Dr. Kathylee Santangelo is a cardiothoracic surgeon practicing as a vein specialist in Oklahoma City, OK. Dr. Santangelo specializes in minimally invasive procedures to treat varicose veins and venous leg ulcers. She is board certified in venous and lymphatic medicine and is the medical director of her privately-owned vein specialty practice, Totality. Totality also offers diagnostic ultrasound imaging services as well as aesthetic services. Our professional staff includes Steve Bernhardt, RVT, RDMS, RPhS, and Connie Fogarty, RN, nurse injector.
Education and Training
HAHNEMANN UNIVERSITY COLLEGE OF MEDICINE 1985
MCP HAHNEMANN UNIV (FORMERLY ALLEGHENY UNIV) 1985
Thoracic SurgeryAmerican Board of Thoracic SurgeryABTS
Dr. Kathylee Santangelo M.D.'s Expert Contributions
Blood clots in the deep veins (most commonly the legs) can be diagnosed clinically with a good history and an ultrasound test, which is about 99% accurate and sensitive. The ultrasound is a noninvasive test that involves jelly on your leg (just like the jelly on the belly test pregnant women have) and allows us to see the superficial and deep veins of your leg and see if there is any obstruction (clot) in them. Your doctor may perform a blood test (called a d-dimer). If the d-dimer is negative (or normal), you do not have a deep vein blood clot. KathyLee Santangelo, MD READ MORE
Raynaud's disease is a vasospastic disorder of the small blood vessels of the fingers or toes. Generally speaking, it is not treated with any surgery. It can respond to treatment with some medications including calcium channel blockers or migraine medications. Reducing stress, nicotine, and exposure to cold all can help with the discoloration and spasm of the small blood vessels in the extremities. KathyLee Santangelo, MD READ MORE
A deep vein thrombosis is basically a blood clot in the pipeline that moves blood out of the periphery of the body (most commonly the legs, but sometimes the arms) back to the heart. Depending where the blood clot is and how extensive it is and what symptoms the patient has, the treatment can be just surveillance (watching the patient and perhaps checking some studies every 3-6 months), outpatient anticoagulation (prescribing blood thinners that the patient can take at home), thrombolytics (clot busters that require a minimally invasive procedure that literally removes the clot), or thrombectomy (a surgical procedure that removes the clot). It isn't a one solution kind of problem therefore, it is important to ask your mother what symptoms she has, where the clot is, and what options were offered to her for treatment. In the meantime, she also should be aware that there are possible consequences of having a blood clot in your deep veins no matter how it is treated and she should ask her doctor about these. KathyLee Santangelo, MD READ MORE
I am 7 months pregnant and suffering from varicose veins. Will this condition persist even after my delivery?
Congratulations on your pregnancy! As for your varicose veins that you have, I trust that your obstetrician has recommended some gradient compression stockings of at least 20-30 mmHg or a V-strap until you deliver. If the veins are on just your lower legs, knee high compression socks are adequate, but if they are above the knee you will feel better and have fewer leg aches and heaviness if you wear thigh high. If the varicosities are in your vulvar area, a V-strap will help a lot. Many varicosities will recede after delivery, especially the vulvar ones. The varicosities of the legs may improve as well AND if you have another pregnancy they will recur and most likely be even worse than they are now. You do not have to struggle with this the rest of our life as there is a permanent solution. Check out the American College of Phlebology's website about varicose vein treatments and after your delivery, consider having an evaluation with a vein specialist who will be able to discuss treatment options with you. Again, best of luck with your new baby!! KathyLee Santangelo, MD READ MORE
My family has a history of cardiac issues, and I'm worried. Is it likely that I will develop issues in the future?
