Podcasts about venous

A 25-year-old pregnant woman presents with a 1-day history of progressive pain and swelling. The foot is cold, pulseless and neurologic function is deteriorating by the hour. Imaging shows a massive iliofemoral DVT. Now both the limb and the pregnancy are threatened. Do you anticoagulate, thrombolyse or operate? Join us as we break down the management and decision making behind this rare but devastating case.Hosts:·      Christian Hadeed -PGY 4 General Surgery, Brookdale Hospital Medical Center·      Paul Haser -Division Chief, Vascular Surgery, Brookdale Hospital Medical Center·      Andrew Harrington, Vascular surgery, Brookdale Hospital Medical Center·      Lucio Flores, Vascular surgery, Brookdale Hospital Medical CenterLearning objectives:-       Recognize the clinical presentation and pathophysiology of phlegmasia cerulea dolens-       Describe how pregnancy affects decision making in patients with phlegmasia and venous thromboembolic disease-       Discuss the goals of treatment for patients with DVT's and identify when operative intervention is indicated-       Describe the sequelae of DVT's and how this relates to post thrombotic syndrome-       Review the indications, risks, and limitations of anticoagulation, catheter-directed thrombolysis, thrombectomy, and fasciotomy in the management of DVT and phlegmasia.-       Explain the role of IVUS in managing venous thromboembolic disease and May Thurner syndromeReferences:-       Vedantham, S., Goldhaber, S. Z., Julian, J. A., Kahn, S. R., Jaff, M. R., Cohen, D. J., Magnuson, E., Razavi, M. K., Comerota, A. J., Gornik, H. L., Murphy, T. P., Lewis, L., Duncan, J. R., Nieters, P., Derfler, M. C., Filion, M., Gu, C.-S., Kee, S., Schneider, J., … Kearon, C. (2017). Pharmacomechanical catheter-directed thrombolysis for deep-vein thrombosis. New England Journal of Medicine, 377(23), 2240–2252. https://doi.org/10.1056/NEJMoa1615066-       Gomes, M. S., Guimarães, M., & Montenegro, N. (2019). Thrombolysis in pregnancy: A literature review. Journal of Maternal-Fetal & Neonatal Medicine, 32(14), 2418–2428. https://doi.org/10.1080/14767058.2018.1438402-       Mangla, A., & Hamad, H. (2023). May-Thurner syndrome. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554377/-       Bates, S. M., Rajasekhar, A., Middeldorp, S., McLintock, C., Rodger, M. A., James, A. H., et al. (2018). American Society of Hematology 2018 guidelines for management of venous thromboembolism: Venous thromboembolism in the context of pregnancy. Blood Advances, 2(22), 3317–3359. https://doi.org/10.1182/bloodadvances.2018024802-       Kahn, S. R., Comerota, A. J., Cushman, M., Evans, N. S., Ginsberg, J. S., Goldenberg, N. A., et al. (2014). The postthrombotic syndrome: Evidence-based prevention, diagnosis, and treatment strategies. Circulation, 130(18), 1636–1661. https://doi.org/10.1161/CIR.0000000000000130 https://pubmed.ncbi.nlm.nih.gov/25246013/Sponsor URL: https://www.goremedical.com/If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

When hemodialysis-dependent patients exhaust all conventional venous access options, how do IRs navigate complex central occlusions to provide a lifeline? In this episode of the BackTable Podcast, Dr. Gian Paolo Zamboni of Clínica Alemana in Santiago, Chile joins guest host Dr. Neil Jain to discuss workup protocols and advanced technical algorithms for complex central venous recanalization cases. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by RADPAD® Radiation Protectionhttps://www.radpad.com/ --- Timestamps 00:00 - Introduction03:06 - IR Practice and Referrals in Santiago07:19 - Pre-Procedure Workup15:06 - Standard Recanalization Techniques20:14 - Dual-Access Sharp Recanalization24:43 - Needle Maneuvers and Alternatives29:32 - Predilation, IVUS, and Stent Sizing37:42 - Transhepatic Technique and Indications45:45 - Tract Closure, Anticoagulation, and Follow-up50:03 - Advice and Closing Remarks --- More about this episode The physicians review the critical role of pre-procedural planning, emphasizing the necessity of thorough workup with CT venography to accurately assess remaining vascular capital. Dr. Zamboni shares how his group addresses severe central venous occlusions, outlining a structured, stepwise approach that begins with standard maneuvers and progresses to sharp recanalization techniques before opting for dual-access approaches. He outlines critical safety measures, highlighting the importance of performing intraprocedural cardiac ultrasound, pre-dilating with caution, and keeping covered stents on the shelf to prevent fatal cardiac tamponade. For patients who lack viable conventional iliofemoral and IVC access, Dr. Zamboni shares an advanced jugular-to-transhepatic strategy, walking through the steps and nuances of creating a reliable working route, optimizing inflow, and managing post-procedure anticoagulation. Finally, Dr. Zamboni offers invaluable advice for IRs on mastering foundational techniques before tackling advanced cases and building strong, collaborative relationships with referring providers. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

When Renal Cell Carcinoma (RCC) invades the veins, the stakes and the surgical challenges rise. Are you prepared? In this episode, Dr. Vidit Sharma (Mayo Clinic) joins guest host Dr. Daniel Roberson to review Renal Cell Carcinoma (RCC) with Venous Tumor Thrombus (VTT), seen in 4 to 10% of cases. They review Mayo level classification and how CT and MRI venography guide surgical planning by defining thrombus extent and IVC involvement. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:03 - What is a Venous Tumor Thrombus?12:32 - Presentation and Workup31:49 - Preoperative Considerations40:26 - Building the Dream Team46:06 - Preop Counseling and Risks51:24 - The Operation01:31:01 - Outcomes and Adjuvant Immunotherapy01:36:40 - Future Neoadjuvant Shrinkage01:39:40 - Final Takeaways --- More about this episode They also cover key management decisions, including when anticoagulation is appropriate and why embolic urgency is often overestimated. Dr. Sharma highlights the importance of experienced multidisciplinary teams, reviews surgical considerations across thrombus levels, and discusses outcomes, including risk stratification with the TeNNiS model and evolving roles for systemic therapy. --- Resources Outcomes for patients with renal tumors and venous tumor thrombushttps://www.mayoclinic.org/medical-professionals/urology/news/outcomes-for-patients-with-renal-tumors-and-venous-tumor-thrombus/mac-20570379 TeNNiS Scorehttps://www.goldjournal.net/article/S0090-4295(26)00078-6/fulltext --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

Why do so many women with chronic pelvic pain get told "this is just motherhood" or "it'll get better when you go through menopause"? What if the heaviness, the aching, the constant discomfort isn't something you have to live with?In this episode, I sit down with Dr. Julie Baron, a pelvic floor physical therapist and director of Pelvic Health and Performance Center in Bellevue, Washington. Dr. Baron blew our minds at ISSWSH this year with her groundbreaking lecture on pelvic venous disorders a condition that's massively underdiagnosed and often dismissed as "just in your head."Dr. Baron shares her own lived experience with pelvic venous disease. For years, she couldn't sit or stand for more than 10 minutes without needing to lie down. She saw urologists, gynecologists, GI docs, colorectal specialists, and pelvic PTs and everyone told her she was normal. She was working as a pelvic floor PT herself, helping other people with pelvic pain while feeling like a fraud because she couldn't solve her own.She finally diagnosed herself, pushed her way into getting the imaging no one wanted to order, and finally felt validated after the report came back showing renal vein obstruction, iliac obstruction, gonadal vein reflux, and 12-millimeter varicose veins across her uterus. After gonadal vein embolization and sclerotherapy, her life changed completely.We discuss the classic presentation of pelvic venous disorderschronic non-cyclical ache or heaviness that gets worse throughout the day, urinary urgency, postcoital pain, and varicose veins. We talk about why pregnancy is one of the biggest risk factors and how hypermobility disorders, MCAS, and POTS all connect. Dr. Baron explains the imaging process and why a normal ultrasound doesn't always mean you're fine.She also explains the five functions of the pelvic floor and how pelvic venous disease impacts everything from bladder support to sexual function. We get into the sump pump concept, why belly breathing can actually make things worse for this patient population, and how compression shorts can be life-changing. Dr. Baron shares her protocol for helping patients optimize venous return through breathing, positioning, and nervous system regulation.If you're experiencing chronic pelvic pain and feel like you're being dismissed or told it's normal, talk to your provider about pelvic venous disease. While it's frustrating, don't stop advocating for yourself even if you're told everything is normal. You know your body, and if something feels off, keep pushing for answers.Make sure to subscribe so you never miss episodes like this one.Episode Mentioned:Dr. Alexis CutchinsGet in Touch with Dr. Baron:WebsiteInstagramGet in Touch with Me:WebsiteInstagramYoutubeSubstack

