Welcome

Welcome to the Vascular Surgery and Vein Center, a comprehensive vascular practice providing state-of-the-art care to patients throughout the tri-state area. Under the direction of board-certified surgeon Dr. Norman Chideckel, we utilize our advanced skills and many years of experience to help patients achieve clear, beautiful and healthy legs.

With our office conveniently located in Manhattan, Dr. Chideckel offers patients a wide range of services to treat varicose and spider veins, deep vein thrombosis, and other vascular conditions, including:

Dedicated to helping patients achieve their desired results through the most effective and minimally invasive treatments available, Dr. Chideckel and his staff take the time to talk with each individual patient and address any concerns or questions they may have before undergoing treatment. Your comfort and satisfaction are among our top priorities.

To learn more about the services provided by Dr. Chideckel, please contact us to schedule an appointment. We always welcome new patients and look forward to meeting you.

Call us today at 212-993-6133 to schedule an appointment.


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Category Archives: top vein surgeon nyc

Treatment of Varicose Veins

treatment-varicose-veins-nyc-top-specialist-dr-chideckel-01Fortunately, treatment of varicose veins doesn’t include a hospital stay or a long, painful recovery. There are many routines you can add to your day that will help reduce the appearance of varicose veins and prevent new veins from surfacing. For those veins that are beyond your control or may be causing pain or restless legs, there are safe ways to eliminate these veins safely. There are several minimally invasive procedures for varicose veins that can be treated on a routine doctor’s visit.

A Few Things You Can Do On Your Own

Practice healthier behavior by adding exercise to your week. Movement will help your muscles do their job in contracting to assist your veins in blood flow. Exercise helps improve circulation and breaks the cycle of standing or sitting for long periods of time. If you are a smoker, you may want to consider quitting. Smoking has negative effects of your blood circulation. This could help to prevent future veins popping up.

how-to-get-rid-varicose-veins-treatment-options-nyc-vascular-surgeon-02Avoid tight fitted clothing that hinders your movement. If your jeans are too tight, they may actually be adding to harmful pressure on your veins, causing varicose veins. While some tight clothing can make veins worse, compression stockings are options to improve the look of your legs. Wearing compression stockings all day is usually the first treatment method to try before moving on to other options. They progressively squeeze your legs just enough to help the veins transport your blood more efficiently.

Medical Treatments

If your body is not responding to the self-care methods, or your condition is more severe, you have several options of varicose vein treatment that can be done in the doctor’s office.  These are all common and safe procedures to choose from when wanting to get rid of your visible unattractive veins.

Sclerotherapy is a procedure in less than an hour in your doctor’s office.  It is a common and safe procedure that does not require anesthesia. The vein doctor injects a solution into the smaller varicose veins, just under the surface of the skin. That injected solution scars the vein and it closes. The vein will not be functional for blood flow since it is sealed shut, though your blood will be rerouted to healthier veins.  You will see results from Sclerotherapy within weeks as the vein fades from visibility.

nyc-vascular-surgeon-varicose-veins-03Doctors use laser treatments to close off smaller varicose veins and spider veins. Endovenous laser treatment is an outpatient procedure that uses light energy to zap your vein closed. Your doctor inserts a thin fiber with a laser into the vein and the heat from the laser then destroys the vein. Results will be seen within a few weeks as the vein is absorbed by surrounding tissue.

Ambulatory phlebectomy is when your doctor removes the smaller varicose veins through a sequence of tiny skin punctures. The parts of your leg that will be receiving these tiny punctures will be numbed in this outpatient procedure. Scarring is usually minimal.

If you would like to learn more about your treatment options, contact us today to schedule an appointment with Dr. Norman Chideckel for the treatment of varicose veins.

Are Varicose Veins Dangerous?

Many people want to treat varicose veins due to cosmetic reasons, but there are many more reasons apart from their unsightly appearance to treat these blemishes on your skin. Varicose veins that are left untreated can cause mild to severe symptoms, depending on the person, and can even become life-threatening.

Lipodermatosclerosis

If the tissues within the skin are swollen or inflamed for a long period of time, it may cause Lipodermatosclerosis, which is an inflammation of the subcutaneous fat. This usually occurs due to venous insufficiency, which is what varicose veins cause due to insufficient blood flow through the veins. The legs may feel sore and swollen and the tissue will feel hard around the leg. This can cause many other conditions such as edema.

Deep Vein Thrombosis (DVT)

This is the most severe condition caused by varicose veins, hence why they should be treated. Many patients complaining of a “pulling sensation” in their leg and this is caused by a blood clot due to the build-up of blood in the vein. If this blood clot travels up further in the body, especially to the heart, lungs or brain, it can cause life-threatening injuries, as insufficient oxygen is delivered.

Hyperpigmentation

When varicose veins are left untreated for a long period of time, it can cause excess blood to leak into the tissues of the affected area. This will cause painful inflammation and swelling of the tissue and the skin can become discolored and dark. Once hyperpigmentation occurs on the skin, it can be hard to get rid of. Although usually medically harmless to the body, it can cause body confidence issues for many people.

Superficial Thrombophlebitis

Superficial Thrombophlebitis is another inflammatory condition caused by a blood clot in the veins beneath the skin. This affects the vein more than the surface of the skin, although the skin may become red around the affected area. The vein may feel very sensitive to touch, which can cause ongoing discomfort. Left untreated, this can cause other complications such as cellulitis, which is a skin infection caused by bacteria.

Leaving varicose veins untreated can cause many other problems within the veins and surrounding tissues. Many problems that occur are very similar and it can be hard to know which one you are suffering from.

Getting treated for varicose veins is always the safest option, so schedule an appointment with the best varicose vein doctor in NYC today.

Call us today at 212-993-6133 to schedule an appointment with the best Varicose vein treatment doctor in New York City.

Raynaud’s (Cold Intolerance)

During this cold winter that we have been experiencing, I would like to take this opportunity to highlight the issue of cold intolerance, also known as Raynaud’s.

Vasospasm

Raynaud’s (vasospasm) is the body’s response to stress or a traumatic event.  It may be a freestanding problem, also known as Raynaud’s disease, or may be a secondary reaction to an underlying medical problem, known as Raynaud’s phenomenon.

Is more common in women, and families, and those people living in colder acclimates.  It will feel as if you have lost the circulation in your hands or feet, but in fact the reason for this feeling is due to vasospasm, and not lack of circulation.  Vasospasm is the regulation of blood flow, and as a result of the stress the body’s protective mechanism will dilate those blood vessels that supply essential portions of the body (heart, liver, brain, kidneys, etc.),  and constrict the blood vessels that feed into the periphery (tips of the fingers, tips of the toes, lips, nose, and ears).  When the stress has passed there will be a re-dilatation to the blood vessels in the periphery.  Hence, the associated color changes; white, then blue, and upon rewarming red.  There may also be associated symptoms of numbness, throbbing, tingling, and or swelling.

Raynaud’s diseaseraynauds_disease

The most common type is Raynaud’s disease, without an identifiable underlying medical condition.

Raynaud’s phenomenon or secondary Raynaud’s, will occur as the result of an underlying medical condition, and may occur later in life.  Several of these medical issues include: Thyroid disease, lupus, scleroderma, rheumatoid arthritis, and carpal tunnel syndrome.  Other factors that contribute include; smoking, repetitive stress injuries, and/or vibration (such as use of power tools and jackhammer’s).  Certain medications have also been linked to these symptoms, and these include the beta blockers, used to treat hypertension, medications used to treat migraines, and medications that are used to treat attention deficit disorder, and hyperactivity.

Diagnosis

When first diagnosed is important to have a thorough medical workup, to determine if there is an underlying issue which can be treated.  Once this treatment begins, very often the symptoms will resolve.

Treatment Of Raynaud’s Disease

In general local measures are recommended as the mainstay of treatment.  Keeping the area warm, by using mittens instead of gloves on the hands, and heavy woolen socks on the feet to protect the toes.  Try to get indoors as quickly as possible into a warmer environment.  Massaging your hands and feet will be of benefit, wiggling the fingers and toes may also be beneficial.  Using hot water on the area affected would be more detrimental; however, using warm water from the tap will help in the rewarming process.

raynauds_disease

Other measures to help reduce the symptoms would include cessation of smoking, exercise, and controlling stress.

The goals of treatment are to reduce the severity of attacks, prevent tissue damage, and if applicable to treat the underlying medical condition.  No one medication as a treatment has had any great success.  However, certain medications have been used including nifedipine, Norvasc, Minipress, Cardura, Cozaar, and even Viagra.  Use of local nitroglycerin cream to the toes or the fingers may help dilate the local blood vessels in the area.  However, the use of any of these medications must be discussed with your medical doctor.  As they all have potential side effects.

There are those medications that may worsen the symptoms, including beta blockers which are being used to treat high blood pressure, including Lopressor, Toprol, Corgard, and Inderal.  Over the counter cold remedies which include pseudoephedrine should also be avoided.  Excessive alcohol consumption should also be avoided, as it initially may cause a vasodilatation, but then cause a rebound in the vasospasm, making the symptoms feel even worse.

Other options for treatment may include use of fish oils, biofeedback, acupuncture, and where applicable local nerve blocks to maintain the vessels at maximum dilatation.

What causes a swollen leg?

Causes of Swollen Leg

Swollen LegThe potential causes of the swollen leg are many. Is the swelling occurring in both legs or is only one leg affected. Swelling of both legs is more likely due to a “central” cause. This may include, medications, as some medications may cause fluid retention in the area of theankles, most notably the antihypertensive medication- Norvasc. Underlying medical issues of the heart, liver, or kidneys, or thyroid may also cause fluid retention. Inflammatory reactions as result of lower back issues, such as spinal stenosis or arthritis, may cause swelling which again will occur most frequently at the area of the ankles, as it is the most dependent area of the body.

Only One Leg

When only one leg is affected, then local causes must be evaluated. Venous thrombosis (blood clot) causes swelling of the lower extremity as the clot blocks the return of blood flow back towards the heart. Venous insufficiency, varicose veins can also cause swelling of a leg as a result of the blood flow refluxing back down the leg. These issues are usually associated with heaviness, throbbing, and a tired and achy leg.

“Baker’s” cystBaker's Cyst

A “Baker’s” cyst commonly known as a pop liteal cyst which causes compression in the area behind the knee may present as a swollen leg. This issue is more common in people with underlying knee issues, such as arthritis or cartilage damage. When the cyst ruptures there may be acute swelling that affects the back portion of the calf. When the cyst enlarges it may cause pressure on the vein known as the popliteal vein in the back of the knee. This has also been known as “pseudo-“ thrombophlebitis. Arthritis of the hip or knee to again to this inflammatory reaction may also present with swelling.

Lymphedema

Lymphedema, where the lymph channels of the lower extremity are not working Lymphedemaeffectively in returning lymph fluid back towards the heart, may also cause swelling. This could be primary lymphedema, without any underlying medical condition, or secondary lymphedema, occurring as a result of a compressive force on the lower extremity. This topic will be discussed in the future blog. The most informative test to start the evaluation process is a venous duplex ultrasound, also known as sonogram with Doppler, which will define if there is an underlying vein problem or thrombosis as the source of the swelling, and often times will diagnose the presence of this Baker’s cyst. These are just a few possible causes of swelling of the lower extremities. Empirically use of a support or compression stocking would be beneficial just to deal with the issue of the swelling. A thorough investigation by your medical doctor is crucial in sorting through this issue.

If you have any questions about a swollen leg due to Lymphedema or a Baker’s cyst, please call NYC’s top varicose vein doctor Dr. Norman Chideckel at 212-993-6133 today.

 

NYC top vein surgeon talks about Vein Damage with Exercise

Potential Vein Damage With Exercise

In a past blog, I addressed the question as to the use of support stockings during exercise.  As mentioned there has not been any proven scientific benefit to the use of support stockings during exercise, however, there has been evidence that using support stockings after exercise, during recovery, is beneficial.  These seem to help with muscle recovery after aerobic activities.

I observe people working out at the gym, and as a vascular surgeon I have had the opportunity to evaluate patients at my office, who have sustained exercise related vein damage.

Firstly, with regards to upper extremity exercises, hyperabduction -or pulling the shoulders too far back, with weight lifting can cause a “scissoring” of the vein under the clavicle (collarbone).  With repetitive motion, this may lead to an obstruction, or blockage, of this vein, causing swelling of the arm, and potential fatigue of the arm during daily activities.  This issue has been mentioned in the previous blog with regards to varicose veins of the upper extremities.Vein Damage

Secondly, with regards to lower extremity exercises, using excessive weights-pushing to and past the limit-can lead to venous blood clots.  Veins are a low flow blood vessel, and excessive pressure, stopping the blood flow for a small amount of time can lead to clotting.  I have evaluated patients who have bench pressed upwards of 1000 pounds with their lower extremities who have developed as a result a venous blood clot.

Excessive straining during exercise may lead to a vein rupture, and or a bleeding episode, usually under the surface of the skin.  It may also lead to the appearance of varicose veins, either of the upper or lower extremity, as the increasing muscle mass, push veins closer to the surface.

Words of caution:

  • Stay hydrated during exercise, with water, in order to maximize muscle performance.  Energy drinks do have added electrolytes as well, and that may be of an added benefit.
  • Try using support stockings after exercise to aid in muscle recovery.
  • Eat a protein load within 30 minutes to an hour after the exercise to prevent muscle breakdown.

Remember that participating in exercise and aerobic activity is to help us stay fit.  Pushing the limits may have more risk than reward.

Varicose VeinsIf you have any questions or desire treatment for vein damage or injury, call Dr. Norman Chideckel, NYC’s top vein surgeon at (212)-993-613 today!