Has a doctor ever told you, either to someone in your family or to yourself, that you have a "blocked blood vessel" or "a blood vessel is swollen like a balloon"? It's normal to feel very scared when we hear something like that. Many people think that something like this requires a major operation, a large incision, and a long recovery time. But did you know that with the advancement of medical science, there is now a way to treat many of these problems without a large incision, through a very small hole. Today, we are going to talk about that amazing treatment method, which is 'endovascular surgery'.
What is Endovascular Surgery?
Simply put, endovascular surgery is a method of treating diseases that affect the vascular system in our body without making large incisions. Imagine a clogged water pipe in your house. To fix it, you insert a small wire into the pipe and remove the blockage without breaking the wall.
The name "Endo" means "inside." "Vascular" means "related to blood vessels." So when these two are combined, "Endovascular" means "treatment done inside the blood vessels." In this, surgeons insert a thin, flexible tube (catheter) into a blood vessel and then pass through it to repair the problem in the blood vessel. This procedure can restore blood flow to the brain, heart, limbs, and lungs.
What is the difference between traditional surgery and this new method?
Although both methods treat blood vessels, there is a big difference in how the doctor approaches the blood vessel. To understand this difference, see the table below.
| Characteristic | Open Surgery | Endovascular Surgery |
|---|---|---|
| How to access | The surgeon cuts the skin, makes a large incision, and reaches the blood vessel. | A small hole is made in the blood vessel with a needle, and thin tubes (catheters) are inserted through it. |
| Cutting Road | It's big, I need stitches. | Very small (about the size of a pinhead). |
| Bleeding | Relatively high. | Very low. |
| Healing time | It could take weeks or even months. | Very rare, it can return to normal in a few days or weeks. |
| Length of stay in the hospital | A few days or more than a week. | Usually a day or two. Maybe you can go home the same day. |
The most important thing is that your doctor will decide which of these two methods is right for you, considering your medical condition, age, and overall health.
What are the main medical conditions treated with this method?
Endovascular surgery is used to treat a variety of conditions related to the heart and blood vessels. Some of them include:
- Aneurysm: This is a weakening of the wall of a blood vessel, causing it to bulge outward like a balloon. These can occur in the abdominal aortic aneurysm or the thoracic aortic aneurysm, as well as in other blood vessels in the body. This is dangerous because if this aneurysm ruptures, it can cause severe internal bleeding.
- Atherosclerosis: You may have heard of this. Simply put, it is the buildup of cholesterol and fat inside the blood vessels, forming a layer of "plaque." This causes the blood vessels to become narrowed and obstruct blood flow. This is the main cause of diseases like heart attacks and strokes.
- Carotid Artery Disease: The carotid arteries are the two main blood vessels in our neck that carry blood to the brain. When these arteries become blocked, the risk of stroke increases significantly.
- Deep Vein Thrombosis (DVT): This is a blood clot that forms in the veins deep in the body, especially in the legs. The danger here is that if this blood clot breaks loose and gets stuck in a blood vessel in the lungs (Pulmonary Embolism), it can be life-threatening.
- Peripheral Artery Disease (PAD): A condition caused by narrowing of the arteries that supply blood to the limbs, especially the legs. The main symptom is pain in the legs when walking for short distances.
What happens before the surgery?
If you are recommended to have this type of surgery, your doctor will first talk to you about your condition and health history. He or she will then perform a physical exam and order several tests to better understand the problem. For example:
- Ultrasound scan: To see how blood flows inside the blood vessels and where the blockage is.
- Angiography: A special dye is injected into the blood vessels and an X-ray is taken to obtain a clear map of the blood vessels.
- CT scan or MRI scan: Get more detailed three-dimensional (3D) images of blood vessels and surrounding tissue.
- ECG and Echocardiogram: Check the function of the heart.
Based on the information obtained from these tests, the medical team will plan the most appropriate treatment for you.
What are the main types of treatments used in this way?
There are several types of endovascular treatments. Depending on your condition, you will choose one or more of these.
| Treatment method (Procedure) | Simply put, what happens? |
|---|---|
| Angioplasty | A catheter with a balloon is inserted into the blocked blood vessel and the balloon is inflated to widen the blocked area. |
| Stent Placement | After angioplasty, a small metal mesh tube (stent) is placed inside the artery to keep it from getting blocked again. |
| Atherectomy | Scraping away plaque that has built up on the walls of the blood vessels with a special device. |
| Stent Grafting | A tube made of fabric and metal mesh is inserted and fixed inside a weakened blood vessel, such as an aneurysm, to strengthen it. |
| Thrombectomy | Mechanical removal or drug dissolution of a blood clot (thrombus) trapped in a blood vessel (thrombolysis). |
| Embolization | Intentional occlusion of a blood vessel by inserting a small bead-like substance into the vessel to stop bleeding or cut off the blood supply to a tumor. |
What happens after surgery? Watch out for these symptoms!
One of the biggest advantages of this surgery is the quick recovery. Depending on the complexity of the surgery, you may go home the same day (outpatient) or stay in the hospital for a day or two. Most people can usually resume their daily activities after about a month. However, your doctor will give you the best advice on this.
It is very important to attend all follow-up appointments with your doctor after surgery. Also, if you experience any of the following symptoms, inform your doctor immediately or go to the Emergency Department (ETU) of the nearest hospital.
- Severe pain in the abdomen, chest, back, or groin
- Bleeding from the surgical site
- Pain or swelling in the leg or arm
- Dizziness or loss of consciousness
- Numbness or loss of feeling in an arm or leg
- Extreme weakness or fatigue
- Redness of the skin or pus-like fluid draining from the small incision made during surgery
- Fever
Take-Home Message
- Endovascular surgery is an advanced and safe method of treating blood vessels within the body, without making a large incision.
- This can successfully treat many dangerous diseases such as atherosclerosis, aneurysm, and deep vein thrombosis (DVT).
- This method has a shorter recovery time, less pain, and a shorter hospital stay than traditional open surgery.
- Only the doctor who examines you can determine whether this treatment method is appropriate for you.
- If any unusual symptoms occur after surgery, it is very important to seek medical advice immediately without ignoring them.
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