Vascular Surgery

Conditions Treated:

• Peripheral artery disease
• Carotid artery stenosis
• Renal artery stenosis
• Iliac or femoral artery narrowing

Before the Procedure:

Your doctor will review your medical history and may order tests like an angiogram or ultrasound to find the blocked area. You may need to stop certain medications or fasting instructions before the procedure. This is usually done under local anesthesia, with sedation to help you relax.

After the Procedure:

Most patients go home the same day or the next. You’ll need to take it easy for a few days. Your doctor may prescribe blood thinners to keep the stent open.

• Open Surgical Aneurysm Repair – Through a large incision, the damaged part of the aorta is replaced with a synthetic graft.
• Endovascular Aneurysm Repair (EVAR) – A stent-graft is placed inside the aorta through a catheter to support the vessel wall without open surgery.
• Thoracic Endovascular Aneurysm Repair (TEVAR) – Like EVAR, but used for aneurysms in the chest area.
• Hybrid Aneurysm Repair – Combines open and endovascular methods, often for complex aneurysms.

Medical and Lifestyle Care: For small or slow-growing aneurysms, treatment may focus on:

• Controlling blood pressure and cholesterol
• Quitting smoking
• Regular imaging tests to check for growth

• Sudden, severe, tearing pain in the chest or back
• Weakness or numbness in the arms or legs
• Pain in the abdomen
• Stroke-like symptoms, such as slurred speech or facial droop

• Aortic Surgery
• Open surgical repair
• Endovascular aortic repair
• Thoracic endovascular aortic repair
• Aortic root replacement
• Valve-sparing aortic root replacement
• Hybrid aortic repair
• Arch replacement surgery
• Frozen elephant trunk procedure
• Emergency stabilization and surgical intervention techniques

• Chest pain or pressure
• Leg pain or cramping while walking
• Numbness, weakness, or coldness in the legs or feet
• Sudden vision changes or loss
• Mini-strokes

Treatment depends on where the blockage is and how severe it is. Options may include minimally invasive procedures or open surgery.

• Angioplasty and Stenting – A balloon opens the narrowed artery, and a stent (small mesh tube) is placed to keep it open. This includes procedures for arteries in the legs, kidneys, or intestines.
• Bypass Surgery – Creates a new path for blood to flow around a blocked artery using a graft. Often done in the legs (lower extremity bypass).
• Carotid Artery Surgery – Opens blockages in the neck arteries to prevent stroke.
• Endarterectomy – Removes plaque from arteries outside the neck.
• Thoracic Outlet Decompression – Relieves pressure on a vein in the upper chest to restore blood flow and prevent clots.
• Dialysis Access Surgery – Creates or repairs access points for dialysis, especially if blood clots form in a graft or fistula.
• Revision of Failed Vascular Surgeries – Fixes issues such as narrowing, blockages, or graft failure from past procedures.

• Swelling in one leg, often with redness or warmth
• Pain or tenderness in the leg, especially when standing or walking
• Skin discoloration or visible veins
• Sudden shortness of breath (possible sign of a pulmonary embolism)
• Chest pain or rapid heartbeat (if the clot travels to the lungs)
• Weakness, numbness, or trouble speaking (if the clot affects the brain)

Treatment depends on where the clot is, what caused it, and how severe it is. Options include medication, minimally invasive procedures, and surgery.

• Blood Thinners (Anticoagulation Therapy) – Medicine to stop clots from growing or forming.
• Thrombectomy or Thrombolysis – Minimally invasive methods to remove or dissolve clots in veins or arteries.
• Inferior Vena Cava (IVC) Filter Placement – A filter placed in a large vein to keep leg clots from reaching the lungs, used for patients who cannot take blood thinners.
• Compression Therapy – Special stockings or wraps to reduce swelling and help prevent new clots, especially in the legs.
• Revision of Failed Vascular Surgeries – Fixes problems when earlier clot-related procedures are no longer working.
• Thoracic Outlet Decompression – Used in rare cases of venous thoracic outlet syndrome that cause repeated clots in the upper body.