In this AJNR Article Summary, Dr. George Vilanilam discusses the article, "Maximizing the Conspicuity of Cerebrospinal Fluid–Venous Fistulas on Computed Tomography Myelography: Assessment of Contrast Density and Timing Effects." Contrast density, not just timing, plays the dominant role in detecting CSF-venous fistulas, with higher subarachnoid contrast significantly improving diagnostic confidence. These findings support prioritizing contrast pooling strategies during CT myelography to enhance fistula detection in patients with spontaneous intracranial hypotension.

Pelvic venous disease is often misattributed, until you recognize the venous “detours” driving symptoms. In this episode of the BackTable Podcast, Dr. Ally Baheti speaks with Dr. Deepak Sudheendra (360 Vascular Institute in Columbus, Ohio) about a symptom-first framework for evaluating and treating pelvic venous disease. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction01:40 - Becoming a Pelvic Vein Specialist04:39 - Sorting Causes of Pelvic Pain06:26 - Symptom Checklist Approach09:45 - Nutcracker Red Flags11:37 - Right Sided Symptoms and Detours15:57 - Conservative Care and Stent Counseling17:27 - Rule Out Superficial Venous Disease21:56 - Procedure Planning and Insurance Hurdles24:04 - IJ Access and Inflow Assessment25:18 - IVUS First Renal and Ovarian Evaluation28:07 - IVUS Iliac Compression Map29:44 - Leg Inflow Venography Setup31:15 - Iliac Stenting From IJ32:24 - Stent Sizing Pitfalls36:31 - Gonadal Vein Embolization42:13 - Internal Iliac Varices Caution43:29 - Post Procedure Meds Follow Up46:49 - Wrap Up --- More about this episode Iliac vein compression can manifest through three collateral pathways, contributing to leg heaviness and groin or hip pain, low back pain via the ascending lumbar system, and pelvic organ symptoms through cross-pelvic internal iliac collaterals. The discussion outlines a practical diagnostic approach grounded in clinical pattern recognition, including the significance of prior DVT as a post-thrombotic etiology, differentiation of flank versus low back pain, and the importance of excluding gynecologic pathology. Emphasis is placed on standing venous reflux ultrasound and pelvic ultrasound, with caution against overreliance on cross-sectional imaging for Nutcracker physiology. Procedural strategy centers on IVUS-guided evaluation, targeted iliac vein stenting (often unilateral) and thoughtful use of gonadal vein embolization, including sequencing considerations and avoidance of common pitfalls. The episode also reviews conservative management, follow-up imaging, and post-procedural antithrombotic and pain management protocols. --- BackTable Vascular & Interventional (VI) is the go-to podcast for interventional radiologists, vascular surgeons, and interventional cardiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

Did you know that up to 75% of women develop fibroids at some point in their lives? In this episode, I speak with Dr. Bryan Treacy about what fibroids are, how they can affect your health, and the treatment options available. Also we clarify some confusion from our last conversation on fibroids and blood flow. We cover: What fibroids are and why they form Case studies, including women with multiple fibroids How fibroids contribute to heavy menstrual bleeding Different causes of heavy bleeding in the presence of fibroids Uterine fibroid embolization (UFE) and why it's offered Fibroid recurrence after myomectomy Recurrent polyps after menopause and distinguishing polyps from cancer- Gaslighting in women's healthcare – when women are not heard, misdiagnosed or prescribed unnecessary medications *Point of Reference mentioned in the conversation; How fibroids can cause heavy bleeding: Increased surface area of the uterine lining = Submucosal fibroids stretch the lining, causing more tissue to shed. Distortion of the uterus = Fibroids interfere with normal uterine contractions, prolonging bleeding. Fragile blood vessels = Fibroids can form abnormal vessels that rupture easily. Local hormonal signaling = Fibroids can produce signals that overstimulate the endometrium. Venous congestion = Large fibroids compress veins, causing blood pooling. If you're curious about fibroid treatments or want to better understand your options, this episode is a must-watch. Dr BryanTreacy is an esteemed Ob/Gyn with over thirty years of experience, his mission is to empower individuals on their health journey. Dr. Treacy's transition from traditional medicine to health consulting and coaching has opened new avenues for personalized and intuitive healthcare. Dr Treacy has performed hundreds of hysterectomies and delivered just as many babies during his years of practice. His experience and expertise is invaluable to us all. Connect with Dr Treacy here; YouTube - ‪‪@healthwithoutrisk‬ Website - https://www.healthwithoutrisk.com/about LinkedIn - / bryantreacy Instagram - / healthwithoutrisk

In this episode of the ESVS Podcast, supported by Servier, we explore the importance of therapy adherence in chronic venous disease (CVD). The episode opens with short patient testimonies, highlighting real-world reasons for non-adherence.To explore this further, we are joined by Professor Denisa Celovska and Professor Atul Pathak. Professor Celovska is an Associate Professor of Angiology and Internal Medicine at the University Hospital and Comenius University in Bratislava, Slovakia. She is currently the President of the Slovak Angiology Society. Professor Pathak is the Head of the National Institute of Cardiology, Cardiac Surgery and Interventional Cardiology in Luxembourg.In this episode, they share their clinical perspective on why patients frequently disengage from treatment, the most common barriers to adherence in daily practice, and practical strategies to improve long-term treatment persistence.The episode also includes insights from a community pharmacist, offering a complementary view on what happens between prescription and real-life use, particularly regarding venoactive drugs. We conclude by emphasising that effective CVD management extends beyond prescribing treatment. Patient education, shared decision-making, follow-up, and human connection are essential to improve adherence and long-term outcomes in CVD.References:Kim H, Cho S, Lee K, Lee SH, Joh JH. A nationwide study of compliance of venoactive drugs in chronic venous disease patients. Ann Surg Treat Res. 2023 May;104(5):288-295. doi: 10.4174/astr.2023.104.5.288. Epub 2023 Apr 28. PMID: 37179697; PMCID: PMC10172027.Burnier M. The role of adherence in patients with chronic diseases. Eur J Intern Med. 2024 Jan;119:1-5. doi: 10.1016/j.ejim.2023.07.008. Epub 2023 Jul 20. PMID: 37479633.Mezalek ZT, Feodor T, Chernukha L, Chen Z, Rueda A, Sánchez IE, Ochoa AJG, Chirol J, Blanc-Guillemaud V, Lohier-Durel C, Ulloa JH. VEIN STEP: A Prospective, Observational, International Study to Assess Effectiveness of Conservative Treatments in Chronic Venous Disease. Adv Ther. 2023 Nov;40(11):5016-5036. doi: 10.1007/s12325-023-02643-6. Epub 2023 Sep 20. Erratum in: Adv Ther. 2024 Jan;41(1):464-465. doi: 10.1007/s12325-023-02722-8. Erratum in: Adv Ther. 2024 Jun;41(6):2540-2541. doi: 10.1007/s12325-024-02857-2. PMID: 37728696; PMCID: PMC10567827.Bogachev, V., Arribas, J.M.J., Baila, S. et al. Management and evaluation of treatment adherence and effectiveness in chronic venous disorders: results of the international study VEIN Act Program. Drugs Ther Perspect 35, 396–404 (2019). https://doi.org/10.1007/s40267-019-00637-5Golna C, Poimenidou C, Giannoukari EE, Saridi M, Liberopoulos E, Souliotis K. Assessing a pharmacist-enabled intervention to improve adherence to medication for hypertension, dyslipidemia, and chronic venous circulation disorders in Greece. Patient Prefer Adherence. 2023;17:3341–3352. doi:10.2147/PPA.S4208116. Branisteanu DE, Munteanu AE, Dolofan BM, Popescu EG, Vittos O. Adherence to pharmacological treatment in chronic venous disease: results of a real-world, prospective, observational cohort study. Life (Basel). 2025;15(3):377. doi:10.3390/life15030377.7. Ulloa JH, Guerra D, Cadavid LG, Fajardo D, Villarreal R, Bayona G, Hoyos AS, Garcia G. Nonoperative approach for symptomatic patients with chronic venous disease: results from the VEIN Act program. Phlebolymphology. 2018;25(2):123Servier is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Servier. Always consult the Instructions for Use (IFU) prior to using any medical device.

