[Vascular surgery] Procedures

Introduction to vascular surgery

Procedures

 

Investigations

• Intravascular ultrasound
• Carotid ultrasonography
• Carotid duplex
• Digital subtraction angiography
• Cerebral angiography
• Venography
• Impedance phlebography

Removal of foreign bodies

• Vascular snare

Aneurysm repair

• Endovascular aneurysm repair (EVAR)
• Open surgery

Revascularisation

• Thrombectomy 
• Angioplasty
• Percutaneous transluminal angioplasty (PTA)
• Stenting
• Endarterectomy
• Carotid artery
• Femoral artery 
• Laser endarterectomy
• Atherectomy 
• Vascular bypass
• Femoral popliteral bypass surgery

Chronic venous disease

• Vein stripping
• Ambulatory phlebectomy
• Sclerotherapy
• Laser ablation

Endovascular surgery vs open surgery

Endovascular procedures are superior to open surgical procedures in several ways: the risk of infection is lower, the trauma inflicted to the overlying tissues is minimal. Studies have shown that in the short-term, endovascular repair of abdominal aortic aneurysm confers signficantly better patient mortality than open surgical repair.

However, endovascular surgery is a younger field than open surgery, and there are several trade-offs, including reduced visibility. Long-term patient mortality is significantly better in patients treated with open surgical repair, than in patients treated with endovascular repair. The increased mortality associated with endovascular repair is largely attributable to secondary aneurysm sac rupture.