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Vericose Veins Prescott Varicose veins prescott

Keeping Your Legs Healthy and Attractive

Vericose Veins Prescott

Keeping Your Legs Healthy & Attractive

Chronic venous insufficiency is a condition that causes decreased blood flow from the leg veins to the heart. The decreased blood flow causes the blood to pool in the leg veins, which can lead to varicose veins. Special valves in the blood vessels of the legs ensure blood flows up toward the heart for recirculation, and prevent the backflow of blood. When blood flows backward, it is called Venous Reflux Disease. Symptoms such as aching, swelling, fatigue or heaviness in the leg or an ulcer on the leg are common for those with varicose veins. If unchecked and untreated, chronic venous insufficiency can lead to uncontrollable swelling, ulcerations that heal poorly, infections, and tissue loss. Drs. Matthew Dicker, M.D., and Ben Paxton, M.D., of Vascular and Interventional Specialists of Prescott (VISP) are interventional radiologists who are specially-trained in vein and artery health and function and believe it is important to keep your blood vessels healthy. Dr. Dicker said, “Aside from the cosmetic aspect, the symptom of varicose veins that prompts treatment the majority of the time is pain, throbbing or aching, usually at the end of the day. It is rare, but at times a varicose vein may bleed.” There are surgical and non-surgical options for vein treatment. One non-surgical option is vein ablation in which a probe is inserted into the poorly functioning vein to heat and then collapse it. Blood flow then re-routes through healthier veins. “There are many benefits of vein ablation over a surgical option. Ablation is a minimally invasive outpatient procedure that avoids many of the increased risks of surgery, such as pain and infection. The recovery time is much quicker, and there are no scars or stitches. Ablation has a high success rate and lower recurrence rates compared to surgery,” said Dr. Paxton. Phlebectomy, when a vein is removed through a small incision, and sclerotherapy, when the vein is injected with a material and it collapses, are two other treatment options. Prescott’s Frank Colella saw Dr. Dicker for a phlebectomy to treat varicose veins that developed as a result of several biking accidents. In June of 2010, he was in a near-fatal biking accident while riding on White Spar Road. Among other things, he re-injured his left leg and was placed into a cast, which led to poor circulation. The combination of wearing a cast many times, as well as working long hours as a nurse practitioner, led to the development of his varicose veins. Frank said, “I work four long days, almost ten hours each day, and I see 20 or 25 patients every day. I’m on my feet and stationary all day long.” Dr. Dicker said, “Often, patients see me for cosmetic reasons and because their veins are unsightly. We can and do perform the procedure for this reason. We also want to make sure the veins are healthy and to rule out chronic venous insufficiency as the cause of the varicose veins, because it is this underlying condition that can pose a more serious health risk.” Frank is happy with his result and adds, “I’m not sure if it is because of my Italian heritage or what, but biking is in my blood.” And this is a good thing because biking will keep his leg veins healthy for many years to come. If you have questions about varicose vein treatment options, please contact Vascular and Interventional Specialists of Prescott at (928)771-8477.

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Vertebroplasty Prescott

Vertebroplasty: A Minimally-Invasive Method for Healing Spinal Compression Fractures

Vertebroplasty Prescott

Vertebroplasty: A Minimally-Invasive Method for Healing Spinal Compression Fractures