Varicose veins can be a symptom of chronic venous insufficiency (CVI), a progressive medical condition that affects the ability of veins in the legs to return blood to the heart. If left untreated, CVI can lead to discomfort, swelling, skin changes, and even ulcers. Fortunately, advancements in medical technology offer a highly effective and minimally invasive treatment called venous ablation.  Learn more about Chanaka Wickramasinghe, MD 

Your dizziness when you stand up is real. Your pelvic pain is real. Your fatigue is real. And there's actually a connection between all of it that most doctors were never taught to look for.If you've ever been told your dizziness, palpitations, or pelvic pain is "just anxiety," this episode is for you. Dr.Dr. Alexis Cutchins is a cardiologist treating POTS and MCAS—she's willing to say 'I don't know, let's figure it out' instead of dismissing patients.We discuss what POTS actually is, how to diagnose it why 80% of her POTS patients have venous insufficiency, and how treating the veins can sometimes cure the POTS. We also talk about the connection between POTS, mast cell activation syndrome, hypermobility, and pelvic venous disease conditions that often travel together and are frequently dismissed.Dr. Alexis Cutchins explains why the venous system is a "lost organ system" that no one really learns about in med school,how left iliac vein compression (May-Thurner syndrome) can cause everything from pelvic pain to back pain and headachesPlus, we discuss women's cardiovascular health, microvascular disease, coronary vasospasm, and why women's heart attack symptoms can look completely different including neck tightness from allergies that's actually cardiac ischemia.Highlights:You don't need a tilt table test to diagnose POTS simple office based or at home tests can help identify it.First-line POTS treatment: volume expansion (drink water, eat salt), compression stockings, treating comorbid MCAS.About 80% of POTS patients have venous insufficiency treating it can dramatically improve or even cure symptoms.Pelvic venous disease is diagnosed with MRV (not CT) and treated with stenting by interventional radiologists.Women's heart attacks can present as abdominal pain, neck tightness, or jaw pain—not just chest pain.These conditions run in families mothers and daughters often share the same constellation of symptoms.If you've been dismissed for POTS, MCAS, pelvic pain, or any constellation of symptoms that don't fit into a neat diagnostic box, this episode validates what you've been experiencing. These conditions are real. They're treatable. And more doctors are finally starting to listen.Make sure to subscribe to the podcast so you don't miss upcoming episodes on related topics, and share this with anyone who needs to hear that their symptoms matter.Get in Touch with Dr. Cutchins:WebsiteInstagramYoutubeGet in Touch with Me: WebsiteInstagramYoutubeSubstack

What if the symptoms you have been told are “just part of hormonal changes and perimenopause” are actually a misdiagnosed medical condition that's progressively getting worse without being properly addressed?In this episode of Maximizing Hormones, Physique, and Running Through Perimenopause, Louise Valentine, one of the world's leading integrative health practitioners and exercise physiologists, sits down with Dr. Ryan Armstrong to break down fibroids, chronic pain, and vascular issues in a way that finally makes sense. Together, they explore why heavy bleeding, chronic fatigue, knee pain, plantar fasciitis, and leg cramping are so common in active women and why they should never be ignored or normalized.Dr. Ryan explains minimally invasive treatments like uterine fibroid embolization that preserve the uterus while dramatically improving quality of life, often with faster recovery and fewer long-term risks than traditional surgery. Louise adds critical context around hormone balance, nutrition, and strength training, showing how medical care, targeted fitness and lifestyle strategies work best together.Listeners will walk away with clarity around symptoms to watch for, questions to ask their doctors, and reassurance that there are modern, effective options that do not require extreme or life-altering procedures. This episode is empowering, practical, and especially valuable for women who want to stay active, strong, and pain-free through perimenopause and beyond.Learn more about Dr. Armstrong's practice Texas Endovascular at https://texaseva.com/ Learn & level up with my free nutrition guide and award-winning Badass Breakthrough Academy to thrive through perimenopause with less stress: https://www.breakingthroughwellness.com/Link to our FullScript where you can see curated best supplement picks & save 20%: https://us.fullscript.com/welcome/breakingthroughwellness/store-start Take advantage of our podcast listener discount and save 20% off all of Kion's science-backed clean products. Code "LOUISE" saves on all future orders: https://www.getkion.com/pages/maximizing Episode Highlights:(0:00) Intro and natural hormone balance for long-term relief(3:00) Fibroids explained in simple terms(6:10) Hormones, inflammation, and injury risk(12:50) Uterine fibroid embolization explained(18:11) Risks of hysterectomy and why alternatives matter(20:38) Innovative treatments for knee pain and plantar fasciitis(23:29) Venous insufficiency, cramping, and varicose veins(30:20) Heavy bleeding, anemia, and athletic performance(32:29) Ablation vs embolization for fibroid care(36:06) OutroTune in weekly to "Maximizing Hormones, Physique, and Running Through Perimenopause" for our simple female-specific science-based revolution. Let's unlock our best with less stress!I'd love to connect! Email

Swollen, heavy, or restless legs aren't always just part of aging. In many cases, they're signs of underlying vein disease that can be diagnosed and treated.In this episode, we explain how swelling, varicose veins, and skin discoloration are connected to circulation—and why catching vein disease early can make treatment easier and recovery smoother.We cover the full spectrum, from spider veins and visible varicose veins to advanced venous insufficiency and ulcers, and how modern, non-surgical treatments can help patients feel and function better.We also discuss why vein disease can be harder to spot in people of color and why ultrasound evaluations are key to identifying issues that aren't visible on the skin.If you're experiencing heaviness, swelling, discoloration, or restless legs, it may be time to consider vein disease as the cause.Timestamps: 00:00 - Swollen or tired legs are not “just aging” 00:24 - Early signs: heaviness, swelling, restless legs 00:53 - Spider veins vs. varicose veins: when to worry 01:18 - Venous insufficiency and progressing vein disease 01:40 - From swelling to skin discoloration and ulcers 02:06 - Vein disease in people of color (without visible veins) 02:35 - Why an ultrasound is key to diagnosing vein problems 03:10 - Treatment for mild vein disease: office-based, non-surgical 03:42 - Treating advanced swelling and discoloration 04:01 - Caring for venous ulcers and preventing recurrence 04:24 - What improves (and what may not) after treatment 04:55 - Why early treatment protects long-term leg health 05:32 - When to see a vein specialist and what to askLearn More: https://www.alluremedical.com/Books & Research: https://www.alluremedical.com/books/Follow Dr. Charles Mok & Allure Medical: LinkedIn: https://www.linkedin.com/in/charles-mok-4a0432114/ Instagram: https://www.instagram.com/alluremedicals/ YouTube: https://www.youtube.com/@AllureMedical TikTok: https://www.tiktok.com/@alluremedicalAmazon Store: https://www.amazon.com/stores/Dr.-Charles-Mok/author/B0791M9FZQInner Circle Membership: https://www.alluremedic#insidethecure

