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Olympia Fields, IL 60461
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Listening, Understanding and Providing Superior Vascular Care

When your health, wellness and quality of life are jeopardized by poor circulation, you need specialists with advanced education and experience who will concentrate on you.

Dr. Eugene Tanquilut, Dr. Sanjeev Pradhan and Dr. Saadi Alhalbouni are board-certified in both vascular and endovascular surgery. Fellowship trained and award-winning, our physicians have extensive experience and knowledge in both traditional and innovative minimally invasive methods to manage your vascular health.

Best of all, Dr. Tanquilut, Dr. Pradhan and Dr. Alhalbouni approach each patient as a member of the family, with empathy, altruism and honesty.

Wasn’t vaping supposed to be good for you?

It seemed like a great idea to begin with – a device that mimics smoking a cigarette to help people quit smoking altogether. Vaping also seemed safer as there was no tar, no tobacco smoke and no smell, just water vapor. Manufacturers sold it so well, with flavored liquid like cherry, menthol and bubble gum that today, nearly 9 million adults now vape every day or nearly every day.

Unfortunately, the “health” promises of vaping have completely fallen apart, as more and more research and studies show, along with hundreds of hospitalizations and 9 deaths as of today.

Dr. Tanquilut is here to explain exactly what vaping is and why you should kick this habit too, as quickly as possible.

What is vaping?
Vaping means “to inhale water vapor into the lungs.” Vaping with electric cigarettes, also known as e-cigs or vape pens, is exactly that, except the water contains chemical flavoring, propylene glycol or glycerin, often nicotine, and sometimes THC, or tetrahydrocannabinol. This “water” is known as e-juice, vape juice or e-liquid. An e-cigarette usually looks, feels, acts and can even taste like a real cigarette.  It provides the vapor with nicotine while mimicking the act of smoking. A vape pen usually consists of a mouthpiece, a rechargeable battery, a cartridge for containing the e-liquid or e-juice, and a heating component. When the device is used, the battery works to heat up the heating component, which turns the contents of the e-liquid into an aerosol that is inhaled into the lungs and then exhaled.

Why is vaping harmful?
While vape juice doesn’t contain tar, most e-cigs do contain nicotine, which is highly addictive and very harmful to your health. Research shows that a variety of severe damage is caused by vaping nicotine, including damage to your arteries, veins and heart, an increase in your heart rate and an increase in blood pressure. These detrimental effects last long after you’ve stopped vaping, harming your vascular system.

E-liquids also contain other chemicals and additives. When heated, they create dangerous toxins that reduce blood flow and damage blood vessels with each inhalation. While these effects are immediate, they are also long-term, as your blood vessels do not fully recover when you stop vaping. What’s more, these effects were seen when people used e-cigarettes that did not contain nicotine.

While the dangers of smoking cigarettes have been well-documented and unchallenged for decades, the long-term health effects of smoking electronic cigarettes still aren’t clear. The short-term effects, however, are crystal clear and very alarming. The Centers for Disease Control and Prevention are investigating 530 mysterious vaping illnesses and nine deaths nationally, the first confirmed in Illinois just a month ago.

If you’ve successfully transitioned from smoking cigarettes to vaping to becoming completely free of nicotine, congratulations! The addiction to nicotine is as difficult to break as heroin or cocaine, so kicking the habit is an enormous accomplishment.

If you’re smoking now, or have recently switched to vaping, stop both. Now. Your blood vessels and the rest of your body will breathe easier and begin recovering, becoming healthier within days.

If you need help with smoking or vaping cessation, reply to this email or call our office at 815-824-4406 to make an appointment with us. Your Vascular Specialists medical practitioner will help you set clear goals, establish a workable plan and cheer enthusiastically when you are smoke- and vape- free!



Major Breakthrough in Treatment of Carotid Artery Disease

Have you been told carotid artery surgery or stenting is too risky for you?

A new, FDA-approved procedure to treat carotid artery disease dramatically reduces the risk of stroke during and after carotid angioplasty and stenting (CAS). TransCarotid Artery Revascularization, or TCAR, is minimally-invasive, results in less nerve damage, lower risk of infection and reduces the risk of both stroke and heart attack. 

When you’ve experienced bouts of dizziness, confusion or blurred vision, or passing loss of coordination, weakness or numbness, especially in one side of the body, you may have had a mini-stroke or a transient ischemic attack (TIA). Because 1 in 3 people experiencing a TIA will have a full-blown stroke within a year after the TIA, you need to get screened for carotid artery disease immediately.

You may also be screened when your physician hears an abnormal sound through a stethoscope placed on the neck, if you have risk factors such family history, high blood pressure, diabetes, obesity or tobacco use, or if you have peripheral artery disease or vascular disease somewhere else in your body.

The carotid arteries run along either side of the neck and can be felt just below the angle of the jaw. These arteries deliver the oxygen-rich blood necessary for brain function. 

Carotid artery disease, or carotid artery stenosis, occurs when the arteries are narrowed by atherosclerosis, a build up of plaque. When your arteries are narrowed by 70% or more, you are at risk of having a stroke. 

About one-third of strokes are caused by carotid artery disease, and 80% of all strokes are preventable. 

To prevent a life-altering stroke, carotid artery disease must be treated. Seeing a vascular surgeon ensures your treatment is determined by your test results, current health and medical history, as only a vascular surgeon can perform both surgical options or interventional options. 

For decades, carotid endarterectomy (CEA) has been the “gold standard” of treatment. During this 90-minute to 2-hour surgical intervention, Dr. Tanquilut, Dr. Pradhan or Dr. Alhalbouni use a plastic tube to reroute blood flow to ensure the brain continues to receive oxygen. The surgeon will make a 8-10 cm incision in your neck where the blockage has been located, then open the carotid artery. The plaque is removed from the artery and the artery repaired. The surgeon will then restore blood flow to the brain along its natural path. 

Some patients are not candidates for CEA due to previous neck surgeries, radiation to the neck, having a higher surgical risk or unusual physiology; these patients have been treated with transfemoral carotid angioplasty and stenting (CAS). 

However, transfemoral CAS is an inferior treatment option for carotid artery disease. The vascular surgeon inserts a catheter into the femoral or brachial artery, and guides it via x-ray through the aorta to the carotid artery. Contrast materials are injected through the catheter to determine the exact location and severity of blockage. A balloon is inflated, compressing the plaque against the artery wall, and then a stent is placed to hold the newly widened artery open. 

Transfemoral CAS has an associated 4% risk of stroke, compared to surgery which has just a 1% risk of stroke.

Now, with the recent invention of TCAR, the high risk of heart attack and stroke during and after CAS has been drastically reduced, with excellent clinical data to support results. 

In a TCAR procedure, your Vascular Specialists surgeon will make a small incision just above the clavicle. A puncture is made into the carotid artery and a small tube is placed inside the artery, which is connected to the transcarotid neuro-protection system (NPS). The NPS temporarily directs blood flow away from the brain and captures plaque debris that dislodges from the artery. This dangerous debris is diverted away from the brain, preventing a stroke from happening. The blood is then filtered and returned to the femoral vein through a second tube placed in the groin. While the brain is protected during this temporary flow reversal, a stent is placed in the carotid artery to stabilize the plaque and help prevent against future stroke. The blood flow is then returned to normal and the NPS is removed.

You can be treated using a local anesthesia. Any disease in the aorta, aortic arch and the origin of the cartoid arteries is entirely avoided and the femoral artery is left untouched. The procedure takes approximately 40 to 80 minutes.  

You will recover more quickly and there is less risk for nerve damage, heart attack, bleeding and stroke.

TCAR has been clinically proven as a less-invasive alternative to CEA. Over 10,000 TCAR procedures have been performed around the globe since its introduction in 2016.

The TCAR procedure requires the training, experience and skills of a vascular surgeon. Your Vascular Specialist surgeon are the only fellowship-trained specialists with the skills and ability to solely perform open surgeries, minimally-invasive endovascular (stenting) procedures and complicated hybrid procedures such as TCAR. Because of these comprehensive skills, your Vascular Specialist surgeon will provide unbiased recommendations and treatment,  based on your individual needs.

If you have been told you are not a candidate for CEA and that CAS may be too risky, TCAR could be your answer to avoiding a life-changing stroke. Call Vascular Specialists at 815-824-4406. We will be happy to explain how TCAR works and why it may be the best choice for you!

A Seismic Shift in Access Creation

Beautiful Woman Carefree in Blue Sky

Vascular Specialists now performing groundbreaking new procedure for those facing dialysis

For decades, patients facing hemodialysis have had few options for access creation. Fistulas and grafts require surgery and a recommended 6 months of maturation time. Catheter access is an infection-prone method rife with complications. 

Now, Dr. Tanquilut and Vascular Specialists are adopting the FDA-approved Ellipsys Vascular Access System, completely changing how fistulas are created and dramatically improving quality of life for patients. 

The Ellipsys System is non-surgical and minimally invasive, creating a fistula in a procedure that lasts, on average, about 17 minutes instead of hours. This permanent fistula can be utilized for dialysis within weeks instead of months. 

When a patient is told that dialysis is in their future due to kidney failure, make an appointment with Vascular Specialists. Using only a local anesthesia, your vascular surgeon will use high frequency ultrasound to map the veins and arteries in the forearm to identify serviceable blood vessels. 

Still using ultrasound guidance, your vascular surgeon will use a small needle to access the identified vein. It will then pierce through the vein wall and through the wall of the desired artery. The needle will be removed and a sheath put in its place. The Ellipsys catheter slides through the sheath, with the tip of the catheter placed in the artery. 

Using low power thermal energy, the catheter cuts an opening in each blood vessel and then fuses the tissue to create a permanent cross connection between the blood vessels, all without sutures or plastic tubes. 

The advantages of using this groundbreaking new Ellipsys procedure are numerous, including:

  • Lower cost
  • Faster access maturation
  • Minimally invasive endovascular procedure
  • Creates an arteriovenous (AV) fistula without implants or sutures
  • Creates a permanent intravascular seal between vein and artery
  • Vascular bed stays intact
  • Under 30 minutes procedure time
  • Local anesthesia 
  • Patient leaves with a band aid on the wound
  • No lumps, bumps or scars in patient arm
  • Increased patient satisfaction

The Journal of Vascular Surgery reported in October 2018 that the procedure saw a 94% success rate, with the fistulas either already being used or ready for use in just six weeks. They also noted that the ease and simplicity of the procedure could reduce the risk of thrombosis, blood clot formation, and reduce the likelihood of later revisions or interventions. 

The Ellipsys System is a “seismic shift” in how hemodialysis accesses are created and Vascular Specialists is leading the way with this procedure in Chicagoland. When dialysis is in the future, call our office at 815-824-4406 and make an appointment to discuss the Ellipsys procedure. 

Did you know…?

Blood Vessels of human leg

You may think that veins and arteries are pretty straightforward body parts, just 60,000 miles of tubes moving blood around your body. However, your vascular system is actually a wonder of function and structure. Our surgeons at Vascular Specialists are here to share their favorite amazing facts about your veins, arteries and more. 

Did you know…

…the human heart beats an average of 2.5 billion times throughout your lifetime. That’s about 80 beats per minute, constantly pushing blood through your blood vessels.

…men have about 5 quarts of blood and women have 4 quarts, constantly recirculating and moving around the body.

…your blood is constantly regenerating itself, with about 8 million blood cells being created and about 8 million dying every single second. 

…blood moves at different speeds throughout your body. In your aorta, it speeds through at about 15 inches per second. By the time it gets to the capillaries, those blood vessels where microscopic blood cells actually have to line up to move through, blood is moving at its slowest speed. 

…the walls of a capillary are only one cell layer thick, enabling nutrients and oxygen to pass through them. 

…continuous capillaries are formed of cells packed tightly together. Fenestrated capillaries have permeable perforations to allow the transfer of nutrients and oxygen. Discontinuous capillaries have open spaces between cells, making them very permeable and allowing the passage of blood cells between themselves. 

…your lips are red because they are packed full of capillaries. 

…blood is never blue, even if it’s in veins traveling back to the heart to be re-oxygenated. Your veins look blue because your skin filters out certain light wavelengths, and your eye sees only the blue. 

…varicose veins occur when the tiny valves inside the veins of your extremities weaken and are no longer effective at closing to help push blood back up to your heart.

…arteries don’t have valves because the force of your heart muscles pushes blood through them.

…hemorrhoids are varicose veins. 

…when veins are closed medically or collapse from disease or injury, your body redirects blood flow to healthy veins and absorbs the old vein, which can happen in as quickly as two months. 

…while aneurysms can occur anywhere throughout your vascular system, they are most common in the aorta. 

Do you have questions – or an amazing fact or two we’ve missed? Let us know by sending us an email, commenting on our blog or calling 815-824-4406. We are always happy to help!

A healthy vascular system means a healthy this!

Cholesterol plaque in artery

Blood flow is your body’s life force. Oxygen-rich blood that travels through flexible, clear arteries to reach to the very tips of your fingers and toes keeps your organs, muscles, bones, tissues, ligaments – everything! – healthy and well. Robust, unimpeded veins and effective venous pumps return that now oxygen-depleted blood to begin the cycle all over again. 

What’s key in the above description? The words flexible, clear, robust and unimpeded. To properly circulate your blood for a healthy body, your vascular system needs to be healthy. 

You can keep your 60,000 miles (yes – nearly two and a half times around the Earth, all packed inside your amazing body) of vascular system – and therefore your body in good health by following these bits of advice from Dr. Tanquilut, Dr. Pradhan, Dr. Alhalbouni and Dr. Qureshi. 

First – and we really can’t say this often enough – quit smoking and all tobacco products. Not only do they stiffen the walls of your arteries, they also made your blood thicker, making it even more difficult to move through your system. 

Achieve and maintain a blood pressure reading of 120/80. High blood pressure causes arteriosclerosis, which hardens your arteries, inhibiting healthy blood flow. 

Eliminate added sugar and sugar substitutes. Even if you’re not overweight, these empty calories raise blood pressure and worsens cholesterol. Dig into fresh fruits and vegetables and say “no” to meats, which raise your blood pressure, cholesterol and heightens your risk of arteriosclerosis.  

Now, add in water. Your blood is about half H2O, so drinking a lot of water each day – and more when it’s hot or you’re exercising – improves the quality of your blood flow and your vascular system. 

Get up and move. Too much sitting and not enough aerobic exercise inhibits your oxygen intake, weakens the muscles that support your vascular system and raises your blood pressure.


Stretch, twist and bend. Yoga, pilates and similar exercises help you move blood into organs. Get into “Legs Up the Wall” which helps blood flow up legs to your torso. This position is illustrated in the photo above, courtesy of Healthy Kids Running Series. 

Ask us about compression stockings. If you’re seeing signs of challenges in your vascular system, consider compression stockings, which help send blood back up to your heart. Don’t use these without your physician’s advice as you will need the right size and compression strength to be effective. 

So what happens when you don’t have a healthy vascular system? Your skin, hair and nails will all suffer, becoming dry, brittle and cracked. You may lose all the hair on your legs. Your toes and fingers could turn bluish, and be cold and numb. You’ll experience erectile dysfunction – and that’s just the tip of the iceberg. The worse your vascular system gets, the worse your overall health will get. Scratches, scrapes, cuts and open wounds will take a great deal longer to heal, leaving you at risk for infection and amputation. You could experience kidney failure, peripheral artery disease, stroke and deadly aneurysms. 

Keep your vascular system healthy and your entire body will be healthier! If you have questions about this advice, or your vascular system in general, make an appointment with Vascular Specialist by calling 815-824-4406 – and we’ll be happy to help!

Are You Drinking This Instead of That? Make a Better Choice For Your Health!

The dangers of consuming sweetened beverages, from soft drinks to flavored coffees and teas to juices, is well documented. These beverages can add to our daily calorie intake 150 to well over 300 calories with each can, cup or glass, causing weight gain and prompting diabetes, heart disease and stroke. 

To combat this, many people drink diet drinks, artificially sweetened with saccharin, acesulfame, aspartame, neotame, sucralose or stevia. However, while this may cut calories, recent research shows that these artificial sweetened beverages (ASB) raise the risk of stroke and heart disease and are not one bit healthier than their sweetened counterparts

Dr. Tanquilut explains, “The study, published in March, followed over 81,000 post-menopausal women between the ages of 50 and 79 for twelve years. Researchers were careful to factor into their data-crunching stroke risk factors such as smoking, high blood pressure and age. Even after those with pre-existing risks factors were adjusted in the data, the results were very alarming.”

When a woman drinks two or more ASBs a day, she is 23% more likely to have a stroke than a woman who consumes fewer than one diet drink a week or not at all. The ASB drinkers were 31% more likely to suffer an ischemic stroke, an event caused by blockage or clots in the blood vessels. Research found these ASB drinkers also had a higher incidence of dementia which may be caused by a series of nearly undetectable, tiny strokes in the smallest blood vessels in the brain. 

Researchers also determined that ASB drinkers were 16% more likely to die from any cause than non-ASB drinkers. African-American women fared the worse, as even those without heart disease or diabetes previously were nearly 4 times as likely to have an ischemic stroke. 

While researchers did not tease out which artificial sweeteners were associated with the highest stroke risk, they do stress that all of the effects that artificial sweeteners have on the body long-term are still unknown. 

Dr. Tanquilut said, “What is known is that artificial sweeteners don’t satiate your body. The sweet taste, with no real energy or calories behind it, actually prompts your body to want real sugar – and more of it. Drinking diet drinks to lose weight doesn’t work. Studies show that diet drinks can actually cause weight gain.”

So what did the non-ASB drinkers with the significantly lower stroke risk consume? Water – lots of it – along with unsweetened tea.

“Water is the absolute best, healthiest choice,” says Dr. T. “Your body needs plain water to function at its best. Water is a major component of your blood, and adequate water keeps veins and arteries healthy.”

To cut your risk of stroke, diabetes, obesity and a plethora of other health issues, pour those sweetened and artificially sweetened drinks down the drain and drink water. Too difficult to go cold turkey? Switch to unsweetened tea, put frozen or fresh fruit in your water or add sliced cucumbers for a fresh taste. 

Do you have questions about the association between diet drinks and an elevated risk of stroke – and how this could be affecting your health? Reply to this email or call 815-824-4406 to schedule an appointment. We are happy to help!

Seven ways to avoid this life-threatening health crisis – which most Americans are ignoring

Mock up interior font 3d rendering number 7Each day, advances in health care help us live longer, fuller lives. Unfortunately, many Americans are becoming more and more reliant on medications and procedures rather than lifestyle changes in preventing a second stroke – or even a first one.

The American Heart Association recommends making seven changes in your life:

  • Eliminating tobacco use
  • Getting regular exercise
  • Achieving and maintaining a healthy weight
  • Keeping blood pressure in check
  • Controlling cholesterol 
  • Maintaining normal blood sugar levels
  • Enjoying a diet full of vegetables, fruits, lean proteins and whole grains

Why are these seven things so important?

Smoking or being exposed to secondhand smoke increases plaque in your blood vessels, while thickening and narrowing those vessels and damaging the cells that line those vessels.  It also makes your blood more likely to clot. Smoking also lowers good HDL cholesterol and raises triglycerides, a type of fat in your blood. 

Regular exercise is vital to cut your risk of stroke. It lowers your blood pressure and helps you lose weight. It raises your heart rate, strengthening your blood vessels. Brisk walking 30 minutes a day for at least 5 days at week can cut your stroke risk by 27%.

Losing extra pounds and then maintaining a healthy weight eases the stress on your circulatory system, including veins, arteries and heart. Excess weight also raises blood pressure, can cause diabetes and causes sleep apnea, all of which are additional stroke risk factors. Lose just 10% of your body weight and you’ll lower your risk. 

High blood pressure, cholesterol and blood sugar levels damage your blood vessels. High blood pressure weakens your arteries, so they are more likely to clog or burst. High LDL cholesterol causes fatty deposits in your arteries that narrow and harden these blood vessel, and makes developing a blood clot more likely. Elevated blood sugar contributes to plaque buildup in your blood vessels, interfering with blood flow. 

Eating a healthy diet of whole fruits, vegetables, grains and lean proteins ensure that you’re getting all the nutrients you need and none of the sugar, fat and salt you don’t. Set a goal of eliminating processed foods like cereals, frozen meals, boxed meals, boxed vegetables or flavored rices, pastas or white bread (and much more!) for one month and enjoy how much better you feel – along with the weight you’ll lose!

How are patients ignoring this advice?
While patients are seeing positive results in their numbers by using medication to control cholesterol, blood pressure and blood sugar levels, the rate of obesity in stroke survivors has increased from 18% in 1988 to 39% in 2014. Those getting no exercise at all increased from 45% to 71%. Patients with unhealthy diets surged from just 14% to 51%.

Using medication to control some risk factors is smart, and your primary care physician and your specialists will work together to ensure you are taking the correct types and dosages to keep risk factors as low as possible. However, medication can’t control your tobacco use, activity level, weight, and diet – and these are also vital risk factors for a first or second stroke. These factors are in your control. 

Put down the potato chips and cigarettes, put on your walking shoes and put your health first! When you need help with smoking cessation, an activity schedule, weight loss or a daily meal plan, just call our office at 815-824-4406. We will be happy to help!

When Will You Need To Consider An Access?

Nearly a half million Americans are undergoing hemodialysis to treat end stage renal disease (ESRD), with over 62% of these cases caused by diabetes and high blood pressure. When you are informed you require hemodialysis to survive, it can be a scary, tumultuous time. Consulting with specialists, finding a convenient, comfortable dialysis location and making the physical transition to dialysis can be confusing at best.

You can have a smooth transition to hemodialysis when needed. Careful monitoring, early intervention, and a timely referral to a vascular surgeon for permanent access creation, education and management will ease your changeover and help improve your  quality of life.

    You are at risk for developing kidney problems requiring hemodialysis if you are experiencing:
• Diabetes
• High blood pressure
• Autoimmune disease
• Nephrotic syndrome
(when there is too much protein in the urine, low levels of protein in blood, high levels of fat and cholesterol in bloodstream or edema in the legs, feet, ankles or hands)
• Chronic urinary tract infections or problems

You should be screened at each health appointment. Ask about your Glomerular Filtration Rate (GFR), or how much blood passes each minute through the glomeruli, the tiny membranes in the kidneys that filter waste from the blood, allowing the blood cells and protein to remain in the bloodstream.

    Ask for a referral to a vascular surgeon when your GFR is 30 to 40, Stage 3 Kidney Disease. 

