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Vascular Surgery in India

Cardiovascular Surgery

It is An operation for repairing structural defects of the cardiovascular system Examples CABG, repair of congenital heart defects, varicose veins, aortic aneurysms, ventricular remodeling, transmyocardial. Vascular surgery is indicated when a patient has vascular disease that cannot be treated by less invasive, nonsurgical treatments. The purpose of vascular surgery is to treat vascular diseases, which are diseases of the arteries and veins. Arterial disease is a condition in which blood clots, arteriosclerosis, and other vascular conditions occur in the arteries. Venous disease involves problems that occur in the veins. Some vascular conditions occur only in arteries, others occur only in the veins, and some affect both veins and arteries.

Causes for Cardiovascular Disease

Factors that increase the chances of vascular disease include:

  • increasing age (which results in a loss of elasticity in the veins and their valves)
  • a family history of heart or vascular disease
  • illness or injury
  • pregnancy
  • prolonged periods of inactivity sitting, standing, or bed rest
  • smoking
  • obesity
  • hypertension, diabetes, high cholesterol, or other conditions that affect the health of the cardiovascular system
  • lack of exercise

Symptoms of Varicose veins

There may be no symptoms of vascular disease caused by blood clots until the clot grows large enough to block the flow of blood through the vein. The following symptoms may then come on suddenly:

  • pain
  • sudden swelling in the affected limb
  • reddish blue discoloration
  • enlargement of the superficial veins
  • skin that is warm to the touch

Diagnosis

order for a patient to be diagnosed with a vascular disease, they must be clinically evaluated by a vascular surgeon, which includes a history and physical examination . A vascular surgeon also treats vascular disorders by non-operative means, including drug therapy and risk factor management.

The symptoms produced by atherosclerosis, thrombosis, embolisms, or aneurysms depend on the particular artery affected. These conditions can sometimes cause pain, but often there are no symptoms at all.

A physician has many ways of feeling, hearing, measuring, and even seeing arterial blockages. Many arteries in the body can be felt or palpated. A doctor can feel for a pulse in an area he or she believes afflicted. Usually the more advanced the arteriosclerosis, the less pulse in a given area.

As the artery becomes blocked, it can cause a noise very much like water roaring over rocky rapids. Your physician can listen to this noise (bruit) directly, or can use special amplification systems to hear the noise.

There are other tests that can be done to determine if arterial blood flow is normal

  • ankle-brachial index (ABI) test
  • arteriogram
  • segmental pressure test
  • ultrasound scan
  • magnetic resonance imaging
  • computed tomography scan
  • angiography
  • lymphangiography
  • lymphoscintigraphy
  • plethysmography
  • duplex ultrasound scanning

Cardiovascular Surgery

One of the prime treatments of varicose veins is surgery. The other types of  treatments can be medicines and graduated compression stockings and even elevating the legs can offer temporary relief. There are Sapheno-femoral junction ligation and vein stripping operation involves the removal of all or a part of the saphenous vein main trunk after skin incisions are given over the groin and leg.

Laser Cardiovascular Surgery

(A). Endovenous Laser Ablation

The main aim of this less invasive alternative is to provide proper thermal energy to the wall of the damaged vein for the produce of fibrosis and lastly disappearance of the vein. The process takes around 45 minutes on each leg. The endovenous laser ablation (EVLA) procedure involves thermal ablation of incompetent varicose veins. Unlike vein stripping, EVLA permanently shrinks and collapses the abnormal vein, thereby leaving it in place without surgically removing the vein. The process leaves less scars and minimizes pain too.

The key benefits of EVLA:

  • Immediate relief from symptoms
  • No scars
  • Only a local anesthetic is needed
  • Performed in the doctor’s office
  • Treatment in about an hour
  • Can resume walking immediately with little or no pain

(B) Sclerotherapy

Sclerotherapy is a medical procedure used to eliminate varicose veins and spider veins. Sclerotherapy involves an injection of a solution (generally a salt solution) directly into the vein. The solution irritates the lining of the blood vessel, causing it to swell and stick together, and the blood to clot.. The procedure safe as well as effective.

Carotid Endarterectomy

Carotid endarterectomy is a surgical procedure to unblock a carotid artery. The carotid arteries are the main blood vessels that supply the head and neck.

Carotid endarterectomies are carried out when one or both carotid arteries become narrowed because of a build-up of fatty deposits (plaque). This is known as carotid artery disease or carotid artery stenosis.

During the procedure, a 7-10cm (2.5-4 inch) cut will be made between the corner of your jaw and your breastbone. A small cut is then made along the narrowed section of artery, and the fatty deposits that have built up are removed.

The artery is then closed with stitches or a patch and your skin is also closed with stitches.

Carotid Artery Disease

It is also called carotid artery stenosis. The term refers to the narrowing of the carotid arteries. This narrowing is usually caused by the buildup of fatty substances and cholesterol deposits, called plaque. Carotid artery occlusion refers to complete blockage of the artery. When the carotid arteries are obstructed, you are at an increased risk for a stroke

Treatment for Carotid Artery Disease

effectively treat carotid artery disease, doctors recommend the following:

  • Following recommended lifestyle habits.
  • Taking medications as prescribed.
  • Considering a procedure to improve blood flow, if your doctor believes it could help reduce your risk of future stroke

Postoperative care of Vascular Surgery

Diet/ Bowel Care:

  • No restrictions, you may resume your regular diet
  • Advance your diet as you can tolerate, starting with bland (non-greasy, non-spicy) food, in small
  • portions, that is easy to digest for first 2-3 days
  • • Drink plenty of fluids (> 2 Liters per day) to keep well hydrated as your body is recovering(juices, water, broth, sports drinks)
  • Having surgery and/ or narcotic pain medications can cause your bowels to slow down, and can
    cause constipation. You should start taking a stool softener (Colace or generic Ducosate Sodium)
    100mg twice daily (available over the counter), starting the day before your surgery. You do not
  • need to take these if you have loose stools.

• Some bruising and soreness is expected around the incisions.

Activity:

  • You may resume normal activities as you feel you are able. You should be up walking around your house several times per day after surgery. This improves circulation and helps prevent
    complications after surgery. Walking outside and doing stairs are acceptable, and you can increase your activity as you can tolerate.
  • No lifting more than 20 pounds (no more than 5 lbs if you had surgery on your arm) and no aerobic exercise (other than walking) until your follow up office visit (about 2 weeks after
    surgery). Further restrictions will be discussed at that time.
  • You may return to work or school as you feel you are ready, with lifting restrictions in mind if you have a labor-intensive job.
  • NO DRIVING FOR 24HRS AFTER SURGERY AND WHILE TAKING NARCOTICS. You may drive when you feel that you can safely operate the vehicle (think about turning or stopping
    suddenly, maybe take a test drive in a safe area first).

Call your surgeon’s) if you experience any of the following:

  • Temperature higher than 101
  • Any chest pain or difficulty breathing
  • Redness (more than a ¼ inch around the wound)/ drainage/ bleeding/ or pus from wound(s) or IV sites
  • Increased pain at incisions. Some pain is expected but should get progressively better over about aweek.
  • Swelling, increasing pain, numbness, or cold sensation in the arm or leg that was operated on
  • Any other concerns or questions regarding your surgery or recovery.