Carotid Surgery Carotid surgery is performed to clear a blockage in the carotid artery and restore blood flow to the brain. Carotid procedures may take the form of an endarterectomy or an angioplasty with stent placement. Surgery is recommended for blockages greater than 70% in asymptomatic patients and for patients with blockages as low as 50% with symptoms. What is carotid endarterectomy?  An endarterectomy surgically removes diseased material and clogged deposits from the inside of an artery to restore normal blood flow. When the procedure is performed on the carotid artery, it is called a carotid endarterectomy. By keeping blood flow open to the brain, a carotid endarterectomy helps prevent the occurrence or recurrence of stroke. The procedure requires hospitalization for 24 hours. The risks of complications is very low with experienced surgeons. The surgeons at the Vein & Vascular Institute have performed well over a thousand of these procedures.
What is carotid stenting? Carotid stenting involves the implantation of a metal mesh tube (a "stent") to hold a clogged artery open so blood can flow through it unobstructed. The stent is put in place using a technique called balloon angioplasty. A small tube known as a catheter with a tiny balloon on the end is inserted into an artery in the groin, snaked up to the carotid artery, and gently expanded, pushing open the blockage and restoring blood flow. The stent is then put in place to ensure that the artery stays open. Stenting is a relatively new procedure for carotid disease and is only recommended for patients with severe stenosis (blockage) who experience symptoms and not candidates for surgery. Long term results from this procedure are still pending. 
Aortic Treatment Aortic Endovascular Stent Grafting  In an endovascular stent-grafting procedure, a small metal cylinder with a synthetic cover called a stent graft is implanted in the artery to provide a strong new vessel wall. The procedure is typically performed through small groin incisions where the device is delivered through the femoral arteries. During the procedure, a thin tube called a catheter is guided up the aorta to the site of the aneurysm. A balloon on the end of a catheter helps fit the stent into place. Then the catheter is removed. The aneurysm generally shrinks around the stent graft as time passes. Hospitalization is typically 24-48 hours.
For more information on stent grafting for aortic aneurysms, visit: Open Aneurysm Repair Open aneurysm repair involves making an incision in the abdomen and sometimes in the groin area as well. The aneurysm is opened and a graft made of synthetic material is sewn in place. Hospitalization is typically required for 5-7 days. Peripheral Artery Disease (PAD) Treatment There are several treatment methods for peripheral artery disease (PAD), ranging from lifestyle changes (e.g. exercise and diet modifications, no smoking, control of blood sugar and blood pressure) and medications (such as antiplatelet drugs, blood thinners and cholesterol-lowering statins) to angioplasty and surgery. Angioplasty procedures are typically percutaneous, which means the procedure is done through a needle stick in the groin blood vessel after local anesthesia is administered. The procedures are usually done as outpatients. Angioplasty and Stenting During an angioplasty, a small tube known as a catheter with a balloon on the end is inserted into the blocked artery and gently expanded. This pushes open the blockage and restores blood flow. The catheter is then removed. A tiny metal cylinder called a stent may be put in place to ensure that the artery stays open. Cryoplasty In this newer angioplasty technique, the catheter balloon is inflated with nitrous oxide which is freezing cold when the balloon opens the blocked artery and freezes the plaque there. The cold temperature helps to prevent vessel injury and recurrence. For more information on cryoplasty, click here.
Atherectomy
Atherectomy refers to a percutaneous procedure where plaque from the artery walls is "shaved off" and removed creating a larger vessel opening for blood flow.
Bypass Grafting This procedure restores circulation by bypassing a blocked vessel-that is, re-routing blood around it. A healthy vein is taken from another part of the body and re-attached, or grafted, above and below the blocked section of the diseased artery. In cases where a vein is not available a synthetic tube is utilized. |