When your vascular surgeon can place the arteriovenous fistula (AVF) or arteriovenous graft (AVG) at least 6 months before hemodialysis is required, that allows ample time for the access to mature and be ready for use. This timely referral also allows adequate time for proper education and relationship- and trust-building between the vascular surgeon and yourself. Because your vascular surgeon will become a significant and constant healthcare provider, this time to establish trust is vital for a successful working relationship. A prompt referral also drastically reduces the risk of a catheter insertion, which is rife with complications and problems.

An access is always needed to perform hemodialysis. Because your kidneys no longer function to eliminate wastes from the blood stream and body, an “artificial kidney” or dialyser is used to perform this task. The fistula or graft is accessed in two spots; the first is used to carry blood to the dialyser and the second is used to return clean blood back to you. The tubes carry blood into the machine, to a bundle of hollow fibers forming a membrane to filter out the wastes. Blood is diffused with a saline solution, dialysate, and then the dialysate is diffused with blood, cleaning the blood. When this process is finished, cleansed blood is returned via the access. Hemodialysis lasts about 3 to 5 hours and is required 3 times each week.

The health of your vascular system is the determining factor in the choice of an access. Either a fistula or a graft will be created, increasing the blood flow and strengthening the vein to allow an even greater flow, making dialysis efficient and effective.

   A fistula is the preferred choice for an access, if at all possible.A fistula can be created during a minor, outpatient procedure. A fistula is created from the body’s own tissues, joining a vein to an artery, usually at the elbow or wrist. Fistulas tend to be more durable, longer lasting, and are much less inclined to infection and complications.

When veins are not large enough to create a fistula, a graft is a good option. A graft is an artificial tube that is used to join artery to vein. This is also done in a minor, outpatient procedure. When dialysis needs to begin quickly, a graft can be used within 2 weeks.

After surgery, you will be encouraged to strengthen the veins by squeezing a stress ball. Proper care of the access is vital to its long term health.

Complications can include:
• “Steal”, when the fistula causes too much blood to flow away from the hand
• Clotting
• Infection
• Narrowing
• Bleeding
• Formation of an aneurysm in the access

When you see any changes near the access or in the arm, contact your vascular surgeon immediately.Signs of access failure, infection or other complications include:
• Unusual skin color
• Swelling, redness or red streaks
• Increased pain
• Blood or pus at the access site
• Numbness
• Fever

When physicians wait until your GFR dips near or below 15 to recommend a vascular surgeon, you will be in acute kidney failure or acute renal failure, when 85-90% of kidney function has been destroyed. At this point, a catheter may be the only option for access.

Catheter access should only be used in emergent situations, or as a last resortwhen neither fistula nor graft can be placed. Catheters are recommended only while a fistula or graft is maturing or there is no other option for permanent access.

A catheter is inserted under the skin at the neck, with the tubes sitting outside of your body. Because of this outside positioning, catheters are very prone to infections. When a catheter is in place, you cannot shower or take a bath, also increasing the risk of infection from bacteria on the skin.

Catheters dramatically increase the risk of superior vena cava syndrome (SVCS), a serious complication. SVCS occurs when the superior vena cava, a major vein carrying blood from the head, neck, upper chest and arms back to the heart, becomes clogged, obstructing blood flow. Symptoms include shortness of breath, swelling in the eyes, face, neck and upper chest, a blue tinge to the skin, a cough, chest pain and hoarseness.

When a catheter is placed on a temporary basis in an emergent situation, you may be very resistant to a permanent fistula or graft placement due to the emotional and physical pain you have already endured. This can have tragic results as studies show a significantly higher mortality rate for those with catheters; 26% of patients will die within 12 months of catheter insertion, compared with just 11-16% of those who started hemodialysis with an AVF or AVG.

    Asking for a referral to a vascular surgeon for access placement as soon as possible will help avoid these complications. 

Your vascular surgeon should monitor the health and viability of a dialysis access regularly, beyond the checks that are made prior to each dialysis treatment. You’ll make an appointment with your vascular surgeon every 3 months.

Adequate time for thorough patient education and relationship building, placement and proper maturation of the access and ample training in the care of the access will help your retain as much quality of life as possible, and keep you as healthy as possible throughout their dialysis experience.

Central-venous-catheter-2 AV-graft-1 Dialysis_Access_01_Base-1 NKDEP_Hemodialysis_Dialyzer_Illustration_P2

Could this have started during your teens?

Actually, atherosclerosis begins developing in childhood. While the symptoms of atherosclerosis aren’t felt until you’re into middle age or older, this disease develops over decades. 

Atherosclerosis is the buildup of plaque – fats, cholesterol, cells and other substances – on the artery walls. Over time, this plaque narrows your arteries, restricting blood flow. Because this happens so slowly, only when the arteries are so narrow that your organs and tissues aren’t receiving adequate oxygen and nutrients will symptoms appear. Often, atherosclerosis isn’t found until you have a major health event, such as a stroke, heart attack or acute limb ischemia. 

By the age of 10, you likely had fatty streaks evident in your arteries, and by the mid-20’s, there was a build-up of fibrous plaque. This is especially true if you smoked or were overweight as an adolescent or teen. 

Atherosclerosis can happen in any part of your body, in any artery. There may be plaque in your carotid artery, supplying blood to your brain, and putting you at a great risk of stroke. Symptoms include passing weakness or numbness in your arms or legs, slurred or difficult speech, or a blur or loss of vision in one eye. 

Atherosclerosis in your legs or arms causes peripheral artery disease (PAD) and may be evidenced by pain in your legs when walking that eases when you rest. PAD puts you at risk for acute limb ischemia and amputation. 

High blood pressure can be a sign that atherosclerosis is in your renal arteries, leading to your kidneys. Left untreated, this can lead to kidney failure. 

Atherosclerosis anywhere in your body can cause an aneurysm, a weakened spot that bulges in an artery. Aneurysms can be deadly if they burst, and so should be carefully and regularly monitored by a vascular surgeon. 

Talk to your doctor about your risk of atherosclerosis, especially if you:

  • Smoke or use other tobacco products
  • Diabetes
  • Overweight 
  • Lack of exercise
  • Lack of a healthy diet
  • High blood pressure
  • High cholesterol
  • Family history of atherosclerosis or heart disease

If you are diagnosed with atherosclerosis, through a preliminary blood test and then ultrasound and other non-invasive testing, the severity of your condition will dictate your treatment. You may be told to quit smoking, increase exercise, lose weight and adopt healthy eating habits. You may be given medications that lowers blood pressure, lowers your cholesterol or reduces plaque buildup. In severe cases, our physicians may use vascular or endovascular surgical techniques to open or clear the plaque from the affected arteries. 

While it’s not possible to stop this before it begins – because it began so very long ago – it’s possible to slow or halt the progression of atherosclerosis. You can:

  • Quit smoking and all other forms of tobacco
  • Exercise at least 5 days a weeks for at least 30 minutes each day
  • Eat a healthy diet by eliminating processed foods, increasing your intake of fresh whole vegetables and fruits, using olive oil and reducing or eliminating sugar and sugar substitutes
  • Maintain a healthy weight
  • Strictly monitor and manage diabetes
  • Reduce stress by using deep breathing, meditation and relaxation techniques. 

Questions about atherosclerosis treatment and management? Reply to this email or call 815-824-4406. We are happy to help!

Are You Ready To Get Rid Of Your Varicose Veins?

veintalk VSPWith all the snow and ice on the ground, it’s the perfect time to plan for swimsuit and shorts season!

While we know that sounds a little daft, we also know that getting your varicose veins treated now means that your legs will be healthy, smooth and ready for your winter vacation to a warm spot – and for spring. 

How do varicose veins form?
Varicose veins and spider veins happen when the tiny valves in your superficial veins weaken. These tiny valves have a big job: helping your veins return blood back to your heart. When blood moves up, a healthy valve closes to keep blood moving upward. When the valves don’t close properly, blood flows back down the vein and then pools.

Am I at risk of varicose veins?
If mom or dad had varicose veins, men have a 25% great chance of developing varicose veins and women have a whopping 62% chance. Women who’ve had two children have a 30% risk increase, and three children increases the risk by 57%. If you stand or sit a great deal without changing positions frequently, your risk increases. Smoking is a significant factor as is obesity. And of course, the older we get, the greater the chance of developing varicose and spider veins.

So my veins are ugly. Can’t I just live with that?
While the look of your legs may not bother you, the truth is that varicose veins are dangerous to your overall health. Left untreated, varicose veins will make your legs ache and feel “heavy” and make it painful to stand, walk or sit for any period of time. You’ll feel burning, itching, throbbing and cramping. Pooling blood can cause clots, which puts you at the risk of stroke. Varicose and spider veins can also cause eczema, swelling, induration (a hardening of the soft tissue in your leg), ulcers, bleeding and vein ruptures. Varicose veins are a real threat to your good health and quality of life.

Can I cure them at home?
The progression of varicose veins can be slowed with compression stockings, frequent elevation and by altering your lifestyle (quitting smoking, losing weight), but they cannot be reversed without medical intervention.

How are they treated?
Our medical professionals will screen your legs for deep vein thrombosis, May-Thurner Syndrome and to confirm chronic venous insufficiency.

Treatments we may recommend are:
Endovenous Thermal Ablation – Guided by ultrasound, a catheter will be inserted into the affected vein. Heat will then be applied, through radio frequency or laser, causing the vein to collapse and close. When the vein is closed, the body redirects blood to healthy open veins. In time, the collapsed vein is absorbed into the body’s tissue.

The procedure takes about a half hour and is performed with a local anesthetic. Ablation is 98% effective and about 92% of veins remain closed after 5 years. 

Sclerotherapy - Used for small varicose veins, spider and reticular veins, a salt solution is injected into your veins, causing them to scar and close. Your body will redirect blood into healthy veins. 

Phlebectomy or Ligation and Stripping – These surgical methods are rarely performed, and only for the most serious, tortured veins. Phlebectomy involves multiple incisions along the vein to remove it. Ligation is an open surgery which removes the great saphenous vein. Treating varicose veins early, before they progress to tortured veins can help you avoid these procedures.

 How long does it take for the veins to scar and disappear?
Eight weeks after treatment, you should see dramatic differences in the health and look of your legs. When you get treatment in December or January, your legs will be smooth and healthy by February or March – just in time for spring break!

I’m ready! What is my next step?
Call our office at 815-824-4406. We will set up an appointment as soon as possible and put you on the path to healthier, smoother legs!

FREE Breakfast * FREE Health Screenings * FREE Health Presentation

5288 Nov 15 PAD presentation FLYER

Hosted by the Vascular Education Foundation

FREE Health Screenings
FREE Breakfast Buffet
FREE Understanding PAD – Peripheral Artery Disease

• Get screened to learn your vascular disease risk
• Enjoy a complimentary hot breakfast
• Learn the risk factors and symptoms of PAD
• Understand PAD treatment options
• You’ll be entered to win door prizes such as movie tickets and dinner!

These complimentary full, vascular health screenings are recommended for those over the age of 50 with at least one of these risk factors:
• High Blood Pressure
• High Cholesterol
• Diabetes
• Smoker, current or former
• Family History of Vascular Disease including stroke, heart attack, kidney failure, peripheral artery disease or abdominal aortic aneurysms.

The complimentary screenings are non-invasive and painless. We’ll check your ankle-brachial index using blood pressure cuffs and scan your carotid artery and abdomen with ultrasound. When we see or hear anything of concern, you’ll have the opportunity to discuss your results with a medical professional at that time.

Enjoy a free buffet breakfast, including eggs, toast, a variety of sausages, potatoes, coffee and orange juice at one of the best restaurants in Tinley Park.

You’ll also get a fuller understanding of peripheral artery disease, narrowing of the arteries in your limbs, especially your legs. You’ll discover the symptoms you should watch for, including claudication, pain when walking that eases with rest. We’ll discuss evidence-based treatments, and explain the complications you may endure, including amputation and stroked, if PAD is left untreated.

Meet and hear from recognized expert physicians who are board-certified and fellowship trained in both vascular and endovascular surgery, including Dr. Tanquilut, Dr. Pradhan, Dr. Alhalbouni and Dr. Qureshi.


Thursday, November 15
Ashford House
7959 West 159th Street, Tinley Park

7:30 am: PAD, Carotid Artery Disease and Abdominal Aortic Aneurysm Screenings
8:30 am: Breakfast served
9:00 am: Presentation begins

This event is FREE, but seats are limited. Please reserve your seat by contacting julie.rivera.vef@gmail.com or 219-314-1644 by November 10th.

LEA-UP Meeting Focuses On Antibiotic Stewardship – Dr. Brian Yu presents and leads discussion about diabetic foot wound care.

BrianYuLEA-UPA real and growing concern about “superbugs” brought together over eighty medical professionals to hear specialist Dr. Brian Yu discuss diabetic foot infections from an infectious disease perspective.

There has been an uptick in these cases recently, says Yu, an infectious disease physician who treats inpatients at Advocate South Suburban Hospital. About twenty percent of his cases now involve consulting and treating infected foot ulcers in diabetic patients. “While diabetic foot wounds have always been an issue, there is now an increase in cases. There is more peripheral vascular disease and therefore more risk of infection.”

Peripheral vascular disease (PVD) or peripheral artery disease (PAD) is caused by a build up of plaque, fatty deposits, calcium and cholesterol, along the walls of arteries. This narrows the blood vessels and reduces blood flow to organs, arms, legs and feet. Healthy blood flow is vitally necessary for wounds to heal. 

LEA-UP, Lower Extremity Amputation and Ulcer Prevention Event was hosted by the Vascular Education Foundation at Palos Heights’ Capri Ristorante Italiano. LEA-UP meetings, CME presentations and discussions, are open to physicians, specialists, nurse practitioners, and other medical professionals, to learn from presenters, share case studies and discuss methods and results. LEA-UP meetings also offer opportunities for representatives of medical products and services to exhibit and network with these professionals.

Eugene Tanquilut, DO, founded Vascular Education Foundation to increase awareness of the dangers and severity of vascular disease through the education of healthcare professionals and the community. “Our goal is to ensure that everyone is aware of both preventative measures and treatment options for vascular disease,” said Tanquilut. He is a fellowship-trained vascular and endovascular surgeon and president of Vascular Specialists, LLC in Olympia Fields, Orland Park and Chicago. His philosophy of educating his patients about their health issues, their treatment options and their recovery process prompted the formation of Vascular Education Foundation and LEA-UP events to facilitate ongoing learning among medical colleagues. The quarterly dinners are free of charge and open to any medical professional interested in preventing life-changing wounds and amputations. 

“I couldn’t pass up this opportunity,” said Yu, to educate fellow medical professional from all over the Southland about the role of infectious disease in amputation. “It is always better to preserve limbs, for morbidity, mobility and patient satisfaction.” 

That sentiment was echoed in Tanquilut’s welcome to the group and introduction of Dr. Yu. “Quality of life can be different at different stages of one’s life,” he said. “For example, quality of life for a younger person may be the ability to go for a run, swim or even the ability to do their job; however, when one turns 80, quality of life may be as simple as the ability to walk.”

With Vascular Education Foundation and LEA-UP’s collaborative focus, bringing together different specialities from all hospitals throughout the Southland to share information and theories, Tanquilut is working to do just that: give patients quality of life through the ability to walk independently as long as possible by avoiding amputations. 

Vascular Education Foundation and the LEA-UP meetings have already made impacts in real time care. Gladys Macagba, MD, a hospitalist with Advocate South Suburban Hospital, attended the November 2017 meeting that focused on calciphylaxis, a rare, incurable disease often mistaken for PVD. “I had never seen it before, but because of the meeting, I knew what it was when I saw it in a patient. I was able to properly diagnosis it and refer the patient for treatment immediately. I see infections in the foot all the time, so this information is good to know. I will keep coming.”

Dr. Yu earned his medical degree at Rush University Medicine and completed a Fellowship in Infectious Disease at Loyola University Medical Center. He is board certified in Internal Medicine and Infectious Disease. He is with Metro Infectious Disease Consultants, with offices in Crestwood. He has worked and consulted with Dr. Tanquilut for four years at Advocate South Suburban Hospital. “Infectious disease, vascular and podiatry work hand in hand to heal wounds,” he said. “Gene is always cordial in interactions with patients and physicians. He is open-minded about best treatments and we are always on the same page in patient approach.”

George Shehata, MD is a geriatric and wound care physician, seeing patients in area nursing homes. He says wound care and vascular care are “two sides of the same coin. Diabetic cases are more than a third of my patients and the blockage of small arteries, PAD, is the greatest challenge to healing. Most diabetics have PAD. I need this updated information all the time – I want to know if there is anything new.”

Samantha Hathaway, MD, an Advocate South Suburban hospitalist, agrees. “I’m always interesting in learning more.” Susan Diaz, an RN with Palos Hospital, said, “Diabetes is very much everywhere right now. Every one (of my patients) seems to have it. I came here because I want to learn more about it, and how I can use this information to help my patients.” 

Also among those in attendance were Narcisa Ditan, an RN with Optimum Home Health Care, Edna Leong, MD and Florentino Leong, MD. Ditan said, “Nurses are the ones who see the most diabetic wounds and it’s important for us to gain knowledge on this, to apply to our cases. Most of our patients have diabetes, and because of this presentation, I’ll be able to suggest better treatments.” 

Yu covered several points in his presentation including evaluating diabetic foot infections, categorizing their severity, and when, how and for what length of time an infection should be treated with antibiotics. He explained that diabetic foot ulcers account for about twenty-five percent of all hospital stays for diabetic patients, and stresses that medical professionals should urge patients to be compliant with doctor’s instructions and to stop tobacco use. He instructed that infected wounds should be cultured before prescribing antibiotics. A culture, a test that identifies which bacteria are causing the infection, helps determine which antibiotics will be effective in treating the infection and healing the wound. 

His emphasis shifted to a serious problem in health care – growing antimicrobial resistance, or superbugs. Superbugs are bacteria that develop a resistant to antibiotics. Containing superbugs is an ongoing challenge, as medical professional weigh the risks against patient recovery. Each year, over 2 million people are infected with antibiotic-resistant bacteria, and about 23,000 of these infections will be fatal. 

Yu stressed the importance of antibiotic stewardship. This stewardship can optimize the treatment of infections while reducing adverse affects of antibiotic use. Put simply, Yu says, “it’s having the right drug for the right person over the right time frame.” 

Yu guided participants through charts of antibiotic usage; for specific infections, for specific pre-existing conditions and for potential interactions with other medications, always urging the listeners to avoid prescribing antibiotics unless they were conclusively necessary. He repeatedly sounded the alarm that “clinically uninfected wounds should not be treated with antibiotic therapy” and made recommendations for other types of treatment. He stressed that diabetic care requires a multidisciplinary approach, as it affects so many parts of the body. 

Discussion at the end of Yu’s formal presentation clearly showed how the participating medical professionals are invested in patient health. 

Collectively, these medical professionals agreed that any patient with an ulcer or open wound on their foot should be seen by a vascular surgeon, a podiatrist or a wound care specialist to immediately initiate care to prevent the ulcer from progressing to gangrene. 

Mark Gagnon, DPM, reflected Tanquilut’s original statement about quality of life. “Functionality is the key to amputation decisions. We have to ask ourselves – is the foot functional?”

Participants discussed methods of treating persistent infections, how to find answers for the confounding wound that won’t heal, how to approach a patient that will not comply with instructions and treatments, and shoe recommendations. Yu explained that shoes should be well-fitting and comfortable and that shoes with a rubber sole help to prevent the formation of ulcers. 

Asked by several physicians about his recommendation to avoid culturing a wound that does not appear to be infected, Yu clarified that culturing a dry eschar, dead tissue cast off from healthy skin, can pick up normal bacteria, causing the physician to administer unneeded antibiotics. This ultimately leads to a resistance to that antibiotic, making subsequent infections more and more difficult to treat. Several physicians held that culturing and identifying harmful bacteria means an infection can be treated more quickly, avoiding a severe infection. Yu stressed the importance of throughly debriding the wound first to ensure an appropriate culture. 

Yu explained that while there is no real time line for the length of time a patient should be or can be on antibiotics, it’s vitally important to take into account responsible antibiotic stewardship. 

“CDIF (clostridium difficile colitis) is a major concern for us. Doing less harm is always the goal, and prescribing more antibiotics means more toxins in the body, and more chances of an adverse reaction.” 

Nancy Rivera, an NP at Silver Cross Hospital, expressed concern that antibiotic stewardship is necessary at all levels of care, including the primary care physician community. Yu responded, “Yes, there is still too much antibiotic prescribing out there and there’s only a finite amount of antibiotics available. New antibiotics are just not coming in.”

Rivera added, “I love the educational component of LEA-UP to help everyone understand that the overprescribing of antibiotics means infections becoming more and more difficult to treat.”

Yu agreed. “What Gene (Tanquilut) has set up here, these meetings, gets everyone together to talk and to learn. It’s important.” 

“To these medical professionals, patient care is of the utmost importance, whether that’s in saving limbs or defeating superbugs,” said Tanquilut. “Getting everyone together – whatever speciality, nurses, doctors, caregivers – is vital to patient care and preserving quality of life. We need to share information to meet the all the healthcare needs of our patients.”

LEA-UP meets again on Thursday, September 20. Dr. Avni Vora will discuss optimal glucose control in diabetic patients to prevent complications. The CME event is open to any health care professional. For more information, email jrivera@vascspecialists.org or call 815-824-4406 and ask for extension 130. Exhibit opportunities for medical products and services are also available.

Better Health is Just Steps Away!

young man runner tying shoelacesThere’s a life-transforming exercise out there and nearly everyone can do it. It’s free, it requires no expensive equipment and it can be done anytime throughout the day. It’s walking!

Walking is completely individualized and still a complete workout. When you walk at the fastest pace you can manage, you are working your lungs, your heart, your muscles and your veins and arteries. When you’re feeling your heart beat faster and you’re getting a sensation in your leg muscles at least 30 minutes a day, your body is getting a beneficial workout. 

Walking has very little risk of injury. It’s low impact, and if you slowly build speed and mileage, while wearing a well-fitting pair of athletic shoes that don’t rub or irritate, your body will adapt with very few problems. The biggest safety concern is motor vehicles, so stay alert and aware when you are walking near streets and through intersections.

Walking offers variety. Visit Chicago’s lakefront for a relatively flat challenge or head to Palos’ Swallow Cliffs to walk the stairs! Not only can you change the intensity of your workout by visiting different terrains, you can enjoy different surroundings each time, keeping your walks always interesting. 

Walking can be done anytime. By increasing your steps throughout the day, you can still reap the benefits of walking. Always take the stairs instead of the elevator. Park in the farthest spot instead of circling for a closer spot. Walk to any errand that’s a mile or less away. Get up and walk to your coworker instead of sending an email. When the phone rings, get in the habit of standing up and pacing instead of sitting during the entire conversation. Take a 10-minute brisk walk after each meal. 

