Understanding Vascular Surgery

Carotid endarterectomy, one of the mostly commonly performed vascular operations, is intended to reduce the risk of crippling or life-threatening strokes by removing plaque from the wall of the artery that supplies the brain. Clots or bits of plaque can break off and block blood flow to the brain, causing a stroke.

A carotid endarterectomy can be performed under general anesthesia or local anesthesia with sedation. Your surgeon makes an incision to expose the blocked blood vessel and clamps a portion of the artery. An incision is then made into the artery, and the surgeon removes the plaque by peeling away the inner lining of the diseased blood vessel.

Patients are typically discharged the day after the procedure.

There are some risks associated with a carotid endarterectomy. The risks, while rare, include:

• Stroke
• Restenosis, or reblockage of the artery
• Temporary hoarseness
• Temporary difficulty swallowing

Angioplasty stenting is a surgical procedure to treat narrowing or blockage of a blood vessel. Angioplasty stenting is most often used to treat peripheral arterial disease, in which clogged arteries cut blood flow to limbs or organs other than your heart.

Your surgeon will make a small incision in the artery in your groin and insert a catheter into the blood vessel, guiding it through the artery, using a type of X-ray. A balloon catheter will follow the guide catheter, and the surgeon will partially inflate the balloon with liquid to widen the narrow section of artery.

Oftentimes, a tiny mesh tube, called a stent, is placed in the artery to support the walls and keep it open.

There are some risks associated with angioplasty stenting. The risks, while rare, include:

• Restenosis, or reblockage of the artery
• Dissection, or damage to the lining of the artery
• Embolization, or blockages in arteries downstream from the treated artery

Those being treated for kidney failure commonly undergo dialysis, also known as hemodialysis, in which a dialysis machine removes impurities from the blood. Dialysis access is a minor surgical procedure to make the dialysis treatment more efficient, safer and more comfortable for the patient.

Your surgeon will create dialysis access using one of two methods:

Fistula: By surgically joining an artery and a vein, most commonly in the forearm, the blood flow through the vein increases and the vein expands and strengthens.

Graft: A small plastic tube or, rarely, a piece of vein from your leg, is used to connect the vein and artery. Grafts are ready to use more quickly than a fistula, but are more prone to infection.

While rare, there are some risks associated with dialysis access procedures. The risks include:

• Numbness in the hand caused by the diversion of the blood flow, a condition sometimes called “a steal”
• Bleeding
• Infection
• Clotting