Vascular & Endovascular Intervention

These minimally invasive medical procedures are used to treat various conditions affecting the blood vessels. Vascular interventions are open surgery in which the surgeon makes an incision to access the blood vessel being treated. In endovascular interventions, the surgeon inserts tiny instruments through small incisions and operates minimally invasively with the assistance of guided imagery.

Carotid Stenting

Located on each side of your neck, your carotid arteries are the main conduit for blood to your brain. When these arteries become clogged with fatty deposits (plaque), you develop a condition known as carotid artery disease. Over time, clogged arteries can slow or even block blood flow, causing a stroke.

In earlier years, the treatment for carotid artery disease was plaque removal through an open surgery procedure called carotid endarterectomy. Today, physicians treat carotid artery disease with minimally invasive carotid stenting whenever possible.

During the procedure, a catheter with a small balloon at its tip is inserted into the femoral artery in the groin and threaded up to the carotid artery in the neck with the help of guided imagery. Once the catheter reaches the narrowed area, the balloon is inflated to open up the artery and a stent is placed to keep the previously blocked blood vessel open.

Thoracic & Abdominal Aortic Stent Graft Repair

The aorta starts at the left ventricle of the heart. It travels down through the chest, where it is known as the thoracic aorta, and then passes through into the abdominal cavity where it's called the abdominal aorta. Aneurysms, bulges or weak spots in the aorta’s walls, can occur anywhere along the aorta. Thoracic and abdominal aortic stent graft repairs are endovascular aneurysm repairs (EVAR) that treat aneurysms in different parts of the aorta.

Thoracic endovascular aortic repair (TEVAR) is a minimally invasive, catheter-based procedure to treat aneurysms in the chest, especially the descending aorta.
Endovascular repair of an abdominal aortic aneurysm (EVAR) treats aneurysms in the abdomen.

TEVAR and EVAR are safer and less invasive than open surgery techniques, and may reduce the risk of complications, length of hospital stay, and time under anesthesia. Both procedures are performed under general anesthesia.

The access point for surgery depends on the location of the aneurysm.

Guided by fluoroscopy (real time X-ray) the surgeon guides a stent graft to the site of the aneurysm via a catheter, fluoroscopy (real-time X-ray). Once in place, the stent graft is expanded to fit the aorta, cover the aneurysm, and support the weakened section. Patients typically spend a few days in the hospital and can return to normal activities relatively quickly compared to open surgery.

The aorta starts at the left ventricle of the heart. It travels down through the chest, where it is known thoracic aorta, and then passes through into the abdominal cavity where it's called the abdominal aorta. Aneurysms, bulges or weak spots in the aorta’s walls, can occur anywhere along the aorta.

Renal/Mesenteric Stenting

When people think of atherosclerosis, or hardening of the arteries, they tend to think of stroke or heart attack risk first. However, narrowing of the renal arteries that carry blood to the kidneys can also have dangerous consequences. Renal artery blockages affect how blood flows to your kidneys. When blood can’t get to your kidneys, fluid builds up in your body. This results in a type of high blood pressure called renal hypertension, which can lead to kidney failure.

Renal artery stenting is a minimally invasive catheter-based procedure that helps preserve kidney function by improving blood flow through the renal arteries. The procedure also may lower blood pressure.

Lower Extremity Angiography & Intervention

Lower Extremity Angiography is a test to assess the health of blood vessels in the legs and feet, identify blockages or narrowing, and evaluate blood flow. This test is performed via a catheter and uses contrast dye to make the blood vessels visible through fluoroscopy. Lower Extremity Angiography can help diagnose chronic limb ischemia, peripheral artery disease (PAD), and blockages or aneurysms. It also informs pre-surgical planning. Angiography provides guidance for lower extremity interventions to remove blood clots and blockages and open up narrowed arteries.

Limb Salvage Surgery for Peripheral Artery Disease

Peripheral artery disease (PAD) is a common condition in which narrowed arteries reduce blood flow to the arms or legs. Advanced PAD can cause sores, infections, and even gangrene. Limb salvage surgery aims to restore blood flow to an affected arm or leg. Types of limb salvage surgery include:

Angioplasty, a catheter-based approach using a balloon stent to clear a blockage and keep a vessel open.
Atherectomy, a catheter-based procedure in which a blade or laser at the end of the catheter is used to cut or scrape out plaque. This is often combined with an angioplasty.
Peripheral Artery Bypass/Endarterectomy, a procedure for addressing a bypass too severe to treat via catheter. Instead, the surgeon clamps the vessel above the blockage and removes the damaged area. Then, the two ends of the vessel are reattached. Sometimes, a vein graft from another part of the body may be used to reconnect the vessels.

Percutaneous Bypass (PTAB)

A collaboration between a vascular surgeon and an interventional cardiologist, this procedure combines the benefits of a surgical bypass with an endovascular approach. PTAB is used to treat a blockage in the popliteal artery in the leg by creating a bypass through the adjacent femoral vein. The surgeon inserts a stent from the top of the blockage into the femoral vein, and back into the popliteal artery, effectively bypassing the blockage. PTAB does not require general anesthesia, or an overnight hospital stay.

Carotid Stenting

Thoracic & Abdominal Aortic Stent Graft Repair

The aorta starts at the left ventricle of the heart. It travels down through the chest, where it is known thoracic aorta, and then passes through into the abdominal cavity where it’s called the abdominal aorta. Aneurysms, bulges or weak spots in the aorta’s walls, can occur anywhere along the aorta. Thoracic and abdominal aortic stent graft repairs are endovascular aneurysm repairs (EVAR) that treat aneurysms in different parts of the aorta.

Thoracic endovascular aortic repair (TEVAR) is a minimally invasive, catheter-based procedure to treat aneurysms in the chest, especially the descending aorta.
Endovascular repair of an abdominal aortic aneurysm (EVAR) treats aneurysms in the abdomen.

The access point for surgery depends on the location of the aneurysm.

Guided by fluoroscopy (real time X-ray) the surgeon guides a stent graft to the site of the aneurysm via a catheter, fluoroscopy (real-time X-ray). Once in place, the stent graft is expanded to fit the aorta, cover the aneurysm and support to the weakened section. Patients typically spend a few days in the hospital and can return to normal activities relatively quickly compared to open surgery.