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Phlebitis & DVT Milford Vascular Institute specializes in the diagnosis and treatment of phlebitis and blood clots. What is phlebitis? What is DVT? Phlebitis means inflammation of the vein. Phlebitis can occur in superficial, varicose veins or in deep veins. Patients typically get phlebitis in their legs. The inflamed vein may cause blood clots to form. This is called thrombophlebitis. When phlebitis occurs in deep veins, it is called deep vein thrombophlebitis. Deep vein thrombophlebitis is dangerous and potentially life threatening because the blood clots in the deep veins, called deep vein thrombosis (DVT), could end up breaking off and traveling to the lungs. While superficial phlebitis is rarely dangerous, if left untreated, it could lead to the development of dangerous deep vein thrombophlebitis and DVT. What causes phlebitis? What causes DVT? The cause of superficial phlebitis is unclear. Patients may develop phlebitis after a procedure. It can also develop from a trauma to a preexisting varicose vein.DVT may be caused by prolonged inactivity, paralysis, some types of cancer, birth control containing estrogen, genetics, trauma to the inner wall of a vein, or any condition that slows blood flow. Call Now Call Now What are the symptoms of phlebitis? What are the symptoms of DVT? Superficial phlebitis tends to present as redness along the path of a vein. Patients tend to experience tenderness at the site of the inflammation. The affected area may feel warm to the touch or the patient may have a low grade fever. The patient may experience itching or burning. Finally, if clots have formed, the vein may feel hard. Symptoms of DVT are swelling of the affected extremity, warmth, or redness. However, DVT may sometimes be present without any symptoms at all. How is phlebitis/DVT diagnosed? Superficial phlebitis is diagnosed by a physical examination. DVT is diagnosed with an ultrasound or CT scan. How do you treat phlebitis? How do you treat DVT? Superficial phlebitis typically resolves quickly. The providers will tell you to elevate your leg when possible and to use warm compresses on the affected area to ease discomfort. If you have compression stockings, your provider will recommend wearing them. Also, if you are able, your provider will recommend taking an over the counter anti inflammatory, like ibuprofen, to alleviate pain. DVT requires medical diagnosis and treatment. When diagnosed, your physician will start you on an anticoagulant, more commonly called a blood thinner. Depending on the size and location of the blood clot, your doctor may have to intervene surgically to break up the clot. Never hesitate to contact the office if you believe you may be suffering from either of these ailments. The symptoms for these conditions may present very similarly. It is always better to have an ultrasound diagnose superficial phlebitis than to misdiagnose a potentially fatal blood clot. Call (203)882-Vein

MVI is a private vascular practice located in Milford, Connecticut specializing in the treatment of varicose veins, leg swelling, and vascular disease. Vascular Specialists We at Milford Vascular Institute are a group of individuals who come together as a team to provide comprehensive, state-of-the-art care for patients suffering from all aspects of vascular disease. Meet our Providers Varicose Vein Treatments Our procedures for treating venous insufficiency, the condition which causes varicose veins, are quick and easy. They require little to no downtime and are performed in our office located in Milford, CT. Learn More State-of-the-Art Technology Our team is always looking for ways to improve our services. We stay up-to-date on cutting edge procedures and technologies with the intent of always improving our patient experience. Our Services About MVI About MVI Milford Vascular Institute provides multidisciplinary care for all aspects of vascular disease. We are located in the lively seaside town, Milford, CT. Milford is located between New Haven and Bridgeport. Our office is easily accessed from I-95 and the Merritt Parkway. The team of specialists at Milford Vascular have more than 70 years of combined experience in the treatment and prevention of vascular disease. Led by our Cardiac, Thoracic and Vascular surgeon, Dr. David Esposito, and Interventional Radiologist, Dr. Paul Davis, MVI is able to provide a vast array of surgical treatments in office. The initial consultation, diagnostic tests, and definitive treatments are all coordinated and performed through one office. We believe that this streamlined approach offers the patient the most efficient and thorough care with a much higher likelihood of successful outcome. The on-site vascular laboratory