Symptoms:

• Sudden weakness or numbness in the face, arm, or leg (often on one side)
• Trouble speaking or understanding words
• Vision changes in one or both eyes
• Mini-strokes

Surgical Treatments

• Carotid Endarterectomy – Surgery to remove plaque from inside the carotid artery to improve blood flow to the brain.
• Carotid Artery Surgery – A general term for surgeries to repair or clear a blocked carotid artery.

Minimally Invasive Treatment

• Carotid Stenting – A small mesh tube (stent) is placed in the artery using a catheter to hold it open without open surgery.
• Vascular Stenting – A similar approach used for narrowed arteries, including the carotid artery.

Non-Surgical Treatments

• Medical and Lifestyle Care – Using medicines and healthy habits to slow the disease and prevent stroke. This may include blood thinners, cholesterol-lowering drugs, controlling high blood pressure and diabetes, regular checkups, eating a heart-healthy diet, staying active, and quitting smoking.

• Leg pain, cramping, or heaviness when walking (claudication)
• Numbness, tingling, or coldness in the feet or toes
• Sores, ulcers, or wounds on the legs or feet that do not heal
• Swelling in the legs, ankles, or feet
• Skin discoloration, shiny skin, or hair loss on the legs
• Pain relief when resting or elevating the legs (often a sign of vein problems)
• Weak or absent pulses in the legs

Treatment depends on the cause and severity of symptoms or wounds.

• Lower Extremity Angioplasty and Stenting – Opens narrowed arteries with a balloon and stent to restore blood flow.
• Atherectomy – Removes plaque from artery walls to improve circulation.
• Bypass Surgery – Creates a new path for blood to flow around blocked arteries in the legs.
• Endarterectomy – Removes plaque from inside an artery.
• Thrombectomy or Thrombolysis – Removes or dissolves blood clots in deep veins or arteries.
• Endovenous Ablation – Closes damaged veins to improve circulation in vein disease.
• Sclerotherapy – Uses injections to treat smaller or leftover veins.
• Ambulatory Phlebectomy – Removes visible surface veins through tiny incisions.
• Wound Debridement and Skin Grafting – Removes damaged tissue or adds healthy skin to help ulcers and wounds heal.
• Limb Salvage – Uses advanced treatments to save a limb in critical cases and prevent amputation.

Symptoms:

• Ongoing or sharp pain down the arm
• Tingling or “pins and needles” feeling in the arm or hand
• Headaches, neck pain, or stiffness
• Weakness in the arm, especially in certain positions
• Muscle loss in the shoulder or hand
• Sudden swelling in the arm, often after activities like rowing or weightlifting

Treatments & Procedures:

Our team includes specialists in both thoracic surgery and vascular surgery. We work together to help improve arm function, relieve pain, and get you back to your normal activities. Many surgeries can be done through small incisions, which may help you recover faster. Possible treatments include:

Surgical options might include:

• Complete evaluation by surgical specialists
• First rib removal
• Removal of certain neck muscles
• Thoracic outlet decompression
• Surgery through the armpit
• Surgery above the collarbone
• Repair of veins or arteries
• Balloon angioplasty to open compressed blood vessels
• Releasing pressure on nerves
• Surgery to correct an extra rib in the neck (cervical rib) if present

• Aching or throbbing pain in the legs
• Swelling in the lower legs or feet
• Visible, bulging veins beneath the skin

Treatment depends on the severity of symptoms and whether cosmetic improvement is desired.

• Saphenous Vein Ablation: A minimally invasive procedure that closes problem veins using either endovenous laser ablation or radiofrequency ablation.
• Cosmetic Sclerotherapy: Injections that collapse smaller veins. Can be used on its own or after surgery to treat remaining veins.
• Ambulatory Phlebectomy: Removes surface varicose veins through very small skin incisions.