Vascular surgery is an invasive treatment for conditions that affect the veins, arteries, and lymphatic vessels throughout the body. A vascular disorder can greatly reduce a patient’s quality of life and raise the possibility of life-threatening health events, such as stroke.
Since vascular diseases affect the vessels that carry blood throughout the body, there are risks associated with the related blockages and weakness in the vessel walls. These issues can lead to a rupture and internal bleeding. Vascular surgery can help prevent this from happening.
Let’s talk about some of the different types of vascular surgery and which vascular diseases they address.
Your vascular system – the veins and arteries that deliver oxygen to every living cell in your body – is critical to maintaining good health. When these blood vessels become blocked, serious trouble arises.
In many cases, patients with vascular problems like atherosclerosis, may experience no symptoms at all – until it’s too late. Symptoms of advanced vascular conditions might include intermittent pain that feels like cramps or muscle fatigue.
Individuals at Risk
Vascular disease becomes more prevalent as we age. Factors that increase your likelihood of developing vascular problems include the following:
- Increasing age
- Family history
- Injury
- Pregnancy
- Prolonged periods of inactivity
- Smoking
- Obesity
- Hypertension
- Diabetes
Types of Vascular Surgery
There are various types of vascular surgery, depending on the problem you have. Listed below are some of the conventional techniques for addressing issues affecting the vascular system.
1. Angioplasty and Stenting
Angioplasty and stenting is a minimally invasive procedure in which your surgeon opens a narrowed artery using a catheter-guided balloon. This procedure treats conditions that include:
- Carotid artery disease, a narrowing of the blood vessels that carry oxygenated blood from the heart to the brain.
- Peripheral artery disease, a narrowing of the blood vessels that carry oxygenated blood to the arms and legs
The surgical procedure of placing a tiny balloon catheter to address an arterial blockage is called an angioplasty. Today, this can be done as a minimally invasive procedure. The surgeon inflates the balloon to open up and relieve the blockage in the artery.
An angioplasty may include stenting. A stent is a tiny tube that is placed in the now-opened vessel to keep it open for blood and fluids to flow through.
2. Atherectomy
Atherectomy in another minimally invasive procedure in which a specialized catheter is inserted into a blocked artery that allows your vascular surgeon to cut and remove plaque from within your blood vessels. This method can be used to treat patients with peripheral artery disease and allows vascular access for patients who need dialysis.
3. Arteriovenous (AV) Fistula
During an AV fistula procedure, your vascular surgeon connects a vein in your forearm directly to an artery. This makes the vein stronger and wider, and more easily to be accessed for patients with kidney failure who require dialysis.
ARTERIOVENOUS FISTULA SURGERY
The arteriovenous fistula surgery can take place the day after your evaluation (typically a Wednesday) or at a later time, depending on your preference.
During the evaluation, the care team provides you with information about how to prepare for your surgery. Arteriovenous fistula surgery is an outpatient procedure, and an overnight stay at the hospital is rarely needed.
You will receive either local or general anesthesia for the surgery. The surgeon accesses the artery and vein through a small incision in your arm. The operation takes about an hour. Afterward, you’ll rest for one to two hours so the care team can watch you closely before discharging you. If you had general anesthesia, someone else needs to drive you home.
The incision site should heal within one to two weeks. Be sure to watch for signs of infection, such as pain, redness, swelling, or fever.
4. Arteriovenous (AV) Graft
Similar to AV fistula procedure that creates an access point for dialysis, an AV graft procedure also involves surgically connecting an artery to a vein – but in this case, via a synthetic tube (the “graft”).
While an arteriovenous graft is not considered the “gold standard” dialysis access, it’s often considered the next best thing. There are some advantages compared to the other types of hemodialysis vascular access. These advantages of an AV graft include:
- An AV graft is usually ready for use within anywhere from a matter of days (for the “early use” grafts) to 3 – 4 weeks of being placed.
- An AV graft is easy to implant.
- An AV graft has a lower chance of infection than a catheter does.
- Once it heals, you can shower.
5. Open Abdominal Surgery
Open abdominal surgery involves making a small incision to repair an aortic aneurysm or blockage of the aorta (the artery that travels from your heart down to the pelvis) where it passes through the abdomen. In many cases, your vascular surgeon will suture a graft into the aorta to redirect blood flow around the problem area.
Patients with high blood pressure and atherosclerosis may develop a bulging abdominal aorta as a result of the constant pressure and damage to the vessel walls. This bulge is called an aneurysm.
There are two surgical procedures that can treat aneurysms in the abdominal arteries: traditional (open) surgery and minimally invasive surgery. Abdominal endovascular aneurysm repair is the minimally invasive option.
The goal of both surgeries is to fix the bulging part of the abdominal aorta, which is the large vessel that passes oxygenated blood from the heart to the abdomen and the rest of the body. The surgery can prevent the aneurysm from rupturing, which can lead to life-threatening internal bleeding.
6. Thrombectomy
A thrombectomy is a procedure to remove a blood clot from a vein or artery. It is done to restore proper blood flow and prevent life-threatening complications such as when a blood clot travels to the lungs (pulmonary embolism) or brain, which can cause a stroke. Angioplasty and stenting may also be performed at the same time as a thrombectomy.
7. Vascular Bypass Surgery
Bypass grafting is a surgical treatment that focuses on creating an alternate channel for blood flow, bypassing a damaged vessel.
This surgery may be used to treat patients with the following disorders:
- Vertebrobasilar disease, affecting blood flow to the back of the brain
- Peripheral artery disease, affecting blood flow to the arms and legs
- Renal vascular disease, affecting blood flow to the kidneys
- Mesenteric vascular disease, affecting blood flow to the intestines
A peripheral artery bypass addresses a blockage in an artery in your extremities, especially your legs. The surgeon will reroute the blood to other blood vessels, with the goal of bypassing the blocked artery and fostering normal blood flow.
8. Open Carotid and Femoral Endarterectomy
Open carotid and femoral endarterectomy involve the surgical removal of plaque within the inner lining of the arteries feeding blood to your brain or legs, respectively. This surgery is performed in cases of moderate to severe blockage.
The two carotid arteries deliver oxygenated blood from your heart to your brain and to the rest of your head. If you have any blockages in either of these arteries and thus have carotid artery disease, carotid artery surgery can help reduce your risk of having a stroke.
The procedure involves removing the plaque buildup from the carotid artery. This surgery works particularly well when combined with medication and healthy lifestyle habits.