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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

The Leg Swelling & Lymphedema Center The Leg Swelling & Lymphedema Center at Milford Vascular Institute is a state-of-the-art treatment clinic for patients suffering from extremity swelling and lymphedema. The Leg Swelling & Lymphedema Center at Milford Vascular Institute was founded to aid an under served community of people suffering from leg swelling and lymphedema. The Center uses a holistic approach to treating and healing edema. Complete Decongestive Therapy (CDT) is the standard of care for the treatment of lymphedema. CDT is performed by a Certified Lymphedema Therapist (CLT). What Causes Leg Swelling? There are many different potential culprits for swelling in a person's extremities. To achieve an accurate diagnosis, our experts at Milford Vascular Institute use a variety of diagnostic tests. The most common causes for lower extremity (leg) swelling are: Lymphedema NIVL/May Thurner Syndrome Congestive Heart Failure (CHF) Venous Insufficiency Infection Liver Disease DVT Renal Disease Medications Meet Jen MEET JEN JENNIFER PASSONI, DPT, CLT Jen is the Center's Certified Lymphedema Therapist. She is dedicated to helping patients improve their quality of life. Through counseling, Jen and our patients at the Leg Swelling & Lymphedema Center build individualized programs to work for their personal needs and goals. Read More MEET SARAH SARAH OKAMOTO, PTA Sarah is a physical therapy assistant for the Center. She works along side Jen to help improve the quality of life for patients suffering from leg swelling and lymphedema. Read More What to expect There are 6 key components to complete decongestive therapy (CDT); the gold standard of treatment for patients with leg swelling & lymphedema. Manual Lymph Drainage Skin & Nail Care Education Compression Bandaging Self-Care Training Exercise Therapy Compression Garments & Devices Manual Lymph Drainage Manual Lymph Drainage (MLD) MLD is a light massage that focuses on skin-stretching to help promote the movement of lymphatic fluid out of the swollen extremity. For optimal benefits, patients should be scheduled for this therapy 3 to 5 times a week for 4 to 6 weeks. Compression Bandaging Compression Bandaging Bandaging is an important part of lymphedema therapy. A variety of bandages and wrapping techniques are used during therapy to help move the fluid out of the tissues. This technique is used during appointments with the our lymphedema specialist and as part of the maintaince care program. Exercise Therapy Exercise Therapy Exercise therapy is an important aspect of lymphedema rehabilitation. Some studies have even shown that patients who incorporate exercise into their therapy for lymphedema have a reduced incidence for lymphedema flare-ups. This is why we incorporate exercise therapy in our treatment protocol for lymphedema patients. Therapy includes in-office, lymphedema therapist monitored exercises, like walking on a treadmill and pedaling a stationary bike, and an at home exercise regime. For optimal benefits, patients should perform at home exercises daily. Monitored exercise therapy should be scheduled 3 to 5 times a week. Skin & Nail Care Education Skin & Nail Care Educaton Proper skin care education is incredibly important for lymphedema patients. During their initial meeting with our lymphedema therapist, patients will be instructed to keep their skin clean and to moisturize daily with a gentle moisturizer (such as Eucerin). Additionally, since lymphedema patients are at high risk for developing infections, patients are instructed to check their skin daily for cuts, scratches, irritation, or sign of infection. Self-Care Education Self-Care Education Every patient has a different cause for their lymphedema and different factors which contribute to the worsening of their disease. Self-care training is a very important aspect of our lymphedema program to the team at Milford Vascular Institute. We pride ourselves on having created a practice that is able to care for each patient as a whole person, not just the ailment that brought them to our clinic. Our goal with self-care counseling is to help patients learn how to deal with stress, work toward any necessary weight-loss goals, and build healthy habits they can take with them for the rest of their lives. Compression Garments Compression Garments Compression garments may be prescribed to patients for daily wear and use while not at therapy or using their pneumatic compression device. These garments use gradient compression to prevent and reduce swelling. They are very beneficial for helping fluid move to an area that is draining well. Pneumatic Compression Devices Pneumatic Compression Devices Pneumatic compression pumps are prescribed to patients suffering from leg swelling or lymphedema who have failed perviously prescribed conservative therapies. They are also proposed to supplement standard of care for patients with venous ulcers. A variety of pumps are available; they can be single chamber (non-segmented) or multi-chamber (segmented) and have varying design and complexity. ​ Pneumatic compression devices consist of an inflatable garment for the arm, leg, trunk, chest, or a combination of these pieces, and an electrical pneumatic pump that fills the garment with compressed air. The garment is intermittently inflated and deflated with cycle times and pressures that vary between devices. As the compartments fill with air and the device squeezes the affected area. This increases blood flow through the veins and flushes excess fluid and blood built up in the extremities. Most patients notice a significant decrease in swelling when they couple in-office CDT with at-home pneumatic compression device treatments. Call Now Questions about lymphedema or interested in scheduling an appointment? Call (203)882-VEIN(8346) to schedule a new patient consultation.

Amanda Hershman, RN Injections Specialist located in Milford, CT. Amanda Hershman, RN, has been a member of the MVI family for over five years. She attended Mount Holyoke College where she received a Bachelor of Arts in English with a focus on Pre-Health. She holds her nursing degree from St. Vincent's College at Sacred Heart University. Her goal is to continue her education to eventually obtain her Doctorate of Nursing. Amanda specializes in the art of injections and has extensive knowledge of the vascular system, compound injectables and facial lymphatic drainage. She has a passion for skin care, beauty, health and everything in between. Amanda has always been on the cutting edge of beauty trends and the importance of self-care. Amanda is a lifelong resident of Connecticut and currently resides on the shoreline. She frequents a variety of workout classes, including pilates, Pure Bare, and Orange Theory Fitness. Amanda upholds her family above all else. In her free time, she loves playing with her many nieces and nephews. CALL NOW