• CAROTID STENOSIS
    circulation;-disease;-carotid-stenosis

    A stroke, also known as a cerebrovascular accident, or CVA, is a permanent neurological dysfunction which is due to the damage caused by disturbance of blood flow to either the brain or spinal cord resulting from either ischemia, lack of blood flow from blockage (thrombosis, arterial embolism), or a hemorrhage (or bleeding).


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  • CORONARY ARTERY DISEASE
    • Myocardial infarction (MI)

      Myocardial infarction(MI) is caused by an acute interruption of blood supply to a part of the heart usually due to atherosclerotic narrowing of an artery. As opposed to coronary ischemia, myocardial infarction is irreversible damage to the heart muscle, resulting in death of the heart cells. MI, commonly referred to as a heart attack, is the number one cause of death worldwide. Risk factors for MI mirror those for arterial atherosclerosis in addition to states of chronic high stress levels and many chronic diseases affecting the circulatory system.


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    • Congestive heart failure (CHF)

      Congestive heart failure (CHF) is a chronic weakness of the heart, a condition when the heart is unable to pump well enough to provide sufficient blood flow through the body. Among many causes of CHF, the coronary artery disease is the leading one. The major feature of CHF, as it is evident from the term, is congestion of the lungs in the left-sided heart failure or congestion of the entire body in cases of the right-sided heart failure.


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  • THORACIC AORTIC DISSECTION
    Aortic-Dissection

    In the majority of cases, rupture of an arterial dissection leads to immediate acute internal bleeding, which is lethal if not treated with emergency surgical intervention.


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  • ABDOMINAL AORTIC ANEURYSM
    AAA

    In the majority of cases a rupture of an arterial aneurysm leads to an immediate acute internal bleeding, which is lethal if not treated with emergency surgical intervention.


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  • ILIAC ANEURYSM
    Iliac-Aneurysm

    In the majority of cases a rupture of an arterial aneurysm leads to an immediate acute internal bleeding, which is lethal if not treated with emergency surgical intervention.


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  • PERIPHERAL ARTERIAL DISEASE
    Peripheral-Arterial-Disease

    Gangrene is a consequence of arterial atherosclerosis is usually a dry gangrene, as opposed to a wet gangrene - an extreme form of certain infections. Dry gangrene is an irreversible damage to cells and represents the next stage after the reversible state of decreased blood supply - ischemia.


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  • POPLITEAL ARTERY ANEURYSM
    Popliteal-Aneurysm;-New

    Gangrene as a consequence of arterial atherosclerosis is usually a dry gangrene, as opposed to a wet gangrene - an extreme form of certain infections. Dry gangrene is an irreversible damage to cells and represents the next stage after the reversible state of decreased blood supply - ischemia.


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  • LYMPHEDEMA
    • Infection

      The presence of lymphedema is a predisposing factor for different types of infections, since the lymph fluid which accumulates in the soft tissues is rich in nutrients used by bacteria. The following types of lymphedema-related infections are commonly recognized. Cellulitis is a diffuse and reversible infection of soft tissue with no pus formation or necrosis. Lymphadenitis is the inflammation of lymph nodes. Lymphangitis is inflammation of lymphatic channels. Abscesses and necrotizing type of soft tissue infections are unlikely complications of lymphedema.


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    • Lymphangiosarcoma

      Lymphangiosarcoma is the dreaded complication of long-standing lymphedema. It is a malignant and very aggressive type of tumor, but fortunately a very rare one. It involves either upper or lower extremities. Most cases of lymphangiosarcoma are due to upper limb lymphedema following full axillary lymph node dissection, which used to be performed for breast cancer. This type of tumor leads to necrosis of the involved skin and underlying soft tissues and spreads quickly with metastases.


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  • DEEP VEIN THROMBOSIS
    • Post-Thrombotic Syndrome
      PTS

      The post-thrombotic syndrome, also called venous insufficiency, is usually a consequence of either deep vein thrombosis (DVT) or superficial venous thrombophlebitis. In the former case, a thrombus during its disintegration, damages the internal venous valves normally responsible for directing venous blood flow upstream. In the latter, besides valve damage, the vein becomes wider moving valves further away from each other.


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    • IVC Thrombosis
      IVC-Thrombosis

      IVC Thrombosis of the inferior vena cava (IVC) is one of the dreaded complications of deep vein thrombosis and forms due to the expansion of the blood clot from the vein in the lower extremity through the pelvic veins into IVC. This condition can also be a complication of IVC filter presence.


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    • Pulmonary Embolism
      Pulmonary-Embolism

      Pulmonary embolism (PE) is a complication of deep vein thrombosis (DVT), a condition when blood clots from a thrombosed deep vein of an extremity are being thrown with the blood flow into the lungs. A large PE can be lethal, and, therefore, pulmonary embolism is always a medical emergency. Only rarely do blood clots occlude arteries in the heart or brain, resulting in myocardial infarction or stroke correspondingly. Such blood clots are called paradoxical PE and are able to travel from the right side of the heart to the left one, due to a rare congenital connection between them, called potent foramen ovale.


