Are you aware that a stroke is the leading cause of long-term disability in adults in the United States? More specifically, one third of all strokes are due to carotid artery disease. Your two carotid arteries are located on either side of your neck, and their main purpose is to deliver blood and oxygen to your brain. A stroke occurs when blood is interrupted or something slows down the flow of blood. Let’s understand more about carotid artery disease and how to lower your risk of stroke.
Carotid endarterectomy is a surgical procedure that involves removing plaque buildup from the carotid arteries, which are located in the neck and supply blood to the brain. This blog post aims to provide you with a comprehensive understanding of carotid endarterectomy, including its purpose, procedure, and why you might need one.
What is Carotid Artery Disease?
Before delving into carotid endarterectomy, it’s essential to grasp the concept of carotid artery disease. Over time, the carotid arteries can become narrowed due to the accumulation of fatty deposits called plaques. This condition, known as atherosclerosis, restricts blood flow to the brain, potentially leading to a stroke or transient ischemic attack (TIA), often referred to as a mini-stroke.
Purpose of Carotid Endarterectomy:
Carotid endarterectomy aims to reduce the risk of stroke by removing the plaque buildup from the carotid arteries. By restoring normal blood flow, the procedure helps prevent the development of a full-blown stroke or TIA.
Indications for Carotid Endarterectomy:
Significant carotid artery narrowing: Typically, a stenosis of 70% or more is considered significant, but the decision to undergo surgery depends on several factors, including your overall health and the presence of symptoms.
Experienced a recent TIA or minor stroke: If you’ve had a transient ischemic attack or a minor stroke, carotid endarterectomy may be recommended to prevent further, more severe strokes.
Asymptomatic with high-grade stenosis: In some cases, carotid endarterectomy may be considered for individuals without symptoms but with high-grade carotid stenosis (greater than 80%) due to the increased risk of future strokes.
The Carotid Endarterectomy Procedure:
Here’s a general overview of what you can expect during a carotid endarterectomy procedure:
Anesthesia: You will be given either general anesthesia (where you’re asleep) or local anesthesia (where only the neck is numbed).
Incision: A small incision is made in the neck over the affected carotid artery.
Artery Access: The vascular surgeon carefully opens the carotid artery to access the plaque inside.
Plaque Removal: The plaque is removed from the artery, aiming to restore normal blood flow.
Closure: The artery is then closed, and the incision in the neck is stitched or stapled.
Recovery: After the procedure, you will be closely monitored in the hospital for a day or two before being discharged. The recovery period may vary, but most individuals can resume their normal activities within a few weeks.
Carotid endarterectomy is a well-established procedure aimed at reducing the risk of stroke in individuals with significant carotid artery disease. By removing plaque buildup from the carotid arteries, the procedure helps restore normal blood flow to the brain, potentially preventing future strokes. If you’ve been recommended to undergo carotid endarterectomy, it’s crucial to discuss any concerns or questions you may have with your healthcare provider. Remember, the decision to undergo the procedure should be made based on a careful assessment of your individual medical condition and the risks and benefits involved.
Intravascular ultrasound (IVUS) is a medical imaging technique that allows for the visualization of blood vessels from the inside. It involves the use of a tiny ultrasound probe that is threaded into the blood vessels through a catheter, providing detailed images of the vessel walls and structures.
Here’s how intravascular ultrasound works and why it is used in clinical practice:
Insertion of the Catheter:
A catheter, which has a small ultrasound probe at its tip, is inserted into a blood vessel, typically through the groin or the arm. The catheter is carefully guided through the blood vessels until it reaches the area of interest.
Once the catheter is in place, high-frequency sound waves are emitted from the ultrasound probe. These sound waves bounce off the vessel walls and other structures inside the blood vessel.
The reflected sound waves are picked up by the probe and converted into real-time images. These images are then displayed on a monitor and can be recorded for further analysis.
Benefits and Applications of Intravascular Ultrasound:
IVUS provides high