Treatments for Peripheral Arterial Disease (PAD)
Angioplasty and Stenting
Angioplasty is a minimally invasive procedure that may be recommended to widen or open narrowed or blocked arteries. An angioplasty usually takes 1-2 hours to perform and can be done on an outpatient basis. During the procedure, a small catheter is inserted into the artery in your arm or groin. The catheter is guided through your arteries to the blocked area. Once in the blocked or narrowed spot, a balloon is inflated and deflated. This pushes the plaque against the artery wall, widening the vessel and increasing blood flow. In some circumstances, your physician may also place a tiny metal tube, called a stent, into the narrowed area to keep it open.
Atherectomy is a minimally invasive treatment used to remove plaque buildup inside of large blood vessels. Typically, the vascular surgeon will access the patient’s blood vessel via a small incision in the groin. A catheter is then advanced to the part of the vessel that has too much plaque buildup. Techniques used to remove the plaque include spinning the catheter in a circular motion, back and forth motion of the catheter, orbital devices advanced inside of the catheter, and laser plaque removal. Your physician will discuss with you the best method to use specific to your condition. The advantages of choosing an atherectomy over an endarterectomy include less procedure time, faster recovery, ease of use, decreased complications, and repeatability in the event of future occlusions.
When symptoms are severe and blockages cannot be treated with angioplasty, bypass surgery may be recommended. This surgery, which lasts 2-4 hours, requires a hospital stay, and can treat blocked arteries in the abdomen or leg. A graft is used to create a new path around the blockage for blood to flow to your abdominal or leg tissues. The blocked section of the artery is usually not removed, but blood flows around it, bypassing it entirely.
Treatments for Carotid Artery Stenosis (CAS)
Carotid Artery Stenting
Carotid stenting is a procedure that is done in a hospital setting where a metal stent is placed into the carotid artery, which opens up the narrowed area and wedges the plaque against the arterial walls. This opens the carotid artery. Imaging is done at the time of the procedure to ensure proper stent placement.
This is a surgical procedure that is effective for narrowing and plaque buildup in the carotid artery. It involves making an incision in the neck and opening up the artery to remove the plaque. A tube is placed into the artery during the procedure to maintain blood flow, and a patch is then used to close the artery.
Treatment for Abdominal/Thoracic Aortic Aneurysms
Abdominal Aortic Aneurysm (AAA) Repair
AAA repair is a standard surgical treatment which is performed in a hospital setting to replace the section of the aortic vessel where the aneurysm has formed. It generally takes 2-4 hours to complete. An incision is made in the abdomen, and the portion of the aorta that is affected is replaced with a synthetic graft. This requires a hospital stay of several days to ensure close monitoring for any complications.
Endovascular Stent Grafting
EV Stent grafting is an alternative procedure in a hospital setting that takes 2-4 hours, and involves placing a stent graft inside the diseased vessel. This requires an overnight stay, and is used for patients who may be poor surgical candidates or prefer not to undergo conventional surgery. The stent graft is placed inside the aorta at the site of the aneurysm using a delivery catheter. This catheter is positioned into the aorta and the stent is expanded to a preset size. After expansion, the catheter is withdrawn. Imaging allows the physician to verify that the graft is in proper placement at the area of the aneurysm.
Treatments for Deep Vein Thrombosis (DVT)
Blood Thinners (anticoagulants)
The duration of blood thinner treatment depends on the severity of the thrombus, or clot. Generally, blood thinners help to keep the clot from becoming larger as your body attempts to break down the clot over time. Blood thinners may be started as IV infusions or shots, and transitioned to oral medications, the most common one known as Coumadin.
For extensive blood clots, a minimally invasive procedure known as a catheter directed thrombolysis can be performed. Clot busting medications are placed directly into the clot with a catheter that can immediately break down the clot. Angioplasty and stenting may also be used in conjunction with this technique if abnormal lesions are found.
Inferior Vena Cava (IVC) Filter Placement
An IVC Filter is an umbrella like device that is placed into the inferior vena cava between a clot in one’s leg and the lungs. If a clot were to break off from the legs and travel toward the lungs, it would be trapped by the filter. IVC filters are removable, and this can be done as an outpatient procedure once the risk of DVT and/or PE is minimal or nonexistent.
Treatment for Varicose Veins and Venous Reflux/Spider Veins:
Elastic stockings can be work to compress the superficial veins in the legs. This forces blood out of the surface vessels and deep veins, and brings it back to the heart. This improves swelling and may reduce the new formation of varicose veins, but does not cure existing ones. Compression hose are also used in conjunction with our other treatment options for varicose veins and spider veins.
This is an effective procedure for the elimination of spider veins. It involves injecting a chemical agent into the superficial diseased veins along with compression hose to help collapse the vessels. The vein stops carrying blood and therefore disappears with time (usually 2-4 weeks). It is done in conjunction with compression hose, and an average of 3-4 treatments is usually required for optimal results.
This is an effective, minimally invasive outpatient procedure for varicose veins that involves making tiny incisions in the leg to remove short segments of damaged varicose veins. Recovery time is minimal, and it is an effective alternative for those who may not be candidates for the more common Venefit Procedure.
The Venefit Procedure (formerly known as the VNUS Closure Procedure) is a popular and effective, minimally invasive outpatient procedure for the treatment of varicose veins, venous reflux and venous insufficiency. Most insurance companies have recognized treatments for venous reflux and painful varicose veins to be medically necessary if you have attempted conservative treatment for 3 months without relief (elevation, compression hose, exercise and weight control). Please review the Venefit Procedure tab on our website to find out more about this exciting and effective treatment option. For more information on VENEFIT Procedure.