Vascular Surgery Procedures
The vascular system is the network of blood vessels - arteries, veins, and capillaries - that carries blood to all parts of the body. Vascular disease is caused by a variety of factors, including family history, age, sitting or standing for long periods of time, pregnancy, smoking, obesity, and certain conditions such as diabetes that affect the heart and vascular system. Although it is a common condition, vascular disease can be serious and even life threatening.
Angiogram, aortogram, and arteriogram are terms that describe procedures performed to identify narrowing or blockages in blood vessels in the body. These procedures show the flow of blood in vessels, usually arteries, in various parts of the body and help determine if there is a narrowing or blockage in the vessels. The results of these procedures ay lead to an additional procedure for treatment.
Specific terms are used when these procedures pertain to certain vessels or parts of the body; those performed at SIR are:
Aortogram—aorta (the main vessel that carries blood to the upper and lower parts of the body)
Carotid angiogram—neck, leading to the brain
Coronary (or cardiac) angiogram—heart (commonly known as heart cath or cardiac cath)
Iliac angiogram—groin, erectile dysfunction (ED)
Peripheral angiogram—extremities (legs or arms)
Popliteal angiogram—lower leg
Upper extremity arteriogram
The procedure is essentially the same for all of these angiograms/arteriograms. A catheter is placed into a large blood vessel and is guided to the problem area using fluoroscopic imaging. Blockages or narrowing become evident as flow of the contrast dye moves through the vessels.
An angiogram can detect several things:
Aneurysm, a weakening or bulge of the wall of a blood vessel that can rupture and bleed, possibly resulting in a stroke or even death
Narrowing or blockage of a vessel, which may require a procedure to open the vessel or eliminate the blockage to restore blood flow
Presence and degree of coronary artery disease
When ordered by a physician with “runoff,” the contrast dye is allowed to go to where the blood flow goes. For example, an "Abdominal Aortogram with Runoff” checks blood flow in the lower abdominal aorta and the legs.
Atherectomy is a minimally invasive procedure to remove atherosclerosis, a buildup of plaque inside the artery wall, from a blood vessel. In this procedure, a catheter with a small sharp blade is inserted to remove the plaque buildup. Atherectomy is an alternative to angioplasty for the treatment of peripheral artery disease, with no evidence of superiority to angioplasty. Angioplasty involves insertion of a catheter and balloon to inflate the artery and compress the plaque buildup. The physician will evaluate the patient and recommend the proper treatment according to the patient's individual circumstances.
Carotid arteriogram is done to assess blockage in one or both carotid arteries prior to carotid angioplasty and stent placement.
Coil embolization, also called coiling, is a technique used to treat a brain aneurysm, which can rupture and cause a stroke or even death. In this procedure, a mesh coil is inserted to fill the ruptured vessel and form a “clot” that treats the aneurysm. Coil embolization is an alternative to traditional clipping, which involves open brain surgery (craniotomy), then locating and clipping away the aneurysm. Coil embolization is minimally invasive and has a shorter recover time than clipping.
Coil embolization performed to treat aneurysm
IVC Filter Placement
IVC filter is a type of vascular filter that is implanted into the inferior vena cava (IVC) to prevent life-threatening blockage in the lung artery (pulmonary embolism, or PE). It is used for patients who are at high risk for developing blood clots in the legs that may travel to the lungs to create the lung blockage.
A varicocele is an enlarged (varicose) vein in the male scrotum, which can cause pain, swelling, and even infertility. A Varicocele Embolization is an image-guided, interventional procedure that uses a catheter to insert a tiny coil and/or embolic fluid to divert the blood flow away from the varicocele. It results in relief of pain and swelling and may improve sperm quality.