provides immediate diagnostic input and allows for close, long-term surveillance. The physicians are trained and skilled in vascular diagnostics and imaging and all the latest vascular therapeutic techniques, ranging from minimally invasive office procedures to complex endovascular and open surgical repairs. Our vascular specialists are easily accessible and provide continuing educational support throughout the entire healing process. We believe that this model of patient care provides a level of service that is unmatched anywhere in southern Connecticut. Read More Do you have venous insufficiency? Take Our Quiz Patient Education Patient Education Resources Click on the links below to learn more about Milford Vascular Institute. SERVICES WE OFFER Our Providers Educational Videos Patient Glossary What to Expect New Patients What to expect at your first visit. ​ Insurance & Cost Estimating your expenses. ​ ​ Before & After's Pre- and post-operative procedure instructions. ​ FAQ's You have questions... We have answers. ​ What to Expect Testimonials WHAT PEOPLE SAY READ REVIEWS & SUBMIT YOUR OWN Rate Us Don’t love it Not great Good Great Love it Rate Us ROBIN Karen and the staff at Milford Vascular were wonderful! Very caring, considerate and did a wonderful job with minimal pain. I am very pleased with all aspects of my care and would definitely recommend them for any vascular concerns. KATHY Karin is professional, knowledgeable and very gentle when administering her procedures. The office staff is very courteous and efficient. Also, patients are seen on time. I highly recommend MVI-you will not be disappointed! MARSHA While I Haven't finished with my treatments yet I can say that I have been treated very well and the staff does everything to make you comfortable and welcome. SUE All of the staff are amazing and truly care about you. I have referred at least 6 if not more people here and they all are very pleased. I only choose the best doctors to go to and this office is one of them! Contact Us You have questions... We have answers. Message us 24/7/365 and one of our team members will get back to you as soon as possible or the next business day. Submit 20 Commerce Park, Milford CT 06460 (203)882-VEIN(8346) (203)876-9720 FAX (203)882-0384 Monday 7:30 AM - 5:00 PM Tuesday 7:30 AM - 5:00 PM Wednesday 7:30 AM - 5:00 PM Thursday 7:30 AM - 5:00 PM Friday 7:30 AM - 5:00 PM Contact

Angiogram Milford Vascular Institute performs angiograms at our Outpatient Based Laboratory to diagnose peripheral arterial disease. What is an angiogram? An angiogram is a diagnostic test that uses x-rays to take pictures of your blood vessels. A long flexible catheter is inserted through the bloodstream, usually from the groin, to deliver contrast dye into the arteries making them visible on the x-ray. Why do I need to have an angiogram? Having an angiogram is the best method for diagnosing atherosclerosis in the arteries. Atherosclerosis is the hardening of arteries due to plaque buildup within the walls of the arteries. What can I expect when having an angiogram? (203)882-VEIN When you come in for the procedure, you will be greeted by one of our friendly nurses. She will help you dress and prepare you for the procedure. Then, the CRNA will come in and meet with you to go over the medications you will be receiving and their side effects. Finally, the doctor will come in and discuss the procedure with you one last time. You will then be brought into the operating room. Our medical assistant will begin to prepare you for the procedure and simultaneously, our CRNA will begin to administer the anesthesia. Angiograms are performed under twilight sedation. You should expect to have amnesia after the procedure; you will have no memory of it even happening. After the procedure, we will move you to a recovery room. You will stay in the recovery room for at least 2 hours to allow for the anesthesia to fully wear off. Once our nurse has determined you are fully recovered, you will be able to walk out of the building with minimal limitations. What to expect after an angiogram? You may experience some soreness after the procedure. If the provider had to place a stent or perform an angioplasty, you may experience some tingling. This is normal; the blood flow has simply been restored to your extremity. The sensation should not last more than a few days. Things to watch for after an angiogram: If at any point you begin to feel coldness or see discoloration in your extremity, call the office immediately or if there is any bleeding at the insertion site. It is recommended to keep your legs straight and rested after the procedure and shower the next day and can remove any bandages at that time. No major lifting after the procedure as well and hydrate.

