FAQ's

Paducah Vascular Institute accepts most insurance, including Medicare and Kentucky medicaid, as well as most commercial insurance carriers. If you have any questions, please call us at (270) 845-4300.

A vascular/endovascular surgeon treats the arteries and veins in all parts of the body except the heart (cardiothoracic/heart surgeon) and brain (neurovascular surgeon). 

They are the only specialist that can treat vascular conditions medically, with minimally invasive techniques (endovascularly), surgically, or a combination of all three treatment modalities.

A vascular surgeon is the only specialist that can treat vascular conditions in a variety of ways, whichever is best for the patient:

1. Medically (medicines, exercise, compression garments, surveillance, wound care, etc.).
2. Endovascular (think stents, balloons, roto rooter devices, etc.).
3. Surgery (open incisions in the operating room).
4. Hybrid surgery (a combination of surgery and stents.

Cardiologists most often treat patients with heart conditions. Most don't specialize in other blood vessels in the body. If they do, most don't have the extensive training and experience of a vascular surgeon. More importantly, they are limited to treating these conditions with medicines and endovascular procedures only. They do not perform surgery, and if needed will refer you to a vascular surgeon.

Radiologists read X-rays, but some also posess interventional skills, occasionally perform endovascular procedures. They usually don't treat medically and cannot perform surgery if needed.

A vascular surgeon is the only specialist that can offer a full spectrum of treatment for vascular conditions. He/she will decide if medical, endovascular, surgical, or a combination of all three treatment modalities is best for you.

Dr. Sanders trained at the prestigioius Arizona Heart Institute under the tutelage of internationally renowned heart and vascular surgeon Dr. Ted Diethrich in 1999-2000. 

He has over 20 years of experience specializing in treating vascular disease. He has by far the most experience of any vascular surgeon practicing in Paducah, Kentucky. He has helped teach medical students from the University of Lousville, spoken at national vascular conferences, and helped train other vascular surgeons learn endovascular techniques.

He has been in Paducah with his wife and kids for 11 years and considers Paducah home. He wants to finish the last 10 plus years of his career here treating patients in a state of the art facility rivaled only by some centers in Nashville and St. Louis. 

We believe we  provide the best vascular care that no other vascular surgeon in Paducah can match.

Call our office at (270) 845-4300 to schedule an appointment.

No, vascular surgeons do not treat heart problems.

Cardiologists treat heart conditions with medicines or with minimally invasive techniques. If you are having a heart attack or irregular heart rhythm/rate, then you should see a cardiologist.

Cardiothoracic (CT) surgeons treat conditions of the heart or lungs that require surgery for treatment. Often, a cardiologist will refer a patient that needs a heart bypass or heart valve replacement to a CT surgeon. A primary care doctor or lung specialist (pulmonologist) may refer a patient with a lung mass, infection, or collapsed lung to a CT surgeon.

Most often, primary care doctors refer patients to a vascular surgeon. You might be referred for peripheral artery disease, carotid artery stenosis, Abdominal or peripheral aneurysms, varicose veins/spider veins, ulcers or sores on the feet or legs thought to be from poor blood flow or venous disease, etc. Your nephrologist may refer you to vascular surgeon for dialysis access procedures. Your oncologist may refer you for port placement if you need chemotherapy. 

Sometimes, a vascular surgeon is needed on an emergency basis and consulted by an emergency room doctor for bleeding, ruptured aneurysm, blood clots in the legs (DVT) or lungs (PE), or for a lack of blood flow to the legs or arms from a blood clot or blocked artery.

Hospitalists may consult a vascular surgeon in the hospital for infected ulcers on the feet, gangrene, a stroke caused by narrowing of the carotid artery in the neck, need for an IVC filter, urgent need for dialysis access, plus all of the above.

For many chronic vascular conditions, a vascular surgeon may need to see you regularly for many years.

We are absolutely seeing new patients!

We are also happy to see you for a second opinion if you've already been seen by another vascular surgeon, cardiologist (that can only offer medical and endovascular solutions and not surgery if needed), or interventional radiologist (that can only offer endovascular solutions).

Call our office at (270) 845-4300 to schedule an appointment.

Please bring your insurance card and a photo identification card/driver's license. If you have any medical records from other hospitals or providers, please bring them. 

And if you've already had vascular tests (ultrasounds, CT scans, Arteriograms, Venograms) that were performed by another provider or hospital, please bring a copy of the disc, so we can review the actual pictures/images on the computer.

