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Dr. Hratch Karamanoukian

Phlebology
Buffalo, NY
32 years experience male

Locations

Office

Williamsville, NY

Address

5225 Sheridan Drive, Williamsville, NY
Directions

My office hours

Wednesday: 7:00am - 7:00pm
Show more

Fax

(716) 626-7701

About

Bio

I am board certified in surgery (American Board of Surgery), thoracic surgery (American Board of Thoracic Surgery) and have added certification from the American Board of Venous and Lymphatic Medicine. I also have certification as a Registered Vascular Technician (RVT), Registered Physician in Vascular Interpretation (RPVI) and Registered Phlebology Sonographer (RPhS).

Specialties
Doctors may have more than one area of specialty interest. Board certification in a specialty area means the doctor has completed formal training and has practice experience in that specialty, and has passed the certification examination from the corresponding accredited medical specialty board.

Phlebology

Thoracic Surgery

Licenses

United States: New York

Languages spoken

Armenian

Doctor Q&A

153 Answers
24 Agrees
The number of answers this doctor has agreed with.
A 39-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Mondor's disease: This is consistent with superficial vein thrombophlebitis of the breast, also known as Mondor's disesse. Topical heat, ibuprofen and see your primary ... Read More
A 19-year-old male asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Hemmorrhoid: This could be a thrombosed hemorrhoid or anal stricture. Nothing to be ashamed of as it is a common problem. See your doctor.
A 37-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
EVLT: You can exercises within minutes after EVLT. I actually recommend my patients to do that immediately after they drive home following EVLT. This is ver... Read More
A 39-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Chest pain: There is no such thing as 'lung pain'. There is pleuritic pain related to inflammation of the inner lining of the chest due to problems in the thoraci... Read More
A 28-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
GERD: Referred pain could be explanation because alcohol may be irritating your esophagus. It is an unusual presentation nevertheless. I have seen a lot of ... Read More
A male asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Water taste: I suggest that you start with a basic metabolic panel on your blood work to exclude simple electrolyte issues or kidney problems. If that is all norma... Read More
A 38-year-old member asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Yes: you should be able to get them at an urgent care after an exam.
A member asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Allergic reaction: You should go to the ER now. You may need IV steroids.
A 30-year-old male asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Dull ache chest: This sounds of orthopedic nature and less likely to be cardiac given your young age (30) and the fact that it is positional in nature. Best to start w... Read More
A 29-year-old male asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Intestinal metaplasi: Patients with the first phase of Barrett’s esophagus (intestinal metaplasia) have a combined risk of 1.4% per year of progressing to high-grade dyspla... Read More
A 50-year-old member asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Neck lines: Transverse neck lines can be treated with strategic Botox injections and laser resurfacing. Often, volume fillers are also used to reduce these lines.... Read More
A 35-year-old member asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Hyperhidrosis hands: Palmoplantar hyperhidrosis is not contagious. It can be treated with topicals, sometimes oral anticholinergic agents, Botox injection, or micro ETS. S... Read More
A female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Hand veins: Hand veins are normal in 99% of patients and pain is not likely to be pathologic. See your pediatrician for guidance.
A 27-year-old male asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Apixaban for A fib: Risk of bleeding is higher with Apixaban than with aspirin and plavix (clopidogrel) combination.
A 23-year-old male asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Hand veins: Hand veins don't pulsate and hand veins are not prominent on the palmar side of the hand. These may be arterial if you are feeling pulses. You can sta... Read More
A 19-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Palpitations: In a young person with a healthy heart, a good place to start the work up is an ECG followed by Holter monitoring and an echocardiogram. Hormonal alte... Read More
A 38-year-old male asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Shoulder dislocation: Your shoulder may be going in and out of the joint, dislocation. Best to see an orthopedic surgeon.
A 21-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Postural orthostasis: A cardiologist needs to start managing you and in the interim, you should keep yourself well hydrated, perhaps take salt tablets and be careful when y... Read More
A 30-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Costophrenic: This is a sign on chest xray implying there is no fluid in the recesses of the pleural cavity near the diaphragm at the level of the lateral ribs. Cos... Read More
A 17-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Rash on breasts: This is not normal and you should be evaluated in the emergency room or by your primary care doctor. Proper treatment will allow you to continue breas... Read More
A 28-year-old male asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Testicular pain: What you are describing is not normal and you should seek an urgent evaluation by a urologist.
A 34-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Hematoma: The venipuncture for blood draw leaked and caused a hematoma outside of the vein or in the vein wall or both and this will heal in most cases without ... Read More
A 62-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Ultherapy: I have performed Ultherapy since 2010 and have never seen someone present after this procedure with lymphadenopathy.
A 34-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Venous reflux: It would be prudent to seek a Duplex venous scan to rule out DVT. Most likely, this is related to the venous insufficiency. Once DVT is excluded, give... Read More
A 22-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Phlebitis: Phlebitis is inflammation of a vein. itis means inflammation. Phleb means vein. Phlebitis can be from thrombosis (clot), also known as thrombophlebiti... Read More
A 27-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
MVP and MR: Mitral valve prolapse and regurgitation would not cause your facial tingling.
