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Department Of Vascular Surgery

The world runs on a supply chain that brings us essential goods. The human body is no different and its supply chain is the vascular system.

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Department Overview

Overview

The world runs on a supply chain that brings us essential goods. The human body is no different and its supply chain is the vascular system. A collection of blood vessels of varying sizes, this integrated network circulates essential nutrients and oxygen to the cells of the body for energy generation. They also remove waste compounds and regulate body temperature.

Also known as the circulatory system, it is a vital component of the human body as every functional system depends on the vascular system. Naturally, keeping it healthy is a top priority. Vascular surgery is an effective procedure employed to achieve this.

What is Vascular Surgery?

The circulatory system or vascular system is made up of arteries and veins. They do a very important job of transporting blood across the body. Sometimes, a blood clot develops or there is a buildup of plaque restricting blood flow. This blockage can lead to severe complications if left untreated.

Vascular surgery is a surgical sub-speciality that treats such problems in the vascular system.

Conditions treated by Vascular Surgery?

i) Aneurysm

An aneurysm is caused by a weakness in the arterial wall. This weakness incites a ballooning of the weakened area in the artery.

Areas typically affected by aneurysm are:-

  • Aorta (the main artery that carries blood away from the heart)
  • Brain
  • Back of the knee
  • Intestine
  • Spleen

If these aneurysms rupture, it could prove to be fatal. When an aneurysm ruptures it can cause internal bleeding and can even lead to a stroke. Aneurysm does not show any perceptible symptoms at the onset, although patients may experience pain in the abdomen, arm, back or leg.

ii) Atherosclerosis

Atherosclerosis refers to a hardening of arteries due to plaque build up on the walls of the artery. This plaque consists of fats, cholesterol and other substances. This plaque build-up can restrict blood flow through the arteries. It could also burst and trigger a blood clot.

Commonly afflicting the heart, atherosclerosis can affect any artery in the body. Atherosclerosis doesn’t show any symptoms until a rupture occurs. Thus, atherosclerosis is usually undetectable without a medical diagnosis.

However, patients suffering from atherosclerosis could have

  • Leg Pain during exercise
  • Erectile Dysfunction
  • Heart Attacks
  • Mini Stroke / Stroke
  • Take a long time for wounds to heal

iii) Carotid Artery Disease or Peripheral Artery Disease (PAD)

Peripheral arteries refer to arteries in places other than the brain and heart. PAD refers to the narrowing of these arteries. These narrowed blood vessels reduce the blood flow, PAD predominantly affects the legs but can also affect the stomach, arms and head. A common symptom of PAD is leg pain while walking. Patients could also experience pain in their buttocks.

Other Symptoms include

  • Cramping in your hips, thighs or calf muscles after certain activities.
  • Leg numbness or weakness
  • Toes, feet or legs sores that take too long to heal
  • Hair loss in leg
  • Slower growth of your toenails
  • Shiny skin on your legs
  • No pulse or a weak pulse in your legs or feet
  • Erectile dysfunction
  • Leg colour starts changing

iv) Thoracic Outlet Syndrome

The thoracic outlet is the first rib in the body. A bunch of nerves & blood vessels run in the space between the thoracic outlet & the collarbone. Sometimes these nerves and blood vessels get compressed. Thoracic Outlet Syndrome refers to the complications arising out of this compression.

Repetitive trauma or injuries can cause Thoracic Outlet Syndromes. It can also be due to natural causes like pregnancy or any anatomical defects in the rib cage.

Common symptoms of thoracic outlet syndrome are:-

  • Shoulder Pain
  • Neck Pain
  • Fingers feeling weak, numb and cold
  • Headache
  • Muscle Weakness or Swelling

v) Nutcracker Syndrome

Nutcracker syndrome is a very rare disorder caused by the compression of the left renal vein. Sometimes, the left renal vein gets squeezed by the abdominal aorta and superior mesenteric artery. This causes compression in the vein leading to nutcracker syndrome.

Common symptoms of nutcracker syndrome are

  • Abdominal Pain concentrated on the left side
  • Traces of blood in the urine
  • Testicular Pain in men
  • Women may experience pain in the left lower quadrant

vi) Deep Vein Thrombosis (DVT)

Deep vein thrombosis refers to the formation of blood clots in veins that are deep inside the body. It is a very serious condition. Usually, DVTs occur in the thighs or lower leg. But it can also form in other body parts. The dangerous part of DVT is that the blood clots could loosen and lodge in the lungs.