Meet the Team Milford Vascular Institute's strongest asset if our team. Together we are able to provide state-of-the-art care to patients suffering from venous insufficiency and other forms of vascular disease. Nicole, RVT, RDMS, BR Sonographer Nicole completed the Diagnostic Medical Sonography Program for the Institute of Allied Medical Professions in 2013, addition to receiving an associates degree from Gateway Community College. Nicole holds credentials in Registered Diagnostic Medical Sonography and as a Registered Vascular Technologist. Nicole is the lead vascular sonographer at Milford Vascular Institute. Nicole has vast experience working in hospital and outpatient office settings. Prior to working at MVI, she was a sonographer at Milford Hospital and Diagnostic Imaging of Milford. TAYLOR, RVT Sonographer Taylor is a registered vascular sonographer at Milford Vascular Institute. She received her degree in Diagnostic Medical Sonography from the American Institute in West Hartford, CT. Prior to this, she lived in Boston, where she completed a Bachelors in Health Psychology as well as a graduate degree in Nutrition. Taylor is passionate about her role at Milford Vascular as she loves providing good care for patients. She lives locally with her husband and daughter. Chelsea, RVT Sonographer Chelsea is a part of the Milford Vascular Ultrasound team. She received her ultrasound degree from American Institute, in West Hartford, CT. She began her ultrasound career scanning Transcranial Doppler Ultrasound and then decided to fulfill her passion in vascular ultrasound at Milford Vascular. Prior to ultrasound she completed an undergraduate degree at Central Connecticut State University where she majored in Communications. Chelsea was born in Milford and remains a resident with her husband and children. Kaitlyn, RVT Sonographer Kaitlyn joined the Milford Vascular ultrasound team in 2022. She completed her ultrasound degree from American Institute in West Hartford, CT. She always excelled in Vascular Ultrasound and decided to make a career in the field. Previous to a degree in ultrasound, she received a Bachelors of Science in Public Health, from Southern Connecticut State University. Sheri, RN, BSN Registered Nurse Sheri received her associates in Nursing from Coastal Georgia Community College. A Connecticut native, she resides in West Haven. Sheri has over 20yrs of experience in the nursing field and went on to further her nursing education with a Bachelor's degree from Chamberlain University. Working for Milford hospital, gave her the tools to oversee a variety of patient population, including medical/surgical and cardiac care. Sheri's focus is on outpatient based surgical lab at MVI and takes pride in making every patient feel as comfortable as possible. KAYLA Medical Assistant Kayla is a graduate of Platt Technical High School. After graduating she wanted to pursue a career in the medical field. She attended Porter and Chester in Branford, CT where she graduated with her medical assistant certificate. She joined the team at Milford Vascular Institute in 2016 and works hands-on with the patients. Working at Milford Vascular Institute has inspired Kayla to continue her education. She is now attending school for Diagnostic Medical Sonography. PJ Medical Assistant Pasquale (PJ) graduated from East Haven High School in 2013. Following graduation, he attended Branford Hall Career Institute where he received his Medical Assistant License and Certification. Pasquale has prior Medical Assistant experience working for the Yale Health Plan assisting patients in the Student Health and Athletic Medicine fields. Pasquale jointed the Milford Vascular Institute team in October of 2016. He hopes to pursue a nursing career in the future. SHAUNA Medical Assistant Shauna is a registered medical assistant specializing in surgical assisting. She enjoys making sure patients feel comfortable and cared for during their procedures. STephanie Medical Assistant Stephanie is a graduate of Jonathan Law High School. She is currently enjoying her role as a medical assistant where she gets to put into action her passionate care for others and her goal is to always put a smile on someone's face. She's excited to explore the endless possibilities in the medical field. She lives locally in Milford, loves to travel and adventure! Ethan Medical Assistant Ethan graduated from the University of Connecticut in 2021 with a degree in physiology and neurobiology, with a minor in chemistry. He grew up in downtown Milford his entire life, and attended Joseph A. Foran High school before college. His intention is to attend medical school in the near future, but without plans of what specialty to go into yet. Ethan joined Milford Vascular in 2019 as a student intern and has worked as a Medical Assistant since Summer of 2021. Johnae Medical Assistant Johnae is a medical assistant for MVI. JADA Clinical & Admin Supervisor Jada