• Walking 10,000 steps means you’ve walked about 5 miles.
• Walking briskly about 6 miles a week lowers blood pressure and cholesterol, reducing your risk of stroke and heart attack by 31%.
• Walking lowers your blood sugar and helps your body better use sugar, better controlling diabetes.
• Depending upon your weight, you’ll burn 150-250 calories walking 30 minutes.
• Swinging or pumping your arms can burn up to 10% more calories while you walk.
• BONUS – walking in a leafy, natural area also reduces anxiety and depression.

Transform your life. Put on a pair of athletic shoes and go take a walk! 

Not So F.A.S.T. Can Still Mean Stroke

May is World Stroke Awareness Month and here at Vascular Specialists, our medical professionals are committed to helping you avoid this life-changing health challenge, or to make sure you recover as much as absolutely possible in the event of a stroke. 

The F.A.S.T. campaign to identify stroke, Face drooping, Arm weakness, Speech slurred and Time to call 9-1-1, has been an enormous help in getting patients immediate medical care, increasing the chances of a healthy recovery. 

But what about other symptoms of stroke? “There are other, smaller and less visible signs of stroke,” says Dr. Tanquilut. “Recognizing those symptoms quickly – and getting treatment immediately – is also vital to a patient’s recovery.”

Vision Changes
When you have a sudden change in vision, perhaps a blurriness, colored spots or a “blocked” spot in your vision, either in one or both eyes, call 9-1-1.

Coordination Changes
When you feel a sudden onset of dizziness, have trouble walking or handling objects, or are losing your balance, call 9-1-1.

When you experience sudden numbness in your face, your arms, your legs or any part of your body, especially if you feel it only on one side of your body, call 9-1-1.

When you suddenly feel confused, have trouble speaking clearly, have trouble understanding what is being said to you, do not know where you are or how you got there, call 9-1-1.

When you experience a sudden terrible headache, especially if you are over 40 and have never had a migraine, perhaps but not necessarily accompanied by a loss of sight or numbness in your hands or feet, call 9-1-1.

“Notice that in each case,” says Dr. Tanquilut, “we recommend calling 9-1-1 immediately. If you are having a stroke, “time is brain”. The faster you get in an ambulance and start receiving emergency care, the better your chances for a full recovery.”

Don’t wait. Don’t be afraid about being mistaken in your symptoms. Call 9-1-1 immediately when you suspect someone is having a stroke. The medical professionals you’ll meet along the way of your emergency call, whether it’s a stroke or not, will be happy to examine you, treat you and help you stay healthy and maintain full functionality. 

Have you been screened for stroke risk? Call our office at 815-4406 to ask about a screening of your carotid arteries, a PAD assessment and an analysis of other health factors to determine your risk of stroke. 

Eleven Reasons You Need a Vascular Surgeon

EugeneTanquilutDOYou have a family doctor, a dentist and perhaps an eye doctor, all working together to improve or maintain your wellness, your quality of life and help you better understand how you can control your own good health. When more specific health challenges occur, you’ll add specialists, like an orthopedic physician, a rheumatologist or a nephrologist. 

So much of your continuing good health is tied to proper blood flow throughout your body and to the viability of your arteries and veins. It’s vital to have a vascular surgeon on your health care team too. 

Vascular/endovascular surgeons are uniquely trained in treating diseases of the vascular system. These surgeons are the only physicians who can prescribe medications and non-invasive therapies, perform open surgery and perform minimally invasive procedures. They are also the only surgeons who can perform complicated hybrid surgeries involving both open surgery and minimally invasive procedures. 

When should you add a vascular/endovascular surgeon to your health care team?

1) When you experience intermittent claudication, cramping or pain in your buttocks, thighs or legs while walking that eases when you stop activity.

2) when you have a wound that is slow to heal, a wound that gets worse instead of improves, 

3) when you have a wound that shows signs of developing gangrene. Gangrene can discolor the skin in a range of hues, such as very pale, blue, purple, black, bronze or red. There is often swelling, blisters or foul-smelling discharge. You may see a clear delineation between diseased skin and healthy skin. 

4) when you experience pain in your forefoot, toes and ball of foot, especially at night. 

5) when you have coldness, numbness or tingling in your feet.

6) when you are experiencing erectile dysfunction. 

These are all indications that you may have peripheral artery disease (PAD). This life-threatening vascular disease narrows arteries and dramatically increases your stroke risk. PAD developed when cholesterol particles accumulate on your artery walls, causing plaque to form. This plaque will build into thicker deposits, causing atherosclerosis, the narrowing of your arteries, restricting blood flow. This blockage can happen anywhere in your body, in the arteries in your stomach, head, arms, but most commonly your legs.

If left untreated, atherosclerotic plaque can cause stroke and critical limb ischemia. When sores, injuries and infections in your legs can’t heal because of restricted blood flow, the tissue begins to die, causing gangrene and requiring amputation

You should see a vascular surgeon when you have:

7) renal artery disease.

8) family history of abdominal aortic aneurysm or a pulsating abdominal mass. 

9) over 50 years of age with a history of smoking.

10) over 50 years of age with a history of diabetes.

11) history of stroke or transient ischemic attack (TIA).

To make an appointment with Vascular Specialists, call 815-824-4406. Having a vascular/endovascular surgeon on your wellness team means better health for you!

LEA-UP Meeting Focuses On Foot and Leg Wound Care To Avoid Amputation

IMG_7391IMG_7386 IMG_7389
Podiatrist Maureen McShane presents to open group of medical professionals.

Over forty medical professionals gathered to hear Maureen McShane, DPM, explain why a tiny blister could lead to a amputation – and how to prevent that.

“A little blister becomes a big deal in diabetic patients or those with peripheral artery disease,” explained McShane. “These patients typically cannot feel their feet due to nerve and vascular damage. So that little blister gets bigger and the wound gets deeper, without notice.” Ultimately, a blister left untreated can become infected, develop gangrene and make an amputation of the toes, foot or leg necessary.

McShane, a podiatrist with Palos Health, has been practicing medicine for over twenty-five years and seeing patients with chronic wounds for decades. She spoke to the collaborative health care group LEA-UP (Lower Extremity Amputation and Ulcer Prevention) at a meeting in Palos Heights.

LEA-UP was founded by Dr. Eugene Tanquilut of Vascular Specialists in Olympia Fields, New Lenox, Orland Park and Chicago. LEA-UP is an non-competitive, open group of primary care physicians, podiatrists, nephrologists, infectious disease specialists, vascular surgeons, plastic surgeons, nurse practitioners, and other medical professionals from area hospitals including Advocate South Suburban Hospital, UChicago Medicine Ingalls Memorial, Metrosouth Medical Center, Palos Community Hospital and Silver Cross Hospital. Quarterly meetings feature an expert speaker and a sharing forum of questions, answers, case studies and treatment options.

Wounds in the feet may be caused by rubbing, such as blisters, corns and calluses. Patients can develop ulcers from diabetic or vascular complications. Trauma, such as a scratch, puncture or slice, can also be the catalyst for a chronic wound.

“Preventing and healing wounds requires an interdisciplinary approach,” said McShane. “Podiatry is one part of a wheel. We find that when we use podiatry, vascular medicine, infectious disease, wound care, nurse practitioners, and physician assistants all working together patients improve much faster. The chance of amputation is greatly reduced.”

McShane explained that it’s not just the patient’s foot that is of concern, it’s the entire health of the patient. Blood flow is vital to healing, and when vascular health is compromised, wounds just don’t close. This condition could be caused by chronic venous insufficiency, by peripheral artery disease (PAD) and diabetes.

McShane explained how smoking a cigarette constricts blood vessels, and how those vessels won’t open up again for about forty-five minutes after the cigarette is finished. At that time, she says, most smokers will light up again, restricting blood flow all over again. “That means if you smoke a pack a day, you’ve gone an entire day without blood ever getting to your wound.”

Nutrition is always important, and this is where primary care physicians, nurse practitioners and physician assistants play a vital role. McShane says these health care providers can help guide patients to better diets and healthier choices. “We should refer to nutritionists who can help patients resolve protein deficiencies. Patients need to understand the importance of adequate vitamins, particularly A and C, in the body’s production of collagen that strengthens the skin.”

It sounds simple, but McShane stresses the importance of wearing shoes to avoid puncture wounds in the feet. She also explained that ill-fitting shoes are the culprits in the formation of blisters, corns and calluses. Dr. Jerry Chee Sing Chow, a plastic surgeon attending LEA-UP that evening, agreed. “A huge problem is bad shoes that cause rubbing and blisters. Patients need to get properly measured, choose shoes that fit well and consider inserts or custom orthotics.”

Education of patients is paramount in the quest to avoid amputation. Charcot foot, when foot bones fracture and the arch of the foot drops to form a “rocker bottom”, must be diagnosed and treated as early as possible to halt this deformity and avoid ulcers. Patients with neuropathy, significant nerve damage, should watch for warmth, redness and swelling in the foot, along with pain or soreness, and alert their podiatrist immediately of these symptoms.

McShane described a patient who, because of limited education about wound care, for twenty-five years, applied an over-the-counter topical antibiotic ointment to a wound resulting from a motorcycle accident. After just 4 weeks of proper, medically supervised treatment, his wound had shrunk to a fraction of its original size.

When a wound does occur, McShane said, the severity of the wound will dictate the recommended treatment. Medical professionals may consider debridement, which removes diseased tissue or wound V.A.C, which removes bacteria and infection and pulls the wound edges closer together. A variety of skin grafts may be used, either taken from the original patient, from a donor or with dermal substitutes. A soft tissue scaffold may be considered. Topical dressings, gels and ointments may be used to cover the wound and promote healing.

A further step to preventing amputations is consulting a vascular surgeon to see if the foot or leg can be revascularized to get blood flow reestablished. Tanquilut, a board certified and fellowship trained vascular and endovascular surgeon, said, “We try to get a “blush” into the toes, to get aggressive flow into the leg, open up the vessels as much as possible. Sometimes, though the smaller vessels are just shot.”

Unfortunately, there are occasions where patients face amputation. “No patient wants to hear they are losing their toes or foot,” said McShane. “But often, their quality of life will actually improve after an amputation.”

Director of Perioperative Services at Palos Community Hospital Diane Teresczenko was pleased with the information provided at LEA-UP. “I love working with Dr. Tanquilut and there is always more to learn about patient care, improve patient outcomes. I’m excited that this group gets together with a purpose, to interact with each other, learn from each other and share technologies.”

Wendy Valenti, a nurse at Palos Community Hospital said she was glad to find out about LEA-UP and intends to return. Maryann Merlo, Nurse Practitioner, said “I see a ton of diabetic patients that I often refer to Dr. McShane. I’m pleased I can ask questions and get answers from her experiences and knowledge.”

Chris Offerman, CWOSN at Silver Cross Hospital, said the interdisciplinary aspect of LEA-UP is extremely important and is grateful that Dr. Tanquilut runs the group. “We need to know about the latest in wound care to continually improve results for our patients.”

Tanquilut founded LEA-UP to, as he says, “help save limbs. It’s important that medical professionals in all disciplines share information, share results and share therapies so our patients don’t have to face amputation.”

LEA-UP meets quarterly over a sponsored dinner at Zachary’s Grill in Palos Heights. The events are open to any health care professional. Interested professionals should email jrivera@vascspecialists.org or call 815-824-4406 and ask for extension 130. Dinner sponsorship opportunities to introduce medical products and services are also available.

Springtime Special Vein Offer from Vascular Specialists!

Perfect legs.Don’t spend another summer hot, sweaty and uncomfortable because you’re hiding your legs in long pants. Now is the perfect time to start sclerotherapy and vein treatments to get rid of spider veins and varicose veins. Your legs will look fabulous when warm weather begins, and you’ll save with Vascular Specialists Springtime Special Offer.

Book a consultation for just $100 – and we’ll apply that payment to any costs for your vein treatment. 

Your legs deserve the highest level of care from our medical professionals when treating your spider or varicose veins. At your consultation, we’ll thoroughly examine your legs, complete a health history and physical examination, and then discuss your treatment options, answering all your questions completely and to your satisfaction. You will understand everything you want to know about your diagnosis, treatment and expected recovery.

For minor spider veins, a preferred treatment is sclerotherapy, a saline-based solution injected into affected veins, causing them to shrink and disappear. Sclerotherapy is performed in our offices and you’ll walk out of the office. Depending upon the severity of your spider veins, you may or may not need follow up treatments. You’ll wear compression stockings for one to three weeks after treatment, and we’ll see you for a check up within a week or two.

For varicose veins, we may discuss endovenous ablation. Radio frequency or laser technology is used to cauterize the damaged veins which are then regress into your body. Ablation is performed in our offices, often under mild sedation. You will be able to walk out of the office and should wear compression stockings for a few weeks after treatment. We’ll see you to make sure the vein is closed.

Spider and varicose veins do not go away by themselves, with compression stockings or with leg elevation. The only way to eliminate them is with medical intervention. Your insurance may cover costs for varicose vein treatment, as venous insufficiency can lead to serious health problems in some cases.

Summer is coming. Make sure your legs are ready for shorts, skirts and bathing suits.

Call us at 815-824-4406 or reply to this email to make your $100 Consultation Appointment now.

Dr. Tanquilut 1st to Perform Breakthrough Aneurysm Repair at Silver Cross


Fellowship trained surgeon uses fenestrated stent graft to repair abdominal aortic aneurysm. 

On Jan. 31, 82-year-old Salvatore Darpa became the first patient to receive a fenestrated stent graft to repair an abdominal aortic aneurysm at Silver Cross Hospital in New Lenox. Dr. Eugene Tanquilut of Vascular Specialists performed the historic surgery.

“My father had been having pain, and his chest was bulging a bit,” said Sara Darpa, Salvatore’s daughter. The Lockport resident, who speaks only his native Italian, saw his primary care physician Dr. Zafer Jawich and was diagnosed with a hiatal hernia. A hiatal hernia happens when a substantial part of the stomach pushes through the hiatus, a small opening in the diaphragm, the muscle which separates the chest and the abdomen. Dr. Jawich recommended the family to general surgeon Dr. Reza Gamagami. On October 12, Dr. Gamagami surgically repaired Salvatore’s hernia, using Silver Cross Hospital’s da Vinci robotic surgical system. The procedure was successful, but there was a concern.

“When Dr. Gamagami came out to tell us how the surgery went, he told us my dad had an abdominal aortic aneurysm (AAA). No one knew about it,” said Sara Darpa.

An AAA happens in the aorta, the body’s main blood vessel. The aorta is about the size of a garden hose and runs from the heart down through the abdomen, splitting into the iliac arteries below the waist. An aneurysm is a weakening in the wall of the aorta, like a balloon, which begins to expand. Many aneurysms are small and stay small, never causing any problems for a patient. When a smaller AAA is discovered, most physicians recommend a “wait and watch” approach, monitoring the AAA for any growth or signs of impending rupture.

In Salvatore’s case, that conservative approach was not an option. “Dr. Gamagami told us that doctors become concerned and recommend surgery when the AAA is at 5 centimeters,” said Sara Darpa. “My dad’s was already at 7.” Darpa says Dr. Gamagami told the family to call Dr. Tanquilut as soon as Salvatore had healed from the hernia repair. “We went as quickly as possible.”

Dr. Eugene Tanquilut is board-certified and fellowship-trained in vascular and endovascular surgery. He is President of Vascular Specialists, with offices in Olympia Fields, New Lenox, Orland Park and Chicago. He completed his fellowship training at the esteemed Cleveland Clinic in Ohio and is well respected in the Chicago Southland for both his outstanding surgical skills and accessible, warm bedside manner. The group treats patients at Silver Cross Hospital, Advocate South Suburban Hospital, Franciscan Health Olympia Fields and Chicago Heights, and Advocate Trinity Hospital.

At the initial appointment in November, Dr. Tanquilut did a complete examination of Salvatore, and explained that he could feel the AAA using his hands. Sara’s sister was able to feel it through Salvatore’s abdomen too.

“Dr. T made us feel very comfortable immediately. He’s very friendly and very willing to answer questions. He explained everything, talked about our options of the endovascular surgery or opening my dad up from his chest to his groin. Dr. Tanquilut drew out the surgery for us and explained it all start to finish. My dad is not in the best of health. He’s had a triple bypass, lung cancer, he was a heavy smoker, he has heart disease and manages diabetes. Our family made the decision to go with the endovascular option, because why wouldn’t you if that’s possible? We felt very comfortable that Dr. Tanquilut was going to do it right,” said Sara Darpa.

After initial examination and the decision to use endovascular, or minimally invasive, techniques if at all possible, Darpa underwent a CT scan that provided accurate measurements of the location and size of his aorta and the aneurysm along with details of his own unique morphology.

“Mr. Darpa’s AAA is the most complicated sort of AAA,” said Dr. Tanquilut. “While most AAA can be treated with a regular stent graft, because of the position of Mr. Darpa’s, his required a special construction using a fenestrated stent graft.”

Most AAA are infrerenal, meaning the enlarged area is at least 15mm below the intersection of the aorta and the renal arteries which lead to the kidneys. That 15mm gives Dr. Tanquilut ample room to place a standard stent graft, which resembles a very tiny pair of pants, with the elongated torso of the “pants” protecting the aneurysm from rupture while the “legs” branch off into each iliac artery, which provide the lower extremities with blood flow.

Darpa’s AAA was juxtarenal, which means there was at most 5mm of space between the renal arteries and the aneurysm itself. “A regular stent can’t be placed in this location,” said Dr. Tanquilut, “because blood flow to the kidneys would be blocked.

It was as early as 2002 that Dr. Tanquilut began working with the Australian experimental fenestrated stent graft at Cleveland Clinic. “At this time, the fenestrated graft were still in the investigative stages; they were only being used in research institutions,” said Dr. Tanquilut.

In spring 2012, the graft, made of woven polyester fabric and stainless steel, was approved for general use in the United States by the FDA. Data has shown that, within 5 years of placement, there have been zero ruptures and no conversions via open repair. In those 5 years, 97.3% of patients have survived any AAA-related causes of mortality, and there have been no deaths from device failure.

Dr. Tanquilut and his associates at Vascular Specialists, Dr. Sanjeev Pradhan and Dr. Saadi Alhalbouni, are the only board-certified and fellowship-trained endovascular surgeons at Silver Cross Hospital.

“Because of Mr. Darpa’s advanced age and multiple medical conditions, he really couldn’t handle an open operation. In this case, an open procedure would require clamping below the superior mesenteric artery or renal arteries, which stops the blood flow to the kidneys and to the intestines. That increases the chances of complications, possibly leading to mortality,” said Dr. Tanquilut. “In this case, a fenestrated stent graft or a chimney graft were really the only two options to give the patient a chance at a timely and full recovery, with minimal chance of complications. I trust the fenestrated modality.”

In a little less than six weeks, Cook Medical, maker of the Zenith fenestrated stent graft, fashioned Darpa’s fenestrated stent to Darpa’s exact measurements, ensuring a precise fit within his aorta. The result was a tube with openings on both ends, holes on either side and a scallop at the top to accommodate the superior mesenteric artery.

On the last day of January, Salvatore was admitted to Silver Cross Hospital. “Dr. T talked to us before Dad went into surgery, told us it would take about three to four hours, and he would have a nurse update us on Dad’s progress every hour. And he really did,” said Sara Darpa.

In surgery, Dr. Tanquilut made a small incision in Darpa’s groin, then inserted a catheter which he threaded into the aorta. He deployed the fenestrated stent graft, placing the graft within a healthy part of the aorta and aligning the fenestrations – the holes – with the renal arteries. He then placed additional grafts, allowing blood flow into the kidneys and legs. Each stent is small enough to fit on the nail of a little finger, about 6mm in diameter and 6-8mm high.

After surgery, Dr Tanquilut reported to the family. “He said it had gone very well,” said Sara Darpa, “and he didn’t expect there to be any issues going forward. Dr. Tanquilut covered everything, and answered all our questions, even satisfying my sister, who likes a lot of details. When we left that day, we didn’t have any unanswered questions.”

Because of his age and health, Salvatore recovered at Silver Cross for about a week. “He’s home now. A physical therapist and a nurse visit him several times a week,” said Sara Darpa. “It was good for him to get home because he is more motivated here.”

Most astonishing was the phone call and follow up from Dr. Tanquilut. “He called the house and asked when my dad was coming in for a follow-up appointment. I mentioned that we hadn’t made an appointment, because he really wasn’t supposed to leave the house for two weeks. Dr. T asked if he could stop by the house to see Dad and check him out. I mean, oh gosh, did you ever hear that anywhere? Doctors don’t make house calls. Seriously? But Dr. Tanquilut did, he checked out my dad and let us know that everything looked good and his recovery was going well. It was awesome.”

The family didn’t know that Salvatore was the first fenestrated stent graft repair at Silver Cross Hospital. Dr. Tanquilut and his associates have performed fenestrated stent grafts at other area hospitals.

“I think we found out that Dad was the first surgery of this kind at Silver Cross on the day of surgery. Honestly, to us it was no big deal and it never crossed our minds to think about it because we knew Dr. T would do it right.”

“I would recommend Dr. Tanquilut 100%. He has a wonderful personality and the way he explains things is so thorough. He really knows what he’s doing,” said Sara Darpa. “It’s funny to say you feel you have a relationship with a doctor, but because of our relationship with Dr. Tanquilut, my dad made history at Silver Cross, and we never even gave it a thought.”

Is red wine the answer?

grapesFor many years, we’ve been told that red wine, about 4 ounces a day but no more than 7 drinks a week, can lower your risk of heart disease and stroke. Resveratrol, the ingredient found in grape skins, is linked to lowering your “bad” cholesterol, preventing blood clots and preventing damage to your veins and arteries.

Some studies have even recommended that non-drinkers consider adding a glass of wine at least twice a week to improve heart health.

Well, don’t pop that cork just yet, because newer research shows that the benefit of moderate amounts of red wine and other alcoholic drinks may not be all it’s thought to be.

Researchers are beginning to take a closer look at the broader data and are concluding that:

  • Wine drinkers are more likely to have better access to healthcare.
  • Wine drinkers are more likely to exercise regularly.
  • Wine drinkers are more likely to have healthier diets overall.
  • Non-drinkers are more likely to have quit drinking because they had a health-related crisis.

In a nutshell, non-drinkers tend to be less healthy in the first place, whereas wine drinkers have a tendency to be healthier overall. While it will take several more years for scientists to tease out all the data that hasn’t been previously considered in these studies, we at Vascular Specialists do know this: alcohol is detrimental to your vascular health for a variety of reasons.