Q-BANK: https://patreon.com/highyieldfamilymedicineIntro (0:35),Venous leg ulcers (1:45),Arterial (ischemic) ulcers (2:58),Diabetic foot ulcers (4:42),Pressure injuries (6:10),Pyoderma gangrenosum (8:24),Burns (9:36),Stevens-Johnson Syndrome / Toxic Epidermal Necrolysis (13:12),Warfarin necrosis (14:33),Necrotizing fasciitis (15:21),Rocky Mountain Spotted Fever (16:22),Erythema nodosum (17:35),Lipoma (19:08),Epidermal inclusion cyst (20:00),Dermatofibroma (20:51),Cherry hemangiomas (21:52),Seborrheic ketatosis (22:37),Actinic keratosis (23:41),Basal cell carcinoma (24:47),Squamous cell carcinoma (26:24),Melanoma (28:05),Kaposi sarcoma (30:29),Mycosis fungoides (31:26),Practice questions (32:50)

When conventional revascularization fails, can deep venous arterialization offer a new lifeline to limb salvage? Dr. Lucas Ferrer Cardona, vascular surgeon at Ascension and Dr. Miguel Montero Baker, vascular surgeon and medical director at HOPE Clinical Innovation Center join host Dr. Sabeen Dhand for an insightful discussion on deep venous arterialization (DVA). --- This podcast is supported by: RADPAD® Radiation Protectionhttps://www.radpad.com/ --- SYNPOSIS The doctors discuss the progression of deep venous arterialization, highlighting the benefits of open, endovascular, and hybrid approaches. They draw on their personal experiences to share key technical nuances and explore new devices such as the Aveera Boomerang device. They emphasize the critical role of patient selection, family support, and close postoperative surveillance, including weekly wound assessments and monthly ultrasound evaluations. Although currently FDA-approved for no-option chronic limb-threatening ischemia (CLTI), Dr. Baker notes that deep venous arterialization may hold promise even for patients earlier in the disease course.The episode concludes by exploring future directions for deep venous arterialization, highlighting the ongoing need for research to advance limb preservation. --- TIMESTAMPS 00:00 - Introduction03:15 - The Inspiration Behind Their Podcast10:05 - Challenges and Success Stories in Vascular Surgery10:29 - Exploring Deep Venous Arterialization (DVA)25:16 - Hybrid Approaches and Patient Outcomes32:06 - Evolution of Endovascular Techniques37:33 - Patient Selection and Criteria38:52 - Understanding the Biology of Procedures43:57 - Exploring New Techniques and Devices58:52 - Challenges and Considerations01:01:51 - Final Thoughts --- RESOURCES Hybrid superficial venous arterialization and endovascular deep venous arterializationhttps://pubmed.ncbi.nlm.nih.gov/37404577/ Transcatheter Arterialization of Deep Veins in Chronic Limb-Threatening Ischemiahttps://www.nejm.org/doi/full/10.1056/NEJMoa2212754

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When Coach Prime, Deion Sanders, left a recent Colorado game in pain from another blood clot, headlines focused on his toes and his comeback. But few understood what his story actually exposes: the difference between arterial and venous clots — and why that distinction can mean the difference between life, limb, and legacy. On this week's Heart of Innovation, I sat down with Dr. Esteban Henao of Albuquerque, NM, and Dr. John Phillips, interventional cardiologist and co-host, to unpack the science, the stories, and the stakes behind blood clots — timed to World Thrombosis Day. We discuss: – Why Deion's “perfect storm” of diabetes, aneurysmal disease, and hereditary hypercoagulability makes his case so complex – How arterial clots (often linked to PAD and plaque buildup) differ from venous clots that can cause deadly pulmonary embolisms – What warning signs too many patients and clinicians still miss – Why who you are can determine how quickly you're treated — and how equity in vascular care could save thousands of limbs As Dr. Henao said on the show: “If Deion wasn't Deion, there's a good chance he would have lost his leg.” And that's exactly why these conversations matter. Listen to the full show! If you have additional questions about blood clots, call the Global PAD Association's Leg Saver Hotline at 1-833-PAD-LEGS or go to PADhelp.org #deionsanders #coachprime #bloodclots #arteryclot #DVT #peripheralarterydisease #legsaverhotline #globalpadassociation

America Out Loud PULSE with Dr. Vaughn & Dr. Tankersley – This time, we review the pelvic venous issue, which causes many different problems, is very underappreciated, and needs urgent attention. This was an issue that we reviewed in some detail in April and June. We thought it necessary to revisit the issue because of our recent cases that fortify our concern about the fundamental injuries resulting from pelvic vein compromise. Every...

America Out Loud PULSE with Dr. Vaughn & Dr. Tankersley – This time, we review the pelvic venous issue, which causes many different problems, is very underappreciated, and needs urgent attention. This was an issue that we reviewed in some detail in April and June. We thought it necessary to revisit the issue because of our recent cases that fortify our concern about the fundamental injuries resulting from pelvic vein compromise. Every...

Dr. Hector Dourron is a board-certified vascular surgeon at Hamilton Vascular Center in Dalton, Georgia and Chatsworth, Georgia. For more information about Hamilton Vascular Center, call 706-259-3336 (Dalton, Georgia) or 706-686-8090 (Chatsworth, Georgia) or visit VitruvianHealth.com/vascular.This program in no way seeks to diagnose or treat illness or to replace professional medical care. Please see your healthcare provider if you have a health problem.

What is the microcirculation? How are terms like volume-status and fluid-responsiveness misleading? Join us as we sit down with Dr. Ross Prager to unpack and de-mystify the concepts of congestion and volume tolerance along with our survey of the tools of the trade as it relates to these terms. On this Critical Care Time episode we really get into the weeds on this stuff and even get theoretical at some points so it's NOT for the faint of heart! However, if you listen to us for the deep dives into physiology and if you want to level-up your ICU patient care, this is the episode for you! Listen, leave us some feedback and drop us a review! Hosted on Acast. See acast.com/privacy for more information.