is a graduate of Platt Technical High School and grew up in Bridgeport. Following graduation, she attended Gateway Community College where she received a degree in General Studies. She has a background knowledge in Emergency Medical Technician training and medical terminology. She is currently attending Gateway Community College nursing program. Her main roles at Milford Vascular include overseeing the Medical Assistants and Administrative staff on a day to day operation. EMMA Administrative Assistant Emma is a graduate of Platt Technical High School in Milford. She is also a graduate of the American Institute of Healthcare and Technology where she earned her certification in Medical Billing and Coding. Kassandra Administrative Assistant Kassandra is an administrative assistant at Milford Vascular Institute. MELODY Greeter Melody is one of our friendly greeters at Milford Vascular Institute. She is the first and last face you will see during your visit at Milford Vascular Institute. Melody strives to make every patient feel like they are a part of our family. SUE Greeter Sue is one of our friendly greeters at Milford Vascular Institute. She is the first and last face you will see during your visit at Milford Vascular Institute. Sue strives to make every patient feel like they are a part of our family. DANA Vein Coordinator Dana was born and raised here in Milford and is a Foran High School graduate. She attended Southern Connecticut State University. Dana worked for many years as a certified nursing assistant and greatly enjoys helping patients. She is looking forward to helping you have a great experience here at MVI! REBECCA Surgical Scheduler Rebecca graduated from Southern Connecticut State University with a BS in Business Management. She brings years of experience from the Radiology and Vascular fields and coordinates the Office Based Lab schedule as well as obtains authorizations for our office procedures. She will be happy to assist scheduling your surgical procedure or help explain your insurance benefits! TINA Accounts Receivable Tina is the Accounts Receivable Manager at Milford Vascular Institute. MARY Insurance Coordinator Billing, collections and insurance have been Mary's areas of expertise for many years. She enjoys providing help to the patients and her team members how ever she can. Mary resides in the local area with her two wonderful children and ever supportive husband, Tim. Marie Insurance Coordinator Marie is an insurance coordinator for MVI. She graduated from Central Connecticut State University with a degree in Computer Science Programming. For the past 25 years, Marie has worked in various Front Desk and Administration Assistant roles in Milford where she raised her children with her husband. She is a people person who always puts the customer first. ASHLEY Operations Manager Ashley is the Operations Manager at Milford Vascular Institute. She graduated from Loyola University Chicago in 2017 with a Bachelor's of Science in Mathematics. Ashley has been working at Milford Vascular Institute in various roles since 2010. She lives locally, in Milford, with her son, Thomas, and her fiancé, Jack.

Vascular Disease Milford Vascular Institute specializes in the treatment and prevention of vascular diseases affecting the arteries in the legs, like atherosclerosis. (203) 882-VEIN What is atherosclerosis? Atherosclerosis is the buildup of plaque in the walls of arteries. This build up causes the artery to narrow which restricts the flow of oxygen rich blood. What causes atherosclerosis? The exact cause of atherosclerosis is unknown. However, studies show that atherosclerosis is a slow, complex disease that may start in childhood. It develops faster as you age. There are certain risk factors associated with the development of atherosclerosis. The number one risk factor is smoking. Other factors include high cholesterol, high blood pressure, and diabetes. Where can atherosclerosis form? Atherosclerosis can form in any artery in the body. Plaque build up in the arteries around the heart is called coronary artery disease. When plaque build up occurs anywhere else in the body, it is called peripheral arterial disease. Blockage in the arteries in the neck is called carotid artery disease. ​ Plaque build up in the aorta tends to lead to a different problem called aneurysm. The pressure in the aorta is so great that when the arterial walls become more rigid from this disease, the walls begin to swell like a balloon. How is atherosclerosis diagnosed? Atherosclerosis is typically first diagnosed during a physical exam with a primary care doctor. When your doctor is listening to your arteries, they may hear a whoosh sound, called a bruit. This sound is an indication of the presence of atherosclerosis. The doctor may then order an ultrasound or CT scan to confirm the atherosclerotic build up. A test called an angiogram is considered the gold standard for diagnosing the disease.

