Think of the network of blood vessels throughout our bodies as being like the roads throughout a city. It is along these roads that blood travels from our heart to every corner of our body. So what happens if there is a blockage, a rupture, a break, or some other problem in these roads? The entire traffic is disrupted, right? Similarly, when there is a problem with our blood vessels, we simply call the special surgeries performed to treat it `(Vascular Surgery)`.
Simply put, what is 'Vascular Surgery'?
Vascular Surgery is a general term for surgeries and treatments that involve the blood vessels (arteries, veins, and capillaries) in our body. It is this network of blood vessels that carries blood from our heart to all the other organs and tissues in the body, and brings blood back to the heart.
These blood vessels can be damaged by various medical conditions. Sometimes these conditions can be managed with lifestyle changes and medication. However, in some cases, you may need surgery to stop the problem from getting worse.
These surgeries mainly involve:
- Repairing damage to blood vessels.
- Reducing the risk of serious complications that can occur due to these conditions.
- Creating access to blood vessels to facilitate medical treatments such as dialysis for kidney patients.
In what conditions is 'Vascular Surgery' necessary?
If you have one or more of the following conditions, you may need vascular surgery. The best decision about this is made by your doctor.
| Condition | A simple explanation |
|---|---|
| Aortic Aneurysm | The aorta weakens and bulges like a balloon. |
| Blood Clots | Blood clots inside blood vessels. |
| Carotid Artery Disease | Blockage of the main artery (carotid artery) in the neck that supplies blood to the brain. |
| Deep Vein Thrombosis (DVT) | A blood clot in a vein deep inside the body. |
| Peripheral Artery Disease (PAD) | Fat deposits block the veins that carry blood to parts of the body, such as the legs and arms. |
| Varicose Veins | The veins in the legs become swollen, blue, and visible on the surface. |
| Renal Artery Stenosis | Narrowing of the arteries that supply blood to the kidneys. |
These surgeries may be necessary for many other diseases like this. Your doctor will carefully examine your condition and decide whether surgery is necessary along with medication.
What are the main types of surgeries?
There are many different surgeries and procedures to treat blood vessel problems. The type of surgery you need will depend on your condition. Let's talk about some of the main types.
1. Aortic Aneurysm Repair
If the largest blood vessel in our body (the aorta) becomes weak and inflates like a balloon, it needs to be repaired before it bursts. This is the surgery that is performed for that.
- Open Aneurysm Surgery: This involves making an incision in the chest or abdomen, removing the damaged blood vessel, and replacing it with an artificial tube (graft).
- Endovascular Aneurysm Repair (EVAR): This involves less surgery. A small hole is made in the skin, a wire mesh tube called a stent graft is inserted through the hole, and blood flows through the new tube.
- Thoracic Endovascular Aneurysm Repair (TEVAR): This is similar to `(EVAR)`, but is done for aneurysms in the aorta in the chest area.
2. Treatment for Peripheral Artery Disease (PAD)
PAD is a condition in which plaque builds up in the arteries that carry blood to the legs and arms. This can cause symptoms such as pain in the legs when walking.
- Angioplasty and Stenting: This involves inserting a small balloon into the blocked blood vessel and inflating it to widen the vessel. Then, a small wire mesh ``stent`` is placed inside to keep it from getting blocked again. It's like cleaning a blocked water pipe and putting a small tube inside to keep it from getting blocked again.
- Atherectomy: This involves using a small blade at the end of a catheter (a thin tube) to scrape away the fatty deposits that have built up on the walls of the blood vessels.
- Peripheral Artery Bypass Surgery: This involves opening up a blocked blood vessel and creating a new path for blood to flow. This involves using another healthy blood vessel from within the body or an artificial tube. It's like building a bypass to bypass traffic on a road.
3. Treatment for Carotid Artery (neck vein) problems
Carotid artery disease is a condition where fatty deposits build up in the main arteries in the neck that supply blood to our brain. This can lead to dangerous conditions like stroke.
- Carotid Angioplasty and Stenting: As mentioned earlier, this artery is widened with a balloon and a stent.
