Home | Procedures | vascular-surgeries
By Dr Sibasankar Dalai
Sr. Consultant Neuro Vascular Intervention
Published on 02 September 2022

Article Context

  1. Overview
  2. Types
  3. Procedure
  4. Care at Medicover
  5. Frequently Asked Questions

Overview

Vascular surgery is the procedure used to repair blood vessels that have become narrowed, blocked, or dilated outside the heart and brain. Vascular surgery is the open surgical treatment of mesenteric, renal, aortic, carotid, and peripheral artery diseases.

Endovascular surgery is an alternative to traditional open vascular surgery. This is a novel, minimally invasive procedure with benefits such as smaller incisions, less pain, shorter hospital stay, and a quick return to regular activities. However, endovascular surgery is not always recommended for all patients. Depending on the patient's condition, the physician will determine which surgery is best for them.

Types of vascular surgeries:

Depending on the type of your problem, there are various types of vascular surgeries. Some of the methods which deal with vascular system are listed below.

Angioplasty and Stenting

Angioplasty and stenting is a minimally invasive surgery in which your surgeon uses a catheter-guided balloon to open a narrowed artery. This procedure is used to treat conditions such as:

  • Carotid artery disease is characterised by the narrowing of the blood vessels that transport oxygenated blood from the heart to the brain.
  • Peripheral artery disease is characterised by a narrowing of the blood vessels that transport oxygenated blood to the arms and legs.

Atherectomy

Atherectomy is another minimally invasive procedure in which a specialised catheter is inserted into a blocked artery, which allows the vascular surgeon to cut and remove plaque from your blood vessels.

Arteriovenous (AV) Fistula

A vascular surgeon connects a vein in your forearm to an artery during an AV fistula procedure. This strengthens and broadens the vein, making it easier for dialysis patients with kidney failure to access.

Arteriovenous (AV) Graft

An AV graft procedure, like an AV fistula procedure that creates a dialysis access point, involves surgically connecting an artery to a vein but in this case, via a synthetic tube (the "graft").

Open Abdominal Surgery

In Open abdominal surgery,the Abdominal Contents are Exposed which entails making a small incision to repair an aortic aneurysm or a blockage of the aorta (the artery that runs from your heart to your pelvis) where it passes through the abdomen and the exposed contents are Temporarily Covered with a Protective Cover . In many cases, vascular surgeons will suture a graft into the aorta to redirect blood flow around the problem area.

Thrombectomy

A thrombectomy is the removal of a blood clot from an artery or vein. It is done to restore blood flow and prevent potentially fatal complications, such as when blood clot travelling to the lungs (pulmonary embolism) or the brain causing stroke. Angioplasty and stenting may also be performed concurrently with thrombectomy.

Vascular Bypass Surgery

Bypass grafting is a surgical procedure that focuses on creating an alternate blood flow channel to bypass a damaged blood vessel. This surgery may be used to treat people suffering from the conditions listed below.

  • Vertebrobasilar disease is a condition that affects blood flow to the back of the brain.
  • Peripheral artery disease is a condition that affects blood flow to the arms and legs.
  • Renal vascular disease is a condition that affects blood flow to the kidneys.
  • Mesenteric vascular disease is a condition that affects blood flow to the intestines.

Open Carotid and Femoral Endarterectomy

Open carotid and femoral endarterectomy are surgical procedures that remove plaque from the inner lining of the arteries that supply blood to brain and legs, respectively. This surgery is used to treat moderate to severe blockages.

Thrombolytic therapy

Clot busters, medically known as thrombolytics, are used to dissolve blood clots that form in the heart, blood vessels or lungs, especially during a heart attack. Thrombolytic therapy can significantly raise a patient's chances for survival after a heart attack.

Ablation, microphlebectomy or sclerotherapy to treat varicose veins or spider veins Varicose veins are enlarged veins appearing as blue or purple twisted, knot-like cords through the skin. Varicose veins can appear anywhere but they are most common in the legs.

Endovascular Aortic Aneurysm Repair (EVAR)

Endovascular grafting is a minimally invasive surgery to treat an aortic aneurysm.

Apart from the Above Mentioned Procedures, Some of the other methods used are Listed Below:

  • Thoracic outlet surgery
  • Diabetic foot surgeries
  • Management of gangrene of limbs to prevent amputation
  • Excision of Vascular malformation

Procedure

  • Your doctor will take medical history and conduct a thorough physical exam. You may also be Suggested tests to determine the health of your heart, such as a stress test, electrocardiogram (ECG), angiography, CT scan, PET scan and MRI.
  • The doctor may recommend an open surgical procedure or minimally invasive procedure based on the findings. An open surgery involves a large incision in the chest, whereas a minimally invasive surgery involves small incisions and a probe such as an endoscope or laparoscope. These instruments enable doctors to see the exact condition of blood vessels or organs in real time. They then operate with extremely small surgical tools.
  • You will be given either a sedative and regional anaesthesia to make you more comfortable and numb the area of operation, or general anaesthesia to put you to sleep completely.
  • To prevent infection, the insertion site will be cleaned and shaved. To access your blood vessels, your doctor will make a small incision around the hip, near the crease between the hip and the thigh.
  • A guide wire is inserted through the incision and pushed through the blood vessel.
  • Special X-rays will be taken to pinpoint the exact location of the problem. The doctor will then insert a catheter over the guide wire. The catheter is used to carry the graft through your blood vessels to the desired location. The graft is released from the catheter once it is in place.
  • Before the procedure is finished, X-rays will be taken to confirm that blood is flowing through the graft. The incisions near your hip will then be closed with sutures.

Risks of vascular surgery

  • Injury to vital organs
  • Anaesthesia may cause allergic reactions.
  • Prolonged bleeding from a skin incision can result in significant blood loss.
  • Infection may occur at the incision site.
  • Bruising and swelling.
  • Irregular heartbeats caused after the surgery may lead to heart failure.

Care at Medicover

Vascular surgeons at Medicover are experienced in providing excellent healthcare services to patients with care and compassion. Our hospital is equipped with world-class advanced technology and equipment to conduct the tests required for the diagnosis of vascular conditions. Vascular surgeons at Medicover diagnose and treat the diseases with utmost precision to bring successful outcomes. The entire treatment process and follow-up schedules are designed to ensure lasting results.

Frequently Asked Questions:

Vascular surgery is surgical treatment for patients with diseases, disorders, inflammation related to veins and arteries. These diseases of blood vessels can include vasculitis, aneurysms, ischemia, thrombosis, varicose veins and immune system abnormalities.

Both vascular surgery and endovascular surgery are treatments for vascular disease. Endovascular refers to a minimally invasive procedure that is typically performed with a needle puncture and a sheath. Traditional vascular surgery is more invasive and requires wide incisions.

Numbness or weakness in the legs. In the legs or feet, there is no or a weak pulse. Cramping in one or both hips, thighs, or calf muscles after performing certain activities such as walking or climbing stairs.

A serious complication of an aortic aneurysm is an aortic dissection. This is an aortic lining tear. It can occur at any point along the aorta. Aortic dissection is a life-threatening emergency.

Sclerotherapy is a treatment for varicose veins and spider veins. A sclerosant, an irritating agent, is injected into the vein as part of this minimally invasive treatment. This irritates the vein, and the chemical causes enough damage to the endothelium, or the inner lining of veins. When it becomes irritated and damaged, it forms a clot that prevents circulation in the vein beyond, effectively rendering the vein dead or obsolete. Because of the lack of circulation caused by the sclerosing agent injected into the area, the vein transforms into scar tissue that gradually fades from view. This means that the vein will be completely safe.

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