Vascular surgery is that branch of surgery that deals with surgical intervention to resolve or improve the prognosis of diseases affecting the body's blood vessels, using techniques of repair, shunt, replacement, and removal. Vascular surgery is a branch of surgery that deals with the vessels of the body: arteries, veins, and the lymphatic system. Diseases and traumas of the blood vessels are treated. It works in close collaboration with angiology and interventional radiology, providing care and treatment of circulatory disorders in the legs, upper limbs, neck and abdomen.

When do you go to the vascular surgeon?

Vascular surgical examination is useful for patients who have already been diagnosed with vascular disease whose only solution is surgery (e.g., narrowing, dilation, or deterioration caused by atherosclerosis, chronic venous insufficiency, aneurysms, malformations, and diabetes).

What diseases are treated and vascular surgery performed?

• Aneurysm: a disease characterized by dilation of the arterial wall that can affect all arteries in the body. Most frequently (80% of cases) the abdominal aorta is affected. The aneurysm tends to expand, so close surveillance is necessary. Progression of the aneurysm can lead to rupture of the vessel, resulting in bleeding and danger to the patient.

• Carotid stenosis: a disease characterized by narrowing (stenosis) of the internal carotid artery, which supplies blood to the brain. If the stenosis is severe, it can cause ischemic stroke. In the area of stenosis, small clots or fragments of plaque can dislodge due to blood flow turbulence and close the vessels supplying the brain.

• Chronic Peripheral Obstructive Arteriopathy: a disease characterized by progressive narrowing (stenosis) to complete obstruction of arteries. It mainly affects the arteries of the lower limbs. The absence of blood is manifested by various clinical pictures ranging from difficulty walking to the appearance of pain and ulcers.

• Dissection: a disease characterized by a tear in the inner layer (intima) of the artery whereby blood flows into the vessel wall forcing the layers of the wall to separate. This event can lead to partial or complete reduction of blood supply to a particular organ or to rupture of the vessel. The most common site of this pathology is the thoracic aorta. 

• Varicose veins: a disease characterized by dilatation of the superficial veins. It represents the most common venous pathology and mainly affects the lower limbs. It can cause a wide spectrum of symptoms ranging from uncomfortable swelling of the legs to the appearance of painful ulcerations with little tendency to heal.

• Deep vein thrombosis: a disease characterized by the formation of a thrombus (clotted blood) within a vein, predominantly affecting the deep venous circulation of the lower limbs. Although some cases are asymptomatic, frequently patients complain of pain, redness and swelling in the leg. The most serious complication of deep vein thrombosis occurs when the thrombus becomes mobilized and stuck at the level of the veins of the lungs, blocking their blood flow (pulmonary embolism).

• Lymphedema: a disease characterized by abnormal accumulation of lymphatic fluid in the tissues. The most common site is the lower extremities. The patient may complain of pain and swelling. It is mainly due to the absence or destruction of lymphatic vessels.
  

  Invasive Treatments

  The aneurysm is treated by:

  • Open aortic replacement surgery, which aims to exclude the aneurysm from the blood circulation by restoring the blood pathway using a synthetic vascular prosthesis. Through an opening of the abdominal cavity, the surgeon clamps the aorta with forceps, opens the aneurysm and replaces it with a vascular prosthesis.

  • Endovascular therapy: It is possible to exclude the aneurysm from the blood circulation by inserting, through the arteries of the inguinal region, an endoprosthesis that consists of a tubular metal mesh (stent) covered with a thin layer of tissue. The endoprosthesis folded into a catheter is released into a healthy aorta treaty where it is able to anchor itself due to its expanding force. Blood will flow into the endoprosthesis, reducing the pressure on the arterial wall, which can no longer rupture.

  
  The stenosis of the carotid artery can be treated through:

  • Carotid thrombo-endarterectomy (TEA): a surgical procedure that aims to physically remove the atherosclerotic plaque that narrows the carotid artery.

  • Percutaneous Transluminal Angioplasty (PTA) and Stenting: without actual surgery the narrowed artery is dilated with u