Ashchi Heart & Vascular Center offers articles on the diagnosis and treatment of heart and vascular diseases (arteries and veins) and a lifestyle blog, including easy-to-share healthy recipes

Case of the Day – Dr. Ashchi

Do you have swollen leg(s)? Are you familiar with May-Thurner Syndrome?

We present to you a great case of May-Thurner Syndrome also known as Iliac Vein Compression Syndrome. It’s usually due to the right common iliac artery compressing the left common iliac vein resulting in Thrombus (clot) formation and/or Stenosis (blockage of the vein).

Once this occurs, the patient develops swelling in the leg, heaviness, tiredness, and fatigue in the leg. More advanced cases can result in chronic venous insufficiency (leaking in veins) and ulcers. Diagnosis is mainly by excellent history and physical exam. To verify the diagnosis, we have a few modalities with different sensitivity and specificity which is IVUS (Intravascular Ultrasound). Other modalities that are less sensitive and more specific are CAT Scan Venography, MRI Venography or a simple ultrasound of the pelvic veins and arteries.

Treatment is involved with a minimally invasive procedure by placing IV or catheters in the common femoral veins and performing venography and IVUS. If the patient has compression, stenosis, or total occlusion, then we perform angioplasty and stenting. There are several stents available in the market, however, the best of which is the Vici Stent by Boston Scientific. Our patient in this case received Vici Stent and angioplasty by Atlas Balloon. One video shows before and one shows after an intervention. The left common iliac vein as well as the left external iliac vein are now widely patent. The collaterals that were seen from left to right before interventions have disappeared.

The patient was sent home on Aspirin and Eliquis and already started having improvement in her symptoms. We are blessed and lucky to be living during this era of cutting edge technology.

I want to thank the Ashchi Heart & Vascular Center Cath Lab team and my partners for their professionalism and dedication.

Case of the Day – Dr. M. Bisharat

Treating totally and chronically occluded leg vessels has been a big challenge for decades. Luckily, with newer and safer technologies, totally occluded vessels are not a challenge to us at AHV using multiple techniques where outpatient intervention with different points of access allows safe and patient opening and reconstruction of these vessels.

In this example, a 65-year-old gentleman with disease smoker, presented with absent circulation in the left lower extremity, the angiographic assessment showed occluded femoral artery, which is a condition causing severe symptoms and predisposes the patient for risk of amputation. This was a 45-minute outpatient procedure that ended up with gradient and excellent results and InStent resolution of severe leg symptoms. The picture below shows the occluded blood vessel before and the results of the open vessel after.

We spare no disease at #AHV.

Case of the Day – Dr. M. Bisharat

Arterial aneurysms in the peripheral vessels are not benign, they can be a source of major complications if they rupture and bleed, they can be also painful and can harbor blood clots that eventually transfer to other healthy organs.

With the new advancements in #Endoprosthesis, this case, performed by Dr. Bisharat, demonstrates how to seal and cover a popliteal artery aneurysm located behind the knee using the most advanced covered stent technology made by GORE® VIABAHN®.

The patient had a long history of severe knee pain ended up walking out happy after a 30-minute procedure. Special thanks to Memorial Hospital for providing the best available technology for our #AHV doctors to best serve the patients.


Case of the Day – Dr. M. Bisharat

Coronary bypass grafts are an excellent choice to manage Coronary Artery Disease, however, they are not time-proof. Graft decay and occlusion is a common problem that worsens with time and suboptimal management of risk factors. Treating such a severe disease doesn’t require repeating the open-heart surgery. With modern treatment options, the occluded grafts can be treated to normal with a safe and quick catheter-based approach.

We share with you a case of a patient who had a stress test, followed by a catheter procedure based on the abnormality of the test, which showed a critical occlusion of the graft to the right side of the heart.

Our team at #AHV was able to identify the problem and provide a timely same-day intervention to save the graft, all in one day.

Thanks to the AHV team, the Memorial Hospital Cath Lab team, and Dr. Bisharat for your hard work and dedication for optimal patient care. #Heartdisease doesn’t wait and we won’t either!

#AshchiHeart #ATeam #CoronaryArteryDisease

Case of the Day – Dr. M. Bisharat

Another exciting case we wanted to share with you all:

Occlusive Venous Disease treatment is expanding very rapidly with new devices and techniques adapted daily. We keep ourselves ahead of the game to provide the best, safest, and most up-to-date care fo our patients.

This is a case of critical #occlusion and #thrombosis of the right subclavian vein and right shoulder area. A painful and very disabled clot formed in that big vein on a pleasant 65-year-old gentleman.

With the use of the most efficient clot-removing technology (INARI FlowTriever device), the clot was successfully removed and the flow in the vein was restored to normal levels.

This procedure was performed courtesy of Dr. M. Bisharat and the Cath Lab team at 📍 Memorial Hospital.

#ATeam #AshchiHeart #OcculsiveVenousDisease

Now Offering Telemedicine

In an effort to serve our community and patients, Ashchi Heart & Vascular Center is now proudly offering televisits with your provider.
To start your televisit with your provider, please follow these steps: 

  1. Call us to let us know you are interested in a televisit.
  2. You will receive a confirmation email for your televisit appointment.
  3. Through a laptop, desktop, or your mobile device click the link emailed or texted to you.
  4. You will then enter your name to enter the waiting room.
  5. Your televisit will begin shortly!

Healthy Green Bean Casserole

Typical green bean casseroles bathe ingredients in a heavy cream sauce and top them with buttered breadcrumbs or cheese. Our healthier version saves about 160 calories and 12 grams of saturated fat compared to a traditional recipe.

Recipe courtesy of EatingWell.

Ready in: 1 hour

Yield: 8 servings

Continue reading

Sudden Cardiac Death in Young People


Insurance Announcement

Dear Patient’s,

It has come to our attention that some of you may have recently received letters from your insurance provider implying that Ashchi Heart & Vascular Center, PA is no longer in network with your insurance provider. This is not the case. Ashchi Heart & Vascular Center, PA remains in network with all major insurance plans. There have been no changes to the insurances we are in network with.

The letters were sent to notify you that Dr. Ahsan “Sonny” Achtchi is no longer participating in those plans, as he is no longer in the with the practice or in the Jacksonville area.  

If you have any questions regarding accepted insurances, please check with us first. We will let you know if we accept the insurance plan.

We apologize for any confusion.

Thank you!

The Staff at Ashchi Heart & Vascular Center

Case of the Day – Dr. Bisharat

Case of the Day - Dr. BisharatCase of the Day:

This patient came in with a completely occluded femoral artery. Dr. Mohannad Bisharat and the cath lab staff at AHV were able to open the femoral artery and restore blood flow. The patient was able to go home a few hours after the outpatient procedure.

Peripheral arterial disease (PAD) is a common circulatory problem in which blocked arteries reduce blood flow to your arms or legs.

When you develop PAD, your extremities cannot receive enough blood flow to keep up with demand. The most common symptom of PAD is leg pain or cramping (claudication).

PAD is also likely a sign of a more widespread accumulation of fatty deposits in your arteries (atherosclerosis) throughout your body. This condition may indicate reduced blood flow to other systems in your body like your heart and brain.

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