern Surgical Congress , February 2000. A technique for gastric intubation in percutaneous endoscopic gastrostomy placement. PE Perkowski , AB Marr. Society of American Gastrointestinal Endoscopic Surgeons . April 2001. Admission patterns at a Level I Trauma Center. PE Perkowski , A Marr, L Smith, E Thompson. January 2000. Louisiana Chapter, American College of Surgeons, New Orleans, LA . Eukaryotic initiation factor 4E overexpression is associated with Vascular Endothelial Growth Factor elevation but not nodal metastases in breast carcinoma. PE Perkowski , F Abreo, C Meschonat, B DL Li. Society of Surgical Oncology . Return to top of page • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[19]=new Array(20,"perkowski_education.htm","2005-01-24","Vascular Clinic - Dr. Paul E. Perkowski, M.D. - Education, Certification, & Memberships","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Dr. Paul E. Perkowski, M.D. | Profile | Publications & Manuscripts | Education, Certification, & Memberships | Years of learning enable a physician to do his job, and ongoing learning helps him to do it better. Dr. Perkowski spent years obtaining a high quality education through study at universities across the country, as well as excellent, sound training with fellowships in vascular surgery and a residency in general surgery. He is licensed to practice medicine in multiple states, and his certifications further show his recognized skills and education. For more details, please continue to read the list that follows. Education & Training Professional Education: Fellow: Peripheral Vascular Surgery Louisiana State University Health Sciences Center Medical Center of Louisiana, New Orleans 2003-2004 Fellow: Cardiovascular and Endovascular Surgery Arizona Heart Institute and Hospital Phoenix, Arizona 2002-2003 Resident: General Surgery Louisiana State University Health Sciences Center Shreveport, Louisiana 1996-2001 Chief Resident, 2001-2002 Medical Education: Doctor of Medicine State University of New York Health Science Center College of Medicine Syracuse, New York 1992-1996 Undergraduate Education: Bachelor of Science with Honors LeMoyne College Syracuse, New York 1988-1992 Licensure, Boards, & Certifications Diplomate, American Board of Surgery, 2003 Arizona License, 2002 Louisiana License, 1997 Basic Life Support Certified Advanced Cardiac Life Support Certified Advanced Trauma Life Support Certififed - ATLS Instructor Memberships - Professional Organizations/Societies Shreveport Medical Society Louisiana State Medical Society American Medical Association American College of Surgeons, Candidate Group Edward B. Diethrich Vascular Surgical Society International Society of Endovascular Specialists (pending) Return to top of page • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[20]=new Array(21,"schellack_publish.htm","2005-01-24","Vascular Clinic - Dr. Jon V. Schellack, M.D., F.A.C.S. - Publications & Presentations","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Dr. Jon V. Schellack, M.D., F.A.C.S. | Profile | Publications & Presentations | Education, Certification, & Memberships | For any doctor, staying aware of and educated about the latest medical technology and research is essential to providing the best possible care and treatment for patients. Dr. Schellack \'s list of publications and presentations illustrate his contributions to the field of vascular surgery, and to the practice of medicine at large. We hope to link some of the following publication and presentations titles to their full texts so that, in the future, you can read some of Dr. Schellack \'s contributions to medical literature. Publications Schellack, J, Fulenwider JT, Olson RA, Smith RB, Mansour K. The Carotid Sinus Syndrome: A Frequently Overlooked Cause of Syncope in the Elderly. Journal of Vascular Surgery 1986; 4:376-383. Schellack, J, Smith RB, Perdue GD. Femoral Aneurysm: Sentinel of Comorbid Disease (Abstract). Southern Medical Journal 1986; 79 (Supplement Number 2): 70. Schellack J, Smith RB, Salam A, Perdue GD. Non-operative Management of Selected Popliteal Aneurysms. Arch. Surg.; 1987; 122:372-375. Schellack J, Salam A, Abouzeid MA, Smith RB, Stewart MT, Perdue GD. Femoral Anastomotic Aneurysms: A Continuing Challenge. Journal of Vascular Surgery 1987; 6:308-17. Schellack J, Fulenwider JT, Smith RB. Descending Thoracic Aortofemoral-femoral Bypass: A Remedial Alternative for the Failed Aortobifemoral Bypass. Journal of Cardiovasc Surgery; 29:201-03, 1988. Schellack J, Stewart MT, Smith RB, Perdue GD, Salam A. Infected Aorto-bifemoral Prosthesis: A Dreaded Complication. American Surgeon; 1988; 3:137-41. Woods JM, Schellack JV, Stewart MT, Murray DR, Schwartzman, SW. Mycotic Abdominal Aortic Aneurysm Induced by immunotherapy with Bacille Calmete-Guerin Vaccine for Malignancy. Journal of Vascular Surgery; 1988; Vol. 3, 6:808-810. Rheudasil JM, Stewart MT, Schellack JV, Smith RB, Salam AA, Perdue GD. Surgical Treatment of Chronic Mesenteric Arterial Insufficiency. Journal of Vascular Surgery, 1988; 8:495-500. Jones TR, Frusha JD, Schellack JV. Traumatic Occupational