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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