Wear loose fitting, comfortable clothes because we will need to examine your legs and feet for most problems. If you are a dialysis patient, we will need to examine your arms, so wear short sleeves or sleeves that easily roll up (or be able to remove your shirt).

You can also print out the new patient form from our website (paducahvascular.com) and fill it out and bring it with you to your appointment. Your check in time should be quicker if you bring the already filled out new patient form.

If you have any questions about what to bring to your appointment, call us at (270) 845-4300.

We can perform a large number of procedures in the office. Some of these include treatment of spider veins, varicose vein treatement, dialysis access procedures, ateriograms with stents, atherectomy, balloon angioplasty, venograms with stents if needed, IVC filters, etc. We can perform many procedures normally done in the hospital safely in our office. 

Some procedures may require only lidocaine to numb the area being treated. Some vein procedures require lidocaine plus valium taken by mouth. Some more invasive procedures require may require a combination of lidocaine plus moderate/ intravenous sedation performed by a CRNA (certified nurse anesthetist).

Convenience 

You are checked in the front of the office, brought back to our preprocedure area 10 yard away to get prepped for your procedure by the same nurse (RN) that will care for you after your procedure. All done in one setting while your family waits in the convenience of our waiting room (with a coffee machine, water, and a television).

You will be cared for by the vascular surgeon that would perform the same procedure in the hospital. The same cutting edge technology (Xray machine, ultrasound, stents, balloons, atherectomy devices, catheters, etc.) used in the hospitals are used in our office.

Personalized care

Paducah Vascular Institute: Park in front of our office. Have your procedure performed by the same team and leave after your procedure. You interacted with a front office person, an RN, a vascular surgeon, and a CRNA.

Hospital: Your family member drops you off in front of the hospital. They have to go find a parking space somewhere. Then hopefully, you can meet up with your family member after they make their way back to the hospital from the parking lot. You have to ask a volunteer or a stranger for directions where to go  (the hospital maze). Then to one side of the hospital to register. Then to another place to get ready for your procedure. Then wait on a transporter to to to the back of the hospital to have your procedure performed. Then back to the preprocedure area. Then your family member goes to find the car and pick you up at the front of the hospital. You might have had up to 10-15 different people care for you for one procedure (maybe a couple of people in registration, a volunteer or two to help you navigate the confusion, a couple of transporters, a receptionist or two, several nurses, a phlebotomist, Xray technicians, etc.). 

Safety

Vascular procedures have been safely performed in an office based setting for over 10 years.

Cost

It's actually less costly for Medicare and your insurance company to have the same exact procedure performed in the office. They reimburse hospitals more for the same exact procedure to subsidize the ER, uninsured patients, the laboratory, etc.

Dr. Sanders performs open surgical, hybrid surgical (a combination of open surgery and stents), and more complex endovascular operations at the hospital. Also, your comorbid medical conditions may make it unsafe to have an office based procedure.

Dr. Sanders is the only vascular surgeon in Paducah with priveleges at both Lourdes/Mercy Health hospital and Western Baptist hospital. 

Dr. Sanders is the only vascular surgeon in Paducah with priveleges at both Lourdes/Mercy Health hospital and Western Baptist hospital. 

Dr. Sanders is not employed by either hospital.

The patient and Dr. Sanders can decide which hospital would best serve the patient. The hospital choice might depend on patient preference, primary care provider preference, insurance constraints, hospital staffing, and scheduling issues. The type of procedure being performed might also influence the choice of hospital. One hospital may not have the necessary equipment or staff for a particular procedure.

Peripheral Arterial Disease (PAD)

Critical Limb Ischemia (CLI)

Carotid Artery Stenosis

Abdominal Aortic Aneurysm (AAA)

Femoral/Popliteal artery aneurysm

Splenic artery aneurysm

Mesenteric artery stenosis

Renal artery stenosis

Subclavian artery stenosis/Subclavian steal

Upper extremity arterial stenosis

Temporal (giant cell) arteritis

The list is extensive:

1. Carotid Endarterectomy (CEA) for carotid artery narrowing/stenosis.
2. Carotid artery stent for carotid artery narrowing/stenosis.
3. Endovascular Aortic Aneurysm Repair (EVAR)
4. Popliteal Artery Aneurysm Stent and surgical repair.
5. Splenic Artery Aneurysm Embolization.
6. Leg bypass for peripheral artery disease (PAD).
7. Aortic and iliac artery stent for peripheral artery disease (PAD).
8. Leg artery atherectomy for peripheral artery disease (PAD).
9. Leg artery balloon angioplasty and stent for peripheral artery disease (PAD)
10. Renal artery stent for narrowing in the kidney artery.
11. Subclavian artery stent for narrowing in the arm artery.

