Vascular Medicine and Surgery

Our vascular team offers some of the most advanced testing, treatment and surgical procedures in the country. You can read more about all these procedures below.

Abdominal Aortic Aneurysm (AAA) Repair
The aorta is the large artery that transports blood from the heart to the rest of the body. Aneurysms can occur when the abdominal aortic wall weakens and swells like a balloon. The swollen portion can rupture, or blood clots inside can break loose and travel to the feet. Aneurysms can be surgically repaired once they expand to a certain size.

There are two ways to repair abdominal aortic aneurysms: Traditional and Endovascular.
In the traditional method a surgeon makes an incision in the patient's abdomen and repairs the aneurysm by sewing a graft (an artificial tube) to the aorta. This method is considered major surgery and may take several hours to perform. Patients usually must stay in the hospital approximately one week.

The endovascular technique requires two small incisions in the groin area. A stent ( a wire mesh) or graft is inserted into the artery to exclude the aneurysm. The patient's hospital stay is much shorter for this procedure because of the much smaller incisions.

Angiography
A procedure involving the insertion of a catheter (a long, narrow, flexible tube) through a blood vessel in the groin and guided through the arteries in the legs or neck. A dye is injected through the catheter causing the blood flow through the peripheral arteries to show up on X-rays and reveal narrowings or blockages.

Angioplasty
A procedure used to dilate (widen) narrowed arteries. A catheter with a deflated balloon on its tip is passed into the narrowed artery. The balloon is inflated and the artery is widened.

Carotid Endarterectomy (CEA)
A procedure in which plaque (cholesterol buildup) is removed from an artery in the neck that carries blood to the brain. If left unchecked, this plaque can break loose and travel to the brain where it can cause a stroke or mini-stroke. The surgeon makes an incision in the neck and the carotid artery, often inserting a tube (or shunt) to maintain blood flow, and carefully removes the plaque. The artery and incision are then closed.

Carotid Stenting
A procedure where a small catheter (a long, narrow, flexible tube) is threaded through a blood vessel in the groin to the carotid artery (the major artery that feeds the brain) to open up a blocked or narrowed vessel. A balloon is inflated to place a stent (a wire mesh) across the blockage. The stent will become a part of the artery wall as a part of the natural healing process. This is often used in patients considered at high risk for problems with more traditional surgery (see above).

IVC (Inferior Vena Cava) Filter Placement
Some patients are at high risk for developing clots in the legs or may already have them. These clots can travel to the lungs causing a life threatening condition called pulmonary embolism or PE. A wire mesh (the IVC Filter) can be placed in the major vein, called the inferior vena cava, returning blood to the heart from below the diaphragm. This will trap any clots that may break free in the leg while treatment is given to prevent or eliminate the clot. The filter can be removed at a later date or be left in place permanently.

Extremity Bypass Grafting
Lower extremity bypass is a procedure required for blockage in the arteries to a leg. This blockage causes decreased blood flow, which can result in cramping, absent pulses, or sores that do not heal. A leg bypass may be necessary if a long section in the patient's leg is blocked and can't be opened with a balloon angioplasty. The surgeon may use one of the patient's own veins or a synthetic tube to make a detour around the blockage.

Extremity Stent Placement
A procedure used to help keep narrowed arteries open. A small, wire-mesh tube is placed in an artery to form a rigid support and hold the artery open. The stent is not removed but becomes a permanent part of the artery as part of the natural healing process. This procedure is much less invasive than traditional extremity bypass grafting and involves shorter hospital stays.

Minimally Invasive Vascular Surgery
Making small incisions and inserting stents (wire meshes) or grafts (artificial tubes or patches) to repair various blood vessels. This type of surgery typically results in a quicker recovery, less discomfort and a shorter length of stay in the hospital.

Renal Artery Bypass
Occasionally, the blood vessels to the kidneys (called renal arteries) cannot be opened using angioplasty or stenting (see below). In this case, an artificial tube or one of the patient's own veins can be used to create a bypass graft and restore normal flow. This requires making an incision in the abdomen and a longer recovery time.

Renal Artery Stenting
The blood vessels that supply the kidneys are called renal arteries. These may develop blockages leading to problems with hypertension and occasionally kidney failure. A wire mesh called a stent can be placed across a blockage to restore normal blood flow using techniques similar to how we open up the arteries that feed the heart.

Thoracic Outlet Obstruction
Surgical removal of a rib that impairs blood flow (or the nervous system of the upper extremity when it is blocked in the shoulder). This procedure is usually only performed after physical therapy has proved unsuccessful.

Uterine Fibroid Embolization
In this procedure, small catheters (hollow tubes) are passed into the arteries that feed the uterus where the fibroid (benign tumor of the womb) is growing. Small coils are used to cause this artery to occlude and stop any further blood supply to the tumor. The body will then reabsorb the tumor as it dies off. These tumors are usually found by a Gynecologist in the setting of abdominal pain. Once found, a referral is made to the Vascular Surgeon to see if the patient is a candidate for this procedure. If not, then the Gynecologist will usually opt for the open, surgical approach.