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Dr. Reid's Articles

W. Scott Reid, D.O. General & Vascular Surgery

Video Interview

Dr. Scott Reid discusses screenings for aortic abdominal aneurysms and less invasive treatments on WEEK TV's "Your Health Matters"

Video Interview

WMBD TV Interview with W. Scott Reid, D.O.

Varicose Veins & Their Treatment

by Dr. W. Scott Reid

Varicose veins, in combination with their symptoms and complications, are the most common vascular problem of the legs.  Published data reveals that 20 million people in the United States alone are affected. What's more, the condition is not only painful, but may develop into open sores, disabling pain, increased risk of infection and loss of the limb if untreated.

Veins are the tubes that move blood from the feet back to the heart. What makes this task more complicated is that the veins must move the blood against the forces of gravity. However, the transport of blood is facilitated by an elaborate mechanism of one-way valves in the veins. When you walk, the muscles in the legs actually push the blood through the one-way valves back toward your heart.  When those valves break, blood pools in the legs and cause varicose veins.

Common Misconceptions

Although treating varicose veins is considered by many to be for cosmetic reasons only, this is not typically the case. Millions of people have disabling pain and swelling related to varicose veins. Those who do not seek treatment because they wrongly assume it is only cosmetic and will not be covered under their insurance plans should be aware that many carriers now cover certain treatments for varicose veins associated with pain and swelling.  In fact, numerous insurance carriers realize the long-term healthcare savings related to early treatment of varicose veins. 

In addition, many people feel that their only option to treating varicose veins is a painful surgery that requires a long recovery. But the treatment of varicose veins has changed by leaps and bounds. There are now numerous options to traditional surgery.  The more cutting-edge options are actually minimally invasive and offer many advantages to traditional surgical procedures.  These newer treatments also decrease post-procedure pain and recovery time. Oftentimes, a minimally invasive procedure can even be available as an office-based procedure, eliminating a trip to the hospital and avoiding the risks of anesthesia.

Common Treatments

The first line treatment of varicose veins involves compression stocking therapy. Some patients may need nothing else to control their symptoms of pain and/or swelling. As manufacturers compete to develop newer, lightweight stockings that are pleasing to the eye, patients have found more comfortable options and relief.

If compression stockings do not help the problem, then there are a number of “surgical” options available... with more being developed all the time.  Although a minimally invasive treatment is preferred and most often can be sufficient for the treatment of varicose veins, the old-fashioned vein stripping may still be required in some cases. Vein stripping does require an anesthetic, a day in the hospital, incisions on the affected leg and a recovery process.  A newer alternative is radiofrequency ablation (RFA).  The VNUS(r) Closure(r) technique is an office-based alternative that can be performed with a local anesthetic and no real downtime.  The technique involves placing a tube similar to an IV in a vein just under the skin.  The vein is then treated and accomplishes the same thing as removal of the vein.  In most cases, patients can return to normal activities within a day, with no real activity limitations.  Smaller varicosities not treatable with vein stripping or RFA may still be treated with direct injections in the office.

The good news is that patients now have numerous treatment options that have not been available in the past. If you are worried about whether you or a loved one is developing varicose veins, please either call or have your primary healthcare provider refer you to a vein care specialist.

Dr. Scott Reid is a surgeon at Mid Illini Surgical Associates and specializes in the treatment of varicose veins and vascular diseases.  He also currently serves on the Board of Directors at Methodist Medical Center.

Abdominal Aortic Aneurysms…
You Can Do Something About Them!

By W. Scott Reid, D.O.

What do you think would happen in this country if every week a treatable medical condition killed an equivalent number of people as on one commercial airline flight? There would be outrage! There would be calls for action! Nobody would stand for it… right? Well, I am sorry to tell you that in this country about 15,000 people die each year from abdominal aortic aneurysms (AAA). This treatable medical condition robs many families of mothers, fathers, brothers, sisters, sons and daughters every year.

Are you or your loved ones at risk?

An abdominal aortic aneurysm (AAA) is a weakness with enlargement of the major blood vessel in the abdomen. Many times these show no symptoms until it is too late. AAA is one of the most common aneurysms seen in a medical practice. Men are affected more often then women by a ratio of 4:1.

In addition, if you have a parent or sibling who has been diagnosed with an AAA, you have about a 25% chance of having an AAA.

The problem with AAAs is that they may rupture, and the rupture risk is related to size. The five-year rupture rates are 25% for smaller aneurysms, but increase to 95% for larger aneurysms. And nearly half the patients with ruptures die before ever getting to the hospital. Even those that make it to the hospital for treatment have a 50% mortality rate.

Unfortunately, aneurysms often reach larger sizes before they can be detected on physical exam, but ultrasound and CAT scans can often detect an AAA much earlier.

What can be done?

The good news is patients often have one of two treatment options available: 1) The traditional treatment has involved major surgery with replacement of the aneurysm with a new blood vessel, often requiring a one-week hospital stay with a six- to eight-week recovery process. 2) A newer option offers treatment via small incisions in the groins. Less invasive than the traditional treatment, this option requires a hospital stay that can be as short as 24 hours, with a shorter recovery process. Not all patients are eligible, but your surgeon can tell you if you are.

If you think you or a loved one are at risk for an AAA, ask your healthcare provider for an exam or a referral to a specialist. All of the Board certified surgeons at Mid Illini Surgical Associates have had a fellowship or other training in the latest surgical options for a variety of problems.

SilverHawk is the latest weapon in a Peoria doctor's artery arsenal

Wednesday, March 8, 2006
By JOHN O'CONNELL of the Journal Star

Reprinted with permission of the Peoria Journal Star.

In constant pain and with a wound that wouldn't heal, Zenobia Hayman, 79, of Galesburg was diagnosed more than a year ago with a blockage in the artery of her lower left leg and faced amputation of the limb. "I was really worried that I was going to lose my leg," Hayman recalled. "My last hope was this new thing that the doctor talked to me about. I thank the Lord it worked. My leg healed, and I'm no longer in that miserable pain."

Hayman was among the first patients locally to undergo a new technique for treating blocked leg arteries. Called SilverHawk Plaque Excision System, this new device has a rotating blade the size of a pea that physicians use to clean out plaque from inside the artery.

The shaved plaque is collected in the tip of the instrument and removed from the patient. With the blockage removed, blood flow to the artery is restored. And with improved circulation in her leg, Hayman's wound healed.

"My mom is back walking with her cane," said Hayman's daughter, Yvonne Hayman. "We put her walker away. When she was in so much pain, she couldn't do the things she loves: going to church and gardening. Now she can."

Vascular surgeon Dr. Scott Reid of Mid Illini Surgical Associates in Peoria is a big booster of the SilverHawk technology. He performed the procedure on Hayman at Methodist Medical Center in February of 2005. He is one of a half-dozen physicians in Peoria using the new technology.

The SilverHawk became available for use in 2003 when the U.S. Food and Drug Administration approved the device in the treatment of peripheral vascular disease. It was developed by FoxHollow Technologies Inc. of Redwood City, Calif.

"I'm very excited about this procedure," Reid said.

"I see a lot of patients with blockages below the knee. For some of these patients you can do open bypass surgery and (balloon) angioplasty to correct the problem, but for others you can't. The problem is the smaller the vessels you are working in, the higher rate of failure for these treatment methods. And the vessels get small below the knee. They can be as small as 2 or 3 millimeters in size at the ankle level."

When he first examined Hayman, Reid didn't believe she was a candidate for traditional treatments such as bypass surgery, balloon angioplasty or stenting.

"She was facing amputation," the surgeon said. "This (the SilverHawk) really was her only option."

During the procedure, which typically takes one to two hours, the SilverHawk is delivered through a catheter and inserted through a small puncture in the patient's groin.

The physician sees the blockage by injecting a contrasting dye in the artery and reviewing the area by X-ray. Once at the site of the blockage, the physician activates SilverHawk's tiny blade and advances the device through the vessel, shaving plaque from the artery walls as it moves forward.

"You must be very attentive not to traumatize or injure the artery," Reid said. "But in some respects it's very similar to doing angioplasty or stents."