Resources:  Rutherford Chapters (10th ed.): 174, 175, 177, 178 Prior Holding Pressure episode on AV access creation: https://www.audiblebleeding.com/vsite-hd-access/ The Society for Vascular Surgery: Clinical practice guidelines for the surgical placement and maintenance of arteriovenous hemodialysis access: https://www.jvascsurg.org/article/S0741-5214%2808%2901399-2/fulltext  KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update: https://pubmed.ncbi.nlm.nih.gov/32778223/    Venous Hypertension   Definition A functioning AV circuit delivers high volume arterial flow towards a stenotic venous segment, causing buildup in pressure and venous hypertension. If there are few or no branching veins between the access and stenosis, thrombosis could occur   Etiology The most common etiology is venous stenosis caused by a history of vessel wall trauma by centrally-inserted venous devices such as tunneled and non-tunneled dialysis catheters, central lines, pacemakers, or defibrillator. In a study performed at a large academic medical center1, new hemodynamically significant central venous stenosis was associated with the duration of catheter dependence (26% in patients with CVCs for more than 6 months, versus 11% in patients with CVCs for less than 6 months). PICC lines can directly damage cephalic and basilic veins Venous stenosis can often go undetected until AV access creation occurs   Patient Presentation Symptoms of venous insufficiency will be present– most commonly regional edema, in the area of venous stenosis. If there are patent venous branches between the AV anastomosis and the stenotic area, swelling can occur throughout the arm. Pigmentation, induration, dermatosclerosis, and ulceration may also be observed. An extensive collateral network of veins may be visible throughout anterior chest, shoulder, or flank SVC obstruction can result in swelling of the head, neck and shoulders, as well as a feeling of head and neck fullness, airway compromise, and visual problems Normal palpable thrill can be replaced by a strong pulse Dialysis can be complicated by difficulty with needle access, recirculation syndrome, and arm swelling after dialysis sessions. Workup  Central vein thrombosis can be hard to detect on ultrasound because clavicle and sternum can block transmission Venography is essential to determine the presence and severity of venous stenosis or occlusion.   Prevention The ideal scenario is to avoid central dialysis catheters completely, and this involves evaluating CKD patients and placing AVF or AVG before the need for dialysis arises.  If a patient presents placement of an AVF/AVG, it is important to perform venography if a patient has a history of a central venous catheter or clinical signs of venous hypertension. A history of SVC obstruction from any cause can preclude permanent AV access creation in both upper extremities Treatment Endovascular approaches to venous outflow stenosis can be first-line treatment options, due to their minimal risk. They can also be performed at the same time as a diagnostic venogram. Angioplasty alone or with stenting are the endovascular options. In a study by Bakken et al2 that compared primary high-pressure balloon angioplasty versus stenting, primary patency was equivalent between groups, with 30-day rates of 76% for both groups and 12-month rates of 29% for angioplasty and 21% for stenting. Assisted primary patency was also equivalent with a 30-day patency rate of 81% and 12-month rate of 73% for the angioplasty group,  84% at 30 days, and 46% at 12 months for the stenting group. This study, along with others, shows that the major downside of endovascular interventions, whether angioplasty or stenting, often require repeat intervention and have poor long-term patency. For subclavian vein stenosis, angioplasty alone is appropriate due to its anatomical location that can put a stent at risk for extrinsic compression from the first rib and clavicle. Surgical bypass can be performed Possible bypasses include axillary-axillary, axillary-jugular, axillary-right atrial, and axillary-femoral. In these bypasses, the preferred conduits are autogenous saphenous or femoral veins. In cases where the proximal subclavian vein is obstructed, a jugular vein turndown can be performed. In this procedure the distal jugular vein is transected, sewed end-to-side at the distal subclavian vein, effectively acting as a bypass route for that obstructed segment. The Hemoaccess Reliable Outflow (HeRO) Vascular Access Device can be used as a hybrid approach, combining endovascular and open surgical techniques to bypass a central venous occlusion  and provide a reliable outflow for dialysis.  This device has a PTFE inflow limb that is sewn end-to-side onto the brachial artery. This limb is tunneled subcutaneously and connected to a silicone-coated nitinol outflow catheter that is inserted into a central vein and tracked directly into the right atrium. This effectively bypasses central venous stenoses. In the largest study to date on HeRO access grafts placed in 167 patients,3 HeRO primary and secondary patency was 48.8% and 90.8%, respectively, at 12 months. Interventions to maintain or re-establish patency were required in 71.3% of patients resulting in an intervention rate of 1.5/year. Access-related infections were reported in 4.3% patients. The authors concluded that HeRO device had performed comparably to standard AVGs and had proven superior to tunneled dialysis catheters in terms of patency, intervention, and infection rates. If no treatment options for venous hypertension or outflow obstruction  are available, an alternate AV access site can be created, either in the contralateral arm if the SVC is uninvolved, or through placement of femoral AV access or a peritoneal dialysis catheter.   Bleeding Access Site   Etiology and Risk Factors Bleeding can be caused by high venous pressure after dialysis, pseudoaneurysm rupture, or trauma. Patients with end stage renal disease (ESRD) have a baseline elevated risk of bleeding due to uremia-induced platelet dysfunction and use of systemic anticoagulation within the hemodialysis circuit. Additional risk factors include dialysis through an AV graft, hypertension, longer duration of access use, and compromised integrity of the vascular access due to complications (clotting, infection) or invasive procedures. Dual antiplatelet therapy is also associated with overall bleeding events in ESRD patients. Dialysis patients could be on antiplatelet therapy for management of comorbid cardiovascular risk and/or patency of AV graft Patients with bleeding fistulas often present from their dialysis unit when standard digital pressure at the cannulation site fails to stop the bleeding. This is a very serious condition since most mature fistulas have high blood flow and the patients are at risk for hemorrhagic shock and death.    Initial Management  The first step of management is to obtain hemostasis. Elevate the limb above the level of the heart and apply firm and directed pressure at the site of bleeding using gauze for at least 30-40 minutes Milosevic et al4 reviewed non-operative management of bleeding fistulas and grafts and found that compared to standard dressings, the use of specialized hemostatic dressings decreased bleeding time at arterial and venous cannulation sites. These hemostatic materials included the IRIS compression bandage and cellulose-based, chitosan-based, poly-N-acetyl glucosamine-based, and thrombin-soaked dressings. There has been a “bottlecap method” described where the hollow side of a bottlecap is pressed on top of the puncture site. Maintaining pressure on the cap will cause the cap to fill with blood and clot, which tamponades the bleeding. The provider can also place a shallow figure-of-8 or purse string stitch just below the skin surface to aid in hemostasis. It is important to avoid placing the suture too deep as this can cause inadvertent fistula ligation. During this process, an assistant applies pressure just proximal and distal to the bleeding site to stop blood flow so the sutures can be placed. If these methods fail to achieve hemostasis, apply a tourniquet proximal to the fistula and tighten it until bleeding stops and the radial pulse is lost. This signifies complete occlusion of arterial inflow to the fistula. Tourniquet use should be limited to 3 hours or less, since limb ischemia beyond this timepoint is associated with permanent neuromuscular damage. Regardless of the method used for initial hemostasis, the patient is at risk for repeat hemorrhage, hematoma formation, vessel stenosis, and thrombosis. They should be evaluated by a vascular surgeon as soon as possible.  Definitive Management Definitive management depends on etiology of each case, and there are a variety of interventions that can be pursued (i.e. aneurysmorrhaphy for aneurysmal bleeding) If skin erosion over the conduit is present, it should be assumed that the AV access is infected and emergency intervention should be pursued. A jump graft can be placed through with healthy tissue.  A covered stent could be introduced through a separate percutaneous puncture site Finally, coagulopathy can be addressed by administering cryoprecipitate, DDAVP, erythropoietin, estrogen, tranexamic acid. Aneurysms and Pseudoaneurysms   Definition and Etiology Aneurysms involve all three layers of the vessel wall and they develop due to hemodynamic changes causing remodeling of the vein wall in an AV fistula. This is necessary for vein maturation, but becomes problematic if the post-anastomotic vein continues to dilate and becomes aneurysmal.  Aneurysms can also occur at anastomosis sites due to technical aspects of the surgery. Pseudoaneurysms only involve some layers of the vessel wall caused by repeated puncture for hemodialysis.  Both aneurysms and pseudoaneurysms can enlarge due to venous outflow stenosis causing increased intraluminal pressures. Both true aneurysms and pseudoaneurysms can lead to overlying skin erosion and subsequent hemorrhage, pain, AV access dysfunction, and cannulation difficulties.  Dialysis cannulation should be avoided at the aneurysmal sites to prevent bleeding complications. Diagnosis They can be diagnosed on ultrasound, which also provide information on flow rates, presence inflow/outflow/stenoses, and vessel diameters.  Indications for Treatment Treatment is indicated for aneurysms that are rapidly expanding or ulcerating through the skin surface. These are at high risk for rupture and hemorrhage, which is life-threatening. Treatment is also indicated when the aneurysm occurs at the anastomotic site of the AV fistula, the patient has a cosmetic concern, cannulation becomes difficult, there is concern for infection, or the patient has high-output heart failure that could be exacerbated by high flow through the fistula. Treatment is not indicated in asymptomatic aneurysms, regardless of their size. True  aneurysms and pseudoaneurysms are not prone to spontaneous rupture.   Treatment Options Aneurysmorrhaphy is the most common treatment. It involves the resection of the aneurysmal vein wall to restore a normal diameter and removal of excess skin. Anastomosis is performed along the lateral wall to prevent issues with cannulation along the suture line. Aneurysm resection with interposition grafting is also possible. If multiple aneurysmal segments require treatment, staging their repairs can allow for continuation of dialysis without needing to place a temporary dialysis catheter. AV access ligation is an appropriate alternative to AV access salvage in certain situations but usually requires excision of the aneurysm/pseudoaneurysm due to the potential to develop thrombophlebitis and the cosmetic appearance of the thrombosed segment. If there is concern for an infected pseudoaneurysm or aneurysm, surgery should include removal of all infected material. References   1. Al-Balas A, Almehmi A, Varma R, Al-Balas H, Allon M. De Novo Central Vein Stenosis in Hemodialysis Patients Following Initial Tunneled Central Vein Catheter Placement. Kidney360. 2022;3(1):99-102. doi:10.34067/KID.0005202021 2. Bakken AM, Protack CD, Saad WE, Lee DE, Waldman DL, Davies MG. Long-term outcomes of primary angioplasty and primary stenting of central venous stenosis in hemodialysis patients. J Vasc Surg. 2007;45(4):776-783. doi:10.1016/j.jvs.2006.12.046 3. Gage SM, Katzman HE, Ross JR, et al. Multi-center Experience of 164 Consecutive Hemodialysis Reliable Outflow [HeRO] Graft Implants for Hemodialysis Treatment. Eur J Vasc Endovasc Surg. 2012;44(1):93-99. doi:10.1016/j.ejvs.2012.04.011 4. Milosevic E, Forster A, Moist L, Rehman F, Thomson B. Non-surgical interventions to control bleeding from arteriovenous fistulas and grafts inside and outside the hemodialysis unit: a scoping review. Clin Kidney J. 2024;17(5):sfae089. doi:10.1093/ckj/sfae089