Osteoporosis and certain types of cancers can cause spinal compression fractures, which lead to collapsed vertebrae and extreme pain. This decreases a person’s ability to be active and can lead to many other complications as a result of becoming sedentary. Prescott Valley resident Norman Walsh was in extreme pain and could barely move from his bed before his recent vertebroplasty procedure. “The pain had been excruciating…a ten or eleven every time I tried to turn over or move. It was awful.” David Lloyd, M.D., is a partner with Prescott Radiologists and a board certified, fellowship-trained Neuroradiologist who specializes in back pain relieving procedures. Dr. Lloyd is also the Director of the Percutaneous Spine Procedure Program at Vascular and Interventional Specialists of Prescott.  “Many patients must stay chairbound or bedridden for the pain to be bearable. Since most compression fractures take several months to fully heal, such immobility can lead to depression, blood clots, and other adverse health outcomes, in addition to increasing stress among loved ones and caregivers,” states Dr. Lloyd. [embed]https://www.youtube.com/watch?v=A7nH4J97z0c[/embed] Vertebroplasty is a minimally invasive procedure that usually eliminates the patient’s pain. The radiologist uses image guidance to inject medical-grade cement into the collapsed vertebra to stabilize it. When other conservative medical therapies, such as pain medicine and rest, fail to help a patient, vertebroplasty can be a good option. According to Dr. Lloyd, “Patients who suffer from osteoporosis are at increased risk for compression fractures of their spine, even after very minimal trauma. These fractures are extremely painful and debilitating and usually take months to heal. Very rarely will conservative treatment with pain medications and rest relieve the pain in a timely fashion, and pain medicines can have very uncomfortable side effects. Vertebroplasty provides pain relief by stabilizing the fracture through the injection of cement into the broken bone.” Prompt evaluation by an interventional radiologist will maximize a successful result. After a certain amount of time has elapsed, the harder it can be to treat the fracture and relieve pain. Dr. Lloyd explains, “The pain from vertebral compression fractures is usually so severe that most patients are severely restricted in their mobility. Hobbies and even basic chores are difficult to impossible to perform. Patients frequently have a hard time even dressing themselves, and even very active, otherwise healthy patients, must begin using a walker or wheelchair. By quickly relieving the pain, patients quickly resume their normal, baseline activity level.” Norman Walsh agrees. “I woke up completely pain free. It was like a miracle.” Now, only a few weeks after the procedure, Mr. Walsh said he is going out to eat and to church and doing things he wasn’t able to do for months. Dr. Lloyd adds, “The beautiful thing about vertebroplasty is its safety, effectiveness, and quick results. Vertebroplasty provides almost immediate pain relief in over 90% of patients. The majority of patients will notice complete pain relief the same day, while the rest will heal completely within the first couple of days after treatment. The procedure is also minimally invasive, meaning the patient does not need general anesthesia and can return home the same day as the procedure.” If you have experienced a compression fracture, or if your doctor feels you may benefit from other pain relieving back procedures such as steroid injections, please contact Vascular and Interventional Specialists of Prescott at (928) 771-8477 for a consultation.

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Catheter Lab at YRMC Prescott

The Catheterization Laboratory: Minimally Invasive Procedures Happen Here

Catheter Lab at YRMC Prescott

The Catheterization Laboratory: Minimally Invasive Procedures Happen Here

The location where an Interventional Radiologist performs image-guided, minimally invasive procedures is a room in the Catheterization Laboratory (Cath Lab) or the Angiography Suite. This state-of-the-art environment is like an operating room with diagnostic imaging equipment that assists the Interventional Radiologist during a procedure. [embed]https://www.youtube.com/watch?v=m5p1ZHWNZmc[/embed] Dr. Matthew Dicker, an Interventional Radiologist with Prescott Radiologists said, “The majority of the procedures performed in the Cath Lab are catheter based, which means that we place a small tube in a blood vessel, through the leg or other body part, in order to take a picture of it.” Procedures such as angiography, angioplasty, vertebroplasty, uterine fibroid embolization, chemoembolization, and aortic stent grafts are performed using image guidance in a Cath Lab environment. Other non-catheter based procedures include the placement of implanted devices such as pacemakers or IV mediports and vascular access procedures such as intravenous PICC lines. External tubes and drains can also be inserted as needed into the stomach, liver, gall bladder or kidneys. As Dr. Dicker explains, “The main imaging equipment is fluoroscopy, or real time X-ray. That, along with ultrasound and CT scan technology, helps to guide us through blood vessels or organs of interest. We use various sizes and shapes of wires, catheters and stents, as well as plaque-busting devices that help us open blockages, deliver medication, or help a patient receive long-term medications in a way that is minimally invasive with a shorter recovery time.” The Cath Lab at the James Family Heart Center at YRMC West has a warm and welcoming environment with an attentive and knowledgeable team of nurses, technologists and other healthcare professionals who meet their patients’ and the doctors’ needs every day. Dr. Dicker added, “With the excellent treatment by caring and supportive nurses before and after the procedure, the care by the team in the procedure room, and the relatively pain-free procedures, a trip to the Cath Lab doesn’t have to be a scary experience.” Please contact Vascular and Interventional Specialists of Prescott at (928) 771-8477 if you have questions about the Cath Lab or the Cath Lab experience. Also follow www.yrmchealthconnect.org for more articles and videos about image-guided, minimally invasive procedures.

