Vascular Surgery Treatments and Procedures
Angiography
Angiography is a type of x-ray that takes pictures of the inside of blood vessels. Angiography can help a physician determine whether the blood vessels are blocked, damaged, enlarged (aneurysmal) or abnormal. Starting from an access point such as a patient’s groin area, the surgeon inserts a catheter through an artery or vein leading to the patient’s body area of interest. Then the physician will inject a liquid, sometimes called "dye", “contrast material” or “contrast agent” to make the blood flowing inside the blood vessels visible on an x-ray. Patients’ bodies later eliminate this contrast material from their bodies through their kidneys and their urine.
Angioplasty and Stent Placement
Angioplasty is a medical procedure in which the surgeon inserts a small balloon on the tip of a catheter into a blood vessel in or near the narrowed or blocked blood vessels. The surgeon inflates the small balloon, thus widening or opening the blocked vessel and restoring adequate blood flow. It is not considered to be a type of surgery. Usually, the surgeon also inserts a tiny, tube-shaped or threadlike expandable coil called a stent at the same site of narrowing or blockage to hold the artery open. Many stents are made of self-expanding, stainless steel or other metal mesh fabric.
Endovascular stent grafts to repair abdominal aortic aneurysms
A relatively new endovascular grafting technology, approved by the FDA in 1999, can often substitute for surgery to repair an AAA. The surgeon makes a small cut in patient’s groin area and then threads a catheter through blood vessels. During the procedure, the surgeon will use live x-ray pictures on a video screen to guide and then position a tiny, tube-shaped or threadlike, fabric and metal expandable coil called an endovascular stent graft (or endograft), to the site of the aneurysm. The endovascular stent graft holds open the aorta. The aorta is the largest artery in the human body. It carries blood away from your heart artery. The surgeon expands the graft inside the aorta and holds it in place with metallic hooks instead of surgical stitches.
Endovenous Laser Treatment (EVLT)
Endovenous laser treatment is one way to treat varicose veins. Varicose veins are swollen veins that often look blue, bulging, and twisted. The surgeon inserts a tiny fiber that is attached to a catheter into a varicose vein. The fiber sends out laser energy that kills the diseased portion of a varicose vein. The vein closes and the patient’s body eventually absorbs it.
Filter placement to protect against pulmonary embolism
A pulmonary embolism is a blockage in an artery in the lungs caused by an embolus (a free-floating blood clot) that travels through the blood vessels (usually from a vein in a leg or in the pelvic area) to the lungs. Sometimes, the surgeon may insert a catheter in a patient’s body to place a special metal filter in a patient’s main vein, the vena cava. Vena cava filters can trap the clots that break away from a patient’s leg veins before they can reach a patient’s lungs and heart.
Thrombolytic Therapy
Thrombolytic therapy is a treatment used to break up dangerous clots inside a patient’s blood vessels. In thrombolytic therapy, the surgeon may insert a catheter in a patient’s body. Then the surgeon guides a catheter through the blood vessels to the area of the blood clot. The catheter then delivers medications to break up the clot. Another alternative that the vascular surgeon may use is a catheter attached to a mechanical device such as a suction cup, a rotating head to break up a clot, or a high-speed fluid jet to mechanically break up the clot.
