Vascular Surgery

• Aneurysm (bulges in the blood vessel wall)
• Carotid artery disease
• Chronic venous disease
• Chronic wound management
• Chronic total occlusion
• Deep vein thrombosis
• Mesenteric ischemia
• Peripheral vascular disease
• Thoracic aortic disease and thoracic outlet syndrome

Noninvasive testing for vascular disease

We use a full array of  imaging and testing to provide a diagnosis. In a test called an ultrasound, high-frequency sound waves produce detailed images of your blood vessels, so we can assess blood flow. A technician applies gel to the area we’re checking and uses a wand (transducer) to gather images. We offer:

• Carotid duplex: This test can confirm a blockage in the carotid arteries, the arteries in the neck that supply blood to the brain.
• Transcranial Doppler (TCD): We check how much, and how rapidly, blood is flowing to certain areas of your brain.
• Venous Doppler (also called venous duplex): This test can assess the cause of pain or swelling in your legs or arms by checking blood flow in your veins.

Arterial testing

• Arterial Doppler (also called arterial duplex): We evaluate the cause of leg muscle pain when you walk by checking blood flow in your arms or legs.
• Arterial pressures and waveforms: This test also checks arteries that circulate blood to the arms and legs. We use blood pressure cuffs to locate blockages and confirm the cause of muscle pain.
• Abdominal Doppler (also called vascular duplex): We evaluate the blood vessels that carry blood to and away from the abdominal organs. We also check the aorta, the main blood vessel in the body, for bulges (aneurysms) or blockages.

Open vascular surgical procedures we perform

The vascular surgeons are experienced in a range of treatments for blocked or damaged veins or arteries. Your surgeon works with you to choose the right method to address your health issue. You may receive open (traditional) or minimally invasive options, depending on your unique needs and eligibility.

Traditional procedures include:

• Abdominal aortic aneurysm repair: An aneurysm is a bulging, weak spot in the aorta, your body’s largest artery. Your surgeon removes the weakened part of your aorta and replace it with a fabric graft to prevent a rupture. Abdominal repairs fix blockages in your abdomen.
• Thoracic aneurysm repair: Your surgeon removes the weakened part of your aorta and replace it with a fabric graft to prevent the aorta wall from bursting. Thoracic repairs fix blockages in your chest.
• Carotid endarterectomy: Your surgeon opens the carotid artery, which supplies blood to your brain, to remove plaque buildup and prevent a stroke.
• Lower and upper extremity arterial revascularization: Your surgeon reopens or reroutes blocked arteries to restore blood flow to your arms and legs.
• Renal and visceral arterial revascularization: Your surgeon reopens or reroutes blocked arteries that supply blood to the kidneys, spleen, kidney, liver and intestines.
• Vascular exposure for spine procedures: Nuvance Health vascular surgeons work with orthopedic surgeons to prepare the vessels around your spine for surgery.

Endovascular surgical procedures we perform

Nuvance Health specialists perform some vascular procedures inside blood vessels (endovascularly) through a small opening. This minimally invasive approach offers many benefits compared to traditional open procedures smaller incisions and faster recovery. We offer:

Percutaneous transluminal angioplasty (PTA) and stenting

Your surgeon guides a balloon-tipped thin, flexible tube (catheter) through the arteries to the location of the blockage. We inflate the balloon, which pushes plaque against the artery walls and widens the blood vessel. Your surgeon may place a tiny mesh-metal tube (stent) into the narrowed artery to prop it open.

Endovascular aneurysm repair (EVAR)

This procedure corrects abdominal aortic aneurysms in less time than traditional open repair. We make small incisions in your groin and guide catheters with stents to the site of the aneurysm.

Transcarotid artery revascularization (TCAR)

TCAR is a minimally invasive surgical procedure that treats carotid artery disease, or plaque in the carotid arteries. This condition can lead to stroke if left untreated.

TCAR is clinically proven to reduce the risk of stroke during the procedure. Your surgeon uses a device that temporarily reverses blood flow away from the brain. This device can help protect your nervous system while filtering plaque out of the blood.

Thrombolytic (lytic) therapy

Drugs called lytic agents can dissolve clots, reopening blocked arteries in the arms and legs. You receive the drugs through a small catheter in the artery. Lytic therapy may also help preserve the vein’s valve function and prevent pulmonary embolism (a blocked lung artery).

Cosmetic venous procedures we perform

Vascular surgeons at Nuvance Health also perform minimally invasive, outpatient cosmetic procedures to treat varicose and spider veins:

• VNUS Closure®: This catheter-based technique uses radiofrequency to seal the vein shut. It’s clinically proven to cause less pain and bruising than laser or surgical treatments.
• Microphlebectomy: Your surgeon removes larger veins through tiny openings that don’t require stitches.
• Sclerotherapy: We inject medicine to shrink small veins and reroute blood to healthier veins.

Comprehensive care and support for vascular disease

Vascular surgery is part of a customized treatment plan that may include vascular medicine and interventional cardiology. Keeping your blood vessels healthy is a lifelong journey. We support you with follow-up appointments to monitor your blood flow and keep you feeling well.