What exactly is vascular surgery?
Vascular surgery encompasses a wide range of treatments used to treat injuries and abnormalities of the arteries, veins, and lymph vessels. Vascular surgical treatments are conducted on the aorta, as well as arteries and veins in the neck, belly, pelvis, legs, and arms, but not on the heart or brain. Cardiothoracic surgeons operate on the coronary arteries and those that leave and enter the heart, while neurosurgeons (and neurovascular) surgeons operate on intracranial vessels.
Types of vascular surgery
Vascular operations include the following:
- Amputation includes treatments to rescue limbs from illness, burns, infection, and other causes.
- Repair of aneurysms, particularly abdominal aortic aneurysms
- Angioplasty and stenting procedures, particularly those on the renal (kidney) arteries
- Non-coronary (heart) artery atherectomy and endarterectomy
- Embolectomy is a procedure that includes emergency surgery to remove a pulmonary embolism (PE), which is a blood clot in the lung.
- Varicose vein surgery, such as vein stripping, phlebectomy, and spider vein surgery, as well as therapies such as sclerotherapy, are available.
- Vascular access operations, such as the development of an arteriovenous (AV) fistula for dialysis, are examples of vascular access procedures.
Peripheral vascular bypass surgery
A vascular surgeon may choose between open or endovascular surgery depending on the treatment and the patient. Open surgery is more intrusive and usually carries additional dangers for the patient, particularly if the patient has existing health issues. The surgeon, on the other hand, has a clear view of the operating region. Endovascular surgery, also known as endovascular intervention, is often conducted using a catheter and under X-ray supervision. It is less intrusive and has a shorter recovery period than open surgery.
What is the purpose of vascular surgery?
If your disease cannot be addressed with medicine or lifestyle modifications, you may need vascular surgery. If the problem is in its early stages, some vascular surgeons may advise watch-and-wait monitoring in conjunction with certain lifestyle changes, such as stopping smoking or managing diabetes. If your doctor believes surgery is essential, be sure you understand all of the risks and benefits.
Some of the problems that may need vascular surgery are as follows:
- Aneurysm. Endovascular surgery or cautious waiting may be acceptable depending on the size of the aneurysm. Otherwise, open surgery can be required.
- Blood clots. Deep vein thrombosis and PE may need surgery if medicine fails to break the clot or if the patient is in an emergency condition.
- Carotid artery disease Because this illness is a primary cause of stroke, the most effective therapy for advanced disease is open surgery (carotid endarterectomy) to remove plaque accumulation.
- Peripheral artery disease For severe condition, open vascular bypass surgery may be required. Endovascular peripheral bypass surgery may be a possibility.
- Occlusive disease of the renal arteries. Although angioplasty is a possibility, late-stage renal artery stenosis may need open artery bypass surgery.
- Trauma treatment includes techniques to halt internal bleeding (hemorrhage) and repair blood vessel damage.
- Vein disease. There are several vein procedures available to address painful varicose veins, chronic venous insufficiency, and potentially dangerous conditions such as deep vein thrombosis. Spider vein treatment is a kind of vascular surgery.
Who performs vascular surgery?
Vascular surgeons undertake the majority of procedures involving blood and lymphatic vessels, with the exception of those affecting the heart (the coronary arteries) and the brain (intracranial arteries and veins). Patients are cared for by these professionals beginning with examination and diagnosis and continuing with surgical treatment and long-term monitoring. Vascular surgeons will choose the best course of therapy for the patient based on the problem and the stage at which it is detected.
Vascular surgery is also performed by general surgeons and critical care (trauma) surgeons. Prior to 2006, vascular surgery had a separate training programme from general surgery. Doctors may now pursue board certification in vascular surgery on their own. Regardless of the route, the essential abilities and competence are the same.
What is the procedure for vascular surgery?
Surgeons do vascular surgery using both open and endovascular procedures, or a mix of the two. Endovascular surgery provides several benefits when it is feasible, including a faster recovery period and a lower risk of problems since it requires fewer incisions—sometimes only one incision—to reach the treatment region. Not all vascular illnesses can be treated endovascularly, especially if the patient has advanced disease. Open surgery with a bigger incision to reach the treatment region is a more conventional method to vascular surgery that is often needed to make the necessary repairs or remove unhealthy tissue.
Surgeons execute a sophisticated endovascular repair in certain circumstances when invasive open surgery is not required but ordinary endovascular surgery is not an option for the patient. These procedures are not accessible at every hospital.