There are many risk factors for coronary artery disease (which is what your father had if he needed coronary artery bypass grafting). Although it is true that a family history of this increases your risk for it, given that your father is 74 years old is a positive! If he didn't have any heart attacks before the age of 60 your risk is not that much greater with just this one factor. Other equally important risk factors are more under your control and these are the ones you and your health care provider should try your best to minimize. Smoking, high cholesterol more specifically high LDL (bad cholesterol) and low HDL (good cholesterol) levels, high blood pressure, a sedentary lifestyle, obesity, diabetes, and high stress are all "controllable" risk factors. YOU can quit smoking, talk with your health care provider about your numbers (your blood pressure and LDL and HDL levels and even your glucose levels), walk 30 minutes a day every day, and breathe deeply more frequently and decrease your risk of cardiac disease. Talk to your health care provider about your concern and make him/her a partner on your quest to a healthier heart! KathyLee Santangelo, MD READ MORE
There are many excellent options for varicose vein treatments today. Whereas in the past, stripping was the "gold standard," the 21st century has brought innovative technology to the treatment of varicose veins. Most of these options take about 1 hour in vein specialist's office while you are awake. The options include: thermal ablation with either radiofrequency or laser; nonthermal nontumescent ablation with either foam or glue; and mechanicochemical ablation. Thermal ablation is the "oldest" of these newer techniques and uses heat to seal the veins that are troublesome to you and causing the varicosities. The devices are little more than "fancy IVs" that the specialist inserts inside the "bad" vein and as the catheter (or fancy IV) is removed from inside the vein, it is heat sealed closed (either with microwave-like heat energy or laser light type heat energy. The nonthermal techniques are done with either a medicine that closes the vein (Varithena- a microfoam sclerosant) or a cyanoacrylate adhesive (VenaSeal) or basically super glue. Again, both these techniques start with the specialist getting into the "bad vein" and then either injecting the foam or the glue to "shut it down." The mechanochemical technique uses a combination of a very "fancy IV" with a spinning tip out of which is injected a sclerosant (medicine that closes veins down). For more education about varicose vein treatments, check out the American College of Phlebology website (www.phlebology.org) or visit a board certified vein specialist. KathyLee Santangelo, MD READ MORE
Diabetes and hypertension are common causes of atherosclerosis and as such are some of the more common indications for bypass surgery. Whether or not your mother is a candidate for bypass surgery will depend on the assessment of a cardiovascular surgeon of her particular problem, her overall health, and her willingness to undergo an invasive procedure. Bypass surgery is an excellent option for many diabetics and for many individuals with high blood pressure. If you are concerned about this, go to your mother's appointment with the specialist and ask questions until you feel you have the answers that allow you to help her make an informed choice. As for her sometimes out of control blood pressure and her blood sugars, the anesthesia providers and intensivists as well as the surgeon will all team up to provide her with the best possible care in those circumstances. KathyLee Santangelo, MD READ MORE
An echocardiogram of the heart is basically an ultrasound that can examine the function and size of the walls of the heart, the 4 valves of the heart, and the overall efficiency of the heart. Some of the information obtained in this study will be whether or not you have normal heart function (an ejection fraction is calculated); normal valvular function (no leaking or tight valves); normal wall thickness (no walls that are too thin or too thick); and normal wall motion (no walls that are not moving well). A normal echo is a very good thing! A stress test adds increased demand to the heart by making it work harder and it checks the wall motions as well. It can pick up when the heart isn't able to handle the stress. A normal stress test is a very good thing!! There are other tests that your cardiologist may recommend if you continue to have chest pain. READ MORE
A vascular surgeon is trained in general surgery with additional training in surgery of the blood vessels of the body. A cardiologist is trained in internal medicine with additional training in the study of the heart and blood vessels. A vascular surgeon and cardiologist treat many of the same diseases, including peripheral arterial disease, carotid artery disease, and abdominal aortic aneurysms. A cardiologist generally is limited in treating with medications and procedures through the skin without "opening you up," whereas the vascular surgeon has the expertise to perform procedures of a major surgical nature -- opening the leg to bypass diseased arteries, or the neck to perform an endarterectomy on your carotid, or the abdomen to fix your abdominal aortic aneurysm. The cardiologist stents the vessels, which is way less invasive. READ MORE
You are a very young man to be diagnosed with peripheral artery disease as it is usually a disease of older individuals as it is basically atherosclerosis of the arteries of the legs usually (actually all the arteries in the body except the ones of your heart and your brain). This disease is more common in smokers so, if you smoke, the first course of action is smoking cessation. As for treatment, it really depends on the severity of your disease. Just as it takes a lot of "junk" to block a water pipe in your house, it takes a lot of plaque in your peripheral arteries to create a problem that requires fixing and in fact, you would only receive treatment if you had a blockage that was causing you symptoms. Symptoms of PAD are usually pain, specifically, pain with exertion and is called claudication. Walking more is one of the ways to help your body make new blood vessels to increase the blood flow to your legs. If you have symptoms and if you need treatment, there are ways to balloon and stent the arteries which many interventional cardiologists and radiologists do and there are bypasses that are surgical procedures performed by vascular surgeons. The treatments do NOT cure the disease; they just solve the problems created by the blockages in the arteries. There are ways to slow the progression of atherosclerosis of your arteries and you can discuss these with your PCP. KathyLee Santangelo, MD READ MORE
Abdominal aortic aneurysms are enlargements in the major artery coursing through the trunk of your body off of which the arteries to your major abdominal organs originate. The AAA (triple A, but not the one you call for automobile service) is usually the result of atherosclerosis (or plaque) in the wall of this major artery and is a concern when it reaches a certain size as with increasing size there is a risk that it could rupture (or break open and bleed). You don't need to be terrified as it is very easy to measure and follow how large your AAA is on abdominal ultrasound, which is a noninvasive test without needles and just "jelly on your belly." The tech won't be looking for a baby in there, but rather measuring the diameter of your aorta and if it is < 5 cm, will continue to monitor every 6 months to 1 year, unless you develop acute abdominal pain that shoots through to your back or acute weakness and fatigue with nausea and vomiting. In general, many AAAs can be treated without open surgery by placing an endograft (or a large walled tube) inside the aorta, which then directs the blood through that "walled tube" and avoids the blood pressure on the thinned out walls of your native aorta. This procedure is a lot less intense than the surgery used to be for this condition. A trained vascular surgeon can do either an endograft or open surgery for your AAA and although you may still be terrified, you will be in safe hands! The short answer to your question - is it reversible? - no, not really, but fixable, yes, definitely!! KathyLee Santangelo, MD READ MORE
Claudication is a symptom of inadequate blood supply to a muscle, i.e., when a muscle is exercised, it requires more oxygen to do the extra work, so the blood flow has to be adequate to meet that demand. Claudication is the symptom of cramping pain that occurs, usually in the calf muscle, when a patient has peripheral arterial disease significant enough to impair the blood supply to the exercising muscle. It typically occurs at the same point in exercise each time, so some people predictably can walk 2 blocks without any pain in the calf and then at 3 blocks, a cramping pain occurs and the only way to relieve it is to rest. Usually, a rest period of as little as a few minutes of sitting or not moving relieves the pain and allows the person to walk again without cramping pain for another 3 blocks. Again, it is an oxygen supply and demand mismatch that occurs usually because of plaque or atherosclerosis in the arteries of the leg, peripheral arterial disease. A vascular rehab program will ease this symptom and can totally relieve it. This consists of walking just a bit beyond the pain each day until eventually the pain occurs at longer distances. You're actually "building new pathways" for the blood to get to the working muscle. Sometimes, a vascular surgeon needs to improve the blood flow to your leg with a bypass procedure; however, both an exercise program and peripheral arterial stents may improve the blood flow enough to avoid any surgeries. Cigarette smoking can definitely make claudication symptoms and peripheral arterial disease worse, so if you have this problem and still smoke, ask your doctor to help with a smoking cessation program. KathyLee Santangelo, MD READ MORE
Indeed it could be! Varicose veins are usually the result of valves in the superficial veins of your legs not working properly. As you know veins carry blood from the feet to the heart so when the one-way valves in them don't work correctly, blood can pool in the lower legs and create those bulges. This can cause swelling in the veins themselves and in the lower legs and ankles that usually spares the feet. The longer you stand or sit, the more you'll swell; the more your calf muscle contracts as with walking or the more you elevate your legs above your heart, the less you'll swell. If your symptoms are severe, consider wearing gradient compression socks of 20-30mmHg and getting evaluated by a vein specialist at an accredited vein center. READ MORE
I doubt your diabetes has much to do with your heart valve disease. Diabetes usually causes problems in the coronary arteries and thus you probably have had not only an echocardiogram to determine your heart valve problem but a coronary angiogram or cath to determine the status of your coronary arteries. A major surgery always causes changes in blood sugars and it wouldn't be unusual for you to be given some insulin to correct them especially during the acute hospitalization period. As you recover, your blood sugars should return to your normal levels and usually can be addressed with the same medication you had before the surgery. Again, it's the major stress of the heart valve replacement surgery that will cause your blood sugars to be a bit more abnormal and your physicians will be well prepared to address this issue. You can trust your medical team to be ready to keep your sugars in safe ranges during this entire time! READ MORE
Areas of expertise and specialization
- Varicose Veins
- Venous Insufficiency
- American College of Surgeons; American College of Phlebology
- Penn St University
- University of Pennsylvania Health System Program
Dr. Kathylee Santangelo M.D.'s Practice location
OKLAHOMA CITY, OK 73118Get Direction
Oklahoma City, OK 73110Get Direction
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