Spider Vein Treatments Milford Vascular Institute specializes in the treatment of small varicose and spider veins. Weeding the Garden Analogy: Long term treatment of varicose veins is similar to managing a garden. In a garden, we first spend a lot of time removing the large weeds. Often, once the larger weeds have been removed, we see smaller weeds that were not apparent in the beginning. We then take the time to remove even the smallest weeds so that they do not grow larger in time. If we ignore the small weeds, they will grow into large weeds and we will have to start all over again. ​ This is why we spend so much time in follow up performing ultrasound exams to find those small veins that were not apparent in the beginning. You may need injections of veins that you do not even see on the surface but that we can see on ultrasound. If we ignore these veins and wait for them to become visible, then we may need to start all over with larger procedures. ​ This is why it is important to continue to follow up with ultrasound exams on a regular basis even if your legs feel and look great. Consider it maintenance of your garden to keep it looking healthy and beautiful! FOAM vs Visual Sclerotherapy: A week after the venous ablation procedure, an ultrasound is done to assess the results of the procedure and to see if any smaller veins are present that could lead to recurrence of the insufficiency. If left untreated, these veins can enlarge over time and lead to a recurrence of the symptoms. Therefore, we recommend that these veins be treated immediately to ensure a long-lasting result. The treatment for these veins is called foam sclerotherapy. The veins are identified with ultrasound and a tiny needle is inserted into the vein. Medication is injected to the vein. The medication causes the veins to shrivel up and be absorbed by the body. This procedure is quick and relatively painless. Multiple sessions may be required if multiple veins are discovered on ultrasound. ​ The final step of the process is to address the spider veins visualized on the skin. This procedure is called visual sclerotherapy. During this procedure each individual vein is punctured with a tiny needle and medication is injected into the veins causing them to disappear. Initially there may be some redness as the veins naturally become inflamed in the process of resolving. Multiple sessions may be required. (203)882-VEIN What to expect following the treatment & after care instructions: Wear knee or thigh high stockings for two to three days during waking hours. You may resume normal activity the same day. Walking is encouraged! Do not perform any high impact activities for 24 hours after treatment. Do not soak in a bathtub, a jacuzzi, or pool for three days after treatment. You can fly the next day. ​ ​ You may notice minimal bruising or redness around the injection site. This is normal. ​ ​ After treatment you may have a slight tingling sensation. This is normal. ​ ​ ​ We recommend waiting 2-4 weeks between injections to aid in the healing process. ​ ​ If you experience any discomfort, you may take Vasculera, Ibuprofen, Aleve, or Motrin. If you are unable to take NSAIDs, you may take Tylenol. If you experience any bruising, apply Emla Cream. ​ ​ ​ Got veins? Schedule a new patient consultation. Call Now

Pneumothorax Milford Vascular Institute specializes in treating thoracic diseases, including collapsed lungs. What is a pneumothorax? A pneumothorax is a collapsed lung. A pneumothorax occurs when air leaks into the space between your lung and chest wall. This air pushes on the outside of your lung and makes it collapse. Pneumothorax can be a complete lung collapse or a collapse of only a portion of the lung. What are the symptoms of a pneumothorax? Symptoms usually include sudden chest pain and shortness of breath. What causes a pneumothorax? Pneumothorax can develop from a blunt trauma to the chest. Certain medical procedures may induce this condition. Patients with lung disease are more likely to have their lung collapse due to the damaged tissue. Small air blisters (blebs) can develop on the top of the lungs. These blebs sometimes burst — allowing air to leak into the space that surrounds the lungs. Pneumothorax can also develop for no obvious reason. Who is at risk for pneumothorax? Anyone can develop a pneumothorax, however, generally, men are at higher risk than women. The type of pneumothorax caused by ruptured air blisters is most likely to occur in people between 20 and 40 years old, especially if the person is very tall and underweight. People also put themselves at higher risk for developing a pneumothorax if they smoke. What is the treatment for a pneumothorax? Treatment for a pneumothorax usually involves inserting a needle or chest tube between the ribs to remove the excess air. Milford Vascular Institute can place chest tubes at our Outpatient Based Laboratory. A small pneumothorax may heal on its own. Call Now