Spider veins are only visible at the surface of the skin and are not raised. They look like spider webs and may cause some itching, but are most often considered cosmetic. They can be treated with injections (sclerotherapy). This is usually not covered by insurance, but we would be happy to discuss treatment options and cost of sclerotherapy after evaluation in the office.

Varicose veins tend to be larger and look like a cluster of grapes. They may also cause itching, but can cause significant aching and pain.  They can lead to complications including phlebitis (painful clots), bleeding, and eventually ulceration. Often, non-invasive treatments may help (leg elevation, support stockings, exercise, and weight loss).

If the varicose veins and underlying saphenous vein abnormality is severe enough to warrant intervention, insurance companies usually cover the cost (laser or radiofrequency ablation, stab phlebectomy, or foam sclerotherapy).

Paducah Vascular Institute treats patients with both conditions. Call us to schedule an appointment at (270) 845-4300.

Absolutely!

Sclerotherapy for spider veins

Injection of spider veins with an irritant into the vein with a very small needle which will disappear with time

RF/laser ablation of the saphenous vein

Placing a catheter inside of the saphenous vein under ultrasound guidance to close the vein off with heat. The saphenous vein feeds the varicose veins, so closing it off takes pressure off of the varicose veins. This pretty much replaced the old vein stripping procedure performed in the operating room.

Foam ablation of varicose veins

Injecting a foam solution into varicose veins under ultrasound guidance that are persistent/painful after RF/Laser ablation. May also be used to treat varicose veins when a patient's saphenous vein is normal and doesn't need to be closed off with RF/Laser.

Call our office at (270) 845-4300 for an appointment to evaluate and then treat your varicose and spider veins.

Varicose veins

Spider veins

Chronic venous insufficiency

Deep Vein Thrombosis (DVT) legs and abdomen

Effort thrombosis (DVT of subclavian vein)

Phlebitis (SVT)

Iliac vein stenosis

Superior Vena Cava (SVC) stenosis or occlusion

Pulmonary Embolism (PE)

This list is long:

1. Sclerotherapy for spider Veins
2. Radiofrequency ablation of saphenous vein for Varicose veins
3. Ultrasound guided foam sclerotherapy for varicose veins
4. Micro stab phlebectomy for varicose veins
5. Iliac or Inferior Vena Cava (IVC) stent
6. Inferior Vena Cava (IVC) filter placement
7. Inferior Vena Cava (IVC) filter removal
8. Pulmonary Embolism (PE) suction thrombectomy
9. Deep vein thrombosis (DVT) Suction thrombectomy
10. Port placement for chemotherapy
11. PICC line placement for poor IV access

An endovascular procedure is a minimally invasive way to treat arterial and venous pathology from the inside of the blood vessel. 

It begins with lidocaine to numb the skin and then puncturing the artery or vein with a needle and then placing a sheath to work through. Utilizing special XRay equipment, dye/contrast is injected into the blood vessel, and the pathology is treated from within the artery or vein. 

Examples would include using balloons to open a blockage inside an artery, placing a metal stent to keep the artery or vein open, using a roto-rooter device (atherectomy) to remove plaque or scar tissue in the vessel, placing an IVC filter, removing clot using clot busting medicine and/or suction devices, just to name a few.

Once a person develops kidney failure, they have to go on dialysis to have the toxins in the blood removed. There are two ways to get dialysis. Your nephrologist and you will decide which option is best and send you to a vascular surgeon or general surgeon. Hopefully, you are a candidate for a kidney transplant in which case you will be referred to a big city like  Nashville or St. Louis to see a transplant surgeon.

The most common way to clean the blood is by filtering the blood through a machine. This is called hemodialysis. A vascular surgeon will be the one to create this dialysis access. If you need dialysis ASAP, the vascular surgeon will place a dialysis catheter into the vein. This can be used right away, but is not a good long term solution. The second way is to create a fistula or graft in your arm by attaching an artery to a vein. This takes several weeks to heal before it can be used for dialysis. The vascular surgeon also maintains your access should you clot or have any narrow spots develop over the years.

