Cerebrovascular and Carotid Artery Surgery
Stroke is the 5th leading cause of death in the U.S. according to the CDC, affecting roughly 800,000 people every year. Plaque build-up in the carotid arteries of the neck contributes significantly to the risk of stroke. Stroke risk may be decreased by treatment of carotid plaque with surgery or stenting when appropriate indications exist. We provide treatment for carotid disease with conventional carotid endarterectomy as well as minimally invasive transfemoral carotid artery stenting and new-age Trans Carotid Arterial Stenting (TCAR). TCAR is the newest advancement in carotid surgery and is done in conjunction as members of the Vascular Quality Initiative registry databank.
Aortic Aneurysm Surgery
An aneurysm is an abnormal widening of a blood vessel that can occur anywhere in the body. Abdominal Aortic Aneurysms (AAA) are the most common aneurysms outside of the brain. Aneurysm rupture results in bleeding that is usually fatal. Most people with AAA have their aneurysm detected while testing for something unrelated. This makes screening for AAA extremely important. The surgeons at the artery and vein institute have advanced training which allows them to treat most of these complex aneurysms with a variety of different available endovascular grafts in a minimally invasive manner. Most patients leave the hospital in 1-2 days with no surgical incisions after total percutaneous Endovascular Abdominal Aortic Aneurysm Repair (EVAR). Ask your physician if screening is right for you, or call us for a consultation.
Hemodialysis Access Surgery
The CDC reports there are 3.9 million adults in the U.S. diagnosed with kidney disease and that it is the 9th leading cause of death. For those with kidney failure, hemodialysis is a lifesaving therapy that filters the blood of toxins. A dialysis access is needed to receive hemodialysis treatments and is the site where is blood removed to be filtered. Dialysis accesses are usually fistulas, grafts, or catheters. Hemodialysis is often life long and generally requires the creation of a fistula or a graft as well as lifelong maintenance to insure proper function – the surgeons at the artery and vein institute can provide all necessary creation and maintenance of these hemodialysis sites avoiding the necessity for multiple physicians and added locations of care. Speak with your primary care physician or nephrologist if currently on hemodialysis or are planning for future hemodialysis.
Limb Salvage and Peripheral Vascular Surgery
Peripheral Vascular Disease (PVD) results from plaque build-up in the arteries that deliver blood to the legs. People may have no symptoms, experience leg pain at rest or with walking, or develop ulcerations on their legs or feet. PAD is a risk factor for heart disease and can lead to limb loss. It has been reported there are greater than 2 million living amputees with the leading cause of amputation being PVD. For these people limb salvage with revascularization may be an option. We perform complex open reconstructions and use cutting edge technology in more minimally invasive techniques to restore much needed blood flow to the lower extremity, such as balloon angioplasty, stenting, and atherectomy. Each person’s case is totally unique, and the surgeons at the artery and vein institute take special interest in limb salvage. We hold positions in area institutes as Director and Co-director of limb salvage programs.
The number of chronic, non-healing wounds in the population is rising along with the average age. Such wounds contribute to a decreased quality of life and an increased risk for limb loss. There are often multiple factors that contribute to the development of wounds that must be addressed to achieve wound healing. Of these factors many people have underlying arterial and/or venous disease that is of the highest priority for treatment to promote wound healing. We provided comprehensive vascular and wound care to expedite a course for earliest recovery. If you or someone that you know is suffering with a non-healing wound, contact us to schedule a consultation.
Varicose Vein and Insufficiency Procedures
Veins are thin walled blood vessels that passively return oxygen depleted blood to the heart and lungs. Valves present in veins function to keep blood moving in one direction at relatively low pressures. When valves fail and permit blood to flow backwards, symptoms may develop resulting in venous insufficiency. Symptoms include leg swelling, heaviness, fatigue, aches, burning, pain, skin changes, varicose veins, and ulcerations. We provide compressive care including compression stockings, wound care, minimally invasive needle based procedures with injectable sclerosants or ablative catheters, and direct removal of symptomatic veins among other more complicated procedures.
Leg Swelling Care
Multiple factors often contribute to leg swelling, which requires a multi-disciplinary approach to your care. In conjunction with your primary care physician we can provide treatment plans for success. We have an onsite accredited vascular lab and can evaluate for underlying vascular disease which could be a contributor to your leg swelling. We offer advanced medical and minimally invasive procedures to help you with essentially no down time. No matter the etiology we can structure a treatment regiment that is tailored to your needs.
