Vascular surgery involves the blood vessels and the lymphatic system. This specialty includes the diagnosis and treatment of the arteries, veins, and other circulatory structures.
Operating on these body parts is complex. Because of this, vascular surgeons train to perform testing, evaluation, and surgical treatments on the circulatory system. They also help perform medical therapy and advanced cases like amputations.
Aside from their clinical practice, vascular surgeons take care of their patients and teach people about cardiovascular health. They also show leadership in the operating room and research their specialty.
At present, capable hospitals offer traditional vascular surgery and minimally invasive operations. Some facilities might even employ robots for extensive vein and artery diseases.
What is the history of vascular surgery?
The surgical treatment of the circulatory system evolved rapidly in the past century. But this specialty traces back its roots in ancient times.
- In the second century AD, a Greek surgeon named Antyllus operated on an aneurysm and the aorta.
- In 1507, Leonardo da Vinci drew diagrams of human anatomy, including the circulatory and cardiovascular systems.
- On September 9, 1896, L. Rehn successfully performed surgery on a stabbed heart. This achievement marks the birth of modern heart surgery.
- Nikolai Korotkov is a pioneer of modern vascular surgery. He is a surgeon in the Russian Empire during the early 20th century. In 1905, Korotkov invented how to measure blood pressure.
- In 1955, surgeons performed a homograft implant procedure for a thoracic aneurysm for the first time.
- In 1964, Charles Dotter and Robert Paton invented minimally invasive angioplasty.
- Edwin Wylie started training future vascular surgeons in the 1970s. He also encouraged the medical community to recognize it as a specialty in the United States.
Eventually, vascular surgery became separated from general surgery. First-world countries established societies and training programs for this specialty.
These include organizations like the Australia and New Zealand Society of Vascular Surgeons and the Melbourne Vascular Surgical Association. The Royal Australasian College of Surgeons, the primary surgical society in the continent, encourages and monitors these specialty organizations.
Vascular surgery now includes laser treatment and non-operative treatments. Its patients recover quicker, so they no longer have to stay at the hospital much longer. Most importantly, these latest technologies have less risk of complications and death.
What are the examples of vascular surgery procedures?
Because the circulatory system encompasses the entire human body, vascular surgeons perform numerous operations. Here is a list of the typical vascular surgeries offered in hospitals today:
- Aortic aneurysm repair. In this disease, the aorta bursts, making blood leak into other sections of the heart. In this repair procedure, the surgeons implant a grafted tissue onto the aorta.
- Aortocaval fistula repair. A fistula abnormally links two organs or blood vessels through an ulcer or infection. In this rare and deadly vascular disease, an aneurysm erodes the inferior vena cava. So surgeons directly suture the fistula to close the rupture.
- Arteriovenous malformation surgery. Blood vessels in the brain may become entangled, posing a fatal risk. This surgery aims to remove this malformation by opening the skull and removing the clogged connections.
- Bypass surgery. A clogged coronary artery leads to heart attack and death. In this procedure, the surgeons remove a blood vessel from the patient’s leg or arm. Then, they will graft this into the heart to redirect the blood flow there.
- Carotid angioplasty and stenting. Fats and plaque can get stuck in the carotid arteries, the blood vessel to the brain. Once these arteries clog, the patient can suffer from a stroke. Surgeons insert a tiny sac or coil in the affected artery to resume blood flow to the brain.
- Carotid endarterectomy. If the carotid artery is severely blocked, stroke comes next. To avoid this, surgeons may open the patient’s neck and carotid arteries. Then, they will remove the plaque of fats.
- Coronary angioplasty and stents. Clogged coronary arteries can be deadly. The plaques of fats in the heart may even cause blood clots and heart attacks. This surgery widens a blocked artery and improves blood flow.
- Endovascular reconstruction. This operation grafts a new blood vessel into a damaged artery. Endovascular reconstruction also involves inserting a tube into the aorta if it is already weak.
- Endovenous laser therapy. Varicose veins are enlarged and swollen blood vessels that appear on the thighs. These veins are not just unappealing, but they are also painful. Through laser and heat, surgeons can shrink and relieve varicose veins.
- Inferior vena cava filter retrieval. Patients with deep vein thrombosis suffer from blood clots forming in their legs. These clots can flow into the lungs, causing pulmonary damage and blockage. To prevent this, surgeons may put a filter into the heart’s inferior vena cava.
- Laser ablation. This treatment helps patients with arrhythmias or irregular heart rhythms. In this procedure, the surgeon exposes the heart to energy waves that block abnormal neural signals. This ablation corrects the heart’s beating.
- Mesenteric artery bypass. The mesenteric artery delivers blood to the intestines. But if it is blocked, those organs will fail and die. This bypass surgery will install a replacement graft.
- Radiofrequency ablation. This treatment uses radiofrequency energy to scar a portion of the heart, causing an irregular beating rhythm.
- Renal artery angioplasty. The renal artery delivers blood to the kidneys. If this blood vessel becomes clogged, the surgeon will insert a plastic tube.
- Renal artery bypass. When the renal artery is severely blocked or ruptured, bypass surgery might be necessary. The surgeon will pump air into the renal artery to make it larger.
- Subfascial endoscopic perforator surgery. Blood clots and inadequate oxygen can form ulcers on the veins. This surgery cuts the damaged veins and allows the ulcerated vein to recover much quicker.
- Thrombectomy. The surgeon removes a blood clot that formed inside blood vessels. An X-ray will guide the surgeon in locating the blood clots.
- Vena cava reconstructions. This procedure involves resectioning and fixing a vena cave destroyed by blood clots and malignant tumours.
- Vertebral artery reconstructions. This surgery treats the arteries that supply blood along the spinal column.