What is Vascular Surgery?

What is Vascular Surgery?

Vascular surgery refers to a number of procedures which are performed on the blood vessels. This includes the veins, arteries and capillaries that carry blood to and from the heart. Vascular surgery can be performed in one of two ways:

• Open surgery: Performed through a long incision so the surgeon can access the vessels directly
• Endovascular surgery: A minimally invasive approach in which the surgeon uses very small incisions or punctures to insert a thin tube (catheter) and directs it to the vessels needing treatment.

Cleveland Clinic Abu Dhabi’s team of experienced and knowledgeable vascular surgeons offer a wide range of innovative, minimally invasive options to patients needing vascular surgery.

When is Vascular Surgery Needed?

Vascular surgery may be needed in patients who have vascular disease which has caused damage to the blood vessels. Certain vascular diseases can be successfully treated by lifestyle changes or medication. But in some cases, the damage puts the patient at risk of other complications, and surgery is required to prevent or repair the problem.

Vascular surgery is performed to repair the damage that vascular disease has caused to the blood and reduce the risk of further complications from vascular diseases. It can also help surgeons to create access to the blood vessels, so that therapies such as dialysis can be performed.

Who Needs Vascular Surgery?

Patients with the following diseases may require vascular surgery if other treatment options have not been successful:

• Peripheral artery disease
• Aortic disease
• Varicose veins
• Blood clots
• Deep vein thrombosis
• Carotid artery disease

What Types of Vascular Surgery are Available?

There are many different types of vascular surgeries available to treat many vascular conditions. These range from traditional, open surgery to innovative, minimally invasive procedures.

Thanks to advances in vascular surgery, many cases can now be treated in a minimally invasive way, meaning patient recovery is faster, the procedures are safer, and outcomes are improved.

Examples of surgery for more common vascular diseases include:

Aortic disease:

The aorta is the main blood vessel in the body which carries blood from the heart to the organs. Aortic diseases involve the blockage or enlargement (aneurysm) of the aorta, leading to reduced blood flow. If a part of the aorta becomes weakened or blocked, surgery may be needed to repair it and prevent complications

• .Endovascular aneurysm repair: A minimally invasive procedure to repair an aneurysm, which may be suitable for some patients (including those with an abdominal aortic aneurysm, a rare and complex condition). Very small punctures are made, and a stent is placed in the area needing repair.
• Transcatheter Aortic Valve Replacement (TAVR): Performed in a Hybrid OR, this is a technologically advanced treatment for patients with severe aortic stenosis who are not candidates for open surgery to replace the aortic valve.
• Transcatheter Aortic Valve Implantation (TAVI): A minimally invasive surgical procedure to replace a valve without removing the old, damaged valve. The valve is replaced using catheters inserted through the groin.
• Modified Branch-First Technique: Developed and performed for this first time globally by Cleveland Clinic Abu Dhabi for the surgical repair of the aorta, the procedure greatly reduces the risk involved in aortic aneurysm surgery.
• Open surgery: Traditional surgery involves an incision in the chest to remove and replace the damaged aorta.

Peripheral artery disease:

When plaque has built up inside the arteries, it increases the risk of complications such as blood clots and limb ischemia.

• Angioplasty: A minimally invasive surgery that allows surgeons to widen the artery by inserting and inflating a balloon to open the artery, then placing a stent to ensure it stays open.
• Atherectomy: Another type of minimally invasive procedure which involves the insertion of a catheter with a blade on its end, that allows the surgeon to remove the plaque from the artery wall. A femoral endarterectomy removes plaque from your femoral arteries, going from the groin to leg, and an aortoiliac endarterectomy removes plaque from the lower aorta and iliac arteries.
• Peripheral artery bypass surgery: An open surgery for patients with severe peripheral artery disease. A detour for the blood is created surgically, to avoid the blockage. The surgeon either uses a healthy vessel or an artificial one to make the bypass.

Venous diseases:

The veins in our legs carry deoxygenated blood back to the heart and contain valves to ensure it only flows in one direction. Venous diseases damage these valves, and they don’t work properly, so blood begins to gather in the veins in the legs, which can lead to complications.

• Endovenous thermal ablation: A minimally invasive option for some patients that involves using a laser or radiofrequency to close problem veins, so they no longer carry blood.
• Endovenous non-thermal therapy: Instead of using a laser to close the vein, a glue-like substance is injected.
• Vein ligation: For patients with chronic venous sufficiency, the diseases veins can be removed surgically.
• Bypass surgery: For patients with a blockage in their vein, a graft can be created from healthy veins and used to divert the flow of blood around the blockage.

Carotid artery disease:

Carotid arteries supply blood to the brain. If plaque builds up in these vessels, it can be very dangerous. Vascular surgery reduces the risk of complications (like a stroke) and improves blood flow.

• Carotid angioplasty: Balloons and stents are used to open the blood vessels and restore the flow if blood to the brain.
• Carotid endarterectomy: Involves the removal of plaque from the arteries via an incision in the neck.
• Endovascular carotid aneurysm repair: Stent grafting can repair an aneurysm and provide a safe blood pathway.
• Vascular surgeons also treat carotid body tumors, which are tumors that form in the vessels near the carotid artery.

Learn more about the innovative range of minimally invasive vascular surgery options available at Cleveland Clinic Abu Dhabi, here.