A less common way, but also a good option for some patients is called peritoneal dialysis. This is when a tube placed into the abdominal cavity by a general surgeon . Fluid is flushed through the tube into the abdomen to remove toxins from the blood stream indirectly.

Dr. Sanders performs most of the dialysis procedures in Western Kentucky. He has 20 plus years experience with dialysis access for patients with Chronic Kidney Disease (CKD) and End Stage Renal Disease (ESRD).

1. Surgical AV fistula creation
2. Percutaneous AV fistula creation
3. Surgical AV graft creation
4. AV fistula or graft surgical revision
5. Temporary dialysis catheter placement
6. Tunneled dialysis catheter placement
7. Percutaneous AV fistula or graft declot
8. Fistulogram with balloon angioplasty or stent

Absolutely!

Vascular surgeons are vascular access experts. This includes ports, dialysis catheters, central lines, PICC lines, etc. We would be happy to place your port for chemotherapy or long term IV access. 

We perform a port study in the office if your port is not working well to diagnose any problems.

We are also called to treat problems with ports that your general surgeon may have placed (leaking port, fractured/broken catheter attached to your port, DVT caused by your port, etc.).

Call our office to schedule a port placement or to troubleshoot your poorly/non-functioning port at (270) 845-4300.

At Paducah Vascular Institute, we treat the most common ulcers seen in patients with diabetes, venous disorders, and arterial disease (PAD). Dr. Sanders has 20 plus years experience treating these types of wounds and ulcers.

1. Diabetic foot ulcers
2. Venous stasis ulcers
3. Arterial ulcers in legs/feet
4. Bone infection (Osteomyelitis) of the toes or feet
5. Gangrene of the toes/feet 

Dr. Sanders is the wound center director at Lourdes/Mercy Health. He sees patients at the wound center every week and would love to help you heal your chronic vascular or diabetic wound.

If you have any questions, you can call Paducah Vascular Institute at (270) 845-4300.

All other types of wounds are treated by the experts and general surgeons at Mercy Health/Paducah wound center. These types of wounds would include:

Pressure ulcers seen in patients with paraplegia

Pressure ulcers in nursing home patients

Abdominal wounds

Chest/breast wounds

Upper extremity wounds

Non healing surgical wounds

Radiation wounds

Burns

Infection

Hard to heal wounds

If you have any of these types of wounds, you can call Mercy Health/Paducah wound center at (270) 441-4462.

Definitions:

1. Claudication. Pain in the legs when walking from a lack of artery flow to the muscles usually caused by narrowing in the arteries.
2. Rest pain. Pain in the foot from a severe lack of artery flow to the foot. Usually occurs at night when the legs are flat because gravity cannot help the blood flow to the foot.
3. Critical Limb Ischemia. Severe narrowing in the leg arteries that causes ulcer, rest pain, gangrene and eventually if untreated will lead to leg amputation.
4. Popliteal artery. The artery behind the knee.
5. Subclavian Artery. The artery to the arm. Also the artery that supplies flow to the back of the brain because the vertebral artery is one of the first branches of the subclavian artery.
6. Renal artery. The artery that supplies blood flow to the kidney.
7. Iliac artery. The artery in the pelvis that supplies blood flow to the pelvis and eventually the legs.
8. Carotid artery. The artery in the neck that supplies blood flow to the brain face (External Carotid Artery) and the brain (Internal Carotid Artery).
9. Inferior Vena Cava. The main vein in the abdomen that returns blood from the legs and organs in the abdomen to be reoxygenated by the lungs.
10. Superior Vena Cava. The main vein in the chest that returns blood from the head and arms to the lungs to be reoxygenated.
11. Cerebrovascular Accident. Stroke. Can be caused by narrowing in the carotid arteries, a clot thrown to the brain from a heart attack or irregular heart beat, or high blood pressure.

Common Abbreviations in Vascular Surgery

1. PAD-Peripheral Arterial DIsease
2. AAA-Abdominal Aortic Aneurysm
3. EVAR-Endovascular Aneurysm Repair
4. CAS-Carotid Artery Stenosis
5. RAS-Renal Artery Stenosis
6. CAD-Coronary Artery Disease
7. DVT-Deep Vein Thrombosis
8. PE-Pulmonary Embolism
9. CVD-Cerebrovascular Disease
10. CVA-Cerebrovascular Accident (stroke)
11. TIA-Transient Ischemic Attack (mini stroke)
12. CLI-Critical Limb Ischemia
13. IVC-Inferior Vena Cava
14. SVC-Superior Vena Cava