Angioplasty is the procedure of opening a coronary artery blockage with the help of wire balloon and stent. This procedure is done to open the blocked coronary arteries if they are causing symptoms or acute heart attacks.

HOW IT IS DONE?

The procedure is usually done in local anaesthesia. A wrist artery (radial) or a groin artery (femoral) is used to gain access to the coronary artery as is done in angiography. A hollow tube called a catheter is passed upto heart artery and through this, a guidewire is passed across the blockage and over this wire balloon is passed and blockage dilated.

After this balloon is removed and the metallic stent is passed over this wire. The stent is then inflated and it takes its shape of the hollow tube so that the flow in the coronary artery is restored.

WHAT ARE INDICATIONS OF ANGIOPLASTY AND STENTING:

An acute Heart attack is the most definite indication of angioplasty and stenting. At the time of the heart attack, there is an urgent need to restore the blood flow of block coronary artery which is usually not possible with medicines alone. Angioplasty is the most effective and definite way of opening the artery urgently in such situation.

SHOULD ALL BLOCKAGES BE OPENED UP BY ANGIOPLASTY AND STENTING?

NO, all blockages do not warrant this procedure. There is some amount of risk involved in the angioplasty procedure itself. When the risk of blockage is considered more than the risk of opening the artery then the procedure is indicated. Patients who are doing good on medicines may be followed up without angioplasty.

All About Angioplasty!

Vascular disorders are disorders of the vessels in your body that carry either blood or waste products. The vascular system consists of the arteries (that carry blood away from the heart), veins (that carry blood to the heart) and lymph vessels (that carry waste products to be excreted from the body). The various diseases of the vascular or circulatory system are:

Peripheral Artery Disease: Peripheral arteries carry blood to the various organs and tissues in the body. Accumulation of cholesterol and fat in the vessels narrow the pathway for the blood to flow. This can impair blood flow to the tissues in the body and cause complications. Various medications used to lower cholesterol and blood pressure can also be used for peripheral artery disease.
Buerger's Disease: This disease causes obstructions in the veins and arteries in the legs. This can hamper blood supply in the toes and the feet. It causes pain and may require amputation in severe cases. Treatments for this disease include smoking cessation and medications to dilute blood vessels.
Aneurysm: An aneurysm is swelling in the blood vessel walls; it usually occurs in the aorta. The artery walls become fragile and are placed under a lot of stress; this may lead to a sudden rupture of the aortic vessels. This disorder is usually treated by surgical procedures.
Peripheral Venous Disease: Peripheral venous disease is characterized by damage to the valves that allows blood to flow in a single direction. Damaged valves can cause blood to flow backwards and therefore, accumulate. Treatments for this disorder are incorporating certain lifestyle habits such as quitting smoking and alcohol.
Blood clots in the veins: Blood clots may occur in the veins present inside the muscles of the thighs and lower legs which lead to deep vein thrombosis. You may be prescribed anti-coagulants, also known as blood thinners, to treat this disorder.
Causes
People with diseases such diabetes, high blood pressure, or kidney failure can be more likely to have vessel problems. Working with vibrating tools, being in cold temperatures, and smoking can worsen vascular problems. Causes of vascular disorders usually fit into one of 5 groups:

Traumatic, which occur after injury
Compressive, which occur when the pipes flatten
Occlusive, which occur when pipes are blocked
Tumors (growths) or malformations (deformed, tangled pipes), which may or may not be present at birth
Vessel spasms, which occur when abnormal control of vessels causes them to narrow
Symptoms
Symptoms of vascular disorders can include:

Pain
Abnormal color changes in the fingertips
Ulcers or wounds that do not heal
Hand problems when in cold temperatures or locations
Numbness or tingling of the fingertips
Swelling
Cool or cold fingers and/or hands

5 Common Vascular Disorders

The veins are a type of blood vessels which collect impure blood from all parts of the body and return it to the heart. The veins in the legs especially are quite thick and need to exert extra pressure to pump blood against gravity towards the heart. In quite a few people, these veins could be engorged, swollen, and twisted, which are known medically as varicose veins.

