Do you have symptoms such as leg pain and swelling, swollen arms and legs, or varicose veins in the legs or arms?
Do you think you have a blood clot deep within your legs?
Narrowing or closure of a vein?
Or impaired blood flow?
Are you looking for a solution that won’t
require invasive surgery?
Call Dr. Hollander to discuss how YOUR life can
be changed today!

Vascular Intervention Treatments 

for various conditions and their subsequent procedures

Remarkable Treatment Will Save You from Amputation

     PAD, Peripheral Arterial Disease, is characterized by narrowing or blockage of the arteries that carry oxygenated blood to extremities such as the limbs, head and internal organs. This blockage, called atherosclerosis, is caused by fatty buildup, plaque, that impedes upon normal blood flow. When arteries are blocked, your body begins to deteriorate, causing stroke, amputation and even death. PAD is predominant in men and women above 40 with a variety of risks and predispositions:

Risk Factors

Smoking

Aging (most common over the age of 50)

Obesity

Race (more prevalent in Hispanics and African Americans)

Predispositions

Diabetes

Hypertension (high blood pressure)

Excess Blood Cholesterol

Existing Heart Disease

Kidney Disease

If you experience any of the following progressive vascular disease symptoms and signs, call Dr. Hollander to get a proper diagnosis and discuss treatment: 

  • ‍Muscle cramping in the lower extremities (calves, thighs, hips)
  • Intermittent claudication
  • Prolonged aching in the muscles that do not subside, even at rest
  • Toe, foot or toenail wounds that are slow to heal or do not heal at all (could eventually develop into ulcers)
  • Cold feet and/or legs (due to loss of temperature)
  • Color changes to legs, feet and toes (paleness or blueness)
  • Weak pulse in the legs or feet
  • Buttock pain
  • Hair loss on the legs
  • Thinning of leg skin
  • ED (erectile dysfunction) in men

Early signs of PAD

Because many of the symptoms of PAD go undetected or mimic other conditions, it may be difficult to detect PAD until it begins to manifest. Avoiding many of the risk factors, like smoking and obesity by cessation and exercise will stop the disease before it starts.

Click here for more information on what happens when PAD is left untreated....
What happens when PAD is left undiscovered, undiagnosed, and untreated?

Ischemia

Amputation

Stroke





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Diagnosing Peripheral Arterial Disease

Upon coming to the office, Dr. Hollander will ask you a few questions and go over your family history and lifestyle. This will help rule in or out any of the risk factors and predispositions.

physical examination will be conducted to check for weak pulse in the legs and feet, as well as any visible wounds or ulcers.

Other non-invasive exams and measurements include:

Ankle-brachial Index (ABI)
Duplex Imaging (Doppler and Ultrasound)
Intravascular Ultrasound (IVUS)

Treatments of PAD

Angioplasty and Stenting
Atherectomy

Facts and Stats on PAD
  • African Americans are twice more likely to develop PAD than Caucasians.
  • Approximately 2,000 people across Atlantic County will develop PAD in the coming year.
  • Smokers increase the onset of PAD by 10 years (as early as 40 years of age)!
These are just statistics! Together, with Dr. Hollander, you can change the quality of your life and ensure optimal health easily and non-invasively.

Get to know more about PAD risks, diagnosis, treatments and facts by following each link!

Want to schedule a visit to discuss your symptoms?
Schedule Me!

Things You Need to Know About Renal Failure and Dialysis

     Your blood is a highway, sending and receiving, going and coming, complete with inbound and outbound trips. This filtering system allows you to not only send vital nutrients and minerals to your entire body, but also transports and relieves the body of wastes through a process called diffusion.   When your kidneys cannot filter fluids through the blood, the buildup can be toxic and life-threatening. A vascular doctor provides a much needed detour for your blood system, creating vascular access (called dialysis access) by connecting a vein and an artery together (called a fistula) before extraction and cleaning via a dialysis machine, a dialyzer. This renal replacement therapy is beneficial for comfort and sustainability and is a major player in the strategies used by both your surgeon and nephrologist, who place the fistula and perform dialysis, and Dr. Hollander, who maintains and manages the upkeep of the fistula.

Who needs dialysis access?

Risk Factors

Smoking

Aging (most common over the age of 64)

Obesity

Race (more prevalent in Native Americans, Asian Americans and African Americans)

Excess exposure to some toxins

Predispositions

Diabetes

Hypertension (high blood pressure)

High Cholesterol

Existing Heart Disease

Kidney Disease

Liver Disease

Peripheral Arterial Disease (PAD)

Lupus erythematosis

Sickle Cell disease 

Read on to find out causes and symptoms of renal failure...


Causes and Symptoms of Renal Failure
 

If you experience confusion, lethargy, shortness of breath, blood in the urine, anemia, insomnia and/or fatigue (amongst other symptoms of renal failure), and you suffer from any of the risk factors and/or predispositions mentioned above, consider speaking to your nephrologist to see if you are at any stage of renal failure. Renal failure has many causes, including but not limited to: heart attack, infection, use of some pain relievers (like aspirin and ibuprofen), kidney inflammation,  severe burns or dehydration and anaphylaxis. 

So you have renal failure. What next? 

After your nephrologists diagnoses you with renal failure, and months before dialysis begins, an arteriovenous fistula is created. This connects the vein and the artery together and provides good vascular access for years. A pre-treatment is performed, vessel mapping, that uses a dye to illustrate where your veins are. This will allow for proper placement of your fistula. The time it takes for a new fistula to mature, called the fistula maturation, depends on your body and can take several weeks. A fistulagram may be ordered after fistula placement to monitor blood flow rates, venous pressure as well as detect any difficulties at the site of access, called intravenous (IV) cannulation. If immediate dialysis is needed or if the fistula does not take, you may undergo treatment using a hemodialysis catheter, which will re-route
blood flow for cleaning until your fistula is ready to be used.
 

Complications of Dialysis Access and Treatments 

Although placing a fistula is the most efficient way of re-constructing vascular access, complications can arise that can give way to infection, bleeding, aneurysm, clotting and/or narrowing of the vessels. Luckily, Dr. Hollander, your professional vascular doctor, can maintain proper functioning of your vascular access so that you can continue on in your dialysis journey.

Angioplasty and Stenting
Thrombolysis/thrombectomy


The importance of Dialysis Access

When your kidneys cease normal functioning, the nausea, itchiness and lethargy may turn into labored breathing and muscle weakness. You may develop permanent kidney disease which will require a lifetime of dialysis and/or total kidney replacement. This will result in weekly 3-4-hour long dialysis sessions with your nephrologist and/or waiting on a matching donor. Renal failure will eventually lead to death if left untreated. Dr. Hollander provides minimally invasive dialysis access procedures to ensure a failing kidney won’t kill you. 

More on Dialysis Access and Renal Failure  

  • Foods low in potassium, like grapes, cabbage, apples and strawberries, will help decrease adverse effects of a failing kidney.
  • Over 600,000 Americans have had a kidney fail according to the United States Renal Data System.
  • Fistulas are a preferred intervention method over grafts due to its longevity and lower risk of infection in certain patients and patient profiles.
Don’t overlook symptoms! Kidney failure can go undetected until it is too late but you can prevent it by having an active, healthy lifestyle.
Want to schedule a visit to discuss your symptoms?
Schedule Me!

Deadly Deep Vein Thrombosis and Intervention That Will Help You

      Probably the deadliest venous problem one can encounter is deep vein thrombosis (DVT). DVT usually develops in the legs, deep pelvic veins, and other lower extremities but can form in any vein as a result of one or more of a myriad of clot-causing factors. The clot that ensues during this condition is life-threatening. Deep venous thrombosis turns your veins into canons, shooting out an embolus that can lodge into the lungs, heart or brain, causing serious damage. Thrombosis comes in two forms: acute and chronic. The difference between acute and chronic deep vein thrombosis is the length of time a clot has existed in the vein. The more chronic the clot, the more damage it causes to the surrounding vessels and the higher the risk of embolism.

Risk Factors

Pelvis/leg fractures

Pregnancy

Obesity

Injury to veins

Birth Control/Oral Contraceptives

Smoking

Indwelling catheter

Age (Over the age of 60 increases risk)

Immobility (sitting for long periods of time, bedrest)

Predispositions

Family history of blood clots

Cancer

Heart Failure

Lupus and other autoimmune disorders

Inflammatory Bowel Disease

Type A blood group

Read on for more information on diagnoses and treatment...

Symptoms of Deep Vein Thrombosis

  • Redness of the skin
  • Edema of the legs (swelling)
  • Pain in the leg
  • Warm skin

If you have an acute DVT or blood clot in your legs, Dr. Hollander can access the vein in your leg and remove blood clot with various techniques to prevent the clots from traveling to your lung arteries, called a pulmonary embolism. If you have any complicated symptoms such as chest pain, coughing up blood, dizziness and fainting, and/or rapid pulse, you need to get to a hospital.

Diagnosing DVT

Because DVT is so dependent upon history of disease, surgeries and conditions, Dr.
Hollander will ask you a few questions about your symptoms and any occurrences that may have caused clotting. 

physical examination will allow Dr. Hollander to see any redness, swelling and discoloration of the skin.

Other non-invasive exams and measurements include:

Blood Test
Duplex Imaging (Doppler and Ultrasound)
Venogram

Treatment and Drugs for Deep Vein Thrombosis

Anticoagulation medication, like heparin, Coumadin, and others are used to thin out the blood and dissolve clots. For more serious clots, a thrombolytic may be prescribed at an intensive care hospital. Surgical procedures like the ones described below are the last resort, but often helpful to save your life.

Angioplasty and Stenting
Thrombolysis/thrombectomy
Vena Cava Filter

Home Remedies for DVT
  • If you are on a blood thinner, like warfarin, you must limit your Vitamin K intake as it decreases the positive effects of the drug.
  • Keep your doctor appointments to test for clots in the blood. 
  • Don’t be a couch potato! If you keep moving so will your blood; clots are less likely to form this way.
  • Compression stockings may also be used to increase blood pressure in the legs, increasing blood flow while decreasing clot complications.

Always check with Dr. Hollander before taking up a home treatment for deep vein thrombosis.

Did You Know… 

The critical time for positive intervention of a newly formed clot is less than 2 weeks? Ignoring the signs and symptoms of DVT can complicate the situation, costing you more discomfort.

Want to schedule a visit to discuss your symptoms?
Schedule Me!

Drowning in Blood from Chronic Venous Insufficiency

     Inadequate blood flow to and from your heart can cause your blood to pool within the veins of your legs. Normal blood flow allows for blood to travel from your heart to your extremities via arteries and then make its way back to the heart through the strong force of pumping veins. With a condition like chronic venous insufficiency, the veins are weak or obstructed and cannot push blood back up to the heart. The swelling that ensues will be the literal effect of your veins drowning in its own blood!

Risk Factors

Smoking

Gender (more prevalent in women)

Age (more prevalent in women 40-49 and men 70-79)

Obesity

Pregnancy

Leg Injury

Immobility and Sedentariness

Predispositions

Cancer

Phlebitis (swelling of superficial vein)

High Blood Pressure

Varicose Veins

Family history of venous problems

Signs and Symptoms of Venous Insufficiency 
  • Weak legs
  • Edema (swelling in the ankles and/or legs)
  • Discoloration of skin in ankles and/or legs
  • Varicose veins
  • Spider veins
  • Leg cramps or heavy feeling in the legs
  • Leg ulcers or wounds that are slow to heal or don’t heal at all
  • Pain in legs is only relieved while legs are elevated
Click here for more information on venous insufficiency facts and statistics...
Diagnosing Chronic Venous Insufficiency
Once in the office, Dr. Hollander will ask you a few questions and go over your medical history in its totality to document your risk factors and predispositions.  

A physical examination, called Chronic Venous Insufficiency (CVI) Testing, will be conducted to test your blood flow.

Other non-invasive exams and measurements include:

Duplex imaging (Doppler and Ultrasound) 
Venogram

How to Treat Venous Insufficiency

Chronic venous insufficiency will move to minimally invasive surgery when elevation, compression techniques and medications are not effective enough. This is to prevent ulcers from developing and severe swelling. Some procedures include:

Angioplasty and Stenting
Vein Ablation
Sclerotherapy

What happens if you don’t treat venous insufficiency?

Avoiding treatment of your chronic venous insufficiency may result in the escalation of venous problems as well as snowball into other serious vein issues. Untreated varicose veins may lead to increased pain, hyperpigmentation, ulcers, bleeding and swelling as well as the more serious complication called deep vein thrombosis. Dr. Hollander’s expertise will help eradicate CVI before it creates even larger complications. 

You don’t have to suffer from venous insufficiency! 

It is true that over 25 million Americans suffer from varicose veins and other complications caused by venous insufficiency but with a good diet, regular exercise, no smoking, and decreased dormant movement, you can steer clear of those chances. 
Want to schedule a visit to discuss your symptoms?
Schedule Me!

Unrelenting Back Pain from Osteoporotic Vertebral Body Compression Fracture; A Curative Solution Without Surgery

     Osteoporosis is characterized by a low bone mass, due to hormonal changes, old age and a host of other risk factors that can lead to increased bone fractures of the spine. Fractions of the vertebral bodies of the spine can cause agonizing pain and immobility leading to prolonged bed rest, making Interventional vertebral procedures highly sought-after treatment. Kyphoplasty is spine fracture stabilizer that uses a balloon to restore fractured vertebral height and create a channel for cement fixation. This minimally-invasive medical procedure allows for the reduction or cessation of pain, many times immediately following the intervention, by depositing a special cement into the vertebral column.

Risks

Low likelihood of Bleeding

Infection

Cement leakage

Nerve damage

Allergic reaction to medicine

Benefits 

Increases mobility

Decreased or relief of pain 

Minimally invasive - no surgical incision

Proven safe and effective

Quick recovery time (within 24 hours)

No physical therapy or rehabilitation needed

Risk Factors and Predispositions
  • Smoking
  • Gender
    (women are more prone)
  • Age
    (elderly are more prone)
  • Body size (thinner weight is a risk)
  • Ethnicity (Asian and Whites have
    the highest risk)
  • Family History
  • Lack of exercise
  • Overuse of alcohol
  • Some medications decrease bone
    mass
  • Anorexia nervosa
  • Low estrogen/testosterone levels
Click here for more information on symptoms and signs...
Talk to Dr. Hollander about your back-pain symptoms and he’ll decide if vertebral augmentation is right for you. Generally, even less invasive measures like bed rest, pain medication, and/or a back brace is recommended before this surgical procedure is ordered. Discuss some common reasons why people suffer from osteoporosis and the subsequent uses for kyphoplasty:
  • Some metabolic disorders
  • Long-term steroid treatment
  • Malignant tumor that causes a compression fracture in
    the spine
  • Impaired bone healing due to fragility and/or old age
Early signs of Vertebral Bone Fracture

Waiting too long for a diagnoses and treatment plan for your back pain can lower your chances of restoration. Kyphoplasty has a higher probability of success when performed
within 8 weeks of an acute fracture. 

How does the kyphoplasty procedure work? 

See below.
Diagnosing Osteoporosis

Once in the office, Dr. Hollander will ask you a few questions and go over your medical history in its totality to document your risk factors and predispositions.  

A physical examination, will be conducted to check for weaknesses in the spine. Blood tests may also be ordered.

Other non-invasive exams and measurements include:

Magnetic resonance imaging (MRI)
Radioisotope bone scan
Computed tomography (CT)


Facts and Stats on Osteoporosis
  • 1/3 of women in the world will suffer from osteoporotic fractures compared to 1/5 of men worldwide.
  • Every 3 seconds, someone fractures a bone due to osteoporosis.
  • The risk of vertebral and other bone fractures is as high a risk as cardiovascular disease: around 40%.
These are just statistics! Together, with Dr. Hollander, you can alleviate pain in your back and restore full function in a matter of days!
 

Get to know more about how kyphoplasty works, the preparation involved before surgery, and the prevention of osteoporosis and statistics, by following each link!
Want to schedule a visit to discuss your symptoms?
Schedule Me!

Ask The Doc! 

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Getting to Know Dr. Hollander

Interventional Radiology Testing

Ankle-brachial Index (ABI)

This simple test compares the blood pressure in your arm to your legs. Significantly higher blood pressure in the lower extremities could mean narrowing of the arteries in that area. 

Blood Test 

D dimer is what your body produces to dissolves clots naturally. A blood test will show an elevated concentration of this chemical and signify some significant clots in your system.

Chronic Venous Insufficiency Testing (CVI Testing)

Testing for venous insufficiency calls for the measurement of venous refill and/or venous outflow; which tests how many seconds it takes for arterial blood to reach venous circulation and/or detects any obstruction. This is useful in determining if the veins in your legs are pumping sufficient blood back to your heart.

Computed tomography (CT)

This type of x-ray system creates cross-sectional images of blood vessels, internal organs, soft tissue and bone using ionizing electromagnetic radiation.

Duplex Imaging (Doppler and Ultrasound)

A common method that helps visualize the arteries and measure blood flow using sound waves. The Vascular Access Center of Mays Landing is a certified Vascular Lab performing detailed ultrasound of the arteries and veins.

Intravascular Ultrasound (IVUS)

Intravascular Ultrasound, real time ultrasound inside blood vessel, is an ultrasound apparatus placed on a catheter which picks up images via sound waves as it travels through the vascular system. IVUS is helpful in showing plaque formation on the arterial and venous walls and helps Dr. Hollander understand how your vessels undergo change before and after treatment.  Because Intravascular Ultrasound provides detailed imagery, doctors are able to see the vessel area, lumen area and plaque area in real time, which is helpful in determining vessel diameter for teaching and intervention purposes. IVUS is a minimally invasive yet advanced form of medical technology, providing the best imagery for detection and evidence of vascular disease in the extremities.

Magnetic resonance imaging (MRI)

Multiplanar imaging of a patient’s body is formed by energy absorbed from radio pulses that send radio signals to and from the nuclei of all hydrogen atoms, which align in the magnetic field of the system.

Radioisotope bone scan

Using a radioactive material that collects in the bones, a nuclear image of the bones is formed.

Venogram

An intravenous (IV) contrast dye is injected into your veins, allowing the blood vessels to
better show on an X-ray. Doctors can then assess if your veins and arteries are pumping at optimal levels.
stethoscope, interventional radiology testing

Treatments & Procedures

Angioplasty and Stenting

To help open a blocked blood vessel, Dr. Hollander can perform a non-invasive angioplasty and stent procedure. This will prevent the affected artery/vein from closing. During this procedure, you will be awake, as this method only requires a pin prick incision. Imaging helps guide a balloon catheter through this microscopic incision to the blocked area, where the balloon is inflated. Oftentimes, a metal cylinder or wire mesh tube, called a stent, is then placed in this newly widened area to ensure the vessel does not close again.

Atherectomy

To aid in removal of plaque that has formed in a blocked artery/vein, a catheter with a sharp blade is threaded through a needle puncture in the skin to the affected vessel. The plaque is collected then carried away from the blocked area during this minimally invasive procedure.

Kyphoplasty

After the spine has been fractured, bone fragments can press against the spinal cord or rub against the column in a painful way. During balloon vertebroblasty, a hollow needled is guided through the vertebral body to the area of fracture, using image guidance. The balloon is inflated to create room for the cement mixture to be injected and then removed. The cement fuses the bones together, which strengthens the vertebrae and alleviates the pain. This is all done under local anesthesia.

Sclerotherapy

This chemical therapy uses an injection to render the affected vein useless, allowing it to be absorbed by the body. Other, proficient, veins in that area will instead be used in blood flow.

Thrombolysis/thrombectomy

It is common for excessive thrombocytes to build up during the natural process of clotting after a fistula has been formed. Clots can also form as a direct result of a problematic vein issue, as seen in deep vein thrombosis. Thrombolysis is the process by which a catheter is used to bring platelet-dissolving medicine, a thrombolytic, to the affected site. Thrombectomy uses a catheter to physically crush and/or remove the buildup.

Vein Ablation

Vein ablation treats the varicose vein that results from venous insufficiency. This method cauterizes the affected vein with laser energy or radio waves.

Vena Cava Filter

A filter can be placed in the vein leading to your abdomen, vena cava, and this will catch any floating embolus and stop it from impacting the organs that work to keep you alive.
syringe health interventional radiology procedures treatments