First, alcohol is addictive and if you have a family history of alcoholism or alcohol abuse, starting to drink even moderate amounts could trigger addiction. Whether a person drinks a few too many every day, or binges occasionally, alcohol can cause a myriad of problems, including:

  • Irregular heartbeat

The heart doesn’t properly contract with Atrial fibrillation, or Afib, resulting in blood pooling in the heart’s chambers. This pooling can cause clots to form, which causes stroke. Ventricular tachycardia is an electrical signal dysfunction, causing the heart to beat too quickly and not fill with enough blood with each beat, resulting in cardiac arrest and sudden death.

  • Stroke

Besides the alcohol-induced arrhythmias described above that result in stroke, alcohol can cause stroke in drinkers with no evidence of cardiac disease.

  • High blood pressure

Drinking alcohol cause the body to produce a hormone which causes blood vessels to constrict and blood pressure to elevate. Alcohol damages the muscles within blood vessels, also causing constriction.

  • Stretching of the heart muscle, cardiomyopathy

The heart is weakened, and cannot pump enough blood to properly supply organs with oxygen and nutrients.

When you want to reap the harvest of benefits from resveratrol without the dangers of alcohol, indulge in grapes, particularly red, dark grape juice, blueberries and peanuts. These foods are naturally rich in resveratrol. If you’re considering a resveratrol supplement, be aware that studies show supplements are not absorbed into your body as effectively as the resveratrol in whole foods.

Do you have questions about your vascular health and your alcohol consumption? Ask your Vascular Specialists medical professional by calling our office. We are always happy to help!

Wound VAC speeds healing, lowers risk of infection for all types of wounds

FS_380x380_ulta-veraflo-dressings,0When your vascular system is compromised by aging, disease or diabetes, your body’s ability to heal an open wound is also impaired. The slightest of injuries that breaks the skin, even a scratch or split, can result in a chronic wound that grows in size. A surgical incision that cannot be closed, or one that opens during recovery, can lead to dangerous infections.

In these cases, your Vascular Specialists medical professional may prescribe a Wound VAC, or Vacuum Assisted Closure. A wound VAC can be used on nearly any part of the body – legs, chest, abdomen and more.

Simply, a wound VAC removes uses a vacuum to remove blood and fluid from an opening in the body that needs to heal. Removing the fluid means removing bacteria from the wound site to lower your risk of infection and reduce swelling. The negative pressure of the vacuum gently dilates the blood vessels, pulling more nutrient-rich, cell-building blood to the site. Together, the removal of fluid and the enrichment of blood flow, along with maintaining a warm and moist environment, combine to help your body form new connective granulation tissue to close your wound.

Before we begin wound VAC therapy, your wound will need to be completely debrided. We’ll remove all dead and infected tissue from your wound site, ensuring the area is as clean and bacteria-free as possible.

We’ll cover your wound with a piece of medical foam cut to the size and shape of your wound. We’ll place a drain, a plastic tube, on top of the foam. We’ll then cover the whole area with a thin clear dressing, securing it about 1-1/2” into your healthy skin around your wound. The drain tubing is then attached to the small vacuum. This vacuum may drain the fluid constantly or may drain in on/off cycles.

You’ll wear your wound VAC, staying connected to the machine itself, about 22 hours each day. Depending upon the condition of your wound, your dressing may be changed every 24 to 72 hours. The canister that collects the fluid should be changed when it’s about 2/3 full, or at least once a week.

Wound VAC therapy will speed the healing of all types of wounds; acute, subacute or chronic. Large chronic wounds could take 16 to 20 weeks of wound VAC therapy to completely heal.

You can help your healing process. If you smoke, ask us to help you quit immediately. Drink plenty of water and eat fresh fruits, fresh vegetables and lean meats. Get at least 8 hours of sleep each night and add a nap whenever possible.

When you have been recommended for wound VAC therapy or have any questions about this treatment, please call us at 815-824-4406. We want to be sure you understand why this is being prescribed, how it will work and any risks involved. Your Vascular Specialists medical professional will listen carefully and give you thorough answers.

NOTE: The photograph above is a sample of a typical wound VAC. It may not represent the VAC used in your therapy. 

Physicians Gather For Information about Diagnosing Calciphylaxis

64410-0550x0475Dr. Eugene Tanquilut’s LEA-UP group learns that early diagnosis is vital to survival. 

– The thirty-five physicians and medical professionals were discussing a condition so rare, only two of them had ever seen it, and one of those was the specialist speaker, Dr. Tauseef Ahmed Sarguroh, a fellowship-trained nephrologist with Kidney Care Center Olympia Fields.

“It’s really a testament to their commitment to their patients,” said Dr. Eugene Tanquilut, the organizer of the evening’s event. “These medical professionals are spending hours of their evening to learn how to identify a disease they may never see, but know that they can’t miss because of the importance of early diagnosis.”

The disease is question is calciphylaxis, a serious and rare condition that occurs when calcium builds up in the small blood vessels of skin and fat tissues. Researchers are still not sure what actually causes calciphylaxis, and believe a variety of factors must be present for the disease to develop. It almost exclusively affects patients experiencing end stage renal disease, and is found in less than 5% of those cases. Three out of four sufferers are female. Obesity, diabetes and the use of blood thinning medications are other risk factors.

Patients with calciphylaxis face a grim prognosis, with only a 40-20% survival rate. Those who do survive are often faced with the amputation of diseased limbs. “Early diagnosis is really the best hope for those with this disease,” said Sarguroh. “Removing diseased tissue as soon as possible and using evidenced-based new therapies such as sodium thiosulfate and even the flesh-cleaning larvae of greenbottle flies give patients the best chance for stopping the spread of calciphylaxis throughout the body and internal organs.”

Being able to make that early diagnosis was the focus of this meeting of LEA-UP, Lower Extremity Amputation and Ulcer Prevention, founded by Tanquilut of Vascular Specialists in Olympia Fields, New Lenox, Orland Park and Chicago. LEA-UP is an open group of primary care physicians, podiatrists, nephrologists, infectious disease specialists, vascular surgeons, nurse practitioners, and other medical professionals from area hospitals including Advocate South Suburban Hospital, Palos Community Hospital and Silver Cross Hospital. LEA-UP meets quarterly over dinner to listen to presenters and discuss treatment methods, case studies and results. The meetings also offers opportunities to introduce medical products and services to these professionals.

“Knowing the early signs of calciphylaxis, what tests to perform, how to diagnosis, and when to refer to specialists, absolutely saves lives and limbs,” said Tanquilut, who is fellowship-trained in vascular and endovascular surgery. “That’s why the multi-disciplinary approach of LEA-UP is so important. We’re not just educating one kind of doctor or specialist. We’re trying to ensure that everyone who will put eyes on an at-risk patient understands what they’re seeing and the steps to take to give that patient the best results possible for each individual case.”

Symptoms of calciphylaxis include small nodules on the skin that develop into black lesions. “Unfortunately,” said Sarguroh, “because this condition is rare, physicians may diagnose these symptoms as peripheral vascular disease (PVD) or cellulitis. There are no lab tests for calciphylaxis and tissue sample testing can be unreliable. The best choice to date to diagnose is a bone scan, but if a professional is thinking PVD, they wouldn’t order this type of test. Early intervention gives patients the best chance of survival, so proper, timely diagnosis is vital.”

Dr. Maureen McShane, a podiatrist with Palos Medical Group, agrees. “I formerly practiced at Cook County Hospital for over a decade and saw patients who were already in a crisis situation, facing amputation. Unfortunately, there was not a lot of preventative care going on. In my current practice, I am able to better educate patients about diabetes, nutrition and complications from poor health practices. I came here tonight to learn something new, to hear all the different perspectives about helping patients.”

“Knowing when to send patients to another specialist, such as a vascular surgeon,” said Dr. Mark Gagnon, “is important for their long term recovery and health.” The podiatrist with Advanced Podiatry in Orland Park and Crestwood noted that this event was his first LEA-UP meeting, but “I’ve know Tanquilut for years. I knew the content would be valuable. Calciphylaxis is really a new topic for me. I haven’t seen it before, but if I ever run into this in a patient, I will know what I’m looking at.”

Ultimately, that’s the goal of LEA-UP. “By introducing these topics – conditions that affect limbs and usually lead to amputation – to a variety of medical professionals and different specialties throughout the south and southwest region, we will be improving the quality of life for our patients. It has to be a multi-disciplinary approach. It’s vital that, as a community, we have discussions, learn from one another and make connections for necessary, trusted, medical referrals. We have to all work together to preserve limbs and save lives,” said Tanquilut.

LEA-UP meets quarterly over a sponsored dinner and the events are open to any health care professional. Interested professionals should email jcardenas@vascspecialists.org or call 815-824-4406 and ask for extension 130.

Tanquilut is committed to the non-competitive, collaborative approach of LEA-UP. “It’s simple. A multi-disciplinary approach gives patients the most optimal care with the best outcomes possible.”

Survivor of Severed Artery has Message of Hope for Bears’ Zach Miller

zach-miller-103017-usnews-getty-ftr_pvjjdsirmr2z13qkvmip48gd1Dr. Eugene Tanquilut performed same surgery on Tinley Park woman

It was a flip-flop that did her in. As Rachel Draper was walking out of a restaurant on May 7, 2016, her flip-flop folded under her foot. She felt herself falling and overcorrected, trying to land on her backside instead of on her face.

“It was a one in a million chance,” she said. Just like Bear’s tight end Zach Miller, Draper landed at an awkward angle, suffered a posterior dislocation of her left kneecap and severed her artery in that instant.

“I really couldn’t feel anything in that moment. I just got a surge of adrenalin,” Draper said. An Emergency Room nurse who was leaving the building at the same time saw the accident and watched Draper’s knee suddenly swell to extreme proportions. “I just wanted to go home, but this nurse insisted they call an ambulance. They called 911 and I went straight to Silver Cross.”

In the ER, orthopedic surgeon Dr. George Verghese popped her kneecap back into place. “All of a sudden, I couldn’t feel my leg,” said Draper. “The whole room went into a panic when I said that.”

Silver Cross staff had already notified Dr. Eugene Tanquilut of Vascular Specialists of Draper’s injury and he had made his way to the hospital immediately. Tanquilut says, “I had to consider that Rachel’s artery was compromised, therefore, I thought it was prudent to perform an angiogram.”

ER staff quickly brought in a Doppler ultrasound machine, used to detect abnormalities in blood flow. “They couldn’t find a pulse,” said Draper. “And the whole room panicked again. I was moved into surgery immediately. I really have no idea what happened until I woke up in ICU with a hugely swollen leg.”

Tanquilut knows exactly what happened. “A posterior dislocation of the knee can compromise the popliteal artery, running behind your knee. If the knee is put back into place and the pulse returns as normal, close monitoring is done. Unfortunately, when Rachel’s knee was put back into its anatomically correct position, we couldn’t find a pulse. When I arrived, her leg was already pale and cold and I couldn’t hear any blood flow.”

Tanquilut quickly performed an angiogram, making a small incision in Draper’s groin. He found no blood flow below her knee. He made an incision on the inside of her knee, looking for the popliteal artery.

“The artery was completely traumatized, cut right in half. Because it had spasmed, she wasn’t bleeding out, but both ends of the artery had retracted, making it difficult to find the two ends.  Once he isolated the two ends, Dr. Tanquilut felt it was best to bypass.

Tanquilut then removed the saphenous vein from Draper’s left leg and performed an arterial bypass – exactly how doctors treated Zach Miller on October 30 of this year.

Draper then developed acute compartment syndrome in her leg, a sudden swelling of the muscle which can result in permanent damage to muscles and nerves. Tanquilut performed a fasciotomy, making two long incisions in Draper’s leg to open both the skin and the underlying fascia to relieve the pressure on her muscles. The muscles were allowed to swell outward, instead of crushing the new bypass and damaging nerves.

When Rachel woke up in ICU, she found her leg swelled to about 4 times its normal size and placed in an external fixator. The rod-like device was attached to her leg with screws that reach into the bone, holding her leg stable and aligned, protecting the arterial bypass and the soft tissue while healing.

“My calf was so swollen it was like twice the size of my thigh, but I didn’t really realize the severity of the situation until they changed my bandages. Even then, I saw the incisions, but it didn’t seem real. Then when I was by myself later, it all sunk in. I could easily have lost my leg,” said Draper.

Every day, Tanquilut checked her leg and the blood flow in the new bypass. Every day, he would tell Draper, “Today, you get to keep this leg.” Each day, for three weeks while Draper recovered in ICU, Tanquilut assured her that, for that day, her leg was viable.

Physical therapy started almost immediately. Draper remembers when Silver Cross therapist Anthony came into her room and told her she was going to stand up that day. “I told him “are you insane?”, she laughs. “I told him there was no way that was going to happen. He told me “you’ve got this, you can do this, the faster you get up and get moving, the better you’re going to heal.” He explained how I needed to get on my feet, get the circulation moving normally and strengthen my muscle memory.”

Draper did stand up that day, and each day moved forward step by little step. “I would cry whenever Anthony came in the room because PT hurt so badly. But I stood up. I moved to the chair. I got to the bathroom. I made progress.” She used crutches in the main, as a walker interfered with the fixator.

She was transferred to a regular room after 3 weeks and spent two weeks performing additional therapy and further recovering. “I had such a great team of nurses. The nursing staff at Silver Cross is amazing. The ICU nurses were funny and upbeat and always positive – and so generous. I’m now Facebook friends with all of them,” she laughed.

She left the hospital with the external fixator still in place. It was removed weeks later in an outpatient procedure performed by orthopedic surgeon Dr. Tom Antkowiak.

At-home nurses attended Draper’s wounds daily for months. “Dr. Matthew Endara, a plastic surgeon, helped with the wound closure. The lateral wound, on the outside of my leg, closed just fine. The medial wound, on the inside, needed a wound VAC to close it, because they were concerned about the risk of infection.”

Vacuum-assisted closure of a wound, or wound VAC, removes air pressure and fluids from around a wound, cleaning it and helping to pull it closed. Draper used the wound VAC 24/7 for about six months. “The human body amazes me,” said Draper. “The body is so good at self-healing, just growing new layers of skin over the hole.”

Draper also required surgery to extend her Achilles tendon because her foot had been immobilized for such a length of time. She began outpatient physical therapy at the Athletico facility near her Tinley Park home. “Patrick (Becker) saw me coming in, with really no muscle mass anymore and just said, “okay, let’s get started,” Draper said.

Three or four days each week, for two hours each day, Becker worked with Draper to help her regain full mobility. “At first, Patrick would put a band on my foot and I could barely get it to lift. I could hardly squeeze my left thigh.” As she gained strength, her therapy was cut to 2 days a week, but the workout became more difficult, including at-home exercises.

Because the initial fall had also torn Draper’s anterior cruciate ligament (ACL) and her posterior cruciate ligament (PCL), Antkowiak repaired those in March 2017. “I needed to regain the muscle mass lost from the first surgery to be able to recover from the ACL and PCL surgery, to do the PT properly,” Draper says.

Draper saw Tanquilut in his Vascular Specialists Olympia Fields office every month after her discharge for a Doppler ultrasound to detect any problems in the bypass or in her blood flow. Her appointments then were scheduled for every three months, and now, for the rest of her life, Draper will see Tanquilut every six months.

Tanquilut explains that an arterial bypass will most likely fail at some point. “We must monitor Rachel by ultrasound consistently to identify any problems. With the Doppler, we can see any issues, which will tell us if we need a more precise test with contrast. If we find problems quickly, before the bypass fails, we can get in there and repair them to save Rachel’s leg.”

If the bypass does occlude, Draper’s leg “is toast,” she said cheerfully. “I know it sound crazy for me to be so upbeat about this, but no one understands how really blessed and lucky I am to still have my leg. Every day for three weeks, it was a miracle that I got to keep my leg. I was so close to losing it, but I didn’t. Every day that I keep it is amazing. I just thank God every day that Dr. T was the doctor on call.”

“Dr. T is the reason I still have my leg. I owe him everything. He is a miracle worker,” said Draper. “Dr. T is not just an incredible surgeon, he is an incredible person. He is kind and genuinely compassionate and he always listens to you, really listens. He asks, “how are you doing?” at every appointment, and he actually waits for you to answer, listens to your answers and then actually responds to what you say.”

Draper is off the crutches and working toward her New Year goal, which is to jog, to put an impact on her leg. “Patrick and Dr. T are sticking with me for the long run. I’m not running a 5K anytime soon, but I will get there.” Her latest accomplishment is returning to work as, incredibly, a server.

“Last week, I worked a 7-hour day and was on my feet nearly the whole time. My boss asked me how I was feeling and I said, “I’m amazing! This is so exciting! Look at me go!” I couldn’t get over myself”, she laughed.

Draper realized quickly that Zach Miller’s injury mirrored her own. “I heard about his injury, I heard about the surgery and I thought – I need to write Zach a letter and make sure he gets it.”

Draper didn’t have anyone in a similar situation to talk to when she was in the darkest, most painful times and she feels that Miller could use her encouragement, because she knows what he’s experiencing.

“I want to give Zach hope, because he’s going to come back from this. I was in his shoes and look at me now. I play soccer with my son, I chase after my daughter. I am clearly so lucky and I know he will get there too. I just want him to know that he will really be alright.”

How To Avoid The ER This Holiday Season

Family enjoying Christmas mealMerry Christmas and Happy New Year from all of us at Vascular Specialists!

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The holidays can be a time of “cheats” – eating what you want, taking a pass on exercise, and imbibing just a little too much than is good for you. Add to that a generous dose of stress, brought on by gift-giving decisions, out-of-town guests or political discussions, and you have a recipe for disaster.

Vascular Specialists is here to remind you how to avoid an unwanted holiday surprise – a stroke. Make sure you’re spending Christmas Day doing whatever it is you love best, and not staying the hospital.

Avoid salt.

Holiday tables are usually spread with pretzels, chips and nuts. Skip the pretzels and chips altogether. Not only will you cut salt, you’ll cut processed carbs, which will help control your weight. Substitute unsalted or lightly salted nuts as a healthier choice.

Enjoy leaner, natural meats. 

Salmon and shrimp are fantastic choices, while being holiday favorites. Dig into the turkey and ignore the sausage. Dine on lean filet of beef and skip the meatballs. Avoiding processed meats has an added benefit; you’ll reduce your salt intake too.

Eat more fresh foods. 

Raid the produce department at your grocery store and load your buffet table with fresh, crispy vegetables like green, red and yellow pepper strips, celery, broccoli and cauliflower. Enjoy the natural sweetness of tomatoes. Indulge in the healthy fat of avocados or the zip of hummus for dips. Experiment with jicama!

Cut the processed carbs. 

Stay away from white bread, muffins, donuts, white pastas and white rice. Look for breads with grains you can see, hearty and full of seeds. Switch your pasta to whole wheat varieties. Branch out into quinoa, barley or farro to replace white rice. You’ll find these options a great deal tastier too.

Get moving. 

It’s easy to lay on the couch and watch holiday movies in your pajamas all day, but it’s much better for you to move! Get at least 30 minutes a day of activity each day during the holidays. Added benefit; it will improve your mood and reduce stress too.

Quit smoking. 

Please. Quitting smoking is the very best gift you can give yourself and your loved ones this holiday season.

If you have questions about avoiding stroke at any time of year, just call our office. We are always happy to help!

Seminar Helps Medical Professionals Identify, Diagnose Rare, Usually Fatal Disease

Scintigraphy ScanDr. Tauseef Ahmed Sarguroh explains calciphylaxis at LEA-UP meeting

– The thirty-five physicians and medical professionals were discussing a condition so rare, only two of them had ever seen it, and one of those was the specialist speaker, Dr. Tauseef Ahmed Sarguroh, a fellowship-trained nephrologist with Kidney Care Center Olympia Fields.

“It’s really a testament to their commitment to their patients,” said Dr. Eugene Tanquilut, the organizer of the evening’s event. “These medical professionals are spending hours of their evening to learn how to identify a disease they may never see, but know that they can’t miss because of the importance of early diagnosis.”

The topic of discussion was calciphylaxis, a serious and rare condition that occurs when calcium builds up in the small blood vessels of skin and fat tissues. Researchers are still not sure what actually causes calciphylaxis, and believe a variety of factors must be present for the disease to develop. It almost exclusively affects patients experiencing end stage renal disease. Three out of four sufferers are female. Obesity, diabetes and the use of blood thinning medications are other risk factors.

Patients with calciphylaxis face a grim prognosis, with only a 40-20% survival rate. Those who do survive are often faced with the amputation of diseased limbs. “Early diagnosis is really the best hope for those with this disease,” said Sarguroh. “Removing diseased tissue as soon as possible and using evidenced-based new therapies such as sodium thiosulfate and even the flesh-cleaning larvae of greenbottle flies give patients the best chance for stopping the spread of calciphylaxis throughout the body and internal organs.”

Being able to make that early diagnosis was the focus of this meeting of LEA-UP, Lower Extremity Amputation and Ulcer Prevention, founded by Tanquilut of Vascular Specialists in Olympia Fields, New Lenox, Orland Park and Chicago. LEA-UP is an open group of primary care physicians, podiatrists, nephrologists, infectious disease specialists, vascular surgeons, nurse practitioners, and other medical professionals from area hospitals including Advocate South Suburban Hospital, Palos Community Hospital and Silver Cross Hospital. LEA-UP meets quarterly over dinner to listen to presenters and discuss various case studies, treatment methods, and results. The meetings also offers opportunities to introduce medical products and services to these professionals.

“Knowing the early signs of calciphylaxis, what tests to perform, how to diagnose, and when to refer to specialists, absolutely saves lives and limbs,” said Tanquilut, who is fellowship-trained in vascular and endovascular surgery. “That’s why the multi-disciplinary approach of LEA-UP is so important. We’re not just educating one kind of doctor or specialist. We’re trying to ensure that everyone who will put eyes on an at-risk patient understands what they’re seeing and the steps to take to give that patient the best results possible for each individual case.”

Symptoms of calciphylaxis include small nodules on the skin that develop into black lesions. “Unfortunately,” said Sarguroh, “because this condition is rare, physicians may diagnose these symptoms as peripheral vascular disease (PVD) or cellulitis. There are no lab tests for calciphylaxis and tissue sample testing can be unreliable. The best choice to date to diagnose is a bone scan, but if a professional is thinking PVD, they wouldn’t order this type of test. Early intervention gives patients the best chance of survival, so proper, timely diagnosis is vital.”