Occlusive Arterial Disease of the Hands. Journal of the Louisiana State Medical Society, 1988; 140:28-31. Schellack JV, Jones TR, Frusha JD, Deumite NJ: Chronic Femoral Arteriovenous Fistula Masquerading as the Postphlebitic Syndrome. Journal of the Louisiana State Medical Society, 1991; 143:22-27. Abshire JB, Frusha JD, Jones TR, Schellack JV: Demonstration of Hypothenar Hammer Syndrome by Duplex Ultrasound. Journal of Vascular Technology, 1992; 16(1):39-42. Presentations at Professional Meetings “Descending Thoracic Femoral Bypass.” October 1985. Surgery Grand Rounds Emory School of Medicine. “Carotid Sinus Syndrome: A Frequently Overlooked Origin of Syncope in the Elderly.” January 1986. The Southern Association of Vascular Surgery. Dorodo Beach, Puerto Rico. “Popliteal Arterial Aneurysms.” May 1986. The 10th Annual Meeting of the Association of VA Surgeons. Washington, D.C. “Femoral Aneurysm: Sentinel of Co-morbid Disease.” November 1986. The 80th Annual Scientific Assembly of the Southern Medical Association. Atlanta, GA. “Femoral Anastomotic Aneurysms: A Continuing Challenge.” January 1987. The Southern Association of Vascular Surgery. Scottsdale, Arizona. “Mycotic Aortic Aneurysm.” March 1987. Surgery Grand Rounds, Emory School of Medicine. “Infected Aortobifemoral Prosthesis: A Dreaded Complication.” April 1987. The Southeastern Surgical Congress. Atlanta, GA. “What’s New in Vascular Surgery.” August 15, 1989. Lane Memorial Hospital. Zachary, LA. “A 30-Year-Old with Recurrent Leg Ischemia.” October 14, 1989. Gulf Coast Vascular Society. New Orleans, LA. “Hypercoagulable State in Young Male.” Emory Vascular Society. Atlanta, Georgia. Nov., 1989. “A 30-Year-Old with Recurrent Leg Ischemia.” November 4, 1989. Emory Vascular Society. Atlanta, GA. “Angioscopy and Laser Angioplasty and Mechanical Atherectomy.” January 6, 1990. Nurses, Our Lady of the Lake Regional Medical Center. Baton Rouge, LA. “AV Fistula Masquerading As The Postphlebitic Syndrome.” May 10-12, 1990. The Phlebology Society of America. Chicago, IL. “Abdominal Aortic Aneurysms.” June 14, 1990. Baton Rouge General Medical Center, Emergency Room Staff. Baton Rouge, LA. “Current Management of Aortic Vascular Disease.” August 8, 1990. Staff Physicians, Vencor Hospital. Gonzales, LA. “Traumatic AV Fistula Masquerading as the Postphlebitic Syndrome.” October 27, 1990. Gulf Coast Vascular Society Meeting. New Orleans, Louisiana. “AV Fistula Masquerading as the Postphlebitic Syndrome.” November 2-3, 1990. Emory Vascular Society. Atlanta, GA. “Limb Salvage in Octogenarians.” January 19, 1991. Joint Annual Meeting, Louisiana Chapter American college of Surgeons and the Surgical Association of Louisiana. New Orleans, LA. “Use of Cadaveric Vein for Distal Bypass.” October 22-23, 1993. Emory Vascular Society. Atlanta, GA. “Thromboembolic Disease in Pregnancy.” November 4, 1994. Staff Physicians, Woman’s Hospital. Baton Rouge, LA. Return to top of page • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[21]=new Array(22,"conditions/buergers.htm","2005-01-24","Vascular Clinic - Vascular Conditions - Buerger  \\'s Disease","Vascular Clinic","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Buerger \'s Disease Jump to a Section: Overview | Possible Causes | Symptoms | Diagnosis | Treatment Options Overview Also known as Thromboangiitis obliterans (TAO), Buerger’s disease is fairly rare, affecting anywhere from eight to eleven in every 100,000 North Americans or every six out of 10,000 people, depending on the type of reporting. TAO causes blockage of the blood vessels (typically of the arteries) of the hands and feet. TAO may also cause thrombophlebitis (inflammation of the veins). Possible Causes Buerger’s disease is caused by vasculitis, which is an inflammation of blood vessels. This disease is most common in men between the ages of 20 and 40 who use tobacco. Symptoms The inflammation caused by Buerger’s disease frequently leads to blocked arteries in the lower parts of the arms and legs, and may lead to intermittent claudication – pain that occurs when a person walks. Patients with Buerger’s disease typically complain of foot claudication rather than calf claudication. For more information, please see the page on intermittent claudication. In advanced cases, Buerger’s disease may cause rest pain, which is pain in the limbs due to lack of blood flow that occurs either when the patient sleeps (nocturnal rest pain) or constantly. People with Buerger’s disease may also experience persistent sores or ulcers, a condition known as Critical Limb Ischemia. A patient with Buerger’s disease may even develop gangrene of digits (dead fingers or toes). Other symptoms may include: Numbness and tingling in the feet and hands Pain or tenderness in the calves, feet, or toes Pain may increase with activity such as walking Clammy and cold skin A diminished sense of heat and cold Skin ulcers or gangrenous (dead) fingers or toes Decreased or absent pulse in affected extremity Diagnosis The symptoms of Buerger’s disease may overlap with the symptoms of other vascular diseases. Because of this, more