Let's learn about vascular surgery in a simple way.

Our body is like a busy city. This city has a system of roads that carry essential things, such as oxygen and nutrients, to every part of it. These roads are what we call "blood vessels" or "blood vessels." Sometimes these roads get damaged, become blocked, or become weak and close to bursting. That's when we need specialist help to repair these roads. In medicine, the field that deals with this work is called Vascular Surgery.

Simply put, what is vascular surgery?

Vascular Surgery is not a single surgery. It is a general term for a variety of surgeries and treatments that involve the blood vessels in our body, namely arteries (the vessels that carry blood from the heart), veins (the vessels that return blood from the body to the heart), and capillaries (the very fine blood vessels) .

Sometimes these conditions can be managed with lifestyle changes and medication, but in some cases, surgery is necessary to prevent the condition from getting worse.

There are three main goals of vascular surgery:

• Repairing damage to blood vessels.
• Reducing the risk of dangerous complications caused by these diseases.
• Preparing vascular access routes for treatments such as dialysis for kidney patients.

What conditions require vascular surgery?

If you have one or more of the following conditions, you may need vascular surgery. You may have heard of some of these.

• Aortic aneurysm: The largest artery in our body (aorta) weakens and bulges like a balloon.
• Blood clots: Blood clots, especially in the deep veins of the legs (Deep Vein Thrombosis - DVT).
• Carotid artery disease: Fatty deposits block the arteries in the neck that supply blood to the brain.
• Varicose veins: Swollen, blue veins in the legs that appear above the skin.
• Peripheral artery disease (PAD): A blockage of the arteries that supply blood to the arms and especially the legs due to fatty deposits.
• Renal artery stenosis.
• To establish an access route for dialysis.

A vascular surgeon will examine your condition and decide what treatment is best for you.

What are the main types of vascular surgery?

There are many different types of surgeries used to treat different medical conditions. Let's take a look at some of the most commonly performed surgeries.

Aortic Aneurysm Surgery

If the aneurysm becomes too large, or if there is a risk of it rupturing, surgery is performed.

• Open Aneurysm Surgery: An incision is made in the chest or abdomen, the damaged part of the artery is removed, and an artificial tube (graft) is implanted in its place.
• Endovascular Aneurysm Repair (EVAR): This is a surgery performed through a small incision. A small tube (catheter) is inserted through the groin, through which a metal frame-like artificial tube (stent graft) is passed into the bulging area, strengthening the artery from the inside.

Treatment for Peripheral Artery Disease (PAD)

This treatment is used if you experience intermittent claudication (pain that feels like a rolling motion when you walk) due to narrowed arteries in your legs, or if your wounds have not healed.

• Angioplasty and stenting: A catheter is inserted into the blocked artery, inflated, and the blockage is widened. A mesh-like device (stent) is then inserted to keep the blockage from reoccurring.
• Peripheral artery bypass surgery: Just like when a road is blocked, a new route is created to bypass the blocked blood vessel. This is done using another healthy vein or an artificial tube from within the body.

Surgeries for problems with the carotid arteries

This blockage of the artery is a major risk factor for stroke.

• Carotid endarterectomy: A small incision is made in the neck, the artery is opened, and the fatty layer (plaque) that has built up inside is surgically scraped away.
• Carotid angioplasty and stenting: As mentioned earlier, a balloon and a stent are used to widen the blocked area.

Treatment for diseases related to veins

When the valves in the veins in the legs become weak, blood pools in the legs instead of returning to the heart. This causes swelling, pain, and varicose veins.

• Vein ligation and stripping: A common treatment for varicose veins. In this procedure, the diseased vein is completely removed surgically.
• Endovenous thermal ablation: Without a large incision, a laser or high-frequency radio waves are used to burn and seal off the diseased vein from the inside. This then stops blood flow through the vein.
• Sclerotherapy: A treatment for small varicose veins and spider veins. A chemical solution is injected into the vein and sealed off.

What happens before, during and after the surgery?

Before the surgery, your doctor will perform a complete examination of you, perform any necessary blood tests, scans (such as Doppler ultrasound, CT angiogram), and give you instructions on what you need to do to prepare for the surgery.

• You may be asked to temporarily stop taking some medications (especially blood thinners).
• You will be asked to fast from the night before the surgery.
• If you smoke, it is very important to stop completely a few weeks before surgery.

There are two main types of surgery. Your doctor will choose the method that is right for you.

The recovery time after surgery depends on the type of surgery performed. Some major surgeries may require a few days in the intensive care unit (ICU). After a minor procedure like sclerotherapy, you may be able to go home the same day.

What are the benefits and risks of these surgeries?

Main advantages:

• Some of these are life-saving surgeries.
• It greatly improves your quality of life (e.g., being able to walk without pain).
• Dangerous complications such as stroke and heart attack can be prevented .

Possible risks:

• Allergy to anesthesia or the dyes used.
• Bleeding.
• Blood clots.
• Infections at the surgical site.
• Nerve damage.

The risk may vary depending on factors such as your age, the presence of other medical conditions (diabetes, kidney disease), etc. Your doctor will discuss all of these things with you clearly before the surgery.

When should you see a doctor after surgery?

If you experience any of the following symptoms during your recovery after surgery, notify your doctor immediately or go to the Emergency Department (ETU) at the nearest hospital.

• Bleeding or pus from the surgical wound, redness and swelling, and severe pain.
• Fever.
• Numbness or extreme pain or swelling in the arms or legs.
• Severe pain in the chest, abdomen, or back.
• Coughing up blood or green/yellow mucus.
• Difficulty seeing or speaking.