Vascular surgery includes the treatment of diseases within the vascular system, veins, arteries and lymphatic circulation. A vascular surgeon is trained and equipped to use non-invasive (endovascular) and invasive surgical approaches, for treatment of wide interventions in all the areas of the circulatory system (except heart or brain).
What are venous interventions?
Venous interventions are treatments for venous disorders, which are basically conditions that damage your veins. Following are the usual treatments provided under the venous category:
Endovenous laser therapy (EVLT)
It uses laser heat for the treatment of varicose veins. Varicose veins, a condition in which your veins get swollen and enlarged, and occur most often in the legs. During an EVLT procedure, heat is created using a laser that is sent into the vein through a thin, flexible tube (catheter)
Venaseal (glue vein closure)
This again is used to treat varicose veins. The treatment uses a medical glue known as VenaSeal (cyanoacrylate) to physically shut and seal the main defective/ saphenous vein
Radiofrequency (RF) ablation of the varicose vein
It is a minimally invasive treatment for varicose veins. Through ablation, your doctor uses heat to damage the tissue, which makes the formation of scar tissue. This scar tissue then closes the vein. This technique is different than laser therapy, as it uses radiofrequency energy, instead of laser energy
Sclerotherapy (liquid & foam)
Sclerotherapy is where your doctor will inject a medicine into your blood vessels or lymph vessels that will cause them to shrink. Again, the treatment is used for varicose veins. It is a non-surgical procedure. After the liquid is injected, it will mix with the blood in the vein and dilute the concentration of the sclerosant. While using foam injection instead of liquid injection, will displace the blood allowing direct contact of the sclerosant with the endothelium
Management of deep vein thrombosis (DVT)
It means the occurrence of a blood clot (thrombus) in deep veins, commonly within the lower leg and thigh. If a DVT breaks loose and travels through the body to the heart and lungs, there is a risk of serious complications, which can be life-threatening. DVT is diagnosed by an ultrasound scan, blood test (D-Dimers) and/or venogram. Treatment involves anticoagulants and in special cases thrombolysis and/or thrombectomy (mechanical or surgical) and endovenous stenting
Thrombolysis is also called fibrinolytic therapy. It involves breaking down of blood clots formed in blood vessels, by medication. It is used in ST elevation myocardial infarction, stroke, and in cases of severe venous thromboembolism
Venous stenting for May Turners syndrome (MTS)
Also known as the iliac vein compression syndrome, MTS is the compression of common venous outflow tract of the left lower extremity. It usually results in discomfort, swelling, pain or clots in the iliofemoral veins. The most common treatments for MTS are angioplasty and a stent. The doctor will first use a small balloon to expand the left iliac vein, after which a device called stent will be placed. Venous stents (metal mesh tubes) expand the blocked/narrowed vein walls. They help in keeping the veins open
Is an inflammatory process causing a blood clot to form and block one or more veins. It occurs usually in the legs. The affected vein can be near the surface of the skin (superficial thrombophlebitis) or deep within a muscle (deep vein thrombosis, or DVT). For superficial thrombophlebitis, common recommends are applying heat to the painful area, elevating the affected leg, using an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) and possibly wearing compression stockings. The condition may also improve on its own
What are arterial interventions?
These are treatments for arterial diseases, which affect the arteries of your body. They are the vessels that carry oxygen-rich blood away from your heart to the tissues of the body.
Following are the usual treatments provided under the arterial category:
Treatment for peripheral (occlusive) artery disease
In peripheral artery disease (PAD), there will be a decrease in the blood flow in the arteries to the legs and feet. It can result in leg muscle fatigue, discomfort or pain when walking, diminished quality of life and independence, and can also lead to amputation. Treatment for peripheral artery disease happens in two phases: managing the symptoms, like leg pain, to ensure you can resume physical activities; and to stop the progression of atherosclerosis throughout your body, for reducing your risk of heart attack and stroke
Treatment for aneurysms (abdominal, thoracic & peripheral)
An aneurysm happens when the wall of an artery weakens and bulges, resulting in a potential serious health situation. It can happen anywhere in the body, most common being the upper and lower limbs, chest (thoracic aortic aneurysm) and abdomen (abdominal aortic aneurysm). The growth of an aneurysm must be ideally monitored closely, and intervention options include endovascular repair or open surgery
Carotid artery surgery
The build-up of fatty plaques (atherosclerosis) in the arteries leading to the brain and heart (carotid arteries) is known as carotid artery disease (CAD). There are many risk factors that can contribute to the occurrence of CAD, including but not limited to smoking, poor diet, age, high blood pressure and diabetes. Atherosclerosis can occur in any artery within the body, and may not cause any signs or symptoms until a severe narrowing or blockage has occurred. Lifestyle changes, medicines and medical procedures can help to prevent or treat CAD and other forms of atherosclerosis, helping to reduce the risk of stroke
What are the other kinds of vascular issues?
Some of them are as below:
Arteriovenous malformations (AVMs)
It is an abnormal tangle of blood vessels connecting arteries and veins, disrupting normal blood flow and oxygen circulation. Surgery is the most common treatment for AVMs. In some cases, a catheter or radiation may be used to close off vessels. Medication may be used to treat headaches and seizures
Vaso-spastic conditions (Raynaud’s)
This is where small blood vessels near the surface of the skin have spasms, limiting the blood flow. Mostly, it is temporary. A common vasospastic disorder is Raynaud’s syndrome, affecting the hands and feet, making them feel cold. To widen blood vessels and increase blood flow, you may be prescribed calcium channel blockers, which relax and open the small blood vessels in the hands and feet. It reduces the severity and number of attacks in most people with Raynaud’s
Are there any other vascular treatments?
Yes. Vascular treatments are also undertaken for diabetic foot care, gangrene and limb salvage including dressings for ulcers and wound care. Plus, for management of swelling, lymphedema and cellulitis. Also, for patients requiring access for dialysis:
- Arterio venous fistula (AVF)
- Arterio venous graft (AVG)
- Dialysis catheters
- Chemotherapy ports
- IV infusions