common disorders must be ruled out first. Obstruction of blood vessels in the hands and feet caused by Buerger’s disease may be detected by one of the following diagnostic tests: Angiogram (or arteriogram) of the upper or lower extremities Doppler ultrasound Such diagnostic tests can help to rule out the possibility of atherosclerosis, a different vascular disease in which the blood vessels degenerate. Atherosclerosis is a much more common cause of obstructed arteries. Skin biopsies are not typically used to diagnose Buerger’s disease because of concern that a biopsy site near an area with poor blood circulation will not heal. Treatment Options There is no cure for Buerger’s disease, though symptoms, such as pain and ulcers, can sometimes be helped. If an affected person smokes, that person should immediately stop smoking, as that typically will stabilize or improve the condition. If someone with Buerger’s disease continues to smoke, that person will generally require amputation of the fingers and toes and may require amputation of both feet and hands. If a person stops smoking but continues to have symptoms—particularly claudication, rest pain, or tissue ulceration—there are some medications which may be beneficial: Blood thinners such as Aspirin or Plavix Pentoxyphylline (decreases viscosity of blood) Pletal (vasodilator) Exercise is also important for patients with Buerger’s disease. Return to top of page • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[22]=new Array(23,"schellack_education.htm","2005-01-24","Vascular Clinic - Dr. Jon V. Schellack, M.D., F.A.C.S. - Education, Certification, & Memberships","","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Dr. Jon V. Schellack, M.D., F.A.C.S. | Profile | Publications & Presentations | Education, Certification, & Memberships | Years of learning enable a physician to do his job, and ongoing learning helps him to do it better. Dr. Schellack spent years obtaining the highest quality education and training through undergraduate & medical school study, and through both a General Surgery Residency and a General Vascular Surgery Fellowship. To enhance and continue his education he attends and participates in medical meetings and conferences around the world. He is licensed to practice medicine in multiple states, and his certifications and memberships further show his widely-recognized skills and education. For more details, please continue to read the list that follows. Education & Training Bachelor of Science, Cum Laude Tulane University New Orleans, Louisiana 1972-1976 Doctor of Medicine Louisiana State University School of Medicine New Orleans, Louisiana 1976-1980 General Surgery Residency Emory University Atlanta, Georgia Affiliated Hospitals 7/01/1980 – 6/30/1985 General Vascular Surgery Fellowship Emory University Hospital Atlanta, Georgia 7/01/1985 – 6/30/1987 Staff Physician V.A. Medical Center Decatur, Georgia 7/01/1985 – 6/30/1986 Clinical Instructor in Surgery Louisiana State University School of Medicine New Orleans, Louisiana 1987 Licensure, Boards, & Certifications Georgia License, 1983 Louisiana License, 1980 Certified by American Board of Surgery, 12/15/1986 Re-Certified by American Board of Surgery, 10/21/1994 Certified in General Vascular Surgery, 5/16/1988 Re-Certified in General Vascular Surgery, 10/24/1997 Certification in Vascular Technology, Registered Vascular Technologist, October 1993 Memberships - Professional Organizations/Societies American Association of Vascular Surgery American College of Surgeons, Fellow American Venous Forum Christian Medical and Dental Society East Baton Rouge Parish Medical Society Emory Vascular Society Gulf Coast Vascular Society International Society for Endovascular Surgery Louisiana State Medical Society Peripheral Vascular Surgery Society Southeastern Surgical Congress’ Southern Association for Vascular Surgery Southern Medical Association Continued Education and Meetings Twenty-sixth Annual Meeting, The Society for Surgery of the Alimentary Tract, New York. May 14-15, 1985. Eleventh Annual Meeting, The Southern Association for Vascular Surgery. Dorado Beach, Puerto Rico. January 29-February 1, 1986. Fortieth Annual Meeting, The Society for Vascular Surgery. New Orleans, Louisiana. June 9-10, 1986. Thirty-fourth Scientific Meeting, North American Chapter. The International Society for Cardiovascular Surgery. New Orleans, Louisiana. June 10-11, 1986. Fourth Annual UCLA Symposium: A Comprehensive Review of Vascular Surgery. Santa Monica, California. October 6-10, 1986. Twelfth Annual Meeting, The Southern Association of Vascular Surgery, Scottsdale, Arizona. January 28-31, 1987. Current concepts in the Management of Venous Deseases. Atlanta, Georgia. April 3, 1987. Fifth Annual UCLA Symposium – A Comprehensive Review of Vascular Surgery. Santa Monica, California. September 27-October 2, 1987. The Emory Association of Vascular Surgery Meeting, J. C. Thoroughman Lecture. Atlanta, Georgia. October 30 & 31, 1987. Fourteenth Annual Current Critical Problems in vascular Surgery. New York, New York. November 13, 1987. Southern Association for Vascular Surgery Annual Meeting. St. Thomas, Virgin Islands. January 27-30, 1988. “Advanced Trauma Life Support Provider Course.” Alton Ochsner Medical Foundation. New Orleans, Louisiana. March 18-19, 1988. Eleventh Annual Congress of The Phlebology Society of America. Washington, DC. April 8-9, 1988. Gulf coast Vascular Society Meeting. New Orleans, Louisiana. April 23, 1988. 