Thoracic Outlet Syndrome Surgery
Thoracic Outlet Syndrome (TOS) is a complex medical condition caused by a narrowing in the thoracic outlet where nerves, arteries, and veins exit the underneath the collar bone on their way to the arm. As diagnosis is difficult and symptoms vary in range, many people are left undiagnosed for years. The complex nature of this pathology leaves few surgeons with the expertise to diagnosis and treat this problem. Our surgeons have advanced training and experience with this population of patients and can provide diagnostic evaluations and a variety of different complex operations to treat thoracic outlet patients.
Peripheral Aneurysm Surgeries
The number one aneurysm outside of the brain is an aortic aneurysm, however other smaller blood vessels are also susceptible to aneurysmal formation and can be equally as severe or fatal. Many people do not know they have an aneurysm until it is incidentally discovered on a test ordered for another reason. Many aneurysms follow a genetic inherited pattern and can grow with tobacco use. We provide both open reconstruction operations and minimally invasive endovascular graft placements. Our unique training as vascular surgeons allows unique insight into which options are best for you. If you have been diagnosed or have concern for any aneurysm in the neck, arms, legs, chest, or abdomen contact us.
Chronic Mesenteric Ischemia
Chronic mesenteric ischemia occurs when build up of plaque in arteries restricts blood flow to the intestines. Symptoms include unintentional weight loss, food fear, feeling full early after eating very little food. This pain typically resolves within 1-2 hours. If you have symptoms of chronic mesenteric contact your primary care physician or call us for a consultation. We offer a variety of advanced endovascular techniques with balloon angioplasty and stents to enhance blood flow and alleviate your symptoms, as well as conventional open surgeries when clinically warranted. This differs from acute mesenteric ischemia which is an acute occlusion of arterial blood supply to the intestines. If you have severe, abrupt abdominal pain that persists, seek emergency medical care as left untreated can result in bowel necrosis, sepsis and death. Chronic mesenteric ischemia can progress into development of the more acute form of the disease requiring more emergent intervention.
Deep Venous Thrombosis and Venous Occlusive Disease
A blood clot that forms in a deep vein of the body, known as Deep Vein Thrombosis (DVT), can migrate to the lungs, where it is called a pulmonary embolus (PE). PE can be fatal, and together with DVT are referred to as venous thromboembolism (VTE). The CDC estimates 900,000 cases of VTE per year in the U.S. resulting in approximately 100,000 deaths annually. VTE is the most common cause of preventable death in a hospital setting. Complications of VTE include pulmonary hypertension and post-thrombotic syndrome (chronic pain and swelling of the legs). Risk factors include advanced age, immobility, surgery, trauma, malignancy, pregnancy, clotting disorder, smoking and oral contraceptive use. Symptoms are not always appreciated, but when present may include calf pain or swelling, chest pain, and shortness of breath. Timely diagnosis is crucial to direct therapy. If you have symptoms of DVT, seek immediate medical care. We provide structured care in both the acute management of DVT and the chronic venous sequalae including, but not limited to occlusive disease following DVT. Many of the procedures for DVT and chronic venous occlusion are minimally invasive and require no open operations. In many cases we use a variety of state of the art catheters that are able to both deliver medication to dissolve the clot and aspirate thrombus at the same time. These procedures frequently include specialized stent placement at the same time.
Pelvic Congestion Syndrome
Pelvic congestion or pelvic vein incompetency is an enlargement in pelvic veins in women that causes chronic pain. Pain and/or pressure symptoms may worsen with menstruation, standing, sexual intercourse, or pregnancy. External signs may include swelling or varicosities of the vulva, vagina, buttock, thighs, and legs. Prior pregnancy is a risk factor for development of pelvic congestion syndrome itself. There are a variety of diagnostic tests available to make the diagnosis of pelvic congestion syndrome and we can help make the diagnosis and provide minimally invasive catheter based techniques for treatment. Talk to your OBGYN if you are suffering from chronic pelvic pain or call us to schedule a consultation.
Inferior Vena Cava Filter (IVC Filter) Placement and Removal Procedures
During their peak usage it has been estimated that more than 100,00 IVC Filters were being placed annually. Although intended to be temporary, many of those filters were never removed. The FDA has issued new recommendations since that time to remove unnecessary IVC filters when medically possible. There are still specific indications and good use for IVC filters in select patients who have suffered from Deep Vein Thrombosis. If you have been recommended to have an IVC filter or have one removed contact us as we have advanced training with minimally invasive techniques in both placing and removing safely with great success rates.