A 34-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Hemangioma liver: If asymptomatic, hepatic angiomas can be observed at this size with serial ultrasound. Large symptomatic lesions can be treated with resection, RF abl... Read More
A 19-year-old male asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Anorectal discharge: I recommend that you see a colorectal surgeon for an examination and possible scope.
A 29-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Lymphedema: The list of conditions that cause lymphedema is long. It is better to have intermittent lymphedema than chronic lymphedema. Given that you have had te... Read More
A 37-year-old member asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Natto: The Japanese eat a food (natto bean) that contains an enzyme, nattokinase, which lyses fibrin clots. Discuss with your doctor before you take this enz... Read More
A 34-year-old member asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
DVT risk: Active cancer increases risk for DVT significantly. tamoxifen can increase risk for DVT and PE. See this link for guidance. http://www.ncbi.nlm.nih.go... Read More
A 37-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Citrus bioflavonoids: I have written 2 books about these supplements and they are available for free on my website: 1) Diosmin and Citrus Bioflavonoids for Venous Insuffici... Read More
A 35-year-old member asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
What is phlebitis?: itis means inflammation. Phleb means vein. Phlebitis is inflammation of a vein. Phlebitis can occur after placement of an IV catheter, or after blunt ... Read More
A 51-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Groin pain: It is important to get a Duplex vein scan but this rarely shows anything above the groin. In thin patients, the iliac veins may be visualized. Duplex ... Read More
A 42-year-old member asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Pacer life: Pacemakers should be interrogated regularly in a pacemaker clinic and one of the parameters tested is battery life.
A 40-year-old member asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Varicose veins: Varicose veins are not normal but have increased prevalence with aging and sedentary lifestyles. Targeted leg exercises and strong calf muscles reduce... Read More
A 30-year-old member asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
No. EVLT not painful: The procedure may be uncomfortable as it involves using local and tumescent anesthesia. However, most people state that the degree of pain and discomf... Read More
A 37-year-old member asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Thrombosed hemorrhoi: Hemorrhoids can thrombose and such thrombosis can be painful, especially if they are external. i.e. external hemorrhoids. Internal hemorrhoids are rar... Read More
A 42-year-old member asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Glycopyrrolate: In my large hyperhidrosis practice, I find the best oral anticholinergic medications to be glycopyrrolate and oxybutinin, in that order. The Center fo... Read More
A 51-year-old member asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Cysts: Cysts that have developed an epithelial lining are not likely to go away spontaneously as this tissue layer secretes body fluid.
A 42-year-old member asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Finger trauma: It is best to get an xray of the finger to make sure there is no fracture.
A 22-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Axillary sweating: Botox will treat axillary hyperhidrosis for 3-4 months. miraDry is very effective in treating axillary hyperhidrosis.
A 47-year-old member asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Class III stockings: Compression is the way they work, stopping the pooling of blood in the legs. Class 3 is 30 - 40 mm Hg.
A 31-year-old male asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Cancer and D-Dimer: Anything is possible and therefore you need to see your primary care physician for evaluation. D-Dimer is not sensitive test for any one particular pr... Read More
A 21-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Borderline d dimer: D-dimer units (DDU) (< or =0.50 mcg/mL fibrinogen equivalent units: FEU) are normal. D-Dimer is a nonspecific test and the good news is that CT an... Read More
A 18-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
TOS: There is neurogenic, arterial and venous types for TOS. Some that cause arterial or venous obstruction can cause arterial insurfficiency of the upper ... Read More
A 37-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
CABG risk: It is not clear from your description what type of surgery he is getting. I surmise that you mean coronary bypass surgery. Overall risks for patients ... Read More
A 33-year-old female asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
BP measurement: There is no need to obsessively check your blood pressure. I am giving you this advice as a CV surgeon. Meaasuring your blood pressure if you have hyp... Read More
A 20-year-old male asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Hamstring pain: The hamstring in the posterior thigh can be tender for many reasons. If it does not improve, a B mode ultrasound study will be helpful in delineating ... Read More
A 17-year-old male asked:
Dr. Hratch Karamanoukian
Phlebology 32 years experience
Hyperhidrosis Groin: The products I would recommend for the groin area in regards to hyperhidrosis would be 3% gycopyrrolate or 21% aluminum chloride.

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Testimonials
Recommendations and Thank you notes are endorsements given from patients or other doctors.

1
Recommendations
76
Thank you notes
Mar 25, 2016
Dr. Karamanoukian is a very experienced and knowledgeable vein specialist.
HealthTap member
Surgeon said too small to do FNA so to do another ultrasound in one year. Had previous hemithyroidectomy 11 years ago. Have several small foci in remaining lobe with this dominant one.
HealthTap member
I'd love to have a normal 1 on 1 conversation about but I know that won't happen but in case there is a small chance 1-812-208-1562 thanks for the reply though :-)
HealthTap member
This was very helpful. Thanks! So greatful for your kind answer. May you be blessed a thousandfolds. Thank you so much doc Hratch.

Education & Training

Medical/Graduate school

Keck School of Medicine of University of Southern California, CA
Graduated 1990MD

Residency

University at Buffalo

Residency

University at Buffalo

Awards

Top Phlebologist, First Place, National - Spring
2016
Thought Leader, First Place, Buffalo Region - Spring
2016
Most Influential Doctor, Third Place, Buffalo Region - Spring
2016
90,000 U.S. doctors in 147 specialties are here to answer your questions, provide medical advice, write prescriptions, and more.
Answer emailed
in 24 hours or less