Vascular Treatments & Procedures
Just as a cardiac surgeon performs coronary angioplasty or bypass surgery on the heart, vascular surgeons perform peripheral angioplasty on the arteries of the arms, legs, stomach region, etc.
But their expertise is not limited to bypass or angioplasty. Here are some life-changing procedures vascular surgeons perform every day!
Endovascular Procedures
Endovascular procedures treat blood vessel conditions from inside the vessel through a single, small puncture in the skin.
Vascular surgeons use specialised catheters, wires, balloons, stents, and other devices to restore blood flow or repair diseased vessels.
As a minimally invasive approach, endovascular procedures benefit patients:
- Smaller wounds: no incision, no scars
- Early mobilisation
- Less blood loss
- Faster recovery
- Shorter hospital stay
- Early return to normal activities
Peripheral Angioplasty
When arteries in your legs get blocked, blood flow is reduced, causing pain while walking short distances and wounds or ulcers that don’t heal for weeks.
Peripheral angioplasty is an endovascular procedure done through a single puncture. A small balloon opens narrowed arteries and improves blood flow, similar to an angioplasty done for the heart. A stent may be placed to keep the artery open.
This relieves leg pain, helps ulcers heal faster, and reduces the risk of serious complications like amputation or limb loss.
Laser Ablation for Varicose Veins
When the valves in the veins of your legs stop working properly, blood can flow backwards and pool in the veins, causing swollen, twisted, and painful varicose veins.
Endovascular Laser Ablation (EVLA), commonly called laser treatment for varicose veins, is a minimally invasive procedure that uses laser energy to seal the faulty vein. Blood is then naturally redirected through healthier veins.
The procedure is performed through a small puncture, with minimal scarring and patients can resume their daily routine within a few days.
IVC Filter Insertion & Retrieval
A blood clot in the deep veins of the legs (DVT) can travel to the lungs and cause a life-threatening pulmonary embolism (PE).
An IVC filter is a small, cone-shaped device placed inside the inferior vena cava, the largest vein, located in stomach region. It catches clots before they reach the lungs and may be recommended when blood thinners cannot be used or are not sufficient.
Once the risk has passed, the retrievable IVC filter can be removed safely through a minimally invasive procedure.
Endovascular Aneurysm Repair (EVAR)
A dangerous bulge (aneurysm) formed at a weak spot in the artery wall can cause life-threatening internal bleeding if it ruptures.
Vascular surgeons repair it by placing a stent graft to support the weak area and prevent rupture. This procedure, called Endovascular Aneurysm Repair (EVAR), is performed through a single puncture.
It causes less pain and allows quicker recovery and a shorter hospital stay compared to open surgery.
Embolisation
Embolisation is a minimally invasive procedure in which vascular surgeons guide a thin catheter to the targeted blood vessel and release specialised materials to block blood flow.
It is used when abnormal blood flow needs to be controlled, such as during internal bleeding or in certain diseased blood vessels. Additionally, in some tumours, blocking their blood supply can help control their growth or reduce blood loss during surgery.
It is also used to treat conditions such as vascular malformations or aneurysms, and can be performed through a single puncture.
Central Venous Angioplasty or Venoplasty
Narrowing or blockage in the large veins of the chest can restrict blood flow and cause swelling, discomfort, or dialysis access problems.
Central venous angioplasty, or venoplasty, is a minimally invasive procedure in which a balloon catheter is guided to the narrowed vein and inflated to widen it and restore blood flow. In selected cases, a stent may be placed to help keep the vein open.
The procedure can improve venous drainage and help restore or maintain the function of an AV fistula or other dialysis access.
Thrombolysis / Catheter-Directed Thrombolysis
A blood clot can suddenly block a blood vessel, restricting blood flow and potentially causing serious damage to the affected limb or organ.
Catheter-directed thrombolysis is a minimally invasive procedure in which a thin catheter delivers clot-dissolving medication to break it down and restore blood flow.
It may be used in selected cases of extensive DVT or acute arterial blockage, helping restore circulation without open surgery.
Mechanical Thrombectomy
A blood clot can suddenly block an artery or vein, restricting blood flow and causing severe pain, swelling, or tissue damage.
