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Doctor Q&A for Dr. William Davis

A 27-year-old female asked:
Dr. William Davis
Vascular Surgery 39 years experience
No short answer: Prevalent but underdiagnosed condition in which left common iliac vein deep in the pelvis is compressed by right common iliac artery. This is probably the reason left leg blood clots, potentially fatal, outnumber right leg clots. In addition to increasing clot risk, many patients have chronic left leg swelling for which nothing has been done There are right leg variants also.Treated by stenting.
A 18-year-old female asked:
Dr. William Davis
Vascular Surgery 39 years experience
Possible clot.: Late pregnancy at risk for deep vein clot which can be fatal. Symptoms almost always accompanied by swelling on just the one side, left leg is more common. If no swelling then nerve compression more likely (less dangerous). Get to your doc or er now.
A 29-year-old member asked:
Dr. William Davis
Vascular Surgery 39 years experience
Zero to bad!: 25% of us have a pfo and obviously most of us do fine. However i operated on a young lady yesterday (for a related condition) who was in severe congestive heart failure, mostly resolved by closing her pfo. Closure (if deemed necessary by a cardiologist) can often be achieved with catheter-based technology (amplatzer plug) rather than open-heart surgery.
A 38-year-old member asked:
Dr. William Davis
Vascular Surgery 39 years experience
Yes: Thrombus is clot. Most carotid disease is detected as plaque thickening the wall of the artery, and if severe can send small emboli (clots) to the brain causing a stroke or ministroke.The only frank carotid thrombosis I have seen was one day after endarterectomy, eating breakfast one minute, not talking the next. Prompt re-operation brought her back to full function, no deficits.
A 45-year-old member asked:
Dr. William Davis
Vascular Surgery 39 years experience
Yes: Thrombus is clot. Most carotid disease is detected as plaque thickening the wall of the artery, and if severe can send small emboli (clots) to the brain causing a stroke or ministroke.The only frank carotid thrombosis I have seen was one day after endarterectomy, eating breakfast one minute, not talking the next. Prompt re-operation brought her back to full function, no deficits.
A 46-year-old member asked:
Dr. William Davis
Vascular Surgery 39 years experience
Very rarely,if ever.: Usual is amaurosis fugax, like a shade coming down over the vision of one eye only, but not both.An unusual variation is bright light amaurosis, brought on in one eye when in bright light, because the extra light puts more demand on the retina.The key in all vision changes with carotid disease is that it is monocular, a point missed by most practitioners.If a symptom affects both eyes, not carotid!
A 40-year-old member asked:
Dr. William Davis
Vascular Surgery 39 years experience
Yes: The most famous example is from autopsies of us soldiers (ages 18 and above) who died in vietnam. The aortas of many demonstrated fat-laden cells which are the first step toward atherosclerosis. No data, to my knowledge about corresponding lifestyles, but we know many were smokers.
A 41-year-old member asked:
Dr. William Davis
Vascular Surgery 39 years experience
Steroids now!: The only safe thing for proven giant cell arteritis is immediate high-dose corticosteroids (usually prednisone, 40-60 mg by mouth daily) for at least a few weeks, then tapering the dose. These drugs do have side effects but they usually don't cause immediate, untreatable blindness, which untreated gca can. My next procedure today is a temporal artery biopsy to attempt diagnosis of this condition.
3 thanks
A 47-year-old member asked:
Dr. William Davis
Vascular Surgery 39 years experience
FractureComplication: This is almost always preceded by a long-bone fracture, the theory being that fat from bone marrow (and other harmful particles) get into the veins of the bone and travel to the lung. The body's reaction to these particles is what causes most of the trouble, causing tissues to swell and decreasing the movement of oxygen from the lungs into the blood.
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