Treatments & Procedures

Treatment of vascular disease includes lifestyle modifications, or making changes to diet and exercise habits.  Your vascular surgeon may also prescribe medication.  In some cases, surgery may be the only option to treat the condition or illness.

Medications
Because most peripheral vascular disease is associated with atherosclerosis, medications may be prescribed to reduce the overall risks of atherosclerosis, such as heart attack or stroke. Medications to reduce atherosclerotic risk might include:

• Cholesterol-lowering medications
• High blood pressure medications
• Medication to better control diabetes
• Medications to prevent blood clots, such as aspirin

Other medications may be specifically for the vascular disease for which you are being treated. These might include:

• Symptom-relief medications, such as for claudication
• Stronger medications for blood clots, such as warfarin (Coumadin)

Procedures to treat vascular disease

• Angioplasty
• Bypass surgery
• endarterectomy
• Endovascular aneurysm repair
• Endovascular therapy
• Endovenous ablation
• Open (conventional) aneurysm repair
• Stent
• Surgical vein stripping
• Thoracic Endovascular Aneurysm Repair (TEVAR)
• Thrombolytic therapy

Angioplasty
In this procedure, a small hollow tube (catheter) is threaded through a blood vessel to the affected artery. A small balloon on its tip is inflated to reopen the artery and flatten the blockage into the artery wall, while at the same time stretching the artery open to increase blood flow.

Bypass surgery
Bypass surgery refers to rerouting of blood from above a blockage to below the blockage. The rerouted blood is carried by a graft. The surgeon may create a graft bypass using a vessel from another part of the body, or use a graft made of synthetic fabric. This technique allows blood to flow around, or bypass, the blocked or narrowed artery.

endarterectomy
Although it may be performed on any artery, this procedure is most commonly performed for treating carotid artery disease (carotid endarterectomy). With endarterectomy, the surgeon opens the artery and then removes the blockage. This type of open surgery is best for blockages that are short in length. 

Endovascular Aneurysm Repair (EVAR)
This is a minimally invasive procedure to repair aneurysms. Endovascular means that the treatment is performed inside your artery using long, thin tubes called catheters that are threaded through your blood vessels. Using X-ray guidance, the graft is placed inside your aneurysm through these catheters. Your surgeon will make only small incisions in your groin area, through which to thread the catheters, in order to reach the aneurysm.

Endovascular Therapy
This refers to any procedure performed by working inside a blood vessel. The most common are angioplasty, stenting and endovascular aneurysm repair.

Endovenous Ablation
Using ultrasound to “see” the vein, a small catheter is inserted through a small needle puncture into one of the superficial veins of the leg. Subsequently, either laser (laser ablation) or radiofrequency is applied to the vein, which results in closing of the vein. This used for reflux of the long superficial vein of the leg, called the long saphenous vein.

Open (conventional) aneurysm repair. During this procedure, the surgeon makes an incision in the abdomen or chest, and then replaces the diseased aorta (the aneurysm) with an artificial graft that is sewn in place.

Stent
The doctor may also insert a mesh framework called a stent in the artery to help keep it open. This is the same procedure surgeons use to open heart arteries.

Surgical vein stripping
This older technique of treating varicose veins involves a small groin incision through which a catheter is inserted into the vein.  The catheter is then pulled out, resulting in “stripping” of the vein. This is usually combined with removal of the varicose veins through small incisions.

Thoracic Endovascular Aneurysm Repair (TEVAR)
This is a similar technology to endovascular aneurysm repair (see above) except it refers to the repair of those aneurysms in the chest (thorax).

Thrombolytic therapy
If there is a blood clot blocking an artery, the doctor may inject a clot-dissolving drug into the artery at the point of the clot to break it up.