If at all feasible, inquire well in advance of surgery about the precise technique and surgical approach—open or endovascular—that your surgeon prefers, as well as why. Request as much data and information as you need, including the advantages and disadvantages. When you know your choices and what to anticipate from your surgery, it is simpler to prepare and plan for recovery.
What to anticipate with open vascular surgery?
- The following occurrences are to be expected during open surgery:
- Before surgery, a nurse will accompany you to ensure that you understand and sign the surgical permission form, as well as to answer any questions you may have.
- You will be transported to the surgery room by a member of the treatment team.
- You will be given a general anesthesia and maybe an epidural catheter to relieve your discomfort.
- A catheter in your bladder or a breathing tube to link you to a ventilator may be inserted.
- The surgeon will conclude the procedure by making an incision around the damaged blood vessel(s). The length of the procedure is heavily influenced by the cause for the surgery.
- Stitches will be used to close the incision location.
- Following surgery, you may have an intravenous (IV) catheter line in your arm or hand, as well as tubes connected to collect fluid from the operative region.
- A member of the team will accompany you to a room in the intensive care unit (ICU) or post-anesthesia care unit (PACU) .
Endovascular surgery: What to Expect
- The first stages are similar to open surgery, with a few major differences:
- A local or regional anesthetic will be administered to numb just a portion of your body. A general anesthetic may also be used.
- The location of the incision will be cleansed and shaved. The groin is a typical incision location for gaining access to the femoral artery.
- A guide wire will be inserted when the surgeon makes an incision. The surgeon threads the wire to the treatment region, such as an aneurysm or a blocked artery, using a contrast dye and X-rays to follow its placement.
- When the wire is in the proper position, the surgeon puts a catheter over it. The catheter contains the surgical equipment required to finish the procedure, such as an aneurysm graft or a specialized catheter for balloon angioplasty and stenting.
- To close the wound, you will be given stitches (sutures). When healing is complete, skin sutures may need to be removed.
What are the dangers and problems of vascular surgery?
Every kind of surgery has some level of risk and consequence. Endovascular surgery typically has fewer major problems than open surgery. Discuss the risks and possible problems of the operation with your physician. Open vascular surgery may result in problems.
In general, surgical complications include:
- Allergic or other anesthetic response
- A blood clot may cut off blood supply to your legs or feet, or it might move to your lungs and cause a pulmonary embolism.
- Arrhythmia or heart attack (irregular heart rhythm)
- The graft has become infected.
- During the procedure, there was an injury to the intestines, kidneys, or spinal cord.
- Problems with the lungs
- Endovascular surgery risks and complications
When difficulties emerge, they often involve the following:
- Graft that is obstructed or broken
- Blood leaking around the graft
- Graft propagation
- Infection at the site of the incision
- Damage to nearby blood arteries or organs
- A ruptured artery, aneurysm rupture, renal injury, or paralysis are all possible outcomes.
- lowering your chances of problems
You may lower your chance of several issues by doing the following:
Notifying your healthcare professionals if you have an allergy to anesthetics or contrast dyes.
After your doctor's instructions for physical exercise and wound care following surgery
Notifying your doctor right away if you have any concerns, such as bleeding, infection, fever, or discomfort rise.
Taking your medications exactly as prescribed
What should I do to prepare for vascular surgery?
In preparation for surgery, your doctor will give you specific instructions to follow. Preparations may include the following:
Stopping some of your drugs, such as blood thinners, is a possibility.
Eat or drink nothing for at least eight hours before surgery.
One week before surgery, avoid taking aspirin.
Shaving the surgical spot at least two days before the procedure.
What can I anticipate after my vascular surgery?
It is simpler to plan and prepare for a good recovery when you know what to anticipate. In the days, weeks, and months after your operation, be sure to follow up with your doctor as planned.
How much time will it take to recover?
After open vascular surgery, you can anticipate spending five to ten days in the hospital and three months recovering at home. Maintain a clean and dry surgery area—you may require sponge baths instead of regular showers for a time. You will most likely be hurting, so talk to your doctor about pain relievers. For a week or two, you may need assistance with domestic work and other everyday activities. Do not drive until you have received permission from your doctor.
After endovascular surgery, you will spend two to three days in the hospital and four to six weeks at home recovering before returning to regular activities. You may have fatigue or loss of appetite for up to two weeks after surgery.
Following graft surgery to repair an aneurysm or other vascular damage, you will see your doctor in two weeks. Imaging studies will be performed to ensure that the graft is functioning properly.
Book your appointment with the Meddco app for vascular repair or visit the treatment packages on the Meddco website.