- Carotid Endarterectomy: In this, a small incision is made in the neck, the artery is opened, the fatty layer inside is removed, and the artery is stitched back together.
4. Treatment for Venous Diseases
The dirty blood in our body is brought back to the heart through veins. The veins, especially in the legs, have valves that help pump blood upward. When these valves become weak, blood accumulates in the legs, causing conditions like ``Varicose veins``.
- Vena Cava Filter Placement: For people with conditions like deep vein thrombosis (DVT), a small filter is placed inside a major vein to stop blood clots from traveling to the heart or lungs.
- Vein Ligation and Stripping: In this, the diseased veins (varicose veins) are surgically cut and removed.
- Endovenous Thermal Ablation: Using laser beams or high-frequency radio waves, the diseased vein is deactivated from within and closed without making a large incision.
- Sclerotherapy: This involves injecting a chemical solution to close off small varicose veins and spider veins.
What happens before surgery?
It's normal to feel a little nervous and anxious before a surgery like this. But remember, your doctor and medical team will explain everything to you.
Your doctor will examine you carefully before surgery.
- Medical history: Talk about your symptoms, previous illnesses, medications you take, and any allergies you have.
- Tests: Various tests required for the surgery will be ordered. For example, tests like `(Angiogram)`, `(Doppler ultrasound)`, `(Echocardiogram - echo)`, `(Electrocardiogram - EKG)`.
- Your preparation: There are a few things you can do before the surgery.
- The doctor will ask if you need to stop taking any of the medications you regularly take.
- You will be asked to stop eating and drinking the night before surgery.
- If you smoke, you are advised to quit. It is very important to follow these instructions exactly.
Two surgical methods: Open and Endovascular
Most vascular surgeries are performed in two main ways. Your doctor will explain which method is being performed on you.
| Surgical method | Description |
|---|---|
| Open Surgery | In this case, the skin is cut lengthwise where the blood vessel to be treated is located, and the surgery is performed by directly accessing that blood vessel. |
| Endovascular Surgery (Minimally Invasive Surgery) | This is a minimally invasive procedure. A small hole is made in the skin, a catheter (thin tube) is inserted through it, and it is guided along the blood vessel to the area to be treated. The recovery time is usually shorter with this method. |
What happens after the surgery? And what are the risks?
What happens after surgery varies greatly depending on the type of surgery you had. Some major surgeries may require a few days in the intensive care unit (ICU). However, after a minor procedure like sclerotherapy, you may be able to go home the same day.
Like any surgery, these surgeries also have some risks.
- Allergies to anesthesia or the materials used.
- Bleeding.
- Blood clots.
- Infection.
- Nerve damage.
- Heart attack or stroke.
This risk may increase depending on the severity of your illness, your age, and other medical conditions you have, such as diabetes. Talk openly with your doctor about this.
I need to see the doctor soon!
If you develop any symptoms of a complication while you are recovering from surgery, you should contact your doctor immediately. Be especially aware of the following symptoms.
| Symptom | What to be careful about |
|---|---|
| Fever, pus discharge from the wound, redness, swelling | These may be signs of an infection. |
| Sudden pain, swelling, numbness in an arm or leg | A blood clot may be a sign of a stroke. |
| Severe pain in the chest, stomach, back, or abdomen | It could be a sign of a serious internal problem. |
| Coughing up blood or yellow/green mucus | It could be a sign of a lung infection. |
| Blurred vision, difficulty swallowing | It may be a sign that the nervous system is affected. |
Vascular Surgery is a very important medical procedure that can save our lives and improve our quality of life. Never be afraid to ask your doctor about any questions you have, no matter how small.
Take-Home Message
- Vascular Surgery refers to surgeries and treatments performed on the blood vessels (arteries and veins) in our body.
- These surgeries are performed in two main ways: 'open surgery', which involves large incisions, and 'endovascular' surgery, which involves small incisions.
- It is very important to follow your doctor's instructions carefully before and after surgery to ensure a speedy recovery.
- If you experience any unusual symptoms after surgery, such as fever, severe pain, or swelling, notify your doctor immediately.
- Talk openly with your doctor about any questions or concerns you have about your surgery.
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