25.JAN.2019 3 MIN READ | 3 MIN READ

Traditional surgical approaches to treating vascular disease can be overly invasive. Endovascular surgery takes another approach.

Your vascular system is a complex grid of blood vessels around your entire body that includes your arteries, veins and capillaries. This extensive network of tubes is responsible for moving blood around your body, transporting oxygen, removing waste, and in the case of your lymphatic vessels, removing damaged cells and preventing infection. Diseases that affect your vascular system can be serious, so it's important to know your treatment options if you are affected.

Endovascular surgery

Endovascular surgery
Traditional open surgery puts your body under a lot of stress. Endovascular surgery is a much less invasive option than open surgery techniques, which typically involve large incisions to access various internal body parts. In endovascular surgery, a small injection is made, through which a flexible catheter is inserted into a blood vessel, which allows your surgeon access to any blockages or diseased tissue. As only a small injection or puncture is needed, these procedures can be done without the need of general anaesthesia.

Vascular diseases

Endovascular techniques can now be used to treat a variety of vascular diseases, including:

  • Aortic aneurysms

    An aortic aneurysm occurs when the walls of the aorta, which is the primary vessel taking blood from the heart to the rest of your body, weaken. Your blood pushes against the weakened walls and causes swelling, which results in an aneurysm. If this bulge in your aorta bursts, it can be life-threatening. You can have traditional surgery to repair an aneurysm, but endovascular surgery is a much less risky procedure. The catheter is used to assist with the insertion of a stent graft, which is a specialised fabric tube that provides support to the walls of the aorta. Depending on the location of the aneurysm, this surgery is known as endovascular repair of an abdominal aortic aneurysm, thoracic aortic aneurysm, or thoracoabdominal aneurysm. No big operative incisions are needed and it is possible for this to be done, for selected cases, under local anaesthesia with no need for long ICU stay.

  • Deep vein thrombosis
    Endovascular surgery - Deep vein thrombosis

    Deep vein thrombosis (DVT) is a blood clot inside one of your veins, usually in the leg or hip area. If the clot moves towards your lungs, it can become a life-threatening pulmonary embolism (PE). There are many causes for DVT, including blood-clotting disorders, hormone imbalances, damaged veins or lack of movement, but it's important to treat the condition to prevent ulcers, swelling pain, and the risk of an embolism. Endovascular techniques can be used to dissolve the clot, by infusing medication directly into the affected vein or using devices to suck the clots out — all done through a simple groin injection.

  • Atherosclerosis

    Atherosclerosis is the hardening and narrowing of your arteries, which leads to blockages that can result in strokes or amputations. It is caused by the build-up of plaque, which forms in hard lumps on artery walls throughout your body. It tends to develop through long term exposure to high cholesterol levels or cigarette smoke, or when you have high blood pressure. This can be treated using endovascular angioplasty. When your doctor inserts the catheter into your blood vessel, they will then use a balloon to stretch the vessel so blood can flow freely, or they might insert a stent to hold the walls of the blood vessel open and support the walls of the artery.

Benefits of endovascular surgery

Endovascular surgery - Benefits
  • Shorter recovery time than traditional surgery
  • Can often be performed as an outpatient or short stay procedure
  • Can be performed with local anaesthesia instead of general
  • Smaller incisions result in less bleeding
  • Less pain and discomfort during recovery
  • Safer, especially for higher risk patients

Is endovascular surgery for you?

If you suffer from any condition that affects your vascular system, it is best to speak to a vascular surgeon about suitable treatment methods. As medical technology has advanced, minimally invasive techniques are generally the first-line options for treatment if treatment with medications is not feasible.

Staying healthy

Endovascular surgery - Stay healthy
Whether you are diagnosed with a vascular disease or not, it's important to keep your heart and blood vessels as healthy as possible. Eat a balanced diet low in processed meats, fried and oily fast food, refined sugars and high in natural fibre. Quit smoking and get regular exercise to lower your risk of vascular illness.

If you have any concerns about your vascular health or would like to know if endovascular surgery is suitable for you, book an appointment with a vascular surgeon for a thorough examination.

 

Article reviewed by Dr Cheng Shin Chuen, general surgeon at Parkway East Hospital

Reference

Arko, F.R., Arko, Z., Murphy, E.H. (2011, March) Endovascular intervention for lower-extremity deep venous thrombosis. Retrieved 23/12/2018 from https://www.vasculardiseasemanagement.com/content/endovascular-intervention-lower-extremity-deep-venous-thrombosis

Beckerman, J. (2018, August 2) Heart Disease treatment with Angioplasty and Stents. Retrieved 23/12/2018 from https://www.webmd.com/heart-disease/guide/treatment-angioplasty-stents#4

Beckerman, J. (2018, February 12). What is vascular disease? Retrieved 23/12/2018 from https://www.webmd.com/heart-disease/vascular-disease#4

Fibromuscular displaysia. Retrieved 23/12/2018 from https://www.mayoclinic.org/diseases-conditions/fibromuscular-dysplasia/diagnosis-treatment/drc-20352150

Srivastava, S. (n.d.). Endovascular Treatment of Peripheral Artery Disease. Retrieved 23/12/2018 from https://my.clevelandclinic.org/departments/heart/patient-education/videos/transcript-endovascular-treatment-pad-video

What is coronary heart disease? Retrieved 23/12/2018 from https://www.heartfoundation.org.au/your-heart/heart-conditions/what-is-coronary-heart-disease

What is Endovascular Surgery? Retrieved 23/12/2018 from https://www.docdoc.com.sg/info/specialty/endovascular-surgeons/

25.JAN.2019
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Cheng Shin Chuen
General Surgeon
Parkway East Hospital

Dr Cheng Shin Chuen is a General Surgeon with subspecialty interest in Vascular and Endovascular procedures. He read Medicine at the University of New South Wales and completed his training in General Surgery in Singapore. He did his Endovascular fellowship at Prince of Wales Hospital, Sydney as a Senior Clinical Fellow in 2007.