Dr. Maureen McShane, a podiatrist with Palos Medical Group, agrees. “I formerly practiced at Cook County Hospital for over a decade and saw patients who were already in a crisis situation, facing amputation. Unfortunately, there was not a lot of preventative care going on. In my current practice, I am able to better educate patients about diabetes, nutrition and complications from poor health practices. I came here tonight to learn something new, to hear all the different perspectives about helping patients.”

“Knowing when to send patients to another specialist, such as a vascular surgeon,” said Dr. Mark Gagnon, “is important for their long term recovery and health.” The podiatrist with Advanced Podiatry in Orland Park and Crestwood noted that this event was his first LEA-UP meeting, but “I’ve know Tanquilut for years. I knew the content would be valuable. Calciphylaxis is really a new topic for me. I haven’t seen it before, but if I ever run into this in a patient, I will know what I’m looking at.”

Ultimately, that’s the goal of LEA-UP. “By introducing these topics – conditions that affect limbs and usually lead to amputation – to a variety of medical professionals and different specialties throughout the south and southwest region, we will be improving the quality of life for our patients. It has to be a multi-disciplinary approach. It’s vital that, as a community, we have discussions, learn from one another and make connections for necessary, trusted, medical referrals. We have to all work together to preserve limbs and save lives,” said Tanquilut.

LEA-UP meets quarterly over a sponsored dinner and the events are open to any health care professional. Interested professionals should email jcardenas@vascspecialists.org or call 815-824-4406 and ask for extension 130.

Tanquilut is committed to the non-competitive, collaborative approach of LEA-UP. “It’s simple. A multi-disciplinary approach gives patients the most optimal care with the best outcomes possible.”

Have the new guidelines given you high blood pressure?

Blood pressure measurementYour blood pressure readings haven’t move single digit but as of Monday, you may suddenly have hypertension. The American Heart Association (AHA) has changed the guidelines for healthy blood pressure, to possibly include as many as 50% of American adults.


High blood pressure is the leading cause of death worldwide, and second only to smoking as a preventable cause of death in the United States. Having high blood pressure means that the force of your blood pushing on your veins and arteries is too hard. This leads to damaged blood vessels that function poorly, damaging the heart as well.

More than 50% of heart disease and stroke fatalities are caused by high blood pressure. Previously, the AHA formally defined high blood pressure as any reading of 140/90 or above. At this level, about 32% of American were diagnosed with high blood pressure. Now, the guideline is 130/80 and above.

When your blood pressure reading is 121-129/80, Vascular Specialists or your primary care physician will warn you about your elevated blood pressure status. With diet and lifestyle changes, such as eating more fresh fruits and dark leafy vegetables, leaner meats and fewer processed foods, quitting smoking and limiting alcohol and increasing exercise, you may be able to lower your blood pressure within three to six months.

130-139/80-89 is now considered stage 1 high blood pressure, which means you are at risk of developing heart disease and stroke within the next 10 years. Talk to your Vascular Specialists medical professional or your primary care physician about taking more serious steps to lower your blood pressure. Quitting smoking is a must, along with cutting back alcohol. It will mean paying strict attention to your diet, cutting out white bread and pastas and replacing them with whole grains, avoiding processed and high-salt foods completely including canned soups and vegetables, and enjoying more fresh vegetables, salmon and skinless poultry. It also means increasing your activity and adding more cardio, such as running, swimming, Zumba and other fast-paced, get-your-blood-pumping exercises.

You should be reassessed in three to six months to see if these changes are working or if medication is needed to bring your blood pressure into the desired range.

If your blood pressure is over 140/90, you’re considered stage 2 high blood pressure and immediate action should be taken. Vascular Specialists or your primary care physician will prescribe medication along with diet and activity changes with monthly follow ups to ensure the medications are bringing your blood pressure back to healthy levels. You must quit smoking, drastically reduce alcohol intake, change your diet significantly and increase exercise dramatically.

Only 20% of people now affected by the new guidelines will actually need medication, as lifestyle and diet changes can be extremely effective in lowering elevated and stage 1 blood pressure. Medication is not recommended as the first round of therapy.

Genetics, age, gender and race are fixed factors for stroke and heart disease, elements about your health that you cannot change. High blood pressure is one of the preventable risk factors. By properly following your medical professional’s guidance to lower blood pressure through smoking and alcohol cessation, healthy eating and better exercise, you’ll be resolving other preventable risk factors as well.

If you have questions about your blood pressure or general health or wish to make an appointment with Vascular Specialists, just reply to this email! We will be happy to help!

Vascular Specialists Welcomes Alex Del Real, Nurse Practitioner

IMG_7280 blog postDr. Eugene Tanquilut is pleased to announce that Alejandro Del Real, Nurse Practitioner has joined the Vascular Specialists team.

“In the few months since Alex has joined us,” said Tanquilut, “he has contributed to our practice with his expertise, his compassion and his ability to be a real part of the Vascular Specialists family.”

Family is a thread that runs brightly through Del Real’s life. Raised on the Southeast side of Chicago, his parents always put Alex and his older sister Veronica Yeung first. “My mom’s only purpose in life was for us to do okay.” He attended private elementary school and then, along with two cousins, attended St. Lawrence Seminary High School in Mount Calvary, WI. “We had strict dress codes, went to Mass three times a week and followed the rules. It was an environment of buddies living, studying and playing sports together. Those friends became brothers.”

He then earned his Bachelor of Science in Nursing from Loyola University Chicago. He began working at Northwestern Memorial Hospital and gained experience in surgical services, including robotic, gynecologic, cosmetic and reconstructive surgeries, wound care and postoperative care during his nearly 17-year tenure.

During this time, Veronica had earned her Nurse Practitioner degree and was encouraging Del Real to do the same. “She really pushed to keep me going. She’s like a second mom to me – and my inspiration. It took me ten years to listen to her,” he smiles, “but I did it.”

In 2014, Del Real graduated with honors from Resurrection University in Chicago with a Master of Science in Nursing as a Family Nurse Practitioner.

Family intervened again earlier this year, when Del Real’s cousin Korina, on staff at Vascular Specialists, mentioned how much she enjoyed working for the growing practice. Del Real interviewed with Dr. Tanquilut and knew he’d found a new home.

“At Vascular Specialists, I feel like a real part of the team. The community hospital environment is more collegial, and my knowledge and training is respected.” Patients will see Del Real for initial consultations, explaining symptoms and discussing any preliminary test results. Del Real will order further diagnostic testing, can make a diagnosis and then schedule any necessary procedures. He also handles postoperative care such as managing stroke symptoms and risk factors, performing wound care therapies and administering regular Doppler ultrasound on patients with peripheral artery disease (PAD).

“PAD is a serious, lifelong disease. We see these patients several times a year for ultrasounds, medication management and lifestyle management, to keep them as mobile and active as possible,” said Del Real. “We want to catch any problems as early as possible, so there is no need for amputation.”

Besides holding his RN and his APN, Del Real is certified by the American Heart Association in Basic Life Support, is a Certified Nurse, Operating Room and is a Registered Nurse First Assistant.

Del Real is also a hard core Cubs fan and plays in a Wooden Bat League in the Hegewisch area.

Vascular Specialists is the only practice in the southwest and southern suburbs with three fellowship-trained vascular and endovascular surgeons; Dr. Tanquilut, Dr. Sanjeev Pradhan and Dr. Saadi Alhalbouni. The practice has offices in Olympia Fields, New Lenox, Orland Park and Chicago. The medical staff at Vascular Specialists are experts in treating PAD, stroke, varicose veins and deep vein thrombosis, dialysis care, complications from diabetes, abdominal aortic aneurysms and other conditions and diseases of the veins and arteries.

“We know Alex will continue to be a valuable contributor to our practice,” said Dr. Tanquilut. “He listens to his patients, has knowledge and expertise, and the desire to continue to learn evidence-based best practices as they evolve.”

I need an angiogram! What does that mean?

Abdominal AortographyDiagnostic tests, even non-invasive tests like a simple X-ray, can put us all on edge. Being recommended for an angiogram can cause even more anxiety. Here, Dr. Tanquilut, Dr. Pradhan and Dr. Alhalbouni take you through why, how and what of having an angiogram to give you peace of mind about this minimally invasive procedure.

There are a great deal of symptoms that may prompt your physician to recommend an angiogram. You may have leg pain when you walk that improves when you rest, stroke symptoms like a sudden weakness or confusion, swelling in your hands and feet, changes in urination habits, problems breathing – or a dozen other symptoms.

Any one of these symptoms could be an indication that there are problems with your veins or arteries. You may be experiencing atherosclerosis, when arteries are thinned or blocked by plaque. You may have a weak spot in your artery, an aneurysm, that bulges outward. You may also be experiencing a tear or a leak.

When your doctor recommends an angiogram, he is giving you the gold standard of care for evaluating your arteries. Having an angiogram can both help to diagnose a condition and help to treat it.

You will be requested to discontinue taking any aspirin, aspirin-type medications and blood thinners for several days before your angiogram. On the day of the test, you will need to avoid eating and drinking for 6 to 8 hours before the procedure. Depending upon your overall health, the test can be performed either as an outpatient procedure or may necessitate a stay in the hospital.

A Vascular Specialist medical professional will begin an IV. Dr. Tanquilut, Dr. Pradhan or Dr. Alhalbouni will ensure you are properly sedated and then make a small incision into your femoral artery, located in your groin, where the leg meets the hip. A needle will be inserted, then catheters and wires. These will be threaded through your arteries to the area needing diagnose and treatment.

When the area of concern is reached, contrast material such as iodine will be injected. This helps the X-ray produce accurate images of your blood vessels. At this point, depending upon your level of sedation, you may feel a warmth in the targeted area, a slight headache or a metallic taste in your mouth.

Your Vascular Specialists fellowship trained surgeon may actually treat your condition during the angiogram. If conditions are right and images indicate a need, he’ll guide a balloon to the blocked or thinned arteries and then inflate the balloon to compress the blockage against the walls of the artery. Again, contrast material will be injected to carefully examine the procedure’s results. If your artery is not open to our satisfaction, your surgeon will consider inserting a stent to hold open the vessel.

Your angiogram may take 20 minutes or it could take hours, depending upon location of the blockage, image results and treatment options. After the test, a weight or clamp will be put on the incision site to stop bleeding. You will be required to stay in a prone position for several hours before going home.

Our medical professionals will review your aftercare with you, including any activity or weight-lifting restrictions for the next several days. You will probably be encouraged to drink extra fluids to fully flush the contrast materials from your body. You may need someone to drive you home if you’ve been sedated.

An angiogram shouldn’t cause anxiety or distress. In the hands of our experienced and evidence-based specialists, your angiogram will put you on the path to better health.

Questions about your upcoming test? We are here to help!  Dial 815-824-4406 to make an appointment at our offices in Olympia Fields, New Lenox, Orland Park or Chicago. 

Chicago Southland Health Care Professionals Collaborate To Prevent Amputations

Dr. Vivek Patel speaks at August LEA-UP meeting.

Dr. Vivek Patel speaks at August LEA-UP meeting.

Dr. Eugene Tanquilut founded LEA-UP to save limbs in diabetic, PAD and neuropathy patients

– For most people, a blister on the heel is a mere annoyance, perhaps a stinging reminder to wear socks with that particular pair of shoes. For a patient with diabetes, peripheral neuropathy or peripheral artery disease, that small blister may very well be the beginning of a life-altering decline in health, mobility and functionality.

About 20 million Americans suffer from peripheral neuropathy (PN), a type of nerve damage that limits sensation, particularly in the feet and lower legs. One in twenty people over the age of 50 develop peripheral artery disease (PAD), which narrows the arteries in the legs and feet, reducing blood flow. For diabetic patients, the odds are much worse. 70% of people with diabetes will develop PN and are also at a much higher risk of developing PAD.

When a person with neuropathy suffers an injury – a blister, bruise, cut, crack or puncture – to the feet or lower legs, that nerve damage means they have trouble feeling the pain of the wound. When a patient has PAD, the compromised blood flow inhibits the healing process. Having both neuropathy and PAD is a double whammy; it means a patient doesn’t feel the pain of the injury and healing is significantly slowed or non-existent.

“It’s a vicious circle,” said Dr. Eugene Tanquilut of Vascular Specialists. “Because the blood flow is damaged, the injury can’t heal. Because the injury or infection isn’t felt, the patient keeps re-injuring the same spot, worsening the wound. This cycle causes deep, infected, chronic wounds, sores and ulcers.” Unfortunately, notes Tanquilut, for about 24% of ulcer patients, the end result is amputation.

Tanquilut is determined to halt that cycle for as many Chicago Southland patients as possible. A fellowship-trained, board certified vascular and endovascular surgeon, Tanquilut created LEA-UP, Lower Extremity Amputation and Ulcer Prevention. LEA-UP is an open group of physicians, specialists, nurse practitioners, and other medical professionals who meet quarterly over dinner to listen to presenters, share case studies and discuss methods and results. The group meetings also offers opportunities to introduce medical products and services to these professionals.

LEA-UP began in 2006 when Dr. Tanquilut joined the Olympia Fields’ St. James Hospital staff. Because of his passion for limb salvage, Dr. Tanquilut’s educational outreach efforts decreased the number of major amputations, above or below the knee, by 54% within just 5 years. “It’s vitally important to work collaboratively to prevent amputations. When physicians of all kinds and specialities can share information, we can offer better and more effective care to our patients,” said Tanquilut.

Susan Marcotte, a family practice physician in Orland Park, agrees. She, along with more than two dozen other medical professionals, attended the August meeting at Zachary’s Grill in Palos Heights. “I’m seeing more incidences of PAD as patients age. I want to stay ahead and learn as best I can, to continue to provide the best care possible to my patients. Gene (Tanquilut) is known for his attention to follow-up and the ability to touch all the bases. His limb salvation numbers are very impressive. When he invited me to join the group, I wanted to hear what they have to say. I want the best, up-to-date recommendations from the best people so I am able to provide the best care to my patients.”

“LEA-UP is a very trustworthy group. There are a number of specialists here who understand how to deal with this multifactorial problem. A family care physician like myself needs to understand how PAD, hypertension, diabetes and other factors can affect ulcers. I can help the patient manage these conditions, but I also need to know when to bring in a specialist,” said Marcotte.

Dale Brink, a podiatrist with Performance Foot and Ankle Center, and his associate Vivek Patel presented at the September meeting. Brink took the group through two patient case studies detailing their medical history, prior treatments, and new treatments while explaining the importance and challenges of keeping weight off the heel when treating heel ulcers. Patel demonstrated the Salvation External Fixation System, a metal frame specifically designed to enable the patient to remain relatively mobile while keeping the foot completely safe from bearing any weight.

A lively question and answer session involved the entire group, with medical professionals discussing synthetic skin grafts, Charcot foot deformities, walkers and immobilizers, patient compliancy and surgical options.

Brink said, “This group is important because we’re forming a real community, a way of sharing that will make all of us better able to care for our patients.”

“One of our practices’ main concerns is wound care, which we see in patients with diabetes, with neuropathy, patients who’ve neglected caring for a callus, or who’ve neglected their overall care, and even those with just a bad walking gait,” Brink continued. “This group combines the expertise of many specialities that work with a wounded foot. We leave no stone unturned when approaching patients, working together to improve care. Taking a more global approach to care, considering everything from orthopedic appliances all the way to vascular care, helps us intervene earlier and save limbs. Our absolute last resort should be amputation.”

Podiatrist Dr. Brian Wittmayer, also with Performance Foot and Ankle Center, has known Tanquilut for over a decade and is enthusiastic about participating in LEA-UP. “We trust each other’s judgement here. Our relationships mean we can expedite care for our patients. The multi-speciality approach that we’re taking means that everyone is on board – vascular surgeons, internal medicine, podiatrists, endocrinologists, infectious disease specialists, nephrology, orthotics, plastic surgeons – a limb salvage team should work together.”

The physicians and medical professionals who have joined LEA-UP all subscribe to this philosophy – that they are not competing, but focusing on excellent patient care. They desire to be proactive, to understand and better treat underlying health issues. The group freely asks questions of each other and exchanges information during LEA-UP meetings. Discussions can ranges from the structure and content of appointments to best practices that can prevent wounds from ever occurring.

“If a patient has diabetes or is experiencing PAD or PN, I recommend daily self inspections of the feet and lower legs, using a hand mirror to ensure every area is scanned,” said Tanquilut. “Daily washing in lukewarm water and thorough, gentle drying is important, and you want to dry carefully between and under toes. Cracking allows bacteria to enter the feet, so use moisturizer each day.”

If a patient notices calluses, blisters, warts or other lesions, Tanquilut recommends seeing a family physician or podiatrist as soon as possible. “Treating these at home can worsen the wound and cause an infection,” he said. Tanquilut notes recommended foot care to avoid wounds: “Always wear shoes or slippers, even at home, to prevent any injuries. Wear comfortable, natural fibered socks and avoid irritating seams or tight elastic. Wear comfortable, properly fitted shoes, and wear those supporting orthotics, lifts or inserts prescribed by your podiatrist. Don’t wear high heels or shoes with narrow toe boxes.” Most important, he explains, is scheduling yearly foot check appointments, even if there is no sign of injury.

Tanquilut notes that nearly 100,000 PN and PAD patients with ulcers lose an extremity each year and about 55% of those will lose a second limb within three years. “My goal is to make amputation very rare in this region. Limb loss and the subsequent decreased physical mobility and activity can be a catalyst for additional, increasingly serious health problems. By forming LEA-UP and including medical professionals from all around the Chicago Southland, I hope to help disseminate evidence-based limb salvage recommendations, best practices and new procedures and therapies throughout the southwest and south suburbs. LEA-UP welcomes medical professionals of all types and specialities, anyone who understands the value of sharing information and wants to provide the best care for patients.”

The LEA-UP group meets quarterly. The presentations and discussions are open to any health care professional. Interested professionals should email jcardenas@vascspecialists.org or call 815-824-4406 and ask for extension 130.

“We aren’t about competition,” stressed Wittmayer. “We are all part of LEA-UP to take care of patients – or to be able to get them the care they need if we can’t provide it. That is what everyone in this room is trying to accomplish. This is a collaborative effort. We are working together to save limbs.”

If you prick us, do we not bleed?

Many times, the sight of blood is the first indication that we’ve injured ourselves. We may not feel that scratch, that bite or that little puncture, but when a foreign object breaks the skin, we bleed.

But some of us might not – or at least not as well as we should. And that’s bad news for your odds of healing properly. Compromised blood flow, such as with peripheral artery disease (PAD), may cause your wound to take twice as long to heal. Even worse, when you have neuropathy coupled with PAD, you might not feel the wound as it occurs and you may not bleed enough to discover it. For 6.5 million people with these vascular challenges, a wound may never heal.

Blood is vital to the healing process. We may think that it’s skin cells working away – and they are – but your blood is behind it all.

When you first injure yourself and your skin breaks, within seconds blood cells called platelets begins to clot, and the fibrin protein within the platelets forms a net to hold that clot. The clot is created both to form a protective barrier on the wound and to close off the open blood vessel, reducing blood loss.

White blood cells called macrophage now go to work, fighting infection and helping to clean your injury. Red blood cells, rich in the nutrients and oxygen vital to your healing, help to repair the site. Your body creates collagen, a kind of framework, and tissues begin to grow and fill in that framework.

Depending upon the location and severity of your wound, it could take a few days to over a year to fully heal. When your wound is not healing like it should, there are a number of factors to consider.

When your blood flow is compromised, too few platelets are being delivered to the injury site. Blood cannot clot to begin the healing process and infection becomes more likely as the blood vessel remains open to bacteria. If your blood vessels are too narrow to adequately deliver white blood cells, your wound is at a higher risk of infection.

Too few red blood cells arriving at your wound means that your injury doesn’t get the oxygen necessary for healing, and your wound site retains too much carbon dioxide.

Healthy healing depends on healthy blood flow. If you have a wound that is not healing like it should, call our offices in Olympia Fields, New Lenox, Orland Park or Chicago by dialing 815-824-4406. Our vascular professionals will assess your wound and create a healing plan that is just right for your health and lifestyle.

If you have suspect you have PAD, especially if you experience pain while walking that lessens when you rest, make an appointment with us immediately. PAD not only interferes with wound healing, it also puts you at a greater risk of stroke.

50 Years Without Doctor Visit Results In Near Amputation


Eugene Tanquilut, D.O., “worked a miracle” to save leg, function

– Fifty years is a lifetime. In 1967, fifty years ago, Thurgood Marshall became the first African-American Supreme Court Justice, gasoline was 29 cents a gallon and 50,000 people showed up for a music festival in Monterey. Now, those babies conceived during the Summer of Love are planning for retirement. Fifty years is a long time.

Fifty years is also a long time to go without seeing a doctor, but that’s exactly what Ray Meininger did. The New Lenox resident hadn’t been to the doctor since he was 17 years old – fifty years ago. “I wasn’t a fan of doctoring,” he said. “I’m an old fart and I don’t make friends easily. No matter what happened to me, I would not go see a doctor.”

That all changed in January. Meininger, who smoked about three packs of cigarettes a day for years, stopped smoking because he just couldn’t breathe. “My god, it was terrible. The pain was incredible,” he said. But still, “I considered death before going to the hospital.” His wife Joan, 57, called their daughter Dawn Meininger, who is a paramedic for Chicago’s Fire Department. “She took my blood pressure and it was 285 over something – yeah, kinda scary.”

Dawn Meininger convinced Meininger to get to Silver Cross Hospital, and he actually agreed. “The last thing I remember is being told I had pneumonia – and then I woke up three days later with my leg all cut up.”

Those three days were busy for everyone else. Meininger was intubated; a plastic tube was inserted into his throat to help open his airway so he could get sufficient oxygen into his lungs and body. As he slept in the hospital with antibiotics being administered via IV, Joan Meininger noticed his leg was ice cold. “It was like meat from a freezer,” she said.

Joan Meininger called his cold leg to the attention of a physician, who seemed to brush off her concerns. “My wife didn’t let it go,” said Meininger. “It seemed to be getting worse to her, so she told the nurses about it and they agreed it was a concern – that something was wrong.” A second physician recommended immediate amputation.

“That’s when they called in Dr. T,” said Meininger. The Silver Cross nursing staff wanted to give this 67-year-old every chance before amputation, so they called Eugene Tanquilut, D.O., board-certified and fellowship-trained vascular and endovascular surgeon.

Dr. Tanquilut recalls, “I received the call for Ray’s cold leg, folded the cover back and said “oh, my god, we need to be in surgery now” to save his leg.”

A “cold leg” is an emergent situation. It can happen when a blood clot from elsewhere in the body breaks off and suddenly blocks blood flow in the artery of a leg.  Symptoms include severe pain and decreased muscle and sensory function to the foot and/or the leg. The leg will also become cold and pale.