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Interventional Radiology

Defining Interventional Radiology: Meet Your Local IR Doctors

Interventional Radiology

Defining Interventional Radiology: Meet Your Local IR Doctors

“I was having leg pain whenever I walked. My primary care physician referred me to a local interventional radiologist, who she said could help me with this problem.” ~Caroline R. Interventional radiologists tend to fly below the healthcare radar, but they serve a very important function in our community. Typically, people do not know what interventional radiologists do until they are referred to one by their primary care physician, an emergency department physician, hospitalist or other healthcare provider. Click here to watch Dr. Matthew Dicker: Can Interventional Radiology Help You? on YouTube. [embed]https://www.youtube.com/watch?v=e0aU923xS1I[/embed] Interventional radiologists are board-certified radiologists with advanced specialty training in minimally invasive, targeted treatments. There are two fellowship-trained interventional radiologists in the quad-cities area. Matthew Dicker, M.D., was fellowship trained at the Medical College of Wisconsin, and Ben Paxton, M.D., completed his fellowship at Duke University Medical Center. After completing a five year residency in Radiology, in which they learn to read and interpret MRIs, CT scans, ultrasounds, X-rays, and diagnose a wide variety of diseases, illnesses and conditions, they may choose to complete an additional year of interventional radiology fellowship training that is “rigorous and focused, which allows us the opportunity to become experts in our field,” says Dr. Paxton. For this reason, interventional radiologists are considered vein and artery, or blood vessel specialists. Dr. Dicker explains that, “interventional radiologists are pioneers in the development of minimally invasive procedures that are well-known today, such as angioplasty and stents. These were originally used in the legs to treat blockages in the blood vessels caused by peripheral vascular disease.” There are many diseases and conditions that can be treated today by using targeted treatment. “By using MRI, CT scans, ultrasound or X-rays, we can quickly find the source of the problem and either diagnose it or treat it or both,” said Dr. Dicker. This helps shorten recovery time and decrease the risk of infection. These types of procedures are beneficial to patients because they do not require an incision, making it easier for the body to heal and decreasing exposure to infectious organisms. According to Dr. Paxton, “the minimally invasive procedures that we perform are alternatives to more invasive surgical procedures that can involve more risk of pain, infection, bleeding, and longer recovery times.” “When performing procedures on blood vessels, we use X-ray guidance and very tiny wires and small catheters to deliver angioplasty balloons and stents as well as devices and medications to stop bleeds, destroy or reduce tumor size in organs, open blockages and dissolve or eliminate blood clots,” says Dr. Paxton. “We work with almost all the blood vessels in the body and perform various procedures to treat many kinds of illnesses. For example, we treat many kinds of cancers, abdominal aortic aneurysms, kidney stones, and cirrhosis of the liver. We perform biopsies and drainages, shrink uterine fibroids, reduce varicose veins, and facilitate the performance of dialysis and the delivery of antibiotics and nutrition. A whole range of things, really,” said Dr. Dicker. If you would like to have a consultation with an interventional radiologist, please contact your primary care physician or call Prescott Medical Imaging’s Vascular and Interventional Specialists of Prescott clinic at (928) 771-8477.