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Dana thinks it's time we talk about cousin Dennis, Dan has a shredded tankini, Gaye is feeling lucky and Adam wishes Derek Huffman well. If you're a fan of False Positive, you'll love Banned Camp—a comedy podcast about why books are banned. Blue Sky @False-Positive Instagram @False_Positive  

Dr. Jeffrey Kopin, Chief Medical Officer for Northwestern Medicine Lake Forest Hospital, joins John Williams to talk about what happens if you miss a day of your prescribed medications, President Trump being diagnosed with chronic venous insufficiency, a genetic test that could predict the odds of obesity, and what happens when people stop using weight loss drugs.

Dr. Jeffrey Kopin, Chief Medical Officer for Northwestern Medicine Lake Forest Hospital, joins John Williams to talk about what happens if you miss a day of your prescribed medications, President Trump being diagnosed with chronic venous insufficiency, a genetic test that could predict the odds of obesity, and what happens when people stop using weight loss drugs.

Dr. Matthew J Blecha, Vascular Surgery at Loyola Medicine, joins Lisa Dent to discuss what chronic venous insufficiency is. President Donald Trump was seen with swollen ankles. The White House later announced that the president had chronic venous insufficiency. Dr. Blecha shares some information about the condition and what may cause it.

Dr. Jeffrey Kopin, Chief Medical Officer for Northwestern Medicine Lake Forest Hospital, joins John Williams to talk about what happens if you miss a day of your prescribed medications, President Trump being diagnosed with chronic venous insufficiency, a genetic test that could predict the odds of obesity, and what happens when people stop using weight loss drugs.

It's Monday, July 21st, A.D. 2025. This is The Worldview in 5 Minutes heard on 140 radio stations and at www.TheWorldview.com.  I'm Adam McManus. (Adam@TheWorldview.com) By Adam McManus Nigerian Muslims slaughtered 27 Christians including 3-year-old girl At 3:00 a.m. on July 15th, the Christian village of Bindi near Jos in the Plateau State in Nigeria, was plunged into a nightmare. Twenty-seven Christians were slaughtered, including a 3-year-old girl and nine members of Pastor Davou Musa's family, burned alive in their home, reports TruthNigeria.com. These attacks are not isolated incidents. They are part of a coordinated, radical Islamic campaign carried out by Fulani terrorists, with a mission to eradicate Christians from Nigeria and establish a Muslim caliphate. The perpetrators shouted “Allahu Akbar” as they hacked, shot, and burned families alive. One pastor shed light on what that Arabic phrase means. PASTOR: “Allah Akbar. Some will translate that as ‘God is great.' ‘ Perhaps a better translation of that Arabic phrase is, ‘Our God is greater.' This is a declaration that the demon and demons working through these people consider themselves to be greater than Jesus Christ, the God of Abraham Isaac and Jacob. “Ephesians 6:[12] says that our war is not just ‘against flesh and blood, but powers, principalities and spirits.' Practically, what this means is, when you see conflict in the seen realm, there is far greater conflict in the unseen realm. And when you hear, ‘Our God is greater,' that is a declaration of spiritual warfare from a demon against Jesus Christ, the God of Abraham Isaac and Jacob.” And where was the military? Just two miles away, but they arrived two hours late, a disturbing pattern of complicity that Christians have endured over and over again. Equipping The Persecuted is mobilizing immediately to assist survivors, providing emergency aid, trauma care, food, and security. But they urgently need your help. They are the only organization on the ground whose mission is to stop the persecution, not just clean up after it. This is not just a humanitarian crisis. It is genocide. And the world is ignoring it. Make a donation to Equipping the Persecuted through a special link in our transcript today at www.TheWorldview.com. Huckabee rebukes attackers of Christian church in Palestinian town U.S. Ambassador to Israel Mike Huckabee condemned recent attacks on a Christian village and its historic church in the West Bank, calling them “a crime against humanity and God,” reports The Christian Post. His statement came after visiting the site of the arson and ongoing harassment. Huckabee travelled Saturday to Taybeh, a Christian Palestinian town that residents say has endured a wave of assaults by Israeli settlers in recent weeks, according to The Times of Israel.  The attacks include a fire set near the ruins of the Church of St. George, which church leaders described as among the most severe incidents to date. Huckabee, a longtime Evangelical supporter of Israel, said during his visit that the desecration of religious sites represented “an act of terror” and that such actions should carry “harsh consequences.” Trump diagnosed with chronic venous insufficiency after leg swelling Last Thursday, White House Press Secretary Karoline Leavitt gave the press an update on President Donald Trump's health. She told reporters that he has experienced mild swelling in his lower legs, according to a memo from Dr. Sean Barbarella, the physician to the president. LEAVITT: “The president underwent a comprehensive examination, including diagnostic vascular studies. Bilateral lower extremity veinous doppler ultrasounds were performed and revealed chronic venous insufficiency, a benign, common condition, particularly in individuals over the age of 70.” Leavitt also talked about photos showing some minor bruising on the back of the President's hand. She explained the bruising is a minor soft tissue irritation from frequent handshaking and the use of aspirin, reports CBN News. Intercessors for America featured this prayer.  Pray with me now, if you would. “Father, we lift President Trump before You. We ask You would heal him and strengthen his body as he continues to serve our great nation. Amen.” Why Republicans defunded NPR and PBS The U.S. Congress voted to defund the Public Broadcasting Corporation by $1.1 billion, reports The Epoch Times. Republican Congressman Brandon Gill of Texas spoke from the floor of the House. GILL: “Tonight is the culmination of months of work from House Republicans to defund left wing state sponsored media outlets like NPR. “During that process, we got to bring in leadership from these outlets, like the CEO of NPR, Katherine Maher to testify before the House Oversight Committee she's written extensively about every single major woke buzz word that you could think of, including, ‘the ravages of late stage capitalism,' ‘structural privilege,' her own ‘cis white mobility privilege.'  Most Americans, including myself, didn't know what that meant until reading this. “She's written about how ‘I do wish Hillary, [meaning Hillary Clinton], wouldn't use the language of ‘boy and girl.' It's erasing language for non-binary people. “This is the person running the outlet the other side of the aisle wants our tax dollars to subsidize non-partisan news outlets are not run by lunatics like this. Republicans are done using the power that voters give us to fund Democrat media machines. We're playing to win now.” Chip and Joanna Gaines promote homosexuality on new TV show And finally, Christians across America are objecting to the moral compromise of self-proclaimed Christians Chip and Joanna Gaines known for their home renovation show Fixer Upper and the Magnolia Network, reports the New York Post. As producers of a new reality show “Back to the Frontier” which premiered on July 10th, they sparked backlash for casting a homosexual male couple. A source close to Chip and Joanna – who cast a faux-married couple Jason Hanna and Joe Riggs and their 10-year-old twin sons through surrogacy – says they have long affirmed perversion. Conservative Christian leaders like Reverend Franklin Graham and podcaster Allie Beth Stuckey both slammed their decision, with Graham calling the casting “very disappointing.”  Graham was clear in his stance, writing: “His Word is absolute truth. God loves us, and His design for marriage is between one man and one woman.” This prompted Chip to pour gasoline on the controversy by tweeting: “The way of ‘modern American Christian culture' is ‘Judge 1st, understand later/never.' ”  Christian author Matt Walsh replied, “Maybe you should endeavor to understand the basic moral teachings of your own alleged religion before you give lectures to other people about their lack of understanding.” And Robby Starbuck, another Christian influencer, said, “Promoting this show means cash is greater than Christianity. When you reduce it to that simple truth, it's eye opening. I hope you correct course Chip. ‘For what profit is it to a man if he gains the whole world, and loses his own soul? Or what will a man give in exchange for his soul?'” (Matthew 16:26) The TV couple – parents to five children ranging between 20 and seven in age – are active members of the traditionally conservative Antioch Community Church of Waco, Texas. On its website, the church proclaims, “God commissions each of us to go into our spheres of influence and represent Jesus so that His Kingdom would come and His will would be done.” Close And that's The Worldview on this Monday, July 21st, in the year of our Lord 2025. Follow us on X or subscribe for free by Spotify, Amazon Music, or by iTunes or email to our unique Christian newscast at www.TheWorldview.com.  Plus, you can get the Generations app through Google Play or The App Store. I'm Adam McManus (Adam@TheWorldview.com). Seize the day for Jesus Christ.

