Vascular

surgery

Peripheral Artery Disease (PAD)

Peripheral artery disease, or PAD, is a cardiovascular disease which mainly affects the arteries that carry blood to the legs and feet. In PAD, arteries are narrowed and made less elastic by changes in the artery walls. PAD is caused by “atherosclerosis,” which refers to a buildup called “plaque,” made up of cholesterol, fatty substances, calcium and fibrin (protein involved in the clotting of blood). This buildup reduces blood flow through the arteries and can lead to pain and lack of mobility.

PAD Symptoms

Weakness in legs
Leg pain in the muscles while walking or during mild exercise, which goes away when you rest
Cramps, tiredness or pain in your legs, thighs or buttocks
Skin wounds or sores on your legs, feet, or toes that are slow to heal
Foot or toe pain at rest that often disturbs your sleep

Treatment Options

Angioplasty with Stent Placement is a minimally invasive in-office procedure and is performed by making a small incision through which a catheter is inserted to reach the blocked artery. A tiny balloon is inflated inside the artery to open the clog. A stent — a tiny wire mesh cylinder — may also be implanted at this time to help hold the artery open. Sometimes a medicine can be given through the catheter or a special device can be inserted through it to remove a clot that’s blocking the artery.
Atherectomy is a procedure to remove plaque from the artery.

If there’s a long portion of an artery in your leg that’s completely blocked and you’re having severe symptoms, surgery may be necessary. A vein from another part of the body can be used to “bypass” and reroute blood around the closed artery.

BARD Lutonix035 Drug Coated Balloon
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Phoenix atherectomy hybrid system
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Venous Thrombosis

Blood clot within the veins, usually accompanied by inflammation of the vessel wall. Major consequences are embolization (usually to the lung), & postphlebitic syndrome.

Deep Vein Thrombosis (DVT)

Deep vein thrombosis, or DVT, is a large blood clot that forms in one or more of the deep veins in your body. DVT usually happens in the legs or pelvis, but a clot can form anywhere in your body. Sometimes, part of the blood clot can break off and travel to your lungs. This can block blood flow and cause a pulmonary embolism, which is a serious and potentially deadly condition.

Symptoms

Redness over site
Pain in calf when bending foot toward the head
Swelling
Bluish Discoloration

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Treatment Options

Several medications may be used to dissolve a clot, or to prevent a clot formation
An Inferior Vena Cava Filter (IVC) may be placed using catheters that are inserted into a blood vessel, to prevent clots from traveling to the heart and lungs.
Thrombolysis may also be performed that involves placing a catheter at the sight of thrombus, and infusing clot dissolving medication directly on the sight.

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Pulmonary Embolism (PE)

A serious complication of DVT is Pulmonary embolism (Pe). Some or all of the DVT breaks free from its original site in a vein and travels through the heart into the lungs.

Symptoms

Difficulty Breathing
Chest Pain
Heart Palpitations
Racing Heartbeat

Seek treatment as soon as possible.

Treatment Options

Timely intervention with blood thinners and catheter directed thrombolysis can save tissue and lives.

Aneurysms

Abdominal Aortic Aneurysm (AAA)

A progressive weakening of the aortic wall can cause an Abdominal Aortic Aneurysm (AAA), and without treatment, may continue to grow and rupture if not treated. A ruptured AAA is a life-threatening medical emergency.

Thoracic Aortic Aneurysms (TAA)

TAA is the swelling or ballooning of the thoracic aorta. The aorta is the main artery that carries oxygen-filled blood from the heart to all parts of the body. In the thorax (chest), once leaving the heart, blood travels upward through the ascending aorta, turning into the aortic arch, and branching into the innominate, left common carotid, and left subclavian arteries. These branch vessels carry blood to the heart muscle, arms, shoulders, chest, neck, face, and head (including the brain). Once past the aortic arch, the aorta turns downward into the descending aorta and carries blood to the intercostal arteries, spinal arteries, and ultimately other lower organs and areas of the body

A typical exam will include an Abdominal ultrasound and/or an angiography.

Symptoms

There are usually no symptoms, Unless rupture occurs:
- Abdominal pain
- Shock

Treatment Options

Stenting
Endovascular repair is a procedure for the treatment of abdominal aortic aneurysms. Less invasive than open surgery, it involves excluding (sealing off) the aneurysm by placing an endovascular graft inside of the diseased aorta, making a new path for the blood to flow. The GORE® EXCLUDER® AAA Endoprosthesis remains inside the aorta permanently through the use of metal prongs, or anchors, as well as a tight fit (radial force) against the wall of the aorta.

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GORE® EXCLUDER® AAA Endoprosthesis

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Comformable GORE® TAG® Thoracic Endoprosthesis

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Carotid Artery Disease

Narrowing of the carotid artery due to plaque build-up. The carotid arteries are essential as they supply blood to the large front part of the brain. Over time, this narrowing may eventually become so severe that blockages decrease blood flow to the brain and may tragically cause a stroke.

Symptoms

Contralateral Motor or Sensory Defect
Monocular Blindness
Falls without Syncope
Vertigo
Loss of Coordination
Carotid Bruits

Seek treatment as soon as possible.

Treatment Options

Smoking Cessation
Blood Pressure Control
Use of Antiplatelet Medicine, Statins
Carotid Endarterectomy is a surgical procedure to open or clean the carotid artery with the goal of stroke prevention. It is a durable procedure but not a cure; though rare, blockage can accumulate again.
Carotid Artery Stenting (CAS) is an endovascular procedure where a stent is deployed within the lumen of the carotid artery to treat narrowing of the carotid artery and decrease the risk of stroke.