Using mechanical thrombectomy, a specialised catheter is guided to the clot, and a device physically removes it from the blood vessel.
By rapidly restoring blood flow, the procedure can help prevent further tissue damage and reduce the risk of serious complications.
Fistula Angioplasty
A narrowing in an AV fistula can reduce blood flow and make dialysis less effective. If left untreated, it can eventually cause the fistula to stop working.
Fistula angioplasty is similar to peripheral angioplasty. A small balloon catheter is guided to the narrowed section of the fistula artery to widen it and improve blood flow.
By restoring adequate blood flow, the procedure can help maintain dialysis fistula efficiency and prolong its use.
Aortic Dissection Repair
An aortic dissection occurs when a tear develops in the aorta’s inner lining, allowing high-pressure blood to enter the wall and separate its layers. It is a vascular emergency.
Endovascular aortic dissection repair uses a stent graft delivered through a small puncture in the artery to seal the tear and redirect blood flow through the true channel of the aorta.
This helps prevent the dissection from worsening, reduce the risk of rupture, and restore safer blood flow through the aorta.
Open Surgical Procedures
Open vascular procedures involve an incision to access the blood vessel for repair, removal, or bypass of the diseased section.
They are recommended when an endovascular approach is not suitable, or when a blockage, aneurysm, or other vascular complication requires direct surgical access.
AV Fistula for Dialysis
For long-term dialysis to work effectively, doctors need a safe and reliable way to access your bloodstream. An AV fistula (AVF) provides a strong, natural access point that can be used repeatedly.
An arteriovenous (AV) fistula is created through a small surgery, connecting an artery and a vein – usually in the arm, or sometimes in the leg. This allows steady blood flow during dialysis.
If dialysis problems arise, a surgeon can repair or modify the AVF to restore adequate blood flow and make it usable for dialysis again.
When created by a vascular surgeon, an AV fistula lasts longer, reduces the risk of complications, and avoids the need for repeat procedures or fistula failure.
Peripheral Bypass
When arteries in your legs are completely blocked, blood cannot reach your foot, causing severe pain or blackening of toes & nails (gangrene).
Peripheral bypass surgery goes around the blockage to create a new path for blood flow using your own vein or an artificial graft.
This restores blood supply, relieves pain, helps wounds heal, and prevents amputation. This procedure may be recommended when a peripheral angioplasty is not possible or has not worked.
Carotid Endarterectomy
When fatty deposits (plaque) build up inside the carotid arteries in your neck, they can restrict blood flow to the brain and increase the risk of a stroke.
Carotid endarterectomy is an open surgical procedure that removes the plaque from the narrowed carotid artery, restoring smoother blood flow to the brain.
By removing the blockage, the procedure helps reduce the risk of future stroke and may be recommended when carotid artery narrowing is severe or causes stroke-like symptoms called Transient Ischemic Attack (TIA).
Open Aneurysm Repair
An aneurysm is the ballooning of a weakened artery wall. The bulging gradually increases and can rupture, causing life-threatening internal bleeding.
Open aneurysm repair involves making an incision to directly access the affected artery and replacing the weakened section with a strong graft.
This reinforces the artery, prevents rupture, and provides a durable repair when an endovascular approach is not suitable.
Chemoport Insertion
Repeated chemotherapy involves painful needle pricks, and certain medications can damage the smaller veins in your arms, making cancer treatment difficult and uncomfortable.
A chemoport is a small, implantable device, surgically placed under the skin and connected to a large vein. Once healed, the port stays discreetly under the skin and can be used throughout treatment.
It can be accessed for chemotherapy using a special needle without repeated pricks in the arm.
Thrombectomy or Surgical Thromboembolectomy
A blood clot can suddenly block an artery, cutting off blood supply to the limb and causing severe pain, coldness, numbness, or even tissue damage.
Surgical thrombectomy or thromboembolectomy involves removing the clot from the blocked artery to restore blood flow. It may be performed as an emergency procedure in cases of acute limb ischaemia.
Restoring blood flow quickly can help save the affected limb and prevent permanent tissue damage.