Chief Medical Officer at Central DuPage Hospital Dr. Thomas Moran joins Bob Sirott to explain what chronic venous insufficiency is, a study on a possible link between a virus and Parkinson’s, and why there is an increase in gastrointestinal cancer in people under fifty. He also talks about the link between oral health and your […]

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Tony starts the second hour talking more about the explosion at the Los Angeles sheriff’s deputy facility, killing three. Tony also talks about President Donald Trump getting diagnosed with chronic venous insufficiency following leg swelling and hand bruising.See omnystudio.com/listener for privacy information.

This episode we go into strictly politics. We got the 3 LA County Sheriff's Department deputies killed in an explosion, we also go into Trump Chronic Venous Insufficiency diagnosis and Trump rolling back $9B in public media funding and foreign aid. Hosted by your Pastor Michael Smith and co-hosted by your Brotha Lamick IsraelIf you would like tune in and join Brotha Lamick Young Disciples Discord the link is https://discord.gg/SVQygUP2 If you would like to sign up for the Monthly newsletter/ have a special request/report you would like done email Brotha Lamick Israel at Lamick19@outlook.com

Plus 4 dead and 16 hospitalized following an awful bus accident operated by company out of Fort Worth, Keller police and the city jail could soon become the first in Tarrant County to enter into a formal partnership with federal immigration authorities, Chiefs wide receiver Rashee Rice is sentenced to 30 days in jail and five years deferred probation, and more!

President Trump was diagnosed with chronic venous insufficiency, a “benign and common” condition. We talk about what it is, what to watch for, and whether it can be a sign of something more serious in some cases with Dr. Jose Wiley, Professor of Medicine and Chief of the Section of Cardiology at the Tulane School of Medicine

July 18, 2025 ~ Dr. Joel Kahn, Integrative Cadiologist at the Kahn Center for Cardiac Longevity discusses Donald Trump being diagnosed with Chronic Venous Insufficiency.

America Out Loud PULSE with Dr. Vaughn & Dr. Tankersley – As Dr. Jordan Vaughn has identified and treated in many patients, the large veins in the pelvis can cause a myriad of problems. He has been working closely with one of the world's preeminent radiologists for over a year on this issue, and Dr. Brooke Spencer, a renowned expert, has now published her initial findings on the...

America Out Loud PULSE with Dr. Vaughn & Dr. Tankersley – As Dr. Jordan Vaughn has identified and treated in many patients, the large veins in the pelvis can cause a myriad of problems. He has been working closely with one of the world's preeminent radiologists for over a year on this issue, and Dr. Brooke Spencer, a renowned expert, has now published her initial findings on the...

On this episode of the PTA Elevation Podcast, host Dr. Briana Drapp, PT, DPT, PTA, CSCS goes over the important things to know about arterial vs. venous insufficiency ulcers when studying for the NPTE. At the end of this episode, Briana provides and reviews a sample question that helps students get a feel for how this subject will be asked on the NPTE - PTA. Tune in to learn more!Come to the review session on June 22nd and 29th! https://ptaelevation.com/last-minute-reviewCheck out our FREE stuff!: https://ptaelevation.com/freebiesWebsite: https://www.ptaelevation.com/Join our FB group for FREE resources to help you study for the exam!  https://www.facebook.com/groups/382310196801103/If you're interested in our prep course, check it out here: https://ptaelevation.com/the-600-plus-systemFollow us on our other platforms! https://www.ptaelevation.com/linktree

CardioNerds Critical Care Cardiology Council members Dr. Gurleen Kaur and Dr. Katie Vanchiere meet with Dr. Yash Patel, Dr. Akanksha, and Dr. Mohammed El Nayir from Trinity Health Ann Arbor. They discuss a case of pulmonary air embolism, RV failure, and cardiac arrest secondary to an ocular venous air embolism. Expert insights provided by Dr. Tanmay Swadia. Audio editing by CardioNerds Academy intern, Grace Qiu. A 36-year-old man with a history of multiple ocular surgeries, including a complex retinal detachment repair, suffered a post-vitrectomy collapse at home. He was found hypoxic, tachycardic, and hypotensive, later diagnosed with a pulmonary embolism from ocular venous air embolism leading to severe right heart failure. Despite a mild embolic burden, the cardiovascular response was profound, requiring advanced hemodynamic support, including an Impella RP device (Abiomed, Inc.). Multidisciplinary management, including fluid optimization, vasopressors and mechanical support to facilitate recovery. This case underscores the need for early recognition and individualized intervention in cases of ocular venous air embolism. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Case Reports PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls- Clear Vision, Clouded Heart: Ocular Venous Air Embolism with Pulmonary Air Embolism, RV Failure, and Cardiac Arrest Hypoxia, hypotension and tachycardia in a patient following ocular instrumentation are classic findings suggestive of pulmonary embolism from possible air embolism. The diagnosis of RV failure is based on clinical presentation, echocardiographic findings (such as McConnell's sign), and invasive hemodynamic assessment via right heart catheterization. Mechanical circulatory support can be considered as a temporary measure for patients with refractory RV failure. Central Figure: Approach to Pulmonary Embolism with Acute RV Failure Notes - Clear Vision, Clouded Heart: Ocular Venous Air Embolism with Pulmonary Air Embolism, RV Failure, and Cardiac Arrest 1. What is an Ocular Venous Air Embolism (VAE), and how can it be managed in critically ill patients? An Ocular Venous Air Embolism is defined as the entry of air into the systemic venous circulation through the ocular venous circulation, often during vitrectomy procedures. Early diagnosis is key to preventing cardiovascular collapse in cases of Ocular Venous Air Embolism (VAE).  The goal is to stop further air entry. This can be done by covering the surgical site with saline-soaked dressings and checking for air entry points. Adjusting the operating table can help, especially with a reverse Trendelenburg position for lower-body procedures. The moment VAE is suspected, discontinue nitrous oxide and switch to 100% oxygen. This helps with oxygenation, speeds up nitrogen elimination, and shrinks air bubbles. Hyperbaric Oxygen Therapy can reduce bubble size and improve oxygenation, especially in cases of cerebral air embolism, when administered within 6 hours of the incident. Though delayed hyperbaric oxygen therapy can still offer benefits, the evidence is mixed. VAE increases right heart strain, so inotropic agents like dobutamine can help boost cardiac output, while norepinephrine supports ventricular function and systemic vascular resistance, but this may also worsen pulmonary resistance.  Aspiration of air via multi-orifice or Swan-Ganz catheters has limited success, with success rates ranging from 6% to 16%. In contrast, the Bunegin-Albin catheter has shown more promise, with a 30-60% success rate. Catheterization for acute VAE-induced hemodynamic compromise is controversial, and there's insufficient evidence to support its ...