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Aortic Stent Graft

Aortic Stent Graft: A Minimally Invasive Procedure for Abdominal Aortic Aneurysm

Aortic Stent Graft

Aortic Stent Graft: A Minimally Invasive Procedure for Abdominal Aortic Aneurysm

“After Dr. Dicker showed me the before and after pictures, I was shocked. I probably wouldn’t have made it through the year.” –Mark Fillmore, Prescott Valley An aortic aneurysm is a weakened area in the body’s largest artery, the aorta, which carries blood from the heart to the rest of the body. As blood flows through this blood vessel, the weakened area bulges like a balloon and can burst if it grows too large. An abdominal aortic aneurysm (AAA) is an aneurysm that forms in the abdomen behind the navel. When felt through the skin, it can feel like a pulse in the belly. If it bursts, a person can experience signs of shock, nausea or paleness and has an 80-90 percent chance of immediate death due to significant blood loss in a very short amount of time. Click here to watch Dr. Matthew Dicker: Abdominal Aortic Aneurysm Prevention on YouTube. [embed]https://www.youtube.com/watch?v=8ZBXtur8EOo[/embed] Local Interventional Cardiologist, James D’Antonio, M.D., said, “AAA’s are most often asymptomatic and are found through a physical examination or screening imaging. Abrupt onset of abdominal or back pain of a tearing quality suggests an unstable aortic syndrome, which might include a pending AAA rupture and should prompt immediate medical attention.” Prescott Valley resident, Mark Fillmore, had no idea he had this kind of aneurysm. He was experiencing kidney pain and his nephrologist sent him to have an ultrasound. Although his kidneys were determined to be healthy, the ultrasound technologist noticed the very large abdominal aneurysm. When AAA’s grow to be about 5 centimeters they are considered large enough to treat in order to prevent them from rupturing. Mr. Fillmore’s measured at 6.3 centimeters.  He was referred to Dr. D’Antonio for follow up. Dr. D’Antonio said, “Often, men over the age of fifty, especially those who have smoked, have peripheral arterial disease, or who have diabetes, are at higher risk of developing AAA.” It is recommended that men over the age of 65 – especially those who have smoked – have an ultrasound of the abdominal aorta to rule out an aneurysm. Family history is also important to consider. Dr. D’Antonio added, “A first degree relative with AAA is an important risk factor.” Dr. D’Antonio then referred Mr. Fillmore to interventional radiologist Matthew Dicker, M.D., who discussed with him the importance of having an interventional procedure such as an aortic stent graft placed instead of surgery. Dr. Dicker said, “Treating AAA percutaneously, or through the skin, via a tiny, 3 mm incision, is far superior to the older surgical method where a large incision was made in the abdomen. This allows for much faster healing and recovery time with only a fraction of the pain.” Dr. D’Antonio added, “Currently, the vast majority of AAA’s are managed with stent grafts. Open surgical repair is reserved for patients who have anatomy unsuitable for stent graft placement.” “Full recovery from surgery can take several months. The hospital stay with this minimally invasive approach is usually only overnight. The complications such as bleeding, infection, bowel and other organ injury are dramatically reduced,” added Dr. Dicker. Drs. Dicker and D’Antonio worked together to place Mr. Fillmore’s stent graft. They used YRMC’s new, state-of-the-art hybrid operating room on the West Campus in Prescott. Dr. D’Antonio said, “This collaboration between Radiology and Cardiology is a perfect example of how a team approach improves patient care for our community.” ”If I would have dropped one of my motorcycles and strained to pick it up, it probably would have been it for me,” said Mr. Fillmore. Dr. Dicker added, “Ask your doctor about screening for AAA early to detect and treat this silent killer.” If you think you might be at risk for developing AAA, please contact your primary care physician, your cardiologist or contact Vascular and Interventional Specialists of Prescott at (928) 771-8477 for diagnosis and treatment options.

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Interventional Radiologists: Pioneers of Minimally-Invasive Treatments for Peripheral Vascular Disease

Interventional Radiologists: Pioneers of Minimally-Invasive Treatments for Peripheral Vascular Disease