Patients with DVT can experience leg pain and swelling. There are no other major symptoms. Although patients may experience tenderness or warm skin in extremities.

vii) Spider Veins

The medical term for spider veins is telangiectasias. It refers to a collection of tiny blood vessels developing close to the skin or mucous membranes. They appear like a spider’s web and are often red, blue or purple.

Spider veins can occur anywhere in the body but are mostly found on the face or legs. The cause of spider veins could be obesity, hormone fluctuation, trauma or even hereditary. It is usually found in people over 30 and pregnant women.

viii) Varicose Veins

Varicose veins are enlarged, twisted, and swollen veins. Varicose veins are generally benign conditions but can cause aching pains & discomfort. They usually appear blue or dark purple.

Varicose veins are caused by defective valves in veins. These valves allow blood to flow in the opposite direction or to pool.

Common symptoms of Varicose Veins are:-

  • Dark purple or blue colour veins
  • Twisted and Bulging veins
  • Leg aches or Leg feeling heavy
  • Burning, throbbing, muscle cramping and swelling in lower legs
  • Standing for longer periods causing pain
  • The area around veins feeling itchy
  • Discolouration of the skin around a varicose vein

ix) Venous Ulcers

Venous ulcers usually occur in the leg so it is generally referred to as leg ulcers. They are nothing but wounds on the leg or ankle that are caused by damaged venous valves. Reasons for valve damage include obesity, blood clots, injury and ageing. In the majority of cases, leg ulcers lead to chronic wounds.

Symptoms of Venous Ulcers include:-

  • Swelling in the legs
  • Aching or tiredness in the legs
  • Red, Irritated Skin Rashes
  • Rashes developing into open wounds

Who needs Vascular Surgery?

Vascular surgeons specialize in conditions related to the blood vessels. They help diagnose, treat and manage a variety of conditions related to the blood vessels. Anyone suffering from a vascular condition can consult a vascular surgeon. Most of the vascular conditions that could need vascular surgery have been listed above.

Apart from these vascular surgery may be required for:-

  • Placing Graft or Fistula for Dialysis treatment.
  • To treat any trauma to arteries or veins caused by accidents or injuries.

Our Expertise

Rela Hospital is proud to be the home for a vascular surgery department that is at par with international standards. Comprising top-notch surgeons, courteous support staff and state-of-the-art equipment, we are one of the premier institutions in the region.

Our medical professionals conduct thousands of vascular surgeries annually and possess years of experience in treating vascular diseases. From accurate diagnosis to effective treatments, our experts ensure you get the best care.

Rela Hospital’s vascular surgical department houses the very best in medical equipment. From High-Tech labs that diagnose conditions accurately and effectively to the latest surgical equipment, Rela Hospital’s Department of Vascular Surgery is equipped to treat any condition you might have.

With our experts by your side, you can rest without fear. We will ensure that you get back on your feet in no time.

 

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Treatments and Procedures

Diagnosis

To diagnose a patient’s disease, a vascular surgeon checks medical history and lifestyle. And then based on the patient’s symptoms, the surgeon may carry out some physical tests.

Extra tests done for diagnosing vascular diseases include:-

1) Ankle Brachial Index

This test helps understand the severity of PAD ( Peripheral Artery Disease). This test is done by measuring the blood pressure in both arms and ankles. These are then compared.

2) Ultrasound Scans

Ultrasound Scans help diagnose various conditions. Using sound waves pictures of blood vessels are made.

Diseases diagnosed using ultrasound are:-

  • Aneurysms
  • Carotid Artery Disease
  • Varicose Vein.

Treatments

Patients diagnosed with vascular diseases don’t necessarily need surgical treatment. Some conditions can be cured by lifestyle changes like quitting smoking, being more active and healthy eating. Taking medicines that cut blood clot risks are another form of treatment.

Other Non-surgical treatments include:-

1) Compression Therapy

A simple procedure to increase blood flow in the lower limbs. Patients wear specially designed stockings that gently apply pressure to the ankle and legs.

2) Sclerotherapy

Generally used for treating varicose veins and spider veins. Sclerotherapy requires only an injection. A medicine is injected into the blood vessels causing them to shrink.

3) Thrombolysis

Thrombolysis is also known as fibrinolytic therapy. It’s a procedure by which blood clots are dissolved using medication.

Surgical treatments for vascular diseases include both open surgeries and minimally invasive surgery. The type of surgery is decided based on the condition. Wherever possible minimally invasive surgery is preferred.

