Vascular surgery is a specialty of surgery in which diseases of the arteries and veins outside the heart are managed by medical therapy, minimally-invasive catheter procedures, and surgical reconstruction. The specialty has evolved to include minimally invasive techniques using endovascular approaches. Since the early 1990s, the sub specialty of endovascular and endovenous therapy has evolved greatly. Arterial and venous disease treatment by angioplasty, stenting, and non-operative varicose vein treatment sclerotherapy, endovenous laser treatment and radio frequency ablation are rapidly replacing major surgery in many first world countries. These newer procedures provide reasonable outcomes that are comparable to surgery with the advantage of short hospital stay (day or overnight for most cases) with lower morbidity and mortality rates.
Common vascular conditions:
1. Arterial diseases:
- Aortic aneurysm/ dissection/ occlusion
- Lower limb ischemia
- Diabetic foot ulcers
- Mesenteric ischemia
- Renal ischemia
- Carotid Endarterectomy and other carotid surgery
2. Venous disease:
- Deep Vein Thrombosis
- Thrombophlebitis
- Varicose Veins and Varicosities
- Venous malformations
- Lymphatic disease
- Lymphoedema
3. Vascular medicine:
- Non invasive screening for peripheral arterial disease and risk factor modification
Common Vascular procedures:
| Indication/disease | Procedure |
|---|---|
| Abdominal aortic aneurysm | Open AAA repair Endovascular Aneurysm Repair (EVAR) |
| Carotid stenosis | Carotid endarterectomy Carotid stenting |
| Varicose veins | Vein stripping Sclerotherapy and Foam sclerotherapy or Endovenous Laser Treatment, radiofrequency vein ablation Ambulatory phlebectomy |
| Peripheral arterial occlusive disease | Angioplasty with/out Stenting Bypass surgery Endarterectomy Atherectomy |
| Acute limb ischaemia | Balloon embolectomy Thrombectomy Bypass surgery |
| Aortic dissection | Open repair Thoracic Endovascular Aneurysm Repair (TEVAR) |
Links:
- https://www.vascularweb.org
- https://www.vascularsociety.org.uk
- https://www.anzsvs.org.au
- https://www.asianvascular.com
Dr Peter ROBLESS
www.vascular.com.sg