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DAVID J. Esposito, M.D., FCCP, FACS Cardiac, Vascular, & Thoracic Surgeon Located in Milford, CT. Dr. David Esposito, M.D., FACS, FCCP, is a native of Milford. Dr. Esposito graduated from Foran High School and then from Yale University with a degree in Chemistry. He received his medical training at Duke University School of Medicine in Durham, North Carolina in 1994, and completed a general surgery residency at Rush-Presbyterian St. Luke’s Medical Center and Cook County Hospital in Chicago. Dr. Esposito completed fellowships in vascular surgery and cardiothoracic surgery at Carolinas Medical Center in Charlotte, North Carolina. He also earned a master’s degree in business administration from the Yale University School of Management in 2007. He is one of only approximately 130 surgeons in the United States to be Board Certified in 3 specialties: General surgery, Vascular surgery, and Cardiothoracic surgery. Dr. Esposito is a fellow of the American College of Surgeons and of the American College of Chest Physicians, as well as a member of the Society of Thoracic Surgeons and the Society for Vascular Surgery. He enjoys hospital privileges at the nearby Milford Hospital, where he is the Chairman of the Department of Surgery and Chief of Cardiovascular and Thoracic Surgery. In his free time, Dr. Esposito is active in the community as a member of the Milford Columbus Committee, the Milford Rotary Club, and the United Way of Milford. He is on the Board of Trustees of the Milford Bank. He has a lifelong love of sports, and was captain of the Yale Varsity baseball team in 1990. He is the Head Wrestling coach at his alma mater, Foran High School, and led them to State Championships in 2016 and 2018. He lives in Milford with his wife Suzanne. Between them they have seven children and one grandchild! CALL NOW

Dialysis Solutions Milford Vascular Institute specializes in the placement and removal of catheters and the creation and maintenance of AV grafts & fistulas. What is dialysis? Dialysis is a way of cleaning your blood when your kidneys can no longer do the job. It gets rid of your body's wastes, extra salt and water, and helps to control your blood pressure. What are the different types of dialysis? There are two types of dialysis; hemodialysis and peritoneal dialysis. In hemodialysis, blood is pumped out of your body to an artificial kidney machine, called a dialyzer, and returned to your body by tubes that connect you to the machine. In peritoneal dialysis, the inside lining of your own belly acts as a natural filter. How does hemodialysis work? Should you choose to have hemodialysis, your dialysis center will need to access your blood vessels. There are two methods for gaining access to the blood vessels; via a catheter or a fistula/graft. A catheter is a soft tube that is placed in a large vein, usually in your neck. An AV fistula is an access made by joining a patient’s own artery and vein directly to each other. An AV graft is an access made by connecting an artery to a vein using a plastic blood vessel. Why would I need a catheter placement? A catheter is used when a patient needs immediate access for dialysis, typically because the patient has suddenly found out they have kidney failure. A dialysis catheter can be placed by an interventional radiologist or a surgeon. However, using a catheter puts the patient at a much higher risk for infection, since it hangs outside the body. The longer it is in, the higher the risk of infection. Why should I choose an AV Fistula for dialysis access? An AV fistula is considered the gold standard for dialysis access. With an AV fistula, blood flows from the artery directly into the vein, increasing the blood pressure and amount of blood flow through the vein. The increased flow and pressure causes the vein to enlarge. The enlarged vein will be capable of delivering the amount of blood flow necessary to provide an adequate hemodialysis treatment. AV fistulas are the preferred vascular access for long-term dialysis because they are made entirely of the patient’s own tissues. There is no plastic or foreign material. They last longer than any other dialysis access types, are less prone to infection and clotting, and can be relied upon for predictable performance. Why doesn’t everyone choose to have an AV Fistula Creation? The issue with fistula dialysis access is not everyone is able to have a successful fistula created due to individual anatomy. Usually this is due to small caliber veins. Also, once a fistula is created, it typically takes between 6 weeks and 4 months to mature. This means, if the patient needs dialysis immediately, they will still need to have a catheter placed while they wait for the fistula to mature to functionality. Why should I choose an AV Graft for dialysis access? If your vascular surgeon determines you are an unsuitable candidate for an AV Fistula creation, he may then evaluate you for an AV Graft Placement. A graft is usually about one-half inch in diameter and made of plastic (Teflon), or transplanted animal or human vessels. They are usually placed in the arm, but can also be placed in the thigh. Grafts become functional much more quickly than fistulas; they can typically be used two to six weeks after placement. Why are AV Grafts not the preferred mode of vascular access? Grafts are created from foreign materials to the body. This makes them more prone to clotting or becoming infected. For these reasons, the graft may have to be replaced yearly. However, they are still a much safer alternative to using a catheter. How can you plan to have a fistula created or a graft placed to avoid having to use a catheter for dialysis? When patients find out they are in the advanced stages of chronic kidney disease and will need dialysis, their nephrologist will advise them to be evaluated for a fistula or graft. Having the access in place well before beginning dialysis will give this lifeline time to mature, so it can be ready to use. When patients suddenly discover they have kidney failure, a catheter may be placed to allow for immediate dialysis treatment. In this case, the patient should still schedule an appointment to see a vascular surgeon. The surgeon will still be able to evaluate the patient for the fistula or graft and then perform the surgery. The catheter will be used until the fistula or graft has had time to mature. Fistulagram What is a fistulagram? A fistulagram is an X-ray procedure to look at the blood flow and check for blood clots or other blockages in your fistula. If there is a clot, the surgeon will preform an angioplasty or a thrombolysis to break it up or remove it. ​ Milford Vascular Institute has relationships with many renal specialists throughout the Southern Connecticut area. When a patient suddenly develops kidney failure, MVI has the ability to see the patient within the next business day to both place a catheter and evaluate them for a vascular access. Contact us if you or your loved one may soon require dialysis. ​

Endovascular Stenting Milford Vascular Institute places stents at the Outpatient Based Laboratory and Milford Hospital. What is a stent? A stent is a tiny wire mesh tube. It is used to prop open the walls of a blood vessel. Why do I need a stent? When a blood vessel becomes blocked or collapsed, a stent is used to reopen the vessel to restore blood flow. In arteries, stents are typically placed to reopen vessels clogged by atherosclerotic build up. In veins, stents are typically placed to reopen collapsed or compressed veins. Where can stents be placed in my body? You can have a stent placed in almost any blood vessel in the body. At Milford Vascular, our surgeons place stents in peripheral and mesenteric arteries and iliac veins in our outpatient based laboratory. They also perform endovascular abdominal aortic aneurysm repairs using stenting at Milford Hospital. Stents can also be placed in the coronary arteries around the heart to restore blood flow to the heart tissue to prevent or help patients recover from a heart attack. What can I expect when having a stent placement? Stent in an artery in the leg: To prepare you for the procedure, the area of your groin where the delivery catheter and stent are introduced will be cleaned and shaved. You will meet with the nurse anesthetist who will explain to you what to expect. The nurse with then begin to administer the anesthesia. You will be under twilight sedation. After the anesthesia has taken effect, your surgeon will make a small incision in one of your thighs. The incision will be opposite the side where the stent will be deployed. Using x-rays to see the exact location of the aneurysm, the surgeon will guide the delivery catheter through the vessels to the site of the blockage. ​ X-rays and ultrasound imaging help the doctor make sure that the stent graft is properly placed. ​ After the procedure, you should rest for the remainder of the day. Continue