• 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
    • The Post-Thrombotic Syndrome
      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, thrombus during its disintegration, damages 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 of the inferior vena cava (IVC) is one of the dreaded complications of deep vein thrombosis and forms due to an 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 (PE) is a complication of deep vein thrombosis (DVT), a condition during which blood clots from 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 called paradoxical PE 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
    • Thrombophlebitis
      Thrombophlebitis, formation of a blood clot, or thrombus, and development of vein inflammation, or phlebitis, is 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, a 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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    • Ulcers
      In general, the term ulcer refers to a chronic three-dimensional defect in the soft tissue. The ulcers almost always develop from acute lesions or a wound not healing due to various reasons. Circulatory ulcers are usually divided into three major types: ischemic, venous stasis and neuropathic. The ischemic ulcers are the 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 the leakage of soft tissue edema which prevents the accidental wound from healing. This 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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    • External Bleeding
      External bleeding is one of the many complications of superficial venous insufficiency. It happens due to the build up of high pressure in engorged varicose or spider veins. Such bleeding is not pulsatile (undergoing pulsation), since the blood is coming not from the artery, but from the vein, and is almost always painless.

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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