Homer Stevens could not walk far because his legs would tire out quickly and his toe was black, swollen and very painful. His quality of life suffered. His podiatrist suggested that he might have a circulation problem and recommended he get tested for Peripheral Vascular Disease (PVD). What is Peripheral Vascular Disease Click here to watch Dr. Matthew Dicker: What is Peripheral Vascular Disease? on YouTube. [embed]https://www.youtube.com/watch?v=rFxk_DYCm24[/embed] PVD or PAD (Peripheral Arterial Disease), which is also known as atherosclerosis or hardening of the arteries, affects the blood vessels outside of the heart and brain. Scar tissue and cholesterol build up in the arteries and form a plaque that eventually causes blockages. These blockages are serious because they decrease or even stop blood flow to important parts of the body, such as the arms and legs. The blockages from PVD limit the amount of oxygen and nutrients the muscles receive, which leads to pain. Local Interventional Radiologists Matthew Dicker, M.D., and Ben Paxton, M.D., are blood vessel experts who diagnose and treat PVD, which is a serious public health issue that affects as many as twenty percent of Americans 65 and older. Dr. Dicker said, “When blood flow to the extremities decreases, the patient may have several different symptoms. Prior to that time, they may not have any symptoms and attribute their pain to the aging process. When it does become symptomatic, patients most often develop intermittent claudication. This is when pain, burning, tiredness or fatigue is felt in the calf while exercising or walking and stops as soon as the patient stops the activity.” “When the blockage is more severe, blood flow cannot meet the requirements of the body to heal sores or wounds, so wounds may heal very slowly or not at all which can lead to infection and, later, amputation,” added Dr. Dicker. PVD is a systemic disease, which means that it can affect the entire body. diabetes and hypertension are risk factors for PVD, and once someone has PVD, he or she is at increased risk of developing heart disease, aortic aneurysms and stroke. “Diagnosis starts with obtaining a comprehensive patient history and physical examination, which includes assessing the pulses of the legs. Testing ranges from non-invasive modalities such as the Ankle-Brachial Index (ABI), which is used to compare the blood pressure between the arms and legs, Magnetic Resonance Angiogram (MRA), CT Angiogram (CTA), Ultrasound, or the semi-invasive angiogram,” said Dr. Dicker. Initial treatment options for PVD range from lifestyle changes such as smoking cessation, weight loss, exercise or cholesterol-lowering medications. Interventional radiology treatments such as angioplasty and stenting—which were pioneered by interventional radiologists—and atherectomy or stent grafts are all image-guided, minimally-invasive options that might be considered as well. Before Homer Stevens had his stents placed, his blood flow was poor, and walking even short distances was difficult. “I couldn’t even get out and work in the yard for periods of time because my legs would tire out,” said Stevens. Today, Homer says he has a new lease on life.  He can go hunting with his brother, take hikes and play pool because it no longer hurts him to stand for long periods of time or to bend over. He encourages his friends to see their doctors and educates them about paying attention to all symptoms, especially in older age. “I try to steer them in the right direction because I am excited about what Dr. Dicker has done for me.” If you have a family history of arterial blockages such as PVD, PAD or hardening of the arteries, or questions about any symptoms you may be experiencing, please discuss it with your primary care provider or consult a specialist such as a cardiologist, or contact the interventional radiologists at Vascular and Interventional Specialists of Prescott by calling (928) 771-8477.

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Chemoembolization

Chemoembolization: A Minimally Invasive Approach to Treating Cancer

Chemoembolization

Chemoembolization: A Minimally Invasive Approach to Treating Cancer

As vascular specialists, interventional radiologists target specific illnesses and diseases by using image guidance and small devices, which they guide through blood vessels to reach a part of the body that requires treatment. One such treatment is chemoembolization, a minimally invasive procedure that can shrink or even destroy cancerous liver tumors. “Data from published studies on the procedure show that it is effective in up to 70 percent of patients in preventing disease progression,” said Ben Paxton, MD, Interventional Radiologist, Prescott. Liver cancer can be a primary or a secondary cancer. If it is a primary cancer, the cancer tumor originates in the liver. This type of cancer is typically associated with liver cirrhosis or from Hepatitis B or Hepatitis C infection. If it is a secondary cancer, tumor cells have metastasized—spread—from other organs in the body. Patients with other types of cancer are at risk for developing liver cancer since the liver acts as a holding area for circulating cancer cells. While surgery still offers the best chance of a cure, it may not be possible for as many as two-thirds of primary liver cancer patients and as many as 90 percent of those with secondary liver cancer. “Chemoembolization is a minimally invasive treatment for liver cancer that can be used when there is too much tumor to treat with surgical approaches,” said Dr. Paxton. This type of treatment attacks the cancerous tumor from inside the body, while keeping the surrounding tissues and organs healthy. This is different from systemic chemotherapy that attacks the entire body as well as the cancerous tumor. Chemoembolization delivers a high dose of chemotherapy directly into the organ while blocking, or embolizing, the arteries that supply the tumor with blood and nutrients. Embolizing the arteries that feed the tumor can help to shrink or destroy the tumor. Chemoembolization can be used in combination with systemic chemotherapy, radiation and radiofrequency ablation treatments. These other treatments can be used to treat cancer in other parts of the body while doctors can “utilize chemoembolization to control the cancer in the liver,” according to Iyad Hamarneh, MD, Oncologist, Arizona Oncology Associates in Prescott Valley. An example is a patient who has colon cancer that has spread to the liver. This patient has already undergone surgery and chemotherapy. “Chemoembolization provides another, less invasive option to control their disease that has less morbidity and less mortality and potentially could help control the cancer,” said Dr. Hamarneh. Dr. Hamarneh believes it is important that our community is able to provide top-notch cancer treatment because the financial burden of cancer and the time it takes to treat cancer can be considerable. “It is important to give these patients as normal a quality of life as possible and receiving treatment close to home is an important part of this process,” Dr. Hamarneh said. Dr. Paxton agrees. “It is important to provide this treatment locally in our community so that people don’t have to travel to receive it. They can spend more time in the comfort of their homes and with their families, and more time with their local doctors.” Dr. Paxton’s partner, Interventional Radiologist Matthew Dicker, MD, said, “We work closely with oncologists and their patients to provide minimally invasive options to diagnose and treat or aid in the treatment of cancers.” Dr. Hamarneh looks forward to working more closely with the interventional radiologists who perform chemoembolization in the quad-cities area and indicates that it is absolutely great and important that we can provide these options to our patients here locally. “The decision to perform chemoembolization is a complex one that requires close collaboration between the oncologist and interventional radiologist as it may not be the right choice for every patient with primary or secondary liver cancer,” said Dr. Hamarneh. For more information about chemoembolization, as well as image-guided biopsies, placing long-term IV access for chemotherapy, and other cancer treatment options that interventional radiologists perform, please contact Vascular and Interventional Specialists (VISP) at (928) 771-8477.

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Treating Pelvic Congestion Syndrome

Treating Pelvic Congestion Syndrome

Treating Pelvic Congestion Syndrome

Treating Pelvic Congestion Syndrome

Pelvic congestion syndrome is a painful condition resulting from enlarged varicose veins in the pelvis. As with varicose veins in the legs, the valves in the veins that return blood to the heart become weak and do not close properly. This causes pooling of blood and bulging in the vein in the pelvis. “Pelvic congestion syndrome is fairly common,” said Ben Paxton, MD, Interventional Radiologist, Vascular and Interventional Specialists of Prescott (VISP). “It can be difficult to determine exact numbers because chronic pelvic pain is common, too. It affects approximately 15 percent of women between the ages of 15 to 50. So, pelvic congestion syndrome may account for a large proportion of these cases.” Pain from pelvic congestion syndrome is usually described as dull. It occurs when a woman stands for long periods and tends to worsen as the day goes on. Other symptoms are painful menstrual cycles or bulging veins on the buttocks, tops of the thighs or other areas. Although approximately 30 percent of women experience chronic pelvic pain, those who have given birth are at higher risk for developing pelvic congestion syndrome. According to Dr. Ben Paxton, the best way to determine if someone has pelvic congestion syndrome is by having an MRI. An ultrasound is often done first and can also determine if there is pelvic congestion. Once it is clear that a woman has pelvic congestion syndrome, an interventional radiologist can perform an ovarian vein embolization. This is a minimally invasive procedure that can relieve pain and other symptoms. “It is an outpatient procedure that involves placing a small catheter into the enlarged veins in the pelvis through a tiny incision using x-ray guidance,” Dr. Paxton explained. “Contrast is also introduced into the vein so that we can see exactly where to inject an embolic agent. The embolic agent is typically a small metal coil or plug, which helps to clot off the veins and make them close up. Blood then re-routes to healthier veins instead of using the faulty ones. Patients can return home the same day without any significant recovery time needed.” If you have symptoms of pelvic congestion syndrome or have chronic pelvic pain, please contact your gynecologist or primary care provider. If you have questions about pelvic congestion syndrome, contact Vascular and Interventional Specialists of Prescott (VISP) at (928) 771-8477.  

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Sandy & Friends – PRESCOTT RADIOLOGISTS

VASCULAR & INTERVENTIONAL SPECIALISTS OF PRESCOTT. Original Air date Sept. 19, 2017

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Uterine Fibroids: Hysterectomy is Not Your Only Option

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