A sub-section of vascular surgeries is endovascular surgeries. Endovascular means “inside the blood vessel”. During endovascular surgeries, small tubes called catheters are placed in blood vessels. These catheters then repair the blood vessels from inside.

Procedures

1) Thoracic Endovascular Aortic Repair (TEVAR)

TEVAR is a minimally invasive endovascular surgical procedure. During TEVAR small incisions are made in the groin. A stent-graft is then placed to repair the aneurysm.

Condition Treated:-

  • Thoracic Aortic Aneurysm
  • Aortic Dissection

2) Endovascular Aneurysm Repair (EVAR)

EVAR is another minimally invasive procedure. Like TEVAR the surgeon makes an incision in the groin and places a stent-graft. This allows blood to flow through the aorta without further growth or rupture of the Aneurysm.

Condition Treated:-

  • Abdominal Aortic Aneurysm

3) Fenestrated Endovascular Aneurysm Repair (FEVAR)

FEVAR is another viable treatment for Abdominal Aortic Aneurysm. This is also a minimally invasive procedure. Here too an incision is made in the groin and a stent graft is placed. The catheter repairs the aneurysm without changing the blood flow to the kidneys, intestine, stomach and liver.

Condition Treated:-

  • Abdominal Aortic Aneurysm

4) Angioplasty & Stenting

Angioplasty is a procedure to remove clogs in the heart arteries. It requires a tiny balloon catheter. Inserting this catheter into the clogged artery to widen the artery is Angioplasty. It improves blood flow to the heart and is a minimally invasive procedure.

Usually, during Angioplasty a small wire mesh tube or STENT is placed in the artery. The major function of the stent is to open the artery. Usually, these stents are coated with medication that help keep open the artery.

Condition Treated:-

  • Cerebrovascular Disease
  • Vertebrobasilar Disease
  • Peripheral Arterial Disease (PAD)

5) Cryoplasty:-

Cryoplasty is very similar to Angioplasty. Here too a balloon catheter is used. The Surgeon places this catheter blocked artery. On reaching the blockage the catheter is filled with liquid nitrous oxide. This nitrous oxide immediately evaporates into gas inflating the balloon. This freezes the surrounding tissue and opens up the artery. This procedure reduces the growth of new scar tissues and the reoccurrence of blockage.

Condition Treated:-

  • Peripheral Arterial Disease (PAD)

6) Percutaneous or Laser Atherectomy

A procedure to remove plaque buildup that is blocking the arteries. The surgeon inserts a catheter into the affected artery. This catheter is fitted with a sharp rotatable blade or laser filament. It also has a collection system to get the plaque off the wall and collect any debris.

Condition Treated:-

  • Peripheral Arterial Disease (PAD)

7) Open Abdominal Aortic Surgery

This is an open surgery performed in the abdominal region. The artery with an aneurysm is dilated using a fabric graft.

Conditions treated:-

  • Abdominal Aortic Aneurysm
  • Aortoiliac Occlusive Disease

8) Bypass Surgery

Bypass is also an open surgical procedure. It is performed to help blood flow by bypassing damage or blockage in the blood vessel. The graft for the procedure is prepared from another vein in the patient’s body or with synthetic material.

Conditions Treated:-

  • Vertebrobasilar Disease
  • Peripheral Arterial Disease (PAD)
  • Renal Vascular Disease
  • Mesenteric Vascular Disease

Risks of Vascular Surgery:

All surgeries have an element of risk. Vascular surgeries are slightly riskier as they involve blood vessels. Smokers, patients with high BP, elderly people, people with lung or kidney diseases have more chances of complications.

Other risks of vascular surgery include:-

  • Bleeding
  • Heart Attack
  • Swelling of legs
  • Graft Failure
  • Impotence

Surgeons will have detailed discussion about possible complications with the patient.

Aftercare

The duration of hospital stay after the surgery varies based on the procedure. It can also depend on other factors like patients’ health condition, complications during surgery etc.

Patients are usually given medications to control the cholesterol levels, BP and Diabetes. Anticoagulants are prescribed to persons with a risk of blood clots.

Post-surgery patients are encouraged to:

  • Quit Smoking
  • Regularly exercise
  • Eat Healthier (Nutritious Food with low Fat)

A prime vascular system is essential for long and fulfilling life. We understand the importance of vascular health and will always be by your side in the quest for a higher quality of life.

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