Cold leg can also result, as Meininger’s did, from Peripheral Arterial Disease (PAD). PAD is a narrowing of the arteries in the limbs, caused by atherosclerosis, the build-up of plaque in your arteries, which reduces blood flow. Meininger’s cold leg formed due to the plaque blocking his artery, slowing and pooling blood flow, and allowing a clot to form.

Meininger’s heavy and decades-long smoking habit was a major factor contributing to his development of PAD. Other risk factors for PAD are obesity, diabetes, high blood pressure and high cholesterol. After age 50, the risk of PAD increases for everyone. Symptoms include pain when walking that eases when resting, numbness or weakness, loss of hair on legs and toes, and wounds that won’t heal.

Dr. Tanquilut told Joan that Meininger’s chances of a full recovery depended upon how long his leg had been cold and without blood flow, where the clots were and other factors that might occur or become obvious during surgery.  “He didn’t give Joan any false hope, he didn’t take the easy way out,” says Meininger. “He said he would work on the clots and hope for a miracle.”

Meininger was taken to surgery for a thrombectomy, the evacuation of the blood clot. Dr. Tanquilut made a small incision in Meininger’s groin and removed the clot using a balloon and catheter.

“Due to the severe swelling that developed after Ray’s blood flow was restored, I suspected he would develop acute compartment syndrome,” said Dr. Tanquilut. “He did, and the surgery quickly became more complicated.”

Compartment syndrome happens when muscles become severely swollen, resulting in a decrease in blood supply to the limb. If not properly treated quickly, the patient can experience permanent damage to the muscles and nerves, losing the function in the affected arm or leg. In severe cases, amputation may be required.

Dr. Tanquilut quickly switched gears to perform a fasciotomy, only treatment for acute compartment syndrome. “I made two long incisions on each side of Ray’s lower leg, opening the skin and the fascia below, to relieve the internal pressure of the muscles. After a fasciotomy, the muscles swell outward, instead of pressing the artery closed and damaging nerves.”

Dr. Tanquilut says, “I knew he had a viable leg, but I still wasn’t sure how much function he would be able to regain.”

Meininger wasn’t happy when he woke up from surgery, but then he met Dr. Tanquilut – and quickly completely reversed his opinion about doctors. “Whenever he came to check in on me, he always took time to sit down, really say “hello”, ask me “what’s happening” – he knew more about me in a few days than most of my family does,” Meininger said. “It’s remarkable. He came in as my doctor but became my friend so fast.”

Dr. Tanquilut also communicated with everyone with understanding. “He spoke to Dawn in medical terms that she would understand, and then he explained to us in layman’s terms,” said Meininger. “He really earned our respect because he deserves it. He has no airs – he calls me Ray and I call him Dr. T. He doesn’t come at you like he’s superior. He doesn’t have a sense of arrogance at all.”

Meininger had a “huge hole” in his leg after the surgery, plus the opening in his groin from the original balloon insertion. Both took longer than expected to heal, so he spent a month at Silver Cross Hospital recovering. He was discharged with a 24/7 wound VAC (vacuum assisted closure) device, which decreases air pressure on the wound itself, gently removes fluid and bacteria from the wound and helps pull the wound closed. Meininger was then visited at home by Silver Cross After Care medical professionals, whom he also compliments. After the wound VAC therapy was complete, he began making weekly wound care visits to Dr. Tanquilut and the Vascular Specialists team.

Danielle Roach, Nurse Practitioner with Vascular Specialists had just started working with Dr. Tanquilut when Meininger became a patient. “Ray was in a wheelchair when I first met him. Because of the severity of the compartment syndrome and his fasciotomy, we thought it would take about a year before Ray would know if he would regain full use of his leg. But after about three and a half months, Ray was already out of the chair and using a walker. Then he walked in with the walker, pushed it away and said, “Look at me.” He was walking without assistance.”

At the weekly appointments, Roach checks and cleans Meininger’s wound, performing debridements to remove dead tissue. She applies EpiFix, a thin, paper-like dehydrated amniotic membrane allograft, to his wound to encourage his body to heal itself. “EpiFix is a synthetic skin. It contains a variety of proteins and other growth factors, so when it’s applied, it’s basically a signal to the body, saying “Hey, get up here and heal this,” said Roach.

Meininger says, “Dr. T and Danielle are so conscious of my pain level as they work with my leg. Danielle will always say, “I’ll stop if it’s uncomfortable,” but she also watches my face to make sure I’m okay. She is my angel.”

Roach acknowledges that Meininger is a great patient. “He does everything he’s supposed to do and nothing that he isn’t. I’m proud that he’s not smoking. We are hoping that he will be nearly 100% healed by the end of the summer.”

Meininger hasn’t smoked a single cigarette since he entered the hospital in January, and is very careful to avoid second-hand smoke too. He also takes blood pressure medication and blood thinners. “My leg was always a little bit colder, but I really didn’t give it a real thought – I’d just throw on another blanket. I really learned that you have to listen to your own body.”

The wound is Meininger’s leg is now almost completely healed. He considers going through all this is making up for going 50 years without seeing a doctor. “I was a couple of days away from being dead – everything was shutting down. You know, there’s a difference between a doctor and a doctor with a heart. Dr. T saved my leg. He didn’t just chop it off without thinking about it. I don’t speak highly of many people, but nobody can begin to compare to him. He’s not just a phenomenal doctor, but he is an amazing everyday person.”

“Even though I’m not seeing Dr. T at every appointment, he still looks in every appointment,” says Meininger. “He says hello, shakes my hand, greets my wife. It’s amazing. He is just as interested in me and my motorcycle as he is about the condition of my leg. If you want a doctor to be a friend, this is the guy. He hires qualified people with the same attitude he has; they all consider you family.”

“Dr. T’s staff is amazing. We are all on a first-name basis. I didn’t even know what “after care” was but I know Dr. T., Danielle and the nurses are still taking care of me. He is my doctor now, forever. There is no feeling of “it’s all over”.

“I know the recovery is some of me, but the person who really did the work really deserves the credit and that’s Dr. T.,” Meininger says thoughtfully. “I don’t believe in miracles, at least in the sense that everyone talks about. I believe that people work miracles – and Dr. T certainly worked a miracle on me.”

Is this the reason your blood pressure is so high?


Hypertension can be caused by genetics, diet, tobacco use or weight gain. In these circumstances, a combination of lifestyle changes and medication can bring blood pressure numbers back into a normal range.

But what about when you’ve tried just about everything – losing weight, eliminating salt, throwing out your cigarettes, faithfully taking medications – and your blood pressure is still dangerously high?

That’s when it’s time to consider Renal Artery Disease (RAD) as a possible cause.

Your renal arteries branch from your abdominal aorta to your kidneys, supplying them with blood. Renal arteries are about 4-6 centimeters, or 2 inches, long and about 5-6 millimeters, about a quarter inch, in diameter. They sit just above your waist in your abdomen.

Just like peripheral artery disease (PAD), most cases of RAD are caused by atherosclerosis – plaque clogging the arteries. Plaque is formed when cholesterol, fat, calcium, cellular waste and fibrin, which your body uses in blood clotting, gather and adhere to artery walls.

This causes atherosclerosis, a narrowing of the space within your arteries through which blood flows. When atherosclerosis narrows your renal arteries, your kidneys don’t get the oxygen they require to filter wastes. They have a difficult time secreting renin, a hormone which helps to regulate blood pressure.

Untreated RAD can result in kidney failure.

Symptoms of RAD include:
• High blood pressure beginning before 30 years of age
• High blood pressure beginning after 50 years of age
• High blood pressure that suddenly worsens, or suddenly begins
• High blood pressure that cannot be controlled with medication, diet, exercise or other lifestyle changes

Risk factors for RAD include:
• Over 50 years of age
• Diabetes
• Tobacco use
• High cholesterol
• High blood pressure
• Family history of peripheral artery disease
• Family history of renal artery disease
• Neurofibromatosis, a genetic disorder that causes tumors to form in the brain, spinal cord and nerves.

Your Vascular Specialists medical professional will screen for RAD with an ultrasound, MRA, CTA, captopril renal scanning or angiogram, depending upon health history and physical condition.

Treatments for RAD include medication, renal angioplasty, surgery, endarterectomy or bypass, depending upon the severity of blockage.

Fellowship-trained Dr. Saadi Alhalbouni and Nurse Practitioners Roach and Ruffalo Join Vascular Specialists Practice, new offices to serve patients better

All three for Mailchimp
Dr. Saadi Alhalbouni, left. N.P. Danielle Roach, middle. N.P. Lisamarie Ruffalo, right. 

Vascular Specialists, LLC is expanding both medical staff and office locations to better serve our patients in the Southland and Chicago.

Saadi Alhalbouni, M.D., joined Eugene M. Tanquilut, D.O., CEO and President of Vascular Specialists, in June. Dr. Alhalbouni is a board-certified vascular and endovascular surgeon. He attended medical school at Jordan University of Science and Technology and completed his fellowship training at West Virginia University at Charleston/Charleston Area Medical Center in Charleston, West Virginia.

Dr. Alhalbouni brings to Vascular Specialists a passion for educating patients, and is known for his individual, patient-tailored sketches of medical conditions, disease processes and surgical procedures. “Sketches help patients understand what’s going on inside their bodies, and what I will do to fix it. I never want a patient to say, “the doctor did this procedure, but I’m not sure why,” said Dr. Alhalbouni.

“One of the things that drew me to vascular surgery was the fast-evolving technology. The procedures and tools are constantly improving, giving patients better results with faster recovery times,” he said. He is a prolific and respected contributor to medical and vascular papers and a frequent presenter at national vascular conferences.

He and his wife of just over a year have relocated from Kentucky to Orland Park and are enjoying tasting the region’s culinary offerings. “While I was surprised at just how flat and windy it really is in the Midwest, I am also delighted by the multicultural aspect here. The food is just amazing and people are very nice. We are always looking for a new restaurant to try.”

Dr. Alhalbouni will be affiliated with Advocate South Suburban Hospital, Advocate Trinity Hospital, Palos Community Hospital, Silver Cross Hospital and Franciscan St. James Hospital.

We have also welcomed to Danielle Roach, N.P. and Lisamarie Ruffalo, N.P. Roach comes from a family of nurses including her mother, grandmother and various aunts and cousins. She takes a special interest in the treatment of lymphedema. Ruffalo has a depth of experience in vascular and skilled cardiac care. She particularly enjoys using sclerotherapy to treat spider veins, giving patients more confidence.

Vascular Specialists has also opened two more locations in addition to their locations in Olympia Fields and New Lenox. Our Chicago office is at 1516 E 87th Street. The Orland Park office is at 16257 S 106th Court.

After the stroke, it’s time to move.

The stroke itself was terrifying. The uncertainty of “how did this happen to me?”, the rush of physicians, specialists and discomfort of medical treatments were often overwhelming.

Now, you’re recovering, but still extremely tentative about your health. How much exercise is enough? How much is too much? Can’t you just sit on the couch and be safe for the rest of your life?

Unfortunately, no. Becoming active after a stroke – or any health crisis – is vital to a full recovery.

Exercise lowers your blood pressure and improves your heart function. It helps lowers your cholesterol. Activity lowers your risk of developing diabetes, or improves your existing condition. When you are recovering from a stroke, it’s also magnificent mentally. It reduces depression and anxiety and, because there is always improvement however small, you build self-confidence.

Talk to Vascular Specialists first. 

Your exercise program should be part of your physician-approved overall recovery plan. Consult with your Vascular Specialists physician, Dr. Tanquilut, Dr. Pradhan or Dr. Alhalbouni, when considering which activities are most appropriate for your unique situation.

Start small. 

Don’t worry about where your fitness level and capabilities were before the stroke. Start wherever you are now and build your progress slowly, even if you can only manage just 5 minutes a day. Keep track of increasing range of motion in your arms and legs, ounces lifted, steps taken, or minutes pedaled. Seeing gradual improvement is motivating – and when you make a big leap in ability, you’ll feel absolutely amazing.

it’s okay to change up your exercise patterns. 

If you biked before but are now unable to stand or balance, start with chair yoga or Pilates. These activities will build strength, gently tone muscles and improve balance. If you swam laps but find your arms and legs have different ability levels, try water aerobics or water walking. You’ll take advantage of natural buoyancy, low impact and gentle resistance, while adding the advantage of making new friends in a group setting. If you walked 18 holes of golf every weekend, ask the course about accessibility and the Savings Strokes program. You may be able to borrow a modified cart that will get you outdoors, on the course, swinging and socializing.

Include a little bit of everything, often.

Make sure your exercise program includes balance training, strength training and cardio. Balance training is important to prevent falls and build your confidence in your improving physical abilities. Strength training helps rehabilitate your muscles, allowing you to accomplish more and more daily tasks. Cardio builds that heart muscle and improves your vascular system. It’s also important to exercise often, ideally 5-6 days each week.

Listen to your body. 

Stop your exercise immediately and call our office if you experience dizziness, overwhelming fatigue, fainting, leg cramps, chest pain or wheezing.

Don’t underestimate the importance of exercise in avoiding a second stroke. 

You really cannot just sit on the couch. Experts advise avoiding a second stroke by managing blood pressure, atrial fibrillation and cholesterol and controlling diabetes, all of which is aided by exercise. Studies show that patients who exercise 5 or more times per week are less likely to have a stroke.

Do you have questions about your activity after a stroke? Our Vascular Specialists medical professionals are always here to help! Just call 815-824-4406. 

Medicare covers your abdominal aortic aneurysm screening!

Senior patient getting ultrasound from doctorIf you are at risk of an abdominal aortic aneurysm (AAA), Medicare Part B will cover a one-time ultrasound screening, which could safe your life.

This screening is a powerful diagnostic tool that will identify any aneurysms – weak, bulging spots – in your abdominal aorta, a blood vessel about the size of a garden hose running through  the middle of your torso, providing blood to the lower half of your body. Without a screening and because there are few physical symptoms, an aneurysm will go undetected. When it ruptures, with a sudden severe pain, blood pumps into your abdominal cavity and causes death within seconds. 90% of ruptured AAA cases are fatal.

Screening for AAA is vital if you have any risk factors. An AAA diagnosis means our physicians can provide treatment to avoid a life-threatening rupture.

Before your ultrasound, you will be asked to refrain from eating or drinking for 8-12 hours before the test. Having your digestive system “empty” will make it easier for the technician to get clear images of your aorta. Make sure you ask our physicians about any medication you regularly take.

The screening is painless and non-invasive. You’ll lie on your back and gel will be applied to your abdomen. Your ultrasound technician will roll a transducer around your entire abdomen, sending images to a computer. Expect your test to last about half an hour.

Dr. Tanquilut or Dr. Pradhan will then talk to you about your results. If any problems are found, you and our physicians will thoroughly discuss your condition, determine if additional screenings or tests are needed, and then analyze your treatment options.

A small aneurysm may require a “wait and watch” approach, meaning we will monitor your condition on a regular basis. If the aneurysm is more serious, Dr. Tanquilut and Dr. Pradhan will consider your repair options.

Medicare Part B will cover your AAA ultrasound screening if you meet just one of these risk factors:

  • a family history of abdominal aortic aneurysms. 
  • you are a man 65 to 75 years old who has smoked at least 100 cigarettes in your lifetime. 

If you have either of these risk factors, call your primary care physician today and request a referral. A referral is required to have Medicare Part B cover this ultrasound. When your referral is complete, call our office at 815-824-4406 to make an appointment for an AAA screening ultrasound. Early detection and treatment is life-saving!

Questions about AAA or other vascular health issues? Call our office or reply to this email. We will be happy to help!

New Study Shows Measurable Difference In Carotid Artery Disease Treatments

carotid artery

– A new study has announced that different procedures to prevent stroke have different long-term results. The Swedish study compared carotid artery stenting (CAS) and carotid artery endarterectomy (CAE) effectiveness, tracking patients for nearly five years.

Dr. Eugene Tanquilut, fellowship trained vascular and endovascular surgeon, says it’s important that patients know those results before committing to a carotid artery disease procedure.

“The carotid arteries are two large blood vessels, about the size of drinking straws, that run up each side of the neck,” said Tanquilut. “They are the main arteries carrying oxygenated blood to the brain, which controls cognitive functioning such as thinking, learning, problem solving, speech and sensory and motor functions. It’s also the part of the brain where your “personality” resides.”

Carotid artery disease (CAD) is also known as carotid artery stenosis or narrowing. CAD is typically caused by plaque, which is a buildup of cholesterol and calcium within the arteries, narrowing the area through which oxygenated blood can travel.

“Because the carotid arteries supply blood to cognitive functioning, a blockage, called an occlusion, or clot within the arteries will cause stroke and compromise the ability to speak, walk, and simply perform the activities of daily living,” said Tanquilut. “Avoiding carotid artery disease, keeping these arteries healthy and functioning, is vital to preventing a life-changing stroke.”

Carotid artery stenting, Tanquilut explained, is also referred to as carotid angioplasty and stenting. “A stent is a hollow mesh tube, that is collapsed when we insert it. We place the stent inside a catheter and then insert that catheter into a large artery – usually the femoral artery found in the groin. Using dye and imaging technology, the catheter is guided up to the narrowest part of the carotid artery. We move a balloon into the stent, inflate the balloon, which expands the stent. This compresses the plaque against the blood vessel’s wall, opening the artery and increasing blood flow.”

A CAS might be a good choice when arteries are more than 50% narrowed, when the patient has already had a stroke or TIA (transient ischemic attack, considered a warning sign of future stroke), or has had radiation or multiple surgeries to the neck and has abnormal anatomy.

A carotid endarterectomy (CAE) is considered the gold standard for carotid intervention.  It is a more invasive procedure which may be indicated when carotid arteries are more than 50% blocked with stroke or TIA occurrence or when more than 80% of the arteries are blocked with no stroke or TIA occurrence.

Tanquilut explained that a CAE is a completely different procedure. CAS is an endovascular procedure which means it is minimally invasive surgery, with one very small incision in the groin.

CAE is a vascular procedure, more like traditional surgery. “Our incision will be in the front of your neck,” he said. “We open the carotid artery and actually remove the plaque; we don’t just compress it. We then repair the artery by using a natural graft, a piece of vein from elsewhere in the body, or a woven patch. We then close the incision.”

The Swedish study was conducted because of a lack of real evidence about any differences in long-term results for CAS and CAE. Researchers followed 1,157 patients, 409 of whom had the stenting procedure and 748 of whom had the endarterectomy. Most of the patients were men, whose average age was 70. They were matched as closely as possible for sex, age, procedure date and symptoms.

The study found that 25.7% of CA Stenting patients had a stroke in the years following their procedure, versus 18.6% of CA Endarterectomy patients. These were long-term results; outcomes in the first 30 days showed no difference between the procedures.

“While a CAE is a more invasive procedure, the hospital stay is the same as carotid stenting, patients almost always go home the next day and CAE has a better long-term result,” said Tanquilut. “CAS patients may see restenosis, when the artery re-narrows soon after the procedure. Blood clots may form on the stent itself.”

For patients struggling to decide what’s best for their health today and for the long-term, it’s vital to consult a fully qualified endovascular and vascular surgeon. “A surgeon who’s trained in both carotid endarterectomy and carotid stenting is far and away the best choice for patients with carotid artery disease,” says Tanquilut. “By thoroughly understanding both techniques and fully examining the patient’s disease and overall health, a solid decision – one that focuses only on the patient’s best interests – can be made.”

Tanquilut is with Vascular Specialists in New Lenox and Olympia Fields. He is a graduate of Carl Sandburg High School in Orland Park and received his fellowship training at the Cleveland Clinic.

“While CAS and CAE can vastly improve the condition of carotid artery disease, the patient’s lifestyle must change,” says Tanquilut. “Patients will take an antiplatelet medication, must stop smoking and will need to be physically active and eat a healthier diet. If a patient is overweight, weight loss is vital.”

“Without a strong commitment to their health, the patient will see that the disease will undo all the improvements the surgery effected. Once you have carotid artery disease, you can’t get rid of it – you have to take care of yourself every day. There is no cure for CAD.”

Dr. Eugene Tanquilut is a Doctor of Osteopathic Medicine – why does that matter to you?


You’ve seen the initials D.O. behind Dr. Tanquilut’s name but you may never have really thought about what they mean – and what they mean about the care you receive. Likewise, many patients specifically seek out a D.O. for their medical care because they prefer the approach that D.O.s take.

Osteopathic medicine began when Andrew Taylor Still, M.D., noticed that some of the accepted treatment practices seemed to harm patients instead of helping them. He knew that the human body has a miraculous ability to heal itself and created care that took advantage of that ability.

As an osteopathic physician, Dr. Tanquilut looks at the whole patient – more than just a disease or illness. He has a strong foundation in primary care and holistic philosophy. This means that while he’s looking at your veins and arteries, he’s also considered the health and well being of your entire body.

While Vascular Specialists uses high-tech diagnostic testing and innovative, evidence-based surgical techniques, Dr. Tanquilut also engages a hands-on, patient-centered approach. D.O.s are committed to getting to know their patients as people, gaining an understanding of what their health means to improving or maintaining their lifestyle.

Dr. Tanquilut, like other D.Os, is committed to education, both to patients and to the community. You’ll see Dr. Tanquilut at community centers, churches and in the exam room, fully explaining a disease and its treatment options, so patients can make the best decision for their individual lives.

Being a D.O. means that Dr. Tanquilut fully integrates you in your own health care. Armed with information about your illness, information about your own health and information about all treatment options, you feel in control of your life, your health and your future. You will feel comfortable with the decisions you and Dr. Tanquilut will make about treatment.

Osteopathic physicians also take full advantage of medical science, including drugs and medications and the latest diagnostic and surgical technologies. D.O.s can pursue any specialty and train in any fellowship opportunity. There are nearly 74,000 D.O.s practicing throughout the United States and over 20% of all medical students today are training as osteopathic physicians.

For Dr. Tanquilut and D.O.s across the country, being an osteopathic physician means having a deep appreciation for the healing powers of the human body, a great respect for each patient’s overall health and well-being and a powerful commitment to education.

Newly FDA-Approved Iliac Stent Procedure First Ever Within Advocate Healthcare System Performed at South Suburban Hospital

From left to right: Kurt Kalchbrenner (GORE rep), Brian Laskey (IR, nurse), Dr. Sanjeev Pradhan, Dustin Carson (IR, tech), Rachel Pieperbrink (OR, surgical asst.)