to drink plenty of fluids. Avoid excessive lifting and bending. If bleeding occurs at the puncture site, apply firm direct pressure to the site. If bleeding continues, call your doctor or go to the emergency room. You can resume normal activity the following day. ​ Stent in a vein in leg: To prepare you for the procedure, the area of your groin where the delivery catheter and stent are introduced will be cleaned and shaved. You will meet with the nurse anesthetist who will explain to you what to expect. The nurse with then begin to administer the anesthesia. You will be under twilight sedation. After the anesthesia has taken effect, your surgeon will make a small incision in one of your thighs. The incision will be the same side the stent will be placed. Using x-rays to see the exact location of the aneurysm, the surgeon will guide the delivery catheter through the vessels to the site of the blockage. ​ X-rays and ultrasound imaging help the doctor make sure that the stent graft is properly placed. ​ After the procedure, you should rest for the remainder of the day. Continue to drink plenty of fluids. Avoid excessive lifting and bending. If bleeding occurs at the puncture site, apply firm direct pressure to the site. If bleeding continues, call your doctor or go to the emergency room. You can resume normal activity the following day. ​ Stent in the abdominal aorta: To prepare you for the procedure, the area of your groin where the delivery catheter and stent are introduced will be cleaned and shaved. Then you will receive either local anesthesia, to numb the area of the surgery, or general anesthesia to put you to sleep during the surgery. After the anesthesia has taken effect, your surgeon will make a small incision in both of your thighs. Using x-rays to see the exact location of the aneurysm, the surgeon will guide the delivery catheter through the large vessel in your thigh (iliac vessel) to the aneurysm site in your abdomen. The stent graft is slowly released from the delivery catheter into the aorta. As the stent graft is released, it expands to the proper size so that it fits into the aorta both above and below the aneurysm. The delivery catheter is then withdrawn and removed, leaving the stent graft within the aorta. Depending on the shape and size of your aortic aneurysm, additional stent grafts may be placed to ensure that the aneurysm is completely excluded from normal blood flow. X-rays and ultrasound imaging help the doctor make sure that the stent graft is properly placed and excluding blood flow to your abdominal aortic aneurysm. What to expect after a stent placement? You may experience some soreness after the procedure. If you had a stent placed in an artery, you may also experience some tingling in your extremity. If your stent was placed in a vein, you should see a decrease in swelling in your extremity. In both cases, this is normal; the blood flow has simply been restored. The sensation should not last more than a few days. Things to watch for after having a stent placed: If you experience any of the follow symptoms after your procedure, call the office immediately: numbness, bleeding at the incision site, redness at the incision site, fever or chills, or swelling.

PAUL S. Davis, M.D., FASA Interventional Radiologist located in Milford, CT. Paul Davis, M.D., FASA is a leading Interventional Radiologist in the Connecticut area. Dr. Davis graduated Phi Beta Kappa, one of America's most prestigious honors societies, from the University of Colorado where he received his Bachelors of Arts degree. He then went on to complete his medical training at SUNY Medical University in Syracuse, New York in 1984. He completed his general surgery residency at The George Washington University Medical Center in 1985. Dr. Davis then completed a residency in Diagnostic Radiology at Thomas Jefferson University Hospital where he served as Chief Resident from 1987-1988. Dr. Davis completed a fellowship at Yale University in Vascular and Interventional Radiology. He is board certified in Diagnostic Radiology and Vascular and Interventional Radiology. He is a fellow of the American Board of Angiology. In 2006, Dr. Davis joined with Dr. Esposito in founding the Milford Vascular Institute, dedicated to providing state-of-the-art, multidisciplinary care to all patients. He also serves on many medical committees and is a member of our medical executive board. His dedication to high-quality patient care is second to none and he works to provide customized care to meet each individual’s needs. ​ Dr. Davis lives locally in Milford with his wife and King Charles Cavalier, Chewy CALL NOW