Before you dive into learning all about the arteries and veins I would suggest you take a look at some of the key terms associated with the systems. It will be super helpful if you have a good understanding of the bones and muscles of facial expression before you tackle the arteries, veins, and lymphatic system. Additional resources:  Check out my free scorecard for students - you can rank yourself on how you are doing to take action on the steps toward being a successful college student. Sign up on the Google doc ⁠⁠HERE⁠⁠ - I will send along your scorecard to use the entire time you are enrolled in school. Study Sheets: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://thehappyflosserrdh.etsy.com/ ⁠⁠⁠⁠⁠⁠⁠⁠⁠Specialized Course: How to be successful in Dental Hygiene School⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://billie-lunt-s-school.teachable.com/p/how-to-be-successful-in-dental-hygiene-school⁠⁠⁠⁠⁠⁠⁠⁠⁠Other Podcasts: ⁠⁠⁠⁠⁠⁠⁠⁠⁠blog.feedspot.com/dental_hygiene_podcasts/⁠⁠⁠⁠⁠⁠⁠⁠⁠ Take a look at a recent product I have tried and recommend. ⁠⁠⁠⁠⁠⁠⁠⁠⁠bit.ly/thehappyflosser ⁠⁠⁠⁠⁠⁠⁠⁠⁠promo code: HAPPYFLOSSER   Tooth fairy escape room ⁠Here ⁠Email Me: ⁠⁠⁠⁠⁠⁠⁠⁠⁠HappyflosserRDH@gmail.com⁠⁠⁠⁠⁠⁠⁠⁠⁠

The "River" stent is a novel stent designed specifically to account for the anatomical and procedural requirements of venous sinus stenosis. A multicentre study of the device's safety and efficacy is underway, comprising 39 subjects across 5 US centres. The 1-year results have been recently published in JNIS. Editor-in-Chief of JNIS, Dr. Felipe C. Albuquerque, interviews Dr. Athos Patsalides¹, author of the paper: The River study: the first prospective multicenter trial of a novel venous sinus stent for the treatment of idiopathic intracranial hypertension 1. Department of Neurological Surgery, North Shore University Hospital, Manhasset, New York, USA   Please subscribe to the JNIS podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/4aZmlpT) or Spotify (https://spoti.fi/3UKhGT5). We'd love to hear your feedback on social media - @JNIS_BMJ.

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Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is responsible for 9–30% of pregnancy-related mortality in high resource countries and remains a significant, increasing cause of severe maternal morbidity. Peripartum, 50% of VTE events occur in the postpartum interval, which has a 6-fold higher risk compared to antepartum. There is wide variation in LMWH pharmacological postpartum prophylaxis guidance. The RCOG, for example, recommends 10 days of LMWH for all postop CS patients unless it was elective, and additional risk factors exist. The ACOG uses a more selective approach. However, on Jan 16, 2025, a new multicenter retrospective study from the US is raising questions about the efficacy of postpartum VTE pharmacologic therapy. Is there really no need for pp VTE pharmacologic therapy? Or does the answer lie in the reality of VTE as a “low frequency, high acuity” event? Listen in for details!

This week we discuss blood clots A blood clot is a clump of blood that has changed from a liquid to a gel-like or semisolid state. Clotting is a necessary process that can help prevent excessive blood loss when you have a cut, for example. Thrombosis is when a blood clot forms and reduces blood flow. There are two types: Arterial thrombosis occurs when a blood clot forms in an artery. Venous thrombosis occurs when a blood clot forms in a vein. When a clot forms inside one of your veins, it may dissolve on its own. However, sometimes a clot doesn't dissolve on its own, or part of it breaks off and travels elsewhere in your circulatory system. When this happens, the blood clot may get stuck elsewhere and restrict blood flow, known as embolism. These situations can be very dangerous and even life threatening. According to the Centers for Disease Control and Prevention (CDC), 1 in 2 people don't experience any symptoms when they have a deep venous blood clot. When symptoms do appear, it's important to get immediate medical attention. ​ Medical emergency A blood clot may be a medical emergency and life threatening if left untreated. Call 911 or go to the nearest emergency room immediately if you or someone you're with experiences symptoms of a serious blood clot, such as: sudden shortness of breath chest pressure difficulty breathing, seeing, or speaking ​Call a doctor or seek medical attention if you experience throbbing, swelling, and tenderness in one body part.  

Hey Friend, For those that haven't been following along, I have been struggling with symptoms of Pelvic Venous Disorder or PeVD or better known as, Pelvic Congestion Syndrome, for the last year.  It all started with an ovarian cyst like pain, but I later learned that my “menstrual cramps” I was feeling on and off throughout the month, not just during my menses, was also due to these enlarged veins.  The heaviness and cramping was starting to get so uncomfortable that standing or sitting for too long was painful, and even exercise started to become painful.  Thankfully sex was never painful, but painful intercourse or dyspareunia, especially pain or cramping with and after arousal or orgasm, is a very common symptom of PeVD.  I was not a typical presentation for this diagnosis, so it surprised me when I found out from an ultrasound.  So I share my story so that others with pelvic pain, constipation, heaviness, sharp abdominal pain, low back pain or pain with sitting, standing, or exercising, can start to become aware of this diagnosis and advocate for yourself.  As many gynecologists do not believe this condition is a cause of pain…. And I can tell you… it most definitely IS!   After two procedures using coil embolization and sclerotherapy to close off the dysfunctional varicose veins in my pelvis, it was identified that a compression of my Iliac vein was pretty severe and needed to be treated with a stent.  I am two weeks postop and recovery has been a journey.  Many things I was not expecting, so again, I wanted to share with the World so that maybe you can feel more prepared and aware of the treatment options out there for you! Thanks for following along on my health journey and sending all the love and supporting messages, it has meant a lot!  As always, if you are experiencing any pelvic floor/women's health issue like urinary incontinence/leaking, pelvic pain, pain with sex, urgency, heaviness/prolapse or any other back/hip/joint pain let's get you booked for a virtual coaching session or in person physical therapy session for a more individualized plan and one-on-one instructions so you can feel confident in your body and start healing today!!    Make Sure to reach out to> PTDes@balancedmomtality.com  AND/OR Join my FREE Facebook community for ACCOUNTABILITY and a safe and supportive place to share and support each other!> https://www.facebook.com/groups/1696216757461633/    Join my VIP Insider group and receive my Newsletter full of great tips and tricks and upcoming resources! > https://newsletter.balancedmomtality.com/   Follow and get tips/tricks on:  Facebook> @thebalancedmomtality Instagram> @the_balanced_momtality   Learn > www.balancedmomtality.com