What is Vascular Surgery? Early Detection and Treatment Options

Introduction

Vascular surgery refers to a particular subset of surgical procedures that focus on treating conditions and disorders related to the blood vessels in the body. It is an intricate surgery that targets the arteries, veins, and lymphatic vessels to restore blood flow and function, thus enhancing the patient’s quality of life. Vascular surgery may be recommended in case of advanced disease, or there is a risk of severe health outcomes. Various approaches to performing vascular surgeries include traditional techniques and more advanced, less invasive procedures. 

What is Vascular Surgery?

Vascular surgery is a common surgical approach that involves removing obstructions in blood vessels. Blood vessels form a complex network of veins, artilleries, and capillaries enabling flow of oxygen-rich blood to the various organs and tissues around the body. When this connection to a particular organ or area is blocked, it can lead to significant problems, specific to that region. In some cases, obstruction in blood flow can even lead to a heart attack or stroke. Thus, vascular surgery becomes imperative to remove blockage and restore circulation.

Before doctors can decide upon performing vascular surgery, they order various diagnostic tests. Sometimes medications may be recommended to treat a particular condition. The goal of vascular surgery is to:

• Repair damage to the blood vessels
• Reduce further risk of complications
• Make blood vessels accessible for delivering medical treatments, such as dialysis.

There are different types of vascular surgery approaches to treat different blood vessel disorders.

Indications for Vascular Surgery 

Vascular surgery may be recommended to individuals suffering from any vascular disease that is in an advanced stage or poses a high health risk. These diseases may include peripheral artery disease, carotid artery disease, vasculitis, lymphedema, etc. The following list of diseases requires surgical intervention under vascular surgeons.

• Aneurysms: Aneurysms are weak and bulging areas in the walls of the blood vessels, which can pose a risk of getting ruptured, leading to internal bleeding and potentially fatal consequences. Thus, vascular surgery treatment is required for proper management.
• Peripheral Artery Disease: Narrowing or blockage in the arteries of the legs, arms, or other extremities can lead to reduced blood flow, pain, and tissue damage. Vascular surgery for this condition can help avoid potential complications, such as gangrene, by reinstating proper blood flow.
• Carotid Artery Disease: Carotid arteries supplying oxygen-filled blood to the brain can be subject to narrowing or blockages due to plaque accumulation, necessitating surgical intervention to reduce the risk of stroke.
• Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE): Blood clots forming in the deep veins can break blood flow and get dislodged in the lungs. Vascular surgery can prevent such clots from reaching the lungs.
• Lymphedema: Impairment in the lymphatic system can cause swelling and fluid buildup. Vascular surgery can improve lymphatic drainage.
• Renal Artery Stenosis: Kidney function impairment may occur if there are blockages in the arteries supplying blood to the kidneys. Vascular surgery can help restore blood flow. 
• Traumatic vascular injuries: People may sustain specific serious injuries that damage blood vessels, leading to internal bleeding or compromised blood flow. Surgery enables the repair of the damage and restores circulation.
• Varicose veins: Although in many cases, varicose veins may not require surgical intervention, in severe cases, vascular surgery may be recommended to address concerns of pain, discomfort, or complications like ulcers or blood clots.

Exploring Vascular Surgery Options

Vascular surgery can be performed in open vascular and endovascular surgery. Endovascular surgery is a minimally invasive approach involving making small incisions on the skin, unlike conventional open surgery. It also involves a shorter recovery time, a reduced hospital stay, and a lower chance of adverse outcomes and complications. Open vascular surgery, on the other hand, involves making an incision directly above the target blood vessel to provide direct access. However, with the popularity and flexibility of endovascular surgery using advanced, minimally invasive techniques, open surgery for vascular diseases is now less commonly performed.

The primary vascular surgery types to address various vascular diseases include the following.

• Endarterectomy: In this type of surgery, an artery lining is cleaned of plaque accumulation. It is a frequently used procedure for treating conditions that narrow blood vessels, such as atherosclerosis. 
• Aneurysm repair: This procedure can be performed in both ways. Open surgery replaces the weakened section with a graft, while in endovascular repair surgery, a stent-like device is inserted to reinforce the wall of the blood vessel.
• Angioplasty and stenting: This procedure is minimally invasive and involves inflating a balloon into a constricted or clogged artery. During angioplasty, a mesh-like stent may be inserted to keep the artery open. 
• Bypass Surgery: A bypass surgery involves establishing a fresh route for blood circulation by grafting a blood vessel from different body parts or by using a synthetic material.
• Thrombectomy and Embolectomy: These procedures involve removing blood clots from blood vessels to restore blood flow in the event of an acute blockage. 
• Lymphatic Surgery: This procedure is employed to treat conditions like lymphedema.
• Vascular Trauma Repair: When blood vessels suffer injuries due to trauma, they can be repaired through surgery. 
• Hybrid Procedures: In some complex cases, both conventional and minimally invasive techniques can be employed to optimize outcomes and minimize invasiveness.
• Vascular Access Procedures: This surgery may also be employed to create a channel or suitable entry point for delivering various treatments, such as chemotherapy or dialysis. 
• Varicose Vein Treatments: Various vascular surgery procedures like vein ligation and stripping, laser ablation, and sclerotherapy offer a way out as a varicose veins medical procedure to close off or remove the affected veins to improve circulation in those veins. 

Recovering from Vascular Surgery

While the period of hospital stay depends on the complexity and reason for undergoing vascular surgery, minimally invasive techniques allow shorter recovery time and hospital stay. During the hospital stay, doctors can monitor the patient’s condition, manage pain, and address any immediate postoperative issues. Pain management can be done with the help of medications. Increasing the activity level gradually is essential to prevent complications; assisted movements can be performed under the guidance of the healthcare team. Lifestyle changes may be introduced to boost immunity and maintain a healthy body. Patients may be scheduled for follow-up visits with a doctor to monitor progress, address concerns, and ensure their recovery is on track.

Vascular surgery can be a major surgery, depending on the severity of the condition to be treated. It is possible to have a normal and active lifestyle after surgery. However, sometimes there is an increased risk of stroke, due to which patients should keep screening for any further complications. Early diagnosis and prompt treatment are crucial to optimal recovery from this surgery.