1988 Joint Annual Meeting of the Society for Vascular Surgery and North American Chapter of the International Society for Cardiovascular Surgery. Chicago, Illinois. June 13-15, 1988. Angioscopy, Laser Surgery, Endoscopy, and Angioplasty. Boston, Massachusetts. October 31-November 1, 1988. Symposium on Surgery of the Aorta. Chicago, Illinois. December 8-10, 1988. American Venous Forum. New Orleans, Louisiana. February 22-24, 1989. Second Annual International congress of the North American Society of Phlebology. New Orleans, Louisiana. February 25-26, 1989. First Annual UCLA Program on Endovascular Surgery. Beverly Hills, California. May 6-9, 1989. Gulf Coast Vascular Society. New Orleans, Louisiana. October 14, 1989. Annual Meeting, Emory Vascular Society. Atlanta, Georgia. November 3 & 4, 1989. International congress: Lasers, Stents and Interventions in Vascular Disease. Scottsdale, Arizona. February 11-16, 1990. 13th Annual Congress of The Phlebology Society of America. Chicago, Illinois. May 10-12, 1990. Gulf Coast Vascular Society Meeting. New Orleans, Louisiana. October 27, 1990. Annual Meeting, Emory Vascular Society. Atlanta, Georgia. November 2-3, 1990. Joint Annual Meeting, Louisiana Chapter American College of Surgeons and the Surgical Association of Louisiana. New Orleans, Louisiana. January 19-20, 1991. The Fifteenth Annual Meeting of The Southern Association for Vascular Surgery. Rancho Mirage, California. January 23-26, 1991. Spring Meeting of the Gulf Coast Vascular Society. New Orleans, Louisiana. April 20, 1991. 1991 Joint Annual meeting of the Society for Vascular Surgery and North American Chapter of The International Society for Cardiovascular Surgery. Boston, Massachusetts. June 3-5, 1991. Annual Meeting. Emory Vascular Society. Atlanta, Georgia. November 1-2, 1991. International congress: Endovascular Interventions. Scottsdale, Arizona. February 12-16, 1992. Annual Meeting. Emory Vascular Society. Atlanta, Georgia. November 6-7, 1992. Annual Meeting. Southern Association for Vascular Surgery. Ft. Lauderdale, Florida. January 28-31, 1993. Joint Meeting. ISCVS/SVS. Washington, D.C. June 6-11, 1993. Annual Meeting, Emory Vascular Society. Atlanta, Georgia. October 22-23, 1993. Sixth Annual International Symposium on Vascular Diagnosis and Intervention. Miami, Florida. January 10-13, 1994. Phlebology Review, 1994. North American Society of Phlebology. Maui, Hawaii. February 20, 1994. Seventh Annual Congress of The North American Society of Phlebology. Maui, Hawaii. February 21-23, 1994. Sixth Annual American Venous Forum. Maui, Hawaii. February 23-25, 1994. Transcranial Doppler Workshop. Dallas, Texas. August 13-14, 1994. Annual meeting, Emory Vascular Society. Atlanta, Georgia. November 4-5, 1994. The Nineteenth Annual Meeting of The Southern Association for Vascular Surgery. Cancun, Mexico. January 25-28, 1995. International Congress VIII on Endovascular Interventions. Scottsdale, Arizona. February 12-16, 1995. The Rocky Mountain Vascular Disease Symposium. Beaver Creek, Colorado. March 12-17, 1995. Joint Meeting. ISCVS/SVS. New Orleans, Louisiana. June 12-14, 1995. Annual Meeting, Emory Vascular Society. Atlanta, Georgia. November 3-4, 1995. The Twentieth Annual Meeting of The Southern Association for Vascular Surgery. Naples, Florida. January 24-27, 1996. Vascular Access for Hemodialysis V. Tucson, Arizona. May 9-10, 1996. Twenty-first Annual Meeting, Peripheral Vascular Surgery Society. Chicago, Illinois. June 8, 1996. Annual Meeting, North American Chapter of The International Society for Cardiovascular Surgery. Chicago, Illinois. June 10-11, 1996. 19th Annual Conference, Society of Vascular Technology. New Orleans, Louisiana. August 21-25, 1996. Annual Meeting, Emory Vascular Society. Atlanta, Georgia. November 1-2, 1996. The Twenty-First Annual Meeting of the Southern Association for Vascular Surgery. Coronado, California. January 22-25, 1997. Joint Annual Meeting ISCVS/SVS. Boston, Massachusetts. June 1-4, 1997. The Twenty-Second Annual Meeting of the Southern Association for Vascular Surgery. Rio Grande, Puerto Rico. January 21-24, 1998. International Congress XI on Endovascular Interventions. Scottsdale, Arizona. February 8-12, 1998. Annual Meeting. Emory Vascular Society. Atlanta, Georgia. November 13-14, 1998. Annual Meeting. Emory Vascular Society. Atlanta, Georgia. November 12-13, 1999. Tenth Annual Winter Meeting of the Peripheral Vascular Surgery Society. Snowmass, Colorado. January 14-16, 2000. International Congress on Endovascular Interventions. Scottsdale, Arizona. February 13-17, 2000. Rocky Mountain Vascular Disease Symposium. Vail, Colorado. March 5-8, 2000. The Twenty-Fifth Annual Meeting of the Southern Association for