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Less Invasive Vascular Surgery

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    Posted: 08 Aug 2009 at 1:42pm
Less Invasive Vascular Surgery
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The rapidly developing medical specialty of vascular surgery has been revolutionized by the introduction of less invasive procedures for select vascular diseases and disorders. Endovascular surgery and interventional radiology consist of relatively new less invasive procedures which are done from within the vessel itself. Endovascular surgery/ procedures are performed by interventional cardiologists, interventional radiologists, neurosurgeons, and vascular surgeons with specialized training. Less invasive endovascular procedures are employed to treat or diagnose disorders and disease within a vessel such as an aneurysm ( or an occlusion. Click here to read about the history of angioplasty.

Endovascular surgery/ procedures are done using specialized catheters which are advanced within the vessel (artery or vein), to attempt to repair the area of interest. The placement of the catheter is guided using digital x-ray imaging. Once the area of interest is reached, depending on the disorder, specialized stents, radiofrequency ablation, coils, chemoembolization, and/ or balloons are guided into place through the catheters to repair or restore function. During the endovascular procedure, specialized dye which can be seen under imaging, is injected into the vessel (angiogram) to assist the physician or radiologist in the diagnosis of the vascular disorder (aneurysm, stenosis, bleeding or trauma) and to evaluate perfusion or blood flow to the organ.Many traditional open procedures/ surgeries such as carotid endarterectomy, aneurysm repair, and vascular bypass can now be done using a less invasive endovascular approach. These minimally invasive options may not be appropriate for all patients. Each patient is evaluated on a case by case basis. Check with your health care provider if a less invasive endovasular surgery is an option for your particular case. A shift toward a less-invasive endovascular procedure as an alternative to conventional vascular surgery has reduced the risk of death for patients undergoing repair of dangerous abdominal aortic aneurysms (AAAs), reports a study in the March Journal of Vascular Surgery.

Less invasive endovascular surgeries or procedures have many advantages over traditional open surgery and include: smaller incisions, typically percutaneous (via needle puncture of the skin), less stress on the heart, fewer risks for patients with other diseases, such as coronary artery disease, kidney or lung problems, shorter recovery time, less discomfort, local or regional anesthesia vs. general anesthesia, and a reduced need for blood products post procedure.

Carotid Artery Stenting - access to the carotid arteries is achieved via a catheter in an artery in your groin or arm. Through this access, the interventional radiologist/ cardiologist, vascular surgeon guides specialized catheters ( under x ray visualization ) to the area of blockage in your carotid artery. Once the area of blockage or narrowing is reached, the physician can then insert a device that protects against possible debris plaque that can become dislodged during the procedure ( During the procedure the physician may inject dye that can be visualized radiographically to evaluate the severity of the blockage. Subsequently, angioplasty or ballooning of the blockage is done to attempt to flatten the area until a stent is deployed to keep the area open to blood flow. This less invasive method to carotid artery endarterectomy potentially offers the patient a more rapid and complication- free recovery.

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