From left to right:
Kurt Kalchbrenner (GORE rep), Brian Laskey (IR, nurse), Dr. Sanjeev Pradhan, Dustin Carson (IR, tech), Rachel Pieperbrink (OR, surgical asst.)

Dr. Sanjeev Pradhan of Vascular Specialists completed ground-breaking endovascular procedure.

– Daniel Greer didn’t realize that he was becoming part of medical history when Dr. Sanjeev Pradhan of Vascular Specialists used a newly FDA-approved device to repair Greer’s multiple aneurysms at Advocate South Suburban Hospital in Hazel Crest. Greer just knows it worked.

The device, called a GORE® EXCLUDER® Iliac Branch Endoprosthesis, or Modular Aorto-Iliac Stent, was the first ever used anywhere within the Advocate Healthcare System and one of the first used in the Chicagoland area.

“The specialized aorto-iliac stent was approved in the first quarter of 2016 and Daniel was a perfect candidate,” said Dr. Pradhan. “At 79, Daniel is still active, overall very healthy and should have many vibrant years ahead of him.”

The Park Forest native was following up with his primary care physician Dr. Dwayne Buchanan after a 2014 cancer incident when Dr. Buchanan recommended an abdominal aortic artery screening. Greer had smoked for years, was a male over 65 years of age, and was experiencing some slight discomfort in his abdomen. “Dr. Buchanan thought as a precaution, I should have the CT scan,” said Greer.

The scan came back showing multiple aneurysms in both the abdominal aortic artery and his pelvic arteries, also known as the iliac arteries. An aneurysm is a weak spot that bulges in an artery. That weakened spot may continue to grow and then rupture, which is usually fatal. Most people with an abdominal aortic aneurysm (AAA) may never have symptoms, and the first indication of the condition could be a deadly rupture. As in Daniel’s case, AAA typically occurs in patients over 65 years of age. Other risk factors include smoking, being male, having high blood pressure and a family history of AAA. A screening is recommended for everyone over the age of 65.

“Daniel’s condition was advanced, with his iliac artery aneurysms measuring 4 centimeters, about the size of a baseball. There was a 100% chance that these aneurysms would rupture within a year,” said Dr. Pradhan.

Dr. Pradhan examined the CT, reviewed Greer’s medical history and determined he was a very good candidate for the new iliac stent. Because of the location of the aneurysms, before the new iliac stent was approved for use, a case like Daniel’s would require embolization of the iliac branch; the blood flow to this important artery would be stopped permanently. Because the iliac branch is the pelvis’ main blood supply, this causes several life-changing complications, including muscle damage to the buttocks and upper leg, resulting in pain and disability, and a stoppage of blood flow to the pelvis, resulting in erectile dysfunction.

Previously, open surgery could be performed, preserving the iliac artery, and the outcomes were just acceptable, notes Dr. Pradhan. “There were, though, many other complications. Patients experienced deep vein thrombosis, pelvic pain, bleeding complications, and erectile dysfunction.”

“Formerly, there was just no good way to preserve the internal iliac artery when placing an endograft. With the new device, we can keep all the arteries open, keep the blood flowing and keep Daniel living as he should. This system eliminates all those complications, saving the blood flow to the pelvis.” said Dr. Pradhan.

Jack DiBennedetti of GORE has worked with Dr. Pradhan and Dr. Eugene Tanquilut, both of Vascular Specialists, for nearly a decade. DiBennedetti works alongside these physicians before and during the procedures. “These stents are unique. The concept is to preserve the iliac branch with a dedicated device. Formerly, a surgeon could do a makeshift procedure but they were not good for the long term,” said DiBennedetti. “This new iliac stent is really a big deal. It solves the problem of repairing abdominal aortic aneurysm along with iliac aneurysm without stopping blood flow to the pelvis.” More often than not, surgeons will see these conditions together in the same patient.

DiBennedetti notes that patients who require this procedure are younger and younger, and preserving their mobility and functionality gets more and more important. “We can safely treat patients who we may not have treated before; we can address broader anatomies.” Because 80-85% of AAA cases are now treated endovascularly, these designs can treat younger patients, with far greater success.

Dr. Pradhan and DiBennedetti assessed the CT scans prior to Greer’s surgery. They analyzed each artery’s measurements and determined which specific stents to provide in the procedure. “These stents are not custom made, so they can be in our hands within 24 hours. Each artery will have a different diameter, so the stents are then built within the patient.” DiBennedetti hails 3-D imaging as a tremendous help in determining the correct stent sizing for each patient and each artery. “These are very patient specific.”

DiBennedetti was also present during Greer’s procedure, to help with any device questions from Dr. Pradhan or his team.

Dr. Pradhan then consulted with Greer and his family to explain the procedure and the new device. “Dr. Pradhan recommended I take no chances, that a rupture – if I made it through – could be very dangerous. He explained that inserting the stent now would prevent a rupture and would prevent open surgery. He said it was a good choice, and better for my long-term health. My son’s wife said, let’s do this,” smiled Greer.

Greer checked into Advocate South Suburban Hospital for the endovascular surgery. “South Suburban Hospital has all the technology needed for this surgery,” said Dr. Pradhan. “They have the imaging technology and the endovascular tools for advanced procedures such as this.”

Dr. Pradhan used the iliac stent in conjunction with the GORE® EXCLUDER® AAA Endoprosthesis, or AAA stent. Dr. Pradhan and his team made a very small incision in each of Greer’s femoral arteries, at the groin where the legs meet the hips. He then inserted a delivery catheter on the right to place the AAA stent, and a delivery catheter on the left to place the iliac stent.

There are a total of four pieces that make up the mechanism; a trunk, a bridging component, an iliac branch stent and an internal iliac branch component. These pieces come together to resemble an upside-down tree with three branches. The trunk stent repairs the aortic aneurysm and the additional pieces repair lower aneurysms while keeping all the pelvic arteries open, adequately supplying this area with oxygenated blood. The procedure took less than two hours to complete.

Greer said, “I spent a few hours in the ICU, then went to a regular room for monitoring overnight. I got to go home the next day.”

Greer especially notes that Dr. Pradhan explained everything so thoroughly, he’s hardly had any questions, before or after the procedure and during his follow up appointments. “He gave me the reasons why he would do what he did, and explained it all. He’s got a good personality that I like, a good demeanor.”

A fierce advocate of patient education, Dr. Pradhan believes that every patient should be seeing a vascular and endovascular surgeon when facing aneurysm, vein or artery issues. “You should see a surgeon who can deal with your disease in a variety of ways so that, working together, the best choice of treatment can be made for you as an individual. Do your research, find out about latest technologies and devices. Ask your surgeon if he or she is comfortable using those and if they are recommended in your case. Your surgeon should be knowledgeable about new procedures.”

Dr. Pradhan notes with pride that the procedures done by Dr. Tanquilut and himself are university-level care. “There are even universities that are not doing these procedures. I have a great staff and team at Advocate South Suburban Hospital that assist me in performing these complex operations. They are intelligent, compassionate and share my passion for learning and helping patients.”

“This is an uncommon procedure,” agrees DeBennedetti. “And it’s the first implant of its kind in the Advocate System. I work with Dr. Tanquilut and Dr. Pradhan several times a month and these physicians are fantastic. They are both fellowship trained; Dr. Pradhan at Yale and Dr. Tanquilut at Cleveland Clinic, very prestigious programs.”

Dr. Pradhan grew up in Wisconsin and graduated from Northwestern University. He completed his medical degree at Medical College of Wisconsin and completed both his general surgery residency and vascular fellowship at Yale University School of Medicine. He lives in Orland Park.

“I feel it inside me,” said Dr. Pradhan. “I have a real need to increase my toolbox, adapt my approach with each new patient and consider new evidence as it becomes available. I don’t ever want to be comfortable with what I know. It’s passion, it’s knowledge and it’s skill. That’s where it all comes together for the patient’s benefit.”

Dr. Pradhan is joined by Dr. Eugene Tanquilut at Vascular Specialists, with offices in Olympia Fields and New Lenox. The two are the only physicians in the Chicago Southland who are board certified in both vascular and endovascular surgery.

“Dr. Tanquilut and Dr. Pradhan are skilled and qualified,” said DiBennedetti. “They have the knowledge to do the procedures properly. They have access to the right equipment, because Advocate South Suburban has all the proper imaging technology. Their demeanor and personalities are fantastic – they have great bedside manners. Their support staff is great. These guys do a lot of great work.”

Daniel Greer agrees. “‘I have no problems. My follow up was good. I’m exercising more and I quit smoking. Dr. Pradhan told me that these aneurysm were probably a direct result of my smoking for so long. I’m back to volunteering at the food pantry, cutting my lawn.” He smiles. “I feel great. And that’s kinda neat that I’ve made history.”


How Garry Shandling Died



On March 24, 2016, Garry Shandling died. Initial reports speculated a heart attack, but his personal physician refused to sign the death certificate, not agreeing with the coroner’s conclusion. An investigation was launched and the results were finally released December 27.

Shandling died because a blood clot lodged in his lungs, known as a pulmonary embolism. After traveling to Hawaii, he had developed DVT, deep vein thrombosis; blood clots had formed in his leg. That clot, or a piece of that clot, broke away and traveled to his lungs, blocking needed oxygen.

Pulmonary embolisms and DVT are both life-threatening. DVT can be caused by certain medical conditions, but can also occur when you don’t move for a period of time. This can happen during extended bedrest or, as in Shandling’s case, after traveling.

Watch for these DVT symptoms:

  • leg swelling
  • redness
  • pain, cramping or soreness

DVT may also occur without symptoms. DVT may not happen immediately, or symptoms may not occur immediately. It could be several weeks after non-movement for DVT to appear.

When a clot (thrombus), or piece of clot, breaks away from the leg, it travels through the bloodstream and lodges in an artery of the lung, called a pulmonary embolism. The clot robs a portion of your lung of oxygen, killing that part of your lung. That makes it very difficult for the rest of your body to get oxygen. Usually, multiple clots wedge in several lung arteries.

Watch for these symptoms of a pulmonary embolism:

  • sudden shortness of breath that worsens with exertion
  • chest pain which worsens when you breathe, bend, stoop, eat or cough
  • cough, especially with bloody show
  • clammy or bluish skin, particularly around lips, nail beds, nose and mouth
  • sweating
  • irregular or rapid heartbeat
  • dizziness or lightheadedness

A pulmonary embolism or DVT will not resolve without medication and often surgery. These are urgent, life-threatening conditions that need immediate treatment. 

To find out how to prevent DVT or a pulmonary embolism, visit our Facebook page. We’ve been talking about DVT prevention during travel for the holidays.

If you suspect you have DVT, call Vascular Specialists at 815-824-4406 or your physician immediately. You must be evaluated, diagnosed and treated as soon as possible. 

Your Health Back Faster With Our Quick Attention


Here at Vascular Specialists, we are especially proud of our quick response time. We’ve heard many stories of patients who’ve had to wait months for an appointment after being referred to other specialists, or have seen their medical condition deteriorate while waiting for a procedure to be scheduled.

Surveys show that a patient typically waits about 19 days to see a specialist, with some patients waiting over 72 days (Yes!) for an initial appointment. When finally arriving for that appointment, patients could wait for hours, with 23 minutes being average, after their designated appointment time. Even after a diagnosis, many patients find their procedure or surgery delayed by weeks or months.

Vascular Specialists knows that getting you back into optimum health quickly – and keeping you there – is vital to maintaining your lifestyle. We understand that getting an appointment, getting into that appointment in the right frame of mind and completing any necessary testing, surgeries or procedures as soon as possible improves your health quicker. That really seems like a no-brainer, doesn’t it?

That’s why, at Vascular Specialists, you’ll get an initial appointment within just 10 working days of your phone call to us. Most times, we’ll see you even sooner than that. Dr. Eugene Tanquilut and Dr. Sanjeev Pradhan, along with our Physician Assistant Courtney Stanford, are available quickly, to help diagnose and treat your vascular challenges in a timely manner.

We are open Monday through Friday until 5:00 pm, and begin appointments at 6:30 am on Tuesdays.

At our office, you’ll find we respect your time. While emergencies do arise, every attempt is made to have our medical staff see you promptly and efficiently, while affording you plenty of time within your appointment for thorough questions and answers. You will never feel rushed through an appointment at Vascular Specialists!

When you need additional testing or an interventional procedure, we also move quickly. We can typically schedule testing and both vascular and endovascular surgeries within 24-48 hours of diagnosis. Moving your treatment plan along swiftly means you start recovering sooner, and living your full life again sooner.

Vascular Specialists makes a point of getting your health back on track as soon as possible, through convenient, quick appointment setting, respectful wait times and prompt testing and surgery scheduling.

If you would like to discuss your health or vascular issue with us, call 815-824-4406 now. We’ll be happy to schedule an appointment – quickly. 

Dr. Pradhan Performs Unusually Rare Emergency Surgery To Save Tinley Park Resident


Dr. Sanjeev Pradhan credits Advocate South Suburban Hospital ER team with “quick diagnosis and action”

– When Lynn Mead told his wife Shirley he wasn’t feeling well, she told him to “go lay down. He’s 86. Sometimes he just doesn’t feel good.” When she checked on him later that evening, “he was very sweaty and he was all crooked on the bed. I straightened him out and went to bed myself. He grunted a few times when I was moving him,” so she was a little concerned, but not really alarmed.

About thirty minutes later, Shirley heard a thud. “I went to the bedroom and he was laying on the floor, struggling to get up and he couldn’t talk. I got scared and called my son who told me to call 9-1-1. So I did.” The ambulance arrived at their Tinley Park home and took Lynn to Advocate South Suburban Hospital in Hazel Crest.

“My son and grandson met me in the Emergency Room. Lynn was unresponsive and I was just so scared.”

Advocate South Suburban Emergency Room staff ordered an immediate CT scan and the results were both rare and life-threatening. Lynn had suffered a large rupture of an abdominal aortic aneurysm, or an AAA, that had, amazingly, self-clotted.

The aorta is the body’s main blood supply and is about the diameter of an average garden hose. It runs from the heart down through the abdomen before splitting into the iliac arteries in the pelvis, which continue into the legs. When part of the aorta weakens, it enlarges, like that garden hose with a bulge, causing an aneurysm. Without screening, AAA goes undetected and when a rupture occurs, nearly 90% of patients die before any surgery can be performed. About 75% die before they even get to the hospital.

At the ER, “suddenly, out of nowhere, comes this doctor,” says Shirley. “Where did he come from? It was the middle of the night, I think 2 o’clock in the morning by this time, and he just appeared out of nowhere.”

That physician was Dr. Sanjeev Pradhan of Vascular Specialists. Unbeknownst to Shirley, South Suburban Hospital’s ER physicians and nurses had called Dr. Pradhan, sent him a digital copy of the CT scan and Dr. Pradhan had been organizing a life-saving surgery enroute to the Hospital from his Orland Park home.

“The quick diagnosis and action of the Advocate South Suburban Hospital ER staff was crucial to Lynn’s survival. Some people may think of South Sub as a community hospital, but this was university-level care. Lynn would not be with us without their prompt actions,” says Dr. Pradhan.

The CT scan showed Dr. Pradhan that Lynn was extremely and unusually fortunate. “His rupture had sealed itself, forming a tamponade, a clot that prevented his aorta from pumping his blood freely into his body’s abdominal cavity,” said Dr. Pradhan. “For the moment, it was keeping him alive, but that tamponade could break up at any moment. I needed to get Lynn into surgery immediately.”

“This surgery is one of the biggest of the big,” said Dr. Pradhan. “A surgeon without endovascular training might want to fix this with major open surgery, but that would break up the tamponade, increasing the bleeding, which could result in kidney failure, heart attack and immediate death. Given Lynn’s condition and the results on the CT, I wanted to provide him with an operation that treated the rupture without putting his life – and the subsequent quality of life – on the line.”

Because of Dr. Pradhan’s specialized fellowship training at Yale University and extensive experience with both vascular and endovascular surgery, he was able to quickly assess all options – both major surgery and minimally invasive surgery – to determine what would best suit Lynn’s unique condition.

Before he left for the Hospital, Dr. Pradhan used the CT scan to complete all necessary measurements of Lynn’s aorta. He then alerted Jack DiBennedetti from GORE Medical to join him and bring the properly sized stent device needed to insert and seal the ruptured aneurysm. From his car, Dr. Pradhan organized the OR team and the Interventional Radiology/Cath Lab team. The entire team was ready within an hour of the first call to Dr. Pradhan, so that when the physician entered the hospital, he was able to discuss the procedure with the Meads, get their approval and get into the OR.

“This rupture came out of nowhere,” says Shirley. “We had no idea and there were no symptoms. We go to the doctor of course, and nothing ever showed he had this.”

For years, abdominal aortic aneurysms have been known as silent killers. An aneurysm could go undetected and grow for years. “Previously, most victims died at home after experiencing the worst back pain ever,” said Dr. Pradhan.

Shirley says, “Dr. Pradhan told us that Lynn’s condition was very bad, very serious, that something had burst inside him. He explained what a ruptured abdominal aorta was, told us what he’d do in surgery. He was open and told us what he thought, right out.” Lynn was taken to surgery, and then the Meads waited.

“Lynn’s rupture was big, from an aneurysm that was probably about 10 cm, about the size of a softball,” says Dr. Pradhan. During the approximately two-hour surgery, Dr. Pradhan and his team made small, less than 1” long, incision intos Lynn’s groin to access his femoral arteries. Because of Dr. Pradhan’s expertise and knowledge, the team was able to use very little contrast dye during the procedure, less than 10cc, compared to a more typical 80cc. This helped protect Lynn’s kidneys from failing. Dr. Pradhan inserted the GORE Endoprosthesis stent, a combination of nitinol and a nickel titanium alloy scaffold that is covered with polytetrafluoroethylene or PTFE, a type of Teflon fabric. The stent was guided through Lynn’s body to his abdominal aorta and in effect, relined the ruptured area. DiBennedetti was present for the entire procedure, available to provide other materials if needed and ensuring that the stent was working as it’s designed to do.

“Having Jack in the surgery is helpful. He’s a great partner and he can help troubleshoot any issues, as he’s seen so many different surgeries,” said Pradhan.

“Dr. Pradhan came through the door and said Lynn had made it through the surgery. He was happy with the results,” said Shirley. “He showed us the scan before the surgery, which was all cloudy, and the new scan, which was so clear – there was a 100% difference.”

Lynn smiles and remarks that this is really Shirley’s story, “because I don’t remember a thing. I was out of it until I woke up after the surgery.”

Lynn spent the night in ICU. “His heart bounced back, his kidneys bounced back,” said Dr. Pradhan. “Lynn was up walking the next day.” Lynn’s recovery continued at South Suburban Hospital for a couple of weeks, and then he was released to a rehabilitation facility for 2 weeks of physical therapy.

Lynn followed up with Vascular Specialists, and his check-in CT scan “came out good”, says Shirley.

“He’s been okay ever since,” says Shirley. “His PT (physical therapy) is done, he’s raking leaves, he drives us to our doctor appointments, we go shopping. He’s back to all his regular activities. He’s doing good for his age. He is a little tired, but he is going to be 87 in November, you know.”

Patients who experience this type of repair have follow up CT scans one month after surgery, 6 months after surgery, one year after surgery and then annually after that. There is less than a 10% chance that Lynn’s stent might leak, but that would be repaired endovascularly as well. “These stents are strong and flexible,” said Dr. Pradhan. “They have no shelf life and should work forever.”

Risk factors for developing AAA are highest for older white males. Other factors include having hypertension or high blood pressure, a family history of AAA, atherosclerosis and, of course, smoking. Previously, there was limited opportunity for repair, as surgery was often more risky than monitoring the aneurysm. With the advent of endovascular techniques, that has changed.

Dr. Pradhan said, “The limitations are not there any longer as we continue to progress with endovascular innovations. Using different therapies, we can repair an aneurysm before it causes any trouble. If you have any of the risk factors, get screened. Get screened early in life if you have a genetic tendency to develop AAA. Everyone should get screened as soon as they turn 60, especially if you’ve ever smoked. Screening is a simple, painless and non-invasive ultrasound, so there’s no risk involved. It’s always better to know and take action than go through a rupture – because you might not make it through.”

Dr. Sanjeev Pradhan practices with Dr. Eugene Tanquilut at Vascular Specialists, with offices in Olympia Fields and New Lenox. Both physicians are uniquely qualified and outstanding in both the vascular and endovascular fields, providing evidence-based medicine, using the most recent published data and university level care. They are the only award-winning, fellowship trained, board certified vascular and endovascular surgeons in the Chicago Southland.

GORE representative DiBennedetti says, “I’ve worked with Drs. Pradhan and Tanquilut for years now and I can tell you, they are both highly trained surgeons. Both completed fellowships at very prestigious places; Pradhan at Yale and Tanquilut at Cleveland Clinic. They are skilled and qualified, very patient-specific in their practice. Their support staff is great. They also have access to the right equipment. South Sub is fully equipped for these types of surgeries. Besides, they have great personalities and great bedside manners.”

Shirley will attest to that. “I was so scared, so nervous,” she says of that time in the ER. “I thought ‘where am I and what is happening?’ Dr. Pradhan came out of nowhere. I had never met him before and he was sweet and cordial to us. I would tell everyone to go to Dr. Pradhan. He’s a wonderful surgeon and I’ll always stand by him. Dr. Pradhan hurried up and came like an angel through the night to help my husband.”


Stroke Symptoms That Last Just Seconds – Should I Call 9-1-1?

VascSpec TIA

It could last only seconds and it could last for several minutes. A sudden drooping of your face, a disturbing slurring of words, an alarming weakness in one arm. As soon as you and those around you begin to panic, the symptoms disappear.

Everyone around you thought you were having a stroke, they were getting ready to call 9-1-1 and now you’re absolutely fine, as if nothing at all happened. You can talk clearly, lift both arms equally and your face looks just fine. You feel a little silly – what would you tell 9-1-1 if you called now?

You’ll still dial 9-1-1 right now, or have someone drive you to the Emergency Room immediately. You’ll tell them you had a TIA, a Transient Ischemic Attack. There is no time to lose – remember that time is brain.

A TIA is often called a “mini-stroke”, but the common name really should be a “warning stroke.” A TIA and a full-blown ischemic stroke are both caused by exactly the same thing – a clot of plaque, a fatty deposit of cholesterol, white blood cells and other substances.

An ischemic stroke happens when the clot blocks blood flow completely within an artery supplying blood to the brain and doesn’t move. This shuts off the supply of oxygen to the brain. Medical intervention is needed to dissolve the clot and open the artery. Keeping the time lapsed from symptoms occurring to treatment beginning as brief as possible is critical to avoid permanent brain damage.