Vascular Surgery. Rio Grande, Puerto Rico. January 24-27, 2001. Cerebral Revascularization Workshop. Tampa, Florida. March 30-April 1, 2001. Prescribing Controlled Drugs. Vanderbilt University, Nashville, Tennessee. March 27-29, 2002. Transilluminated Powered Phlebectomy. Chicago, Illinois. August 16, 2002. Joint Annual Vascular Meeting. Hymes Convention Center. Boston, Massachusetts. June 9-12, 2002. Received award certificates for reading and passing exam on Vascular Articles in SVU Journal. January 27, 2003. Attended SVU/SVS Advanced Vascular Laboratory Interpretation. Chicago, Illinois. June 7, 2003. Joint Annual Vascular Meeting. Chicago, Illinois. June 8-11, 2003. Attended SVU/SVS Advanced Vascular Laboratory course on the evaluation of Endovascular Interventions. Anaheim, CA. June 2, 2004. Joint Annual Vascular Meeting. Anaheim, California. June 3-6, 2004 Return to top of page • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[23]=new Array(24,"conditions/aorticaneurysms.htm","2005-01-24","Vascular Clinic - Vascular Conditions - Aortic Aneurysms","Vascular Clinic","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Aortic Aneurysms Jump to a Section: Overview | Possible Causes | Symptoms | Diagnosis | Treatment Options Overview An aneurysm is a bulge in the wall of a blood vessel. When an aneurysm forms in the body \'s largest artery—the aorta—it is called an aortic aneurysm. Though most aneurysms occur in the aorta, they can form in any artery, anywhere in the body. Aortic aneurysms are typically found in the lower part of the aorta, the part that runs through your abdomen. These are called abdominal aortic aneurysms. If an aneurysm occurs in the part of the aorta that runs through your upper chest, it is called a thoracic aortic aneurysm. If any aneurysm becomes large, there is a danger that it will break open, or rupture. When an aortic aneurysm ruptures, internal bleeding occurs and may cause death. More than 15,000 American die each year due to ruptured aortic aneurysms. Possible Causes An aortic aneurysm develops from a weakness in the wall of the aorta. This weakness usually occurs due to a gradual degeneration (thinning) of the vessel wall. In many cases, the exact causes of an aortic aneurysm are not known. Factors thought to lead to aneurysms include: Atherosclerosis : Commonly called hardening of the arteries, atherosclerosis is often found in association with an aortic aneurysm. Atherosclerosis is frequently observed in the artery wall of aneurysm patients, though there is much debate as to whether or not atherosclerosis actually causes most aneurysms. In atherosclerosis, a substance called plaque forms on the lining of the blood vessel wall, weakening the wall. Plaque is formed when cholesterol, fibrous cells, and/or calcium deposit themselves in the vessel wall. This process can form stenosis (a narrowing) or, some believe, can lead to aneurysm formation. Genetic susceptibility : Researchers have found that in male patients with an aortic aneurysm, there is a 20-30% incidence of aneurysms in first order male relatives. High blood pressure : High blood pressure puts stress on the walls of the aorta. Over many years, this stress can lead to bulging of the blood vessel wall. This is a leading factor in development or enlargement of aneurysms of the thoracic aorta. If a patient has an aneurysm, it is very important to control his or her blood pressure, as a lack of blood pressure control can lead to rupture of the aneurysm. Cystic medial necrosis : In this condition, the medial (middle) layer of the blood vessel wall degenerates, resulting in a weakening of the supporting structure of the blood vessel wall. This occurs with certain rare, inherited conditions such as Marfan syndrome and Ehlers-Danlos syndrome. Mycotic aneurysm : This condition occurs when bacteria spread in the blood stream and invade the blood vessel wall, causing the artery to weaken and dilate. Often the bacteria attach to an area of previous damage. Although rare today, the advanced form of the sexually transmitted disease syphilis was a common cause of this condition in the early part of the twentieth century. Infections are rare causes of aortic aneurysms. Inflammatory aneurysm : Inflammatory conditions or vasculitis may produce inflammation in the blood vessel wall itself. If the inflammation is not reversed, it eventually weakens the wall of the aorta, producing an aneurysm. This is also a rare cause of aortic aneurysms. Injury : Injury to the chest or abdomen, as in a car wreck or bad fall, can damage an area of the aorta. Such a damaged area may bulge and create what is called a false aneurysm. Although diabetes damages blood vessels by leading to premature, accelerated atherosclerosis, it is not currently believed to be a cause of aortic aneurysms. Symptoms Most aneurysms cause no symptoms and are discovered on an x-ray, CT scan, ultrasound, or by a physician during a physical exam. When an aneurysm leaks or expands, the patient may complain of: Chest pain Abdominal pain Back pain A tearing or ripping pain A pulsating bulge or a strong pulse in the abdomen When the aorta widens, blood clots (called thrombi) are likely to form. If a piece of a blood clot breaks off, it travels through the circulatory system until it lodges somewhere. The clot can cut off blood flow to any area of the body. Symptoms depend on which part of the body is deprived of blood. The most common location for a clot to form is in the leg. A clot can also break off and go to the kidneys, causing kidney failure. If a ruptured aneurysm occurs there can be sudden death. If internal bleeding is slow, symptoms, such as the following, may occur: Light-headedness Confusion Weakness Rapid heart beat Loss of consciousness (fainting) Bruising of the abdomen or flank Abdominal, flank, or groin pain Diagnosis Routine physical examination (not reliable in obese patients) Abdominal ultrasound: Abdominal aortic aneurysms are safely and easily diagnosed by a simple ultrasound scan that can be performed in a few minutes, without risk or discomfort. Abdominal CT (computed tomography) scan: A CT scan (often called a CAT scan) shows much more detail of the organs, blood vessels, and other structures inside the body using a series of x-rays. Ultrasounds can be quickly and easily performed in our vascular laboratory. Please see the Vascular Diagnostic Tests web page for more information. Treatment Options Surgery is usually required to repair an aortic aneurysm, but modern, catheter-based technologies using endovascular grafts have made treatment less invasive in many cases. The combination of early diagnosis and modern treatment of aortic aneurysms can save numerous lives lost due to aneurysm rupture each year. For more information on treatment options, please see our web page devoted to the treatment of aortic aneurysms . Return to top of page • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[24]=new Array(25,"conditions/varicoseveins.htm","2005-01-24","Vascular Clinic - Vascular Conditions - Varicose Veins (superficial venous insufficiency)","Vascular Clinic","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Varicose Veins (Superficial Venous Insufficiency) Jump to a Section: Overview | Possible Causes | Symptoms | Diagnosis | Treatment Options Overview Veins use one-way valves to block the blood from flowing backward, against the flow of gravity, as they carry blood from the body \'s organs back to the heart. If valves become weak and don \'t close properly, blood can flow backward and collect in the veins. This is called reflux. Reflux can cause the veins to become enlarged and twisted. Such veins are called varicose veins. Any vein can become varicose, but varicose veins occur most commonly in the legs and feet. Varicose veins are common, especially among older women and even in men. Pregnant women commonly develop varicose veins. Spider veins are similar to varicose veins, except much smaller. Please see the page devoted to spider veins for more information. Possible Causes Veins carry blood from the body \'s organs and parts to the heart. When the valves that keep the blood flowing toward the heart, rather than away from it, malfunction, the blood remains in the vein, and the vein becomes enlarged and possibly misshapen. If a person stands up for extended periods of time, he or she may be at a higher rick of developing varicose veins. Congenitally defective valves : Some people are born with valves that do not work properly. These can lead to varicose veins relatively early in a person \'s life. Thrombophlebitis : Thrombophlebitis occurs when one or more varicose veins develop a blood clot and inflammation. For more information, please see the page about thrombophlebitis . Pregnancy : When a woman is pregnant, her body produces more blood to care for the growing fetus. The body undergoes changes focused on getting the most blood possible to the fetus. The growing uterus may also cause flow through the veins of the pelvis and abdomen to become limited. Additionally, female hormones cause changes in the veins that can lead to varicose vein formation. DVT (Deep Vein Thrombosis) : Previous blood clots in the deep veins of the leg can destroy the valves or render them unable to function. This leads to reflux and varicose veins. Idiopathic : Many times a cause for varicose veins cannot be found. There is a hereditary component to this disease—half of all patients treated for varicose veins have a family history. Obesity, occupation, and gender all contribute to varicose vein formation. Symptoms Varicose veins are dark purple or blue and may appear like cords of rope or blue threads. They may become twisted or bulging. They most commonly appear on the back of the calves and knees or on the inside of the leg. Symptoms may include the following:. Enlarged veins, visible beneath the skin. Smaller veins, called spider veins , may be present. Pain, aching or a heaving feeling in the legs, especially in the evening, after standing all day. Night cramps may occur. Mild swelling of the ankle; more severe swelling is possible. You may experience itching, burning, or discomfort. Brown discoloration of the skin around the ankles. The skin may turn thick and tough. Skin ulcers around the ankles. This is the most severe complication of varicose veins. The above symptoms are listed in the order of severity. Many people consider varicose veins a cosmetic problem, but once symptoms occur (including those listed above), varicose veins should be considered a legitimate health concern. Diagnosis Diagnosis of varicose veins typically comes when a doctor examines a patient \'s legs for the appearance of swelling, particularly when the patient stands. Occasionally an ultrasound will also be performed to get a better idea of the blood flow in the legs, and to check for blood clots. The ultrasound can also check for reflux in the veins, to see if blood is traveling away from the heart, indicating malfunction of the valves. Treatment Options Varicose veins that appear during pregnancy will often improve within several months. Patients who develop varicose veins may be asked to take several steps to help their condition: Avoid long periods of standing. Elevate the legs when sitting or laying down. Wear elastic support hose. Many patients may require treatment for their varicose veins. If so, one of the following treatment options may be appropriate: Sclerotherapy : This treatment involves injection of a solution that closes the varicose veins. The injected vein(s) should fade after several weeks. Sclerotherapy does not require anesthesia and can be done at the doctor \'s office. Please see the Sclerotherapy page to learn more. Laser ablation : New technology in laser treatment can effectively treat varicose veins in the legs, upper body, and face. No incisions are needed. For more information, please see the Laser Removal of Varicose and Spider Veins page . Catheter-assisted procedures : Large superficial veins that have reflux can be treated by inserting a catheter into the vein. The tip of the catheter is heated, and the heat collapses the vein as the catheter is removed. Catheter-assisted procedures use laser or radio waves as a heat source to destroy varicose veins. Other instruments use rotating blades to destroy clusters of veins. Vein stripping : Several surgical procedures are available to remove varicose veins. The doctor makes small incisions in order to remove a longer vein. The long, diseased vein is stripped from the thigh and leg to control its contribution to varicose veins. Ambulatory phlebectomy : Several tiny skin punctures are used to remove smaller varicose veins. Some local anesthesia may be administered, but the procedure is still outpatient. Endoscopic vein surgery : This operation typically will only be used to treat severe varicose veins of a particular type that include leg ulcers. A tiny video camera is inserted into the leg to visualize and close veins. Only small incisions are needed. It may be used in combination with other procedures, and in the future may be replaced by newer technologies. Return to top of page • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[25]=new Array(26,"conditions/deepveinthrombosis.htm","2005-01-24","Vascular Clinic - Vascular Conditions - Deep Vein Thrombosis","Vascular Clinic","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Deep Vein Thrombosis Jump to a Section: Overview | Possible Causes | Symptoms | Diagnosis | Treatment Options Overview When a blood clot forms in a major vein, located deep within the body, it is called deep vein thrombosis, or DVT (also called deep vein thrombophlebitis). Typically the clot appears in a large vein in the leg or calf, or in the pelvic area. DVT more commonly occurs in adults over age sixty, but can occur in any age group. With prompt diagnosis and treatment, most occurrences of DVT are not life threatening. However, should the clot break free and travel through the vein, it can move to a lung artery and get stuck, a condition known as a pulmonary embolism. Pulmonary embolisms can be fatal if not immediately diagnosed and treated. Possible Causes A combination of any of the following conditions can lead to DVT: Slow blood flow through a deep vein A tendency for a person’s blood to clot quickly, such as inherited or acquired hypercoagulability Irritation or inflammation of the lining of the vein, such as that caused by Buerger’s Disease Trauma to the deep veins Risks for DVT include: Prolonged bed rest or immobilization (such as on extended air or car trips, or due to illness) Recent surgery or trauma Recent pregnancy Use of estrogen and birth control pills A malignant tumor or cancer Family history of vascular disease Obesity Symptoms Many people who develop DVT have no recognizable symptoms. If symptoms are present, they may include any the following: Leg pain or tenderness Swelling of the leg Purple discoloration of the leg or a white leg (milk leg) Diagnosis Proper diagnosis of DVT requires a vascular diagnostic test, even after identifying the associated risk factors. Such tests may include the following: Doppler ultrasound exam D-timer blood test Venography Plethysmography For more information on one of the above tests, please see the web page on vascular diagnostic tests . Treatment Options Conventional treatment of DVT involves the use of a medication called heparin, which is an anticoagulant—it prevents clotting. Heparin is received through an IV (intravenous infusion), and so requires hospitalization. An oral medication called warfarin or Coumadin is also usually taken for a number of months. A new form of heparin, called low molecular weight heparin, can be given through an injection once or twice per day and allows, in some cases, for outpatient treatment of DVT (without hospitalization). In some cases of DVT, thrombolysis may be used. This procedure involves the use of a catheter to directly administer a clot-dissolving drug, and is described more fully on the thrombolysis page. Once the clot is gone, another procedure may be required to keep a narrowed vein open, particularly in the iliac veins, located in the pelvic area. Such procedures may include a balloon angioplasty or stenting. Please click on the name of those procedures for more information. DVT frequently causes swelling of the affected extremity. The swollen limb should be elevated and fitted with a compression stocking. If the edema (swelling) in the leg is not controlled, the patient is at risk for developing post-phlebitic syndrome, which may cause recurrent leg ulcers, pain, and infection and can lead to significant disability. Please see post-phlebitic syndrome for more information. Return to top of page • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[26]=new Array(27,"procedures/sclerotherapy.htm","2005-01-24","Vascular Clinic - Sclerotherapy","Vascular Clinic","","Home Who We Are Surgeons Dr. Jon Schellack Dr. Paul Perkowski Staff What We Do Vascular Conditions Vascular Procedures Vascular Diagnostic Tests General Resources Patient Info Glossary Medical Forms Post-Surgery Contact Us Links Sclerotherapy Jump to a Section: Overview | Possible Complications Overview This treatment involves injection of a solution that closes varicose or spider veins. The solution, called the “sclerosant,” such as hypertonic saline, is injected directly into the blood vessel using a very small needle. The sclerosant causes the fragile lining of the spider vein to become irritated and inflamed. As a result, the small vein develops a tiny clot ( not a dangerous clot). As the area heals, the clotted vein gradually undergoes what is called “fibrosis.” In fibrosis, the tissue of the vessel grows thick and turns into scar tissue that closes off the vessel, effectively obliterating it. The body reroutes the flow of blood, automatically, and the injected vein(s) fade after several weeks as the dead cells are slowly and naturally removed and excreted. For more difficult veins, several injections may be required. Sclerotherapy does not require anesthesia and can be done at the doctor’s office. Sclerotherapy is not typically used for large varicose veins because they are too big and will come back. There are, however, other treatment options for all types of varicose veins. For more information, please see the page devoted to varicose veins. Possible Complications Itching, burning, and redness frequently occur at the Sclerotherapy site. These reactions are normal and are not considered to represent a true “allergic reaction.” As with any medication, however, allergies can occur. Fortunately, they are quite rare with the medications commonly employed during sclerotherapy. The vein may not go away. In this case, the vein is considered “resistant.” Repeat injections may sometimes be needed with a different sclerosing solution (“sclerosant”). New spider veins may develop around the sclerosed veins. This is called “Neovascularization,” and occurs in approximately 2-5% of injections. Sometimes they fade away on their own as the inflammation subsides. Pigment may be left at the site of the sclerosed spider vein. This is due to the blood pigment “hemoglobin” becoming trapped in the tiny vein as it undergoes fibrosis. When a sclerosed vein becomes dark blue, the doctor or nurse will sometimes “lance” the vein with a needle to allow this trapped blood to escape. Only 2-3% of sclerosed veins will leave permanent pigment staining on the skin. Sclerotherapy ulcer is very uncommon. This occurs when the sclerosant is injected outside the spider vein and the overlying skin dies. This can result in a “sore” or “scab” at the site of the injection. A sclerotheraphy ulcer may take weeks to heal and can leave a small scar. For more information about varicose and spider veins, please see the appropriate pages: • Varicose Veins • Spider Veins • Return to top of page • © Copyright 2004, Jon V. Schellack. All rights reserved • Search • Site Map • Disclaimer •",12);arrFiles[27]=new Array(28,"images/vasclinicon.ICO","2005-01-24","vasclinicon.ICO","","","",1);arrFiles[28]=new Array(29,"forms/patientregistration.pdf","2005-01-24","patientregistration","","","",139);arrFiles[29]=new Array(30,"forms/HIPAApatientconsent.pdf","2005-05-02","HIPAApatientconsent","","","",40);arrFiles[30]=new Array(31,"forms/noticeofprivacypolicies.pdf","2005-01-24","noticeofprivacypolicies","","","",87);