Over the past year, Reid has performed the procedure on some 50 patients. The device has some potential risks, including excessive bleeding and injury to the blood vessel. The contrast dye that is used in the procedure also can put stress on the kidneys, the doctor said.

"I haven't had any complications in my patients related to this procedure," Reid said. "We have had two patients who have developed a recurrence of stenosis (blockage of the artery). We may have to repeat the procedure with them."

It isn't always possible to use the SilverHawk device in cases where the artery is completely blocked, the surgeon said. Reid also has used the device for leg blockages above the knee with good results.

"Whether it is a better treatment option above the knee than bypass surgery, angioplasty or stenting, we just don't know yet," the surgeon said.

But Reid believes SilverHawk is potentially "a shift in the treatment thought." The surgeon sees many benefits of using this technology.

"This (SilverHawk) removes the plaque as opposed to angioplasty or stents which simply push the plaque out of the way," Reid said. "And it's far less invasive than bypass surgery and less expensive."

For Hayman, the SilverHawk procedure required only an overnight stay in the hospital. For some patients, it's even been done as an outpatient treatment.

Reid does about two or three SilverHawk procedures a week. He examines 15 to 20 patients a week suffering with peripheral vascular disease (PVD), which is caused by a buildup of fatty deposits in the arteries in the leg. An estimated 12 million people in the United States have the disease, according to Reid.

Risk factors for developing PVD include diabetes, smoking, high cholesterol and a sedentary lifestyle, he said. For less severe PVD patients, the surgeon may prescribe medication, a healthy diet, cessation of smoking and a supervised exercise program.

For now, the device, which costs about $2,200, is only approved for use in the legs, Reid said. Someday, it may be used for plaque removal in coronary vessels, according to a Methodist Medical Center spokesperson.

"What's exciting for me is that patients like Zenobia Hayman, who are facing possible leg amputations, may now have another treatment option," Reid said. "Having an alternative to amputation is so important. Almost half of those who undergo an amputation aren't alive in two years."

Do You Suffer from Peripheral Arterial Disease (PAD)?

Peripheral Arterial Disease (PAD) affects millions of Americans each year, causing the blood vessels of the abdomen and legs to become narrowed or blocked and preventing blood from flowing to the lower extremities. Symptoms may include pain, difficulty walking, numbness, and cuts or sores that do not heal.

Symptoms and Causes

Over 10 million people are believed to have PAD. Even more alarming is that data suggests that nearly 4 million people with symptoms go untreated every year. Although symptoms are often mistakenly blamed on arthritis, diabetes, pinched nerves and old age, it is estimated that 12-17% of people over 50 years of age have PAD. In fact, this arterial disease is more likely to occur with age and tends to be more common in people who are over 70. In addition, smoking, diabetes, hypertension, heart problems and high cholesterol increase the risks. Unfortunately, PAD is also responsible for almost 150,000 amputations each year.

Alarmingly, many people with PAD have minimal to no symptoms. By the time patients have problems or complaints, they are likely to have severe to critical narrowing of the arteries in the legs. Patients at this stage can go on to blockages that put them at risk of losing one or both legs in severe cases. In fact, studies show that patients who lose one or both legs due to PAD are at an increased risk of death over the next five years, as compared to those patients treated for PAD who do not have an amputation.

Other Complications

When left untreated, PAD has also been associated with an increased chance of heart attack or stroke. Research indicates that people with PAD are four times as likely to have a heart attack and twice as likely to suffer from a stroke. The data is even worse for those people who have shown symptoms – a risk of dying from cardiovascular disease that is 15 times greater and a 1 in 4 chance of dying within two years of diagnosis.

Good News

PAD is detectable and often treatable. Your primary care provider can often detect PAD based upon a physical exam and/or an easy, painless test.

Treatment can be as simple as a better lifestyle regimen that includes exercise, dietary changes and smoking cessation. In more advanced cases, it may be necessary to medication, tiny incisions in the groin or an occasional bypass surgery.

The Board-certified specialists at Mid Illini Surgical Associates provide the latest cutting-edge surgical and non-surgical treatments for peripheral arterial disease.

Patients throughout Illinois have benefited from our treatments and in some cases avoided amputations. If you think you have PAD, call your primary care provider for a referral to our experts.