A TIA occurs when the clot blocks blood flow temporarily – or transiently – for just seconds or up to about 5 minutes. The average time of symptoms is one minute. Your body’s natural clot-dissolving agents then break up the plaque and the blockage opens, eliminating symptoms. Usually there is no permanent damage from a TIA.

That doesn’t mean it’s okay to just mention it at your next annual medical exam. A TIA really is a warning stroke. Get to the Emergency Room immediately and report all your symptoms and their duration.

You will be physically examined and, as recommended, may have an ultrasound, CT, or other imaging tests. Your medical professionals will want to identify the cause of your TIA and take steps to avoid an ischemic stroke. Depending upon the severity of your symptoms, the test results and your overall health, medication may be prescribed or surgical procedures may be recommended.

Over 30% of people who experience a TIA will have an ischemic stroke within a year, so do not take a “wait and see” approach. Preventing a stroke after a TIA means preventing permanent brain damage which can severely impact your quality of life.

If you have any questions about TIA or ischemic stroke, call Vascular Specialists at 815-824-4406. Dr. Tanquilut, Dr. Pradhan and our professional staff are always happy to talk about your vascular health!

Dr. Sanjeev Pradhan Recognized By Advocate South Suburban Hospital



His patients have called Dr. Sanjeev Pradhan a clear communicator, honest and sweet and a real lifesaver. His peers speak of his advanced training and his dedication to detail and excellence. Recently, Advocate South Suburban Hospital recognized Dr. Pradhan for his outstanding work in vascular and endovascular surgery.

Advocate South Suburban Hospital honors Dr. Pradhan of Vascular Specialists on its Physician Recognition Wall this quarter. Dr. Pradhan earned this spot on the Wall when chosen by a multi-disciplinary team from across the hospital for his exemplary commitment to Safety, Quality and Service. Criteria for this recognition include patient satisfaction, clinical excellence and outstanding outcomes.

Shirley Mead says that Dr. Pradhan clearly explained what happened to her husband Lynn Mead when his abdominal aortic aneurysm ruptured, and how he could fix it. “He is an angel – a wonderful surgeon and I’ll always stand by him.”

Professional peer Adam Ansel is a representative of Cook Medical, supplying many of the grafts that Dr. Pradhan uses in endovascular surgical procedures. Ansel said that Dr. Pradhan puts an intense amount of time into pre-planning, considering every challenge that could occur and determining how it could best be handled before surgery even begins. That dedication results in excellent outcomes and faster patient recovery.

Jack DeBennedetti of W.L. Gore is also a professional colleague. “Dr. Pradhan attains excellent outcomes with uncommon procedures. He is skilled and qualified, with the knowledge to do these surgeries properly.”

Dr. Sanjeev Pradhan grew up in Wisconsin and attended Northwestern University. He completed medical school at Medical College of Wisconsin and then completed both his residency and vascular fellowship at the prestigious Yale University School of Medicine. He is board certified in both vascular and endovascular surgery. Because of these dual certifications, Dr. Pradhan can offer his patients all the options available to treat their vascular condition. Dr. Pradhan uses the most recently published data, evidence-based medicine and the most current and best information available to treat his patients.

“I am honored to be recognized by my patients and my peers at Advocate South Suburban Hospital,” he stated.

Vascular Specialists, with Dr. Eugene Tanquilut and Dr. Pradhan, has offices in Olympia Fields and in New Lenox.

Vascular Specialists Continues to Grow, Welcoming Courtney Stanford, N.P. 

Vascular Specialists is always looking for the latest best practices, cutting-edge devices and university-level techniques to better serve our patients. Now, we’re introducing our latest “tool” in excellent patient care, our physician extender Courtney Stanford, Nurse Practitioner.

Courtney Stanford earned a Master of Science in Nursing, Family Nurse Practitioner from Loyola University in Chicago after graduating with her Bachelor of Science in Nursing from Michigan State University in East Lansing, Michigan. She is certified in both Basic Life Support and Advanced Cardiovascular Life Support, has successfully completed the Essentials of Critical Care Orientation and is a member of the Illinois Society for Advance Practice Nursing and the American Associaton of Critical Care Nurses. Courtney has experience with

• critical care

• adult intensive care

• adult surgical heart care

Courtney has served on hospital committees to define and improve patient care, quality management and performance and environment improvement.

Dr. Tanquilut and Dr. Pradhan both work closely with Courtney, collaborating with these professionals to ensure our patients receive the careful, thorough attention and honest patient and family education and communication that Vascular Specialists is known for.

Please join us in welcoming Courtney to the Vascular Specialists family! If you have a question about your vascular health, or to make an appointment with our physicians or our physician extenders, call 815-824-4406. We are always happy to help!

Chicagoland Vascular Surgeon Eugene Tanquilut, D.O., Included In Trademark Who’s Who Top Doctors Honors Edition



– The patients and peers of Dr. Eugene Tanquilut of Vascular Specialists have long recognized his compassion and expertise. Committed to providing university-level vascular care and dedicated not just to continually learning himself, but also to educating those around him, Dr. Tanquilut delivers exceptional healthcare with professionalism, integrity and honesty.

Now, Dr. Tanquilut has been selected by the Trademark Who’s Who for inclusion in their Top Doctors Honors Edition.

“During the vetting process, it was noted, along with his exceptional reputation, that he has also maintained a positive peer rating. He is the kind of professional admired by colleagues and peers alike. His kindness and willingness to always help others and find solutions is both exemplary and honorable. Dr. Tanquilut has made his mark on his profession as an expert and will become part of history as one of the top professionals in his field,” said Trademark Who’s Who representative Amber Rogers.

About Dr. Tanquilut

Dr. Tanquilut is a native of Orland Park and a graduate of Carl Sandburg High School. He earned his Bachelors degree at University of Illinois and his D.O. at Midwestern University College of Osteopathic Medicine. He is one of only two physicians in the Chicago Southland who has extensively trained and is board certified in both vascular and endovascular surgery. Dr. Tanquilut trained in both traditional, such as bypass, and minimally invasive vascular surgery, such as stenting, at the prestigious Cleveland Clinic’s Heart and Vascular Institute, ranked for 21 years in a row as No. 1 by U.S. News & World Report. Because of this, he can provide an unbiased opinion about treatment methods that ultimately ensures each patient has the best possible individual care. Dr. Tanquilut has previously been awarded Vital’s Top 10 Doctors/Vascular Surgery, Most Compassionate Doctor and Vital’s Patients Choice for several years. His practice, Vascular Specialists, has offices in Olympia Fields and New Lenox.

“My goal is to first understand my patient and his or her needs, and then to implement a treatment plan that will be both effective and efficient for that patient. I treat my patients with compassion and altruism, a genuine concern for their well-being. I endeavor to understand each patient as an individual, to treat them as a unique person and not see them as a disease. Patients should be given the best quality of care with the goal to significantly improve their quality of life. Patients have the right to be well informed about all treatments available, which helps us make the best decision as a team,” said Dr. Tanquilut.

About Trademark Who’s Who

With expert members representing every major industry, Trademark Who’s Who is the trusted resource and historic tool. Following the same tradition of the now more than 100-year-old concept, Trademark Who’s Who prides itself on preserving the stories of each member as each of them deserve his or her own place in history. The talented professionals profiled in the historic register share such virtues as determination, courage, patience and discipline. It is not these characteristics which set that apart, but their extremely high degree of accomplishment. Now more than ever, these people serve as an example, each of the extraordinary people documented in this book offer tangible evidence of the value of hard work, goal setting and passion.

“Membership in Trademark Who’s Who is a certified and validated third-party endorsement of Dr. Tanquilut’s accomplishments and serves as a way to spread the word about him through a trusted network of individuals brought together by the same common morals, values and dedication,” said Rogers.

Dr. Tanquilut’s inclusion in Trademark Who’s Who highlights his commitment to best practices, university level care and patient education. Dr. Tanquilut said, “I’m honored to be recognized by Trademark Who’s Who and am humbled to be joining these ranks of outstanding physicians.”

First-ever Remote Endarterectomy at Advocate South Suburban Hospital, Treats Peripheral Artery Disease

Dr. Eugene Tanquilut, vascular and endovascular surgeon, one of only two qualified Chicago Southland physicians, performs procedure.



History was made by Dr. Eugene Tanquilut at Advocate South Suburban Hospital recently as Dr. Tanquilut performed the first-ever remote endarterectomy at the Hospital, using LeMaitre MollRing Cutter® Transection Device on Chicago Heights resident Peter Caffarelli.

Remote Endarterectomy, or RE, combines both vascular (traditional) surgery techniques and endovascular (more innovative and less invasive) techniques. Because Dr. Tanquilut is board certified in both vascular and endovascular surgery, he is the only surgeon in the Chicago Southland able to perform this hybrid procedure.

Caffarelli, 57, was diagnosed with peripheral artery disease (PAD), a condition in which plaque, a mix of fat, cholesterol, calcium, tissue and other elements, builds up in the arteries causing atherosclerosis, hardening of the arteries. As plaque builds within the arteries, the blood flow becomes restricted, making it more difficult for oxygenated blood to reach the tissues, muscles and bones that need it. PAD typically affects the arteries in legs, but can also cause problems in those that supply blood to the head, arms, kidneys and stomach. In some cases, patients may never know they have PAD, as other blood vessels take over for the affected arteries. In others, PAD can be a painful, often life-threatening condition.

Caffarelli had for years been experiencing pain. “Mostly in my lower leg, under the knee,” he said. “I dealt with the pain for about a year and then it got a lot worse. I couldn’t do the stairs anymore and I had to hire a guy to mow my lawn.”

This type of pain, which worsens with walking and then improves with rest, is called intermittent claudication. Claudication may include numbness, aching or heaviness, or cramping in the legs, buttocks or feet. Because blood vessels are narrow or blocked, muscles cannot get the oxygen needed during activity. The pain disappears when resting because muscles do not need as much oxygen.

“I finally brought it up to my primary care doctor Dr. (Paul) Chemello,” said Caffarelli, “and he told me, “I got a good guy” and referred me to Dr. Tanquilut.”

“I explained my pain to Dr. Tanquilut and he looked at my leg and set up a test immediately,” said Caffarelli. After a 30-minute, minimally invasive angiogram which showed the extent of Caffarelli’s severe blockage, Dr. Tanquilut presented him with three options.

“We saw complete blockage of the femoral artery above Peter’s knee. Peter’s condition could be treated with traditional bypass, with stenting, or the RE, which is as good as a bypass for longevity and is minimally invasive,” said Dr. Tanquilut. “After giving Peter all the information about each procedure, the decision was made collaboratively to do the RE. Peter was a very good candidate for the procedure, given his condition.”

“With RE, we maintained Peter’s own artery, there was less risk and a faster recovery than with traditional bypass. A small incision was made into Peter’s artery at his groin. We then inserted the MollRing Cutter, a flexible rod with a little ring at the end. With this tool, we were able to transect the total blockage, cut it out without any harm to the artery itself and then pull it back out of the artery. We then inserted a Gortex® stent to allow the smooth flow of blood again within the artery. From the angiogram, I knew Peter had substantial blockage, which measured at about 25 centimeters (nearly 10 inches),” said Dr. Tanquilut.

Caffarelli said, “Dr. Tanquilut talked to me after surgery and was very happy with the results. It’s really great knowing he loves his work that much.”

“Despite the severity and length of the blockage, by a small incision, we were able to get excellent results. Peter was walking very soon after surgery; he’s had almost no down time,” said Dr. Tanquilut. “I’m very pleased that we were able to get such good results through this university-level, minimally invasive modality.”

Cafarelli spent one night in ICU at Advocate South Suburban Hospital. “I was very comfortable there, but when I saw Dr. Tanquilut the next day, he asked me if I’d rather be at home and of course I said yes. I was home by one o’clock that afternoon.”

PAD is a serious condition that increases the risk of stroke, heart attack, transient ischemic attacks or “mini-strokes” and coronary heart disease. Because blood flow is restricted, if untreated, PAD can also cause ulcers and wounds that will not heal, leading to gangrene and possible limb amputation. Depending upon the severity of symptoms, PAD can be treated with lifestyle changes, medication, minimally invasive procedures or surgery. Pain or numbness in arms or legs, sores that are healing slowly or not at all, a lower temperature in one leg or arm, or a pale or bluish color in toes, feet, fingers or hands are all symptoms that should be brought to a doctor’s attention immediately. Erectile dysfunction can also be a symptom of PAD.

Caffarelli’s long term prognosis is very good. He takes a low-dose blood thinner as a prophylactic measure and is back to a normal active life.

Caffarelli doesn’t think it was a big deal that he was making Advocate South Suburban history. “From my first appointment, I have trusted Dr. Tanquilut”, said Caffarelli. “Some people just rub you that way- you know how people just hit you that way? He explained things to me, and he said “when we are done, you will not have any more pain” and that’s what I wanted. He was very nice and so is his whole staff – nurses, the assistants, the girls at the counter.”

Dr. Tanquilut grew up in Orland Park and graduated from Carl Sandburg High School. He earned his Bachelors degree at University of Illinois and his D.O. at Midwestern University College of Osteopathic Medicine. He and his partner at Vascular Specialists, Dr. Sanjeev Pradhan, are the only two physicians in the Chicago Southland who have extensively trained and are board certified in both vascular and endovascular surgery. Dr. Tanquilut trained at the prestigious Cleveland Clinic’s Heart and Vascular Institute, ranked for 21 years in a row as No. 1 by U.S. News & World Report. He can perform RE at Advocate South Suburban Hospital in Hazel Crest, Silver Cross Hospital in New Lenox and Franciscan St. James in Olympia Fields. Vascular Specialists has offices in Olympia Fields and New Lenox.

To others who suffer PAD symptoms, Caffarelli says, “Oh, most definitely I’d recommend Dr. Tanquilut – without a doubt. I don’t have the pain anymore. I walk up and down the stairs to do my laundry and it doesn’t bother me, I get around much better without pain. I can walk outside. I am just about 100% without pain. I highly recommend him – I thank Dr. Tanquilut for what he’s done for me.”

Get your legs ready now for your winter vacation


Whether it’s a quick trip to Florida or an extended vacation to the French Riviera, you’ll probably want to wear a bathing suit this winter. And if you’ve stayed out of shorts this summer because of varicose veins, it’s really time to consider treatment – to not only look better, but also to feel better.

Varicose veins can range from smaller spider veins to gnarled, bulging knots that have the potential to become ulcers or form stroke-causing blood clots. Varicose veins can be practically painless, cause itching and redness, or cause deep aching. Once varicose veins appear, no matter how small, there is no non-medical remedy. Exercises, lifestyle changes and compression stockings can slow progression, but they cannot reverse the damage.

Even if you believe these veins are just a cosmetic annoyance, the appearance of varicose veins should be pointed out to your primary care doctor or to Vascular Specialists, as they could be a symptom of impending circulatory problems.

When you are ready to feel comfortable again when baring your legs, or the ache of varicose veins has started to alter your activity level, it’s time to contact Vascular Specialists. Dr. Tanquilut and Dr. Pradhan have fellowships in both vascular surgery and endovascular surgery, making them much more qualified than “vein clinics”. Because varicose veins can be a symptom of other issues, their education and experience make our physicians much more able to diagnose and treat other vascular issues that affect your health. Your age, overall health, lifestyle and the progression of your varicose veins will all be taken into account when determining appropriate treatment.

When you have spider veins and smaller varicose veins, you may be a good candidate for sclerotherapy. This minimally-invasive procedure is done in our office and patients generally drive themselves home. Our physicians will inject a solution into your troublesome veins using an ultra fine needle. The solution irritates the lining of the vein, causing it to swell, clot and, over time, fade.

For larger varicose veins, together we may consider radiofrequency (RF) energy treatments. Minimally invasive, this procedure is performed in our office using local anesthesia. You will need a driver for the day. Our physicians will insert a catheter into your vein and then apply heat, contracting the collagen in your veins, causing them to collapse and close.

In the case of dangerously compromised varicose veins, our physicians may discuss vascular surgery or “vein stripping.” Stripping is a surgical procedure requiring general anesthesia that is less commonly used today.

Call Vascular Specialists in New Lenox and Olympia Fields at 815-824-4406 today to make a consultation appointment. We’ll discuss your options and schedule your treatment to ensure that your legs are ready for fun in the sun this winter – and next summer.

Is your aorta healthy? Your life depends on it!

VascSpeciaist AAA

While we here at Vascular Specialists think all your veins and arteries are amazing, there’s one in particular that does a simply super job – and your life quite literally depends upon it.

Your aorta is the largest artery in your body, about the thickness of a garden hose. It begins at the top of the heart, connecting with the left ventricle at the aortic arch. Along its way down your body, before splitting into the two iliac arteries at the bottom of your abdomen, the aorta supplies blood to your head, brain, neck and arms, your heart, your ribs and chest, and most of your major organs in your abdomen.

Because the health of your aorta is so vital to your well-being, any sign of an abdominal aortic aneurysm must be carefully monitored. An abdominal aortic aneurysm, or AAA, is a balloon-like bulge, a weakened area, of the lower part of your aorta. An AAA can be very small and nearly impossible to detect, never enlarging and never rupturing. An AAA can “dissect” and split the walls of the artery, causing blood leakage. An AAA can also grow very quickly and dangerously, rupturing and requiring, if possible, emergency surgery. Nearly 9,900 people in the U.S. died from AAA in 2014.

Your risk of AAA increases when you:

• are male

• are over 65

• have ever smoked

• have a family history of AAA

• have high blood pressure or hypertension

• have atherosclerosis or hardening of the arteries

If you have 3 or more of these risk factors, you should be screened via ultrasound for AAA.

The causes of AAA are:

• smoking

• high blood pressure

• atherosclerosis

• disease in the aorta

• trauma or injury, a sudden and intense blow to the chest

• bacterial or fungal infections in the aorta

• genetics

Most often, AAA develops with little to no symptoms. However, if you have risk factors and feel any of the following, call Vascular Specialists immediately:

• pulsating pain near your navel or belly button

• deep, constant pain in your abdomen

• unexplained back pain

• cold foot or feet, with blue or black toe(s)

• unexplained fever or weight loss

If you are diagnosed with AAA, the method of treatment will depend upon the severity of your condition. We may recommend immediate surgery depending upon the size of your AAA relative to the size of your body frame, height and weight. We may also take a “wait-and-see approach,” regularly monitoring the development of AAA. If you are not already taking medication for hypertension and atherosclerosis, we will prescribe it. If you smoke, we offer guidelines to quit. We will also recommend lifestyle and diet changes, including exercise that raises your heart rate every day.

If you have concerns about your aortic or vascular health, give Vascular Specialists a call at (815) 824-4406. Dr. Tanquilut, Dr. Pradhan and our professional staff will be happy to answer your questions!

Vein troubles don’t practice ageism!

Thrombophlebitis in human leg

Often, we think of vascular diseases as something that occurs as we age, affecting those in retirement years and beyond. While it is true that many diseases need decades to become a problem, there are several vascular challenges don’t ignore the younger generations. Here, Dr. Tanquilut and Dr. Pradhan answer your questions about one of those conditions, thrombophlebitis.

What is thrombophlebitis?

Thrombophlebitis (throm-boe-fluh-BY-tis) means a blood clot or clots has formed in your veins,  usually in your legs. The veins in your arm or neck can also be affected, but these locations are much less common.

What can cause thrombophlebitis?

You may experience thrombophlebitis if you’ve:

  • had an injury to your vein
  • used birth control pills or hormone therapy
  • have been or are pregnant
  • sat on an airplane, car or train for too long
  • had prolonged bedrest, either at the hospital or at home
  • had an infection
  • have varicose veins
  • stand for long periods of time
  • are overweight

See? Thrombophlebitis doesn’t discriminate by age!

What symptoms should I watch for?

Thrombophlebitis can present in several ways:

  • swelling in the leg or arm
  • pain or tenderness over a vein
  • increased warmth over a vein
  • red or discolored skin over a vein

Should I see a doctor?

While superficial thrombophlebitis is rarely life-threatening, it can also be a symptom of deep vein thrombosis (DVT). You absolutely must see Dr. Pradhan or Dr. Tanquilut immediately if you suspect DVT. We may perform a blood test, an ultrasound or a CT scan to determine a diagnosis.

How is thrombophlebitis treated?

Treating superficial thrombophlebitis can be as simple as applying heat to the tender area, elevating the leg and using an NSAID such as Motrin or Aleve. In some cases, thrombophlebitis may require taking blood-thinning medication, ablation or sclerotherapy.

If you are concerned about thrombophlebitis – at any age – call Vascular Specialists at 815-824-4406. Dr. Tanquilut and Dr. Pradhan are always ready to thoroughly answer your questions.

What exactly is a stent?

Vascular Specialists

You’ve probably heard it a dozen times about friends or family; “he’s got a stent now.” While we know that means the patient has been treated surgically, do we have any idea what a stent really is?

Dr. Tanquilut, Dr. Pradhan and Vascular Specialists are here to help explain!

So what is a stent?

A stent is, quite simply, a tiny wire mesh tube – like a section of minuscule reinforced garden hose.

Why would you need a stent?

Arteries that become lined with plaque cannot handle normal blood flow and cause a wide variety of symptoms, from shortness of breath to chest pain. When you are diagnosed with this condition, atherosclerosis, you could be treated in a variety of ways depending upon the severity of the disease. You may just be prescribed lifestyle changes if the disease is caught very early, or you may be a candidate for a stent insertion if your atherosclerosis is advanced.

How are they placed?

To insert the stent, Dr. Tanquilut or Dr. Pradhan will perform an angioplasty. A stent is placed over the tip of a balloon catheter. The catheter is inserted into the artery, positioned at the blockage and the balloon inflated. The stent expands along with the balloon, locks into place and the balloon is deflated. Catheter and balloon are removed, but the stent remains in the artery permanently, helping to keep the artery open.

Does everyone with advanced atherosclerosis get a stent?

Angioplasties can be performed without stents, where the balloon just pushes the plaque aside, but research shows patients who are able to have stents inserted have better long-term results. The ability to use angioplasty and a stent to open an arterial blockage depends on the blockage’s location, the size of the artery and other factors relating to the patient’s health.

How tiny is “tiny”?

Take a close look at the photograph above. Stents can be as narrow as 2mm and as short as 8mm. Dr. Tanquilut and Dr. Pradhan will carefully analyze the size of your arteries and blockage to make sure your stent is the correct size for optimal recovery.

When you or someone you know has been diagnosed with atherosclerosis and is considering a stent, Vascular Specialists is glad to answer any questions, discuss treatment options, or provide a second opinion. Just call 815-824-4406 and make an appointment in New Lenox or Olympia Fields.