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  • SUPERFICIAL VENOUS INSUFFICIENCY
    • Ulcers
      SVI,-Ulcer

      In general, the term ulcer refers to a chronic three-dimensional defect in the soft tissues. The ulcers almost always develop from acute lesions or a wound not healing due to different reasons. Circulatory ulcers are usually divided into three major types: ischemic, venous stasis and neuropathic. The ischemic ulcers are a result of arterial atherosclerosis and, therefore, are caused by insufficient delivery of fresh blood. That is the reason why they commonly develop on the tips of the toes, the places most remotely located from the heart. The venous stasis ulcers have a different mechanism of formation. They usually appear due to leakage of soft tissue edema, preventing accidental wounds from healing. That happens most often in parts of the body with the most gravity dependent congestion - the ankles. The neuropathic ulcers, including diabetic ones, form on the bottom of the foot, the place with the highest mechanical pressure. That is where innocent accidental wounds fail to heal due to abnormally regulated blood flow in the microscopic blood vessels - capillaries.


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    • Thrombophlebitis
      Veins,-Superficial-Insufficiency,-Thrombophlebitis

      Thrombophlebitis is defined as the formation of a blood clot, or thrombus, and the development of vein inflammation, or phlebitis - a complication of superficial venous insufficiency. This condition is often being confused with deep vein thrombosis (DVT), which is the development of a blood clot with no inflammation in the veins of the deep system, a disease independent from thrombophlebitis. Thrombophlebitis is usually accompanied by swelling, pain, tenderness and redness, as opposed to DVT (where redness is never a symptom). Often, the thrombosed superficial vein can be felt under the skin, as a tender cord. Thrombophlebitis, as opposed to DVT, does not cause pulmonary embolism (PE), or blood clots thrown into the lungs, and, therefore, does not require anticoagulation, or blood thinning.


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    • Bleeding
      Veins,-Superficial-Insufficiency,-Varicosities,-Bleeding

      External bleeding is one of the many complications of superficial venous insufficiency. It happens due to the build up of high pressure in the engorged varicose or spider veins. Such bleeding is not pulsatile, since the blood is coming not from the artery, but from the vein, and is almost always painless.


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    • Infection

      SVI,-Infection

      Superficial venous insufficiency is often complicated by numerous different types of infectious processes. The most often among them is called reperfusion cellulitis. During this condition, abnormalities of venous circulation lead to the development of swelling, when large amounts of fluid being entrapped in-between cells of the soft tissues of the lower extremities. The contributing factors to the above infection are multiple and include; the presence of the overstretched skin, easily permeable for bacterial replacement of fresh arterial blood with “recycled” venous blood, absence of adequate perfusion of the fat tissue, etc. The combination of the above factors triggers diffuse infection, when swollen extremity becomes red, extremely tender and hot. Often the body temperature rises as well. The skin of the affected area becomes covered with typical blister-looking lesions. Interestingly, this infectious process is cyclic and self-resolving. This is because the addition of the infection to the swelling causes the already elevated tissue pressure to rise to the degree exceeding the pressure in the veins. As a consequence of that, the insufficient veins become narrow, the valves become functional again, normal circulation ensures, and excessive fluid in the tissues goes back into the circulation with eventual resolution of the infection. The decrease in edema, however, allows veins to become wide and insufficient all over again and the entire process repeats itself.


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Anatomy


Visiting Dr. Khitin was a refreshing experience. I've visited multiple physicians and it looks like most of them treated me like a number. Dr. Khitin has an amazing ability to patiently explain all of the intricacies of the disease. Treatment went smooth. I feel 15 years younger! Thanks doc! –Anastasia L., Manhattan NY

I usually don't write reviews, but I feel that Dr. Lev literally saved my leg. I am 35 and not the typical patient for this kind of stuff, but I had an open ulcer on my leg for 3 years!!! Compression, creams, special diet - nothing helped. After Dr. K's treatment, the ulcer slowly began disappearing and it was gone in 6 weeks. If you ever had an ulcer, you know exactly how I felt! Thank You! Thank You! Thank You! – Mike B., Fair Lawn NJ

I was referred to Dr. Khitin by my primary after suffering for many years from restless leg syndrome and varicose veins. Dr. Khitin is the best! Knowledgeable, experienced, but most importantly, he cares! Relief came shortly after the very first treatment. Definitely recommend this doctor. –Samantha K., Manhattan NY

What a wonderful experience I've had! The problems with my legs are gone! I only wish I came here much earlier! Thank you, thank you, thank you! –Christine P., Manhattan NY

Thank you so much for all your terrific work. I have spent over a decade trying to find the right doctor, while my legs have been getting worse and worse. Dr. Khitin has changed my life and returned my freedom: finally, I can walk independently! –Donna W., Manhattan NY

The most outstanding treatment I have received! All questions answered, tests done, procedures performed and I feel like a new person in no time! Thank you so very much! –Peter R., Philadelphia PA

I have suffered from trophic ulcers for 28 years until I got to Dr. Khitin’s office! He has literally saved my legs! If you have problems with your legs and do not want to get an amputation, do not see any other physician: do see Dr. Khitin right away! –Bob from UPS,  NY

I have traveled thousands of miles to see Dr. Khitin, who literally returned me my health back! Thank you and all your staff for the most wonderful experience! –Dominique S., Montreal, Canada

On behalf of my father, I would like to express our sincere gratitude for your hard work and dedication: you have returned my dad his life and independence back: previously wheel-chair bound for years, now he is walking by himself! –Andre Y., Newark NJ