When Does One Need Vascular Surgery?
Vascular surgery is recommended in instances where other types of treatment are deemed ineffective to resolve the issue at hand. For example, a doctor may prescribe blood-thinning medications for blood clots but may opt for surgical intervention if there is a large enough clot that may pose a threat to the patient.
Before undergoing vascular surgery, however, says cardiologist and founder of the Heart and Vascular Institute of Florida, Dr. Irfan Siddiqui, your doctor will perform extensive tests to understand the nature of your vascular problem. Usually, your doctor will pick invasive surgery as a last resort because it often comes with risks associated with any form of invasive surgery.
Who Performs Vascular Surgery?
A vascular surgeon performs vascular surgery. Vascular surgeons are specially trained to understand and navigate the body’s complex vascular system. Unlike other surgeons who perhaps must master only one organ in the body, vascular surgeons must master the entire vascular system that traverses the whole body.
When you come in with a vascular problem, the vascular surgeon will explain to you what surgical options you have for your condition and what each option means in terms of results and risks. Once you settle on a procedure, the vascular surgeon will schedule you for surgery, which may take anywhere from less than an hour to several hours depending on the type of vascular surgery.
What Are the Main Types of Vascular Surgery?
Surgical thrombectomy is performed to remove a blood clot (thrombus) lodged in a blood vessel. The procedure can be done in one of two ways. An endovascular thrombectomy involves the insertion of a catheter or sheath into a major blood vessel which is then guided to the affected blood vessel. The clot is then either sucked out (catheter aspiration thrombectomy) or broken into small pieces (mechanical thrombectomy). Alternatively, the surgeon may perform a surgical thrombectomy where they incise the affected vessel, remove the clot, and then repair the vessel.
Angioplasty, also known as balloon angioplasty, is a minimally invasive surgical procedure used to widen narrowed blood vessels and improve blood flow. Angioplasty is typically used to treat arterial atherosclerosis, says Dr. Irfan Siddiqui, which is characterized by narrowed and hardened blood vessels. In the procedure, the surgeon uses a guide wire to guide a balloon catheter to the affected area. Once positioned, the deflated balloon is inflated to a certain size to force the vessel to expand. The balloon is then deflated and retracted. In some cases, a stent may be installed to ensure the vessel remains open.
endarterectomy is a vascular surgical procedure used to remove hardened deposits (plaque) lining a constricted blood vessel. In the procedure, the vascular surgeon opens the blood vessel, removes the deposits by separating them from the wall of the vessel, then closes the vessel. The procedure is primarily used to treat a constricted carotid artery to reduce the chances of stroke, in which case it is called a carotid endarterectomy.
As the name suggests, says Dr. Irfan Siddiqui, vascular bypass surgery is performed to bypass a damaged or blocked blood vessel. The vascular bypass is indicated in cases where the affected blood vessel cannot be treated or restored, such as in cases of advanced atherosclerosis. In the procedure, the surgeon will use a graft from another blood vessel and stitch it into a conduit that redirects blood to another vessel. Once done, the surgeon may cut out the diseased or damaged vessel.
Atherectomy is a vascular surgical procedure used to treat diseased blood vessels that may have fat or plaque deposits constricting blood flow. In most cases, this technique is used to treat atherosclerosis in what is called atherosclerosis atherectomy. In the procedure, the surgeon inserts a catheter with a sharp blade and chamber at the tip into the diseased vessel. As the catheter proceeds, the blade cuts out fat and plaque deposits, which are deposited in the adjacent chamber. When the catheter is withdrawn, it withdraws with all the material that has been cut out.
What to Expect from a Vascular Surgery?
As with any surgery, there are risks associated with the procedures listed above. However, as tried and tested procedures, they have a high success rate, with patients going on to live healthier and fuller lives. As an experienced cardiologist, Dr. Irfan Siddiqui recommends anyone with vascular pain or disease to see their doctor and discuss the surgical options listed above.