Causes:
Defective or damaged valves in the blood vessels. Normally, the blood flow is controlled by valves which ensure blood flows in the desirable direction. When these valves are not able to control the flow of blood, then varicose veins can return
Thin vein walls can lead to improper flow of blood, resulting in varicose veins

Risk factors:

Prolonged standing
Obesity
Pregnancy
Smoking
Surgery in the leg, which could have hampered the values or veins
Age, as the elasticity of the vessels, reduces with age and can impede normal blood flow
Family history
Symptoms:

Blue, swollen veins in the legs which are thin and ropy
Pain with prolonged standing followed by pain and tenderness
Itching and heaviness in the legs
Cramping in the night
Blood clots in the superficial vessels
Severe varicose veins can cause bleeding
The area around the leg feels firm and/or hard
There could be skin changes like scaling, dryness, and color changes
Increased propensity to bleed in the affected leg
Diagnosis:

Usually easily diagnosed in clinical examination
The above-listed features are very characteristic and help in identifying them
Further testing may be done to identify the problematic valve, usually using a tourniquet
Doppler ultrasound, scanning, and MRI may be required to confirm diagnosis, which are quite rarely used
Prevention/Treatment:

Keep the legs elevated as much as possible. During working hours, take short breaks where you are able to elevate the legs
Even in prolonged journeys, try to take a break which will improve circulation
Quit smoking
Compression stocking (Ted hose or Jobst stocking) can be used to improve circulation. They also help in controlling pain and are very commonly recommended to treat varicose veins
Avoiding alcohol, which leads to venous dilation
Weight management, as being overweight is a big risk factor
Do not cross legs when sitting, as it puts constant pressure on the valves
Avoid tight clothing which can put pressure on the veins and/or valves
Keep a regular exercise regimen like walking to improve blood flow
Surgical treatment options include sclerotherapy, laser treatment, and stripping off the vein, but are not usually required.

Varicose Veins - 9 Signs You Are Suffering From It!

Dialysis is a very important and life-saving procedure. It is performed to replace kidney function in case of renal failure. Wastes and extra fluids in the blood are filtered out during this process. To be able to perform Dialysis, the connection between the patient s bloodstream and the equipment for performing Dialysis (dialyzer) outside the body is established. This connection is created through Dialysis Access Surgery. It is a type of Vascular Surgery which forms the vascular opening for access during Dialysis. Thus, Dialysis Access Surgery is the lifeline for the survival of the patient.

Types of Vascular Access for Dialysis- 
There are three types of Vascular Access for Dialysis: Arteriovenous (AV) Fistula, Arteriovenous (AV) Graft, and Venous Catheter.

  Arteriovenous (AV) fistula is a surgical connection of an artery to a vein. An AV fistula is usually placed in the upper arm or in the forearm. It causes extra blood to flow into vein making it grow large. A larger vein hence provides easy access to blood vessels. An AV fistula is preferred over other methods as it lasts longer than other methods of access and provides a good flow of blood. Moreover, it is less prone to infection and blood clots than other methods. Before an AV Surgery, a Vessel Mapping Test is sometimes performed for assessing the blood vessels most suitable for Dialysis. An AV fistula is performed under local anaesthesia and requires two to three months for maturation before hemodialysis. If it fails to mature, the procedure is repeated.

  Arteriovenous (AV) graft is performed when AV fistula fails to mature. It is hence the second most preferred choice for long-lasting access to vascular tissues for Dialysis. An AV graft is a looped plastic tube which establishes a connection between an artery and a vein. Like AV fistula, AV graft is also performed under local anaesthesia. It is slightly more difficult to maintain than an AV fistula.

  A venous catheter is used for short- term hemodialysis. It is a tube which is inserted into chest, neck, leg, or near groin for vascular access. After exiting the body, the tube splits into two halves. In the case where a renal disease has made quick progression leaving little or no time for the AV fistula or AV graft to mature, a venous catheter is used to establish the required vascular connection. This procedure is also performed under local anaesthesia. It is a tool for emergencies but is not suited for long- term use. It can cause narrow vein due to an infection,
scarring, or blood clot. If long- term venous catheter is used, it is tunnelled under the skin which has fewer problems associated with it and is more comfortable. 

How to Care for a Vascular Access?
  Get checked for infections and other problems before each hemodialysis session;
  Use the operated site for access only for the intended use;
  Always keep the access clean;
  Prevent cutting or bumping the access;
  Check for thrill/ vibration in the access and inform the doctor if any;
  Do not put pressure on the access site;
  Do not put blood pressure cuff around the access arm;
  Do not wear jewellery or tight-fitting garments over the site;
  Do not lift a weight.

Take Away-
Vascular Surgery for Dialysis is performed to provide vascular access for the procedure. AV fistula is the most preferred type followed by an AV graft. A venous catheter is recommended to be used only in case of an emergency when there is not much time left for the other two options to mature.

Vascular Surgery - Can It Help For Dialysis?

Varicose veins are superficial, swollen, enlarged and twisting veins, often appearing dark purple or blue on the feet and legs. The condition occurs when blood through the veins flow in the wrong direction and starts accumulating.

Although varicose veins is not a serious condition, you should seek treatment if it causes symptoms like swelling and pain in the extremities. In severe cases, where a varicose vein ruptures or develops to form skin ulcers, your doctor may recommend laser treatment.

Can laser treatment cure varicose veins?

Laser surgery can effectively treat varicose veins. The procedure involves using a high-intensity beam of light to reduce enlarged, bulging veins that are observed usually on the calves or thighs.

How does the procedure work?

The heat emitted from the laser damages a vein, which causes scar tissues to form. This scar tissue shrinks and closes the vein. A closed vein gradually loses its source of blood and dies. After some time, usually in a year or two, the vein disappears on its own.

Two types of laser surgery are performed, namely  

  Simple Laser Treatment   This is done on the outer layers of your skin. It can cure small varicose veins and spider veins under the skin surface. Normally, more than one session, scheduled every 6-12 weeks is needed.
  Endovenous Laser Treatment   This particular procedure is used to cure large varicose veins that appear on the legs.
The steps of the procedure are as follows  
  Your healthcare provider will administer local anaesthesia to numb the area. You may be provided with an eyeglass to protect your eyes
  The surgeon will make a small incision on the skin and pass a laser fibre through a catheter into the veins while closely monitoring the vein on a screen
  As he/she pulls out the catheter, the length of the vein will heat up and shrink, and eventually close

This outpatient procedure is less painful than stripping and litigation. It has a shorter recovery period and can be performed under local anaesthesia or mild sedatives.

What to Expect

After the laser treatment, you can walk around without much complication. The recovery period is typically brief. You can expect to return to your daily activities following simple laser surgery. However, you might need to wear a compression stocking for a week or so after the endovenous laser procedure.
You may notice redness, bruising or burns on the skin after the treatment. That is only normal, so you need not worry. Do follow up with your doctor to see if the vein has closed.


Laser Treatment For Varicose Veins!

Varicose veins are large veins that appear on the legs of some patients. Usually, blood travels to the legs from the heart through the arteries, and the veins take it back to the heart. The valves in the veins allow the blood to travel from the legs to the heart against gravity. During this process, the valves may leak and blood may collect in the veins, making them appear enlarged.
EVLT (Endovenous laser therapy) is the latest method for curing varicose veins without surgery. It heats the affected veins them through a laser instead of removing them.
Process
In this process, at first, an ultrasound scan is carried out to locate the veins that have to be treated. After marking them, the doctor applies local anaesthetic on the skin and a needle is inserted into it. A wire is then passed through the needle up to the target vein. Over this wire, a catheter is passed after removing the needle. After that, the wire is removed.
Through the catheter, a laser fibre is placed whose tip usually reaches up to the groin crease. Using tiny needles, a large amount of local anaesthetic solution is applied in the region surrounding the vein. The laser is then applied for 5 minutes on the veins. You might hear a buzz or feel a burning sensation but won t feel any pain. The catheter and the laser are then removed and the incision is covered.
The process takes about 30 minutes to complete. After the treatment, you will be advised to wear compressions stockings and can go back to your normal routine immediately.
Benefits
The different benefits of the surgery are:
The skin does not have to be stitched 
There is no pain in the process and patients can go back to work right after the treatment
The process is free from complications 
No scars are left after the treatment

Common uses of the process
EVLT is also used for treating the following:
Swelling of the veins 
Discolouration of the skin
The heaviness of the leg
Skin ulcers and irritation
Precautions
These are the precautions that you must take:
A week before the process, avoid taking arthritis medications, aspirin, and Ibuprofen as they can increase the chances of bruising 
Avoid alcohol and tobacco 2 days before the procedure
After the treatment, ask someone to drive you back home and do not use public transport
Avoid activities like swimming, running, jogging and weightlifting for at least 2 weeks after the procedure

The varicosities fade away after the process but rarely disappear completely. You might require further treatment for improving the appearance of the veins. 


EVLT Varicose Veins Treatment!

Don't wait any longer, manage your Vascular Surgery online with a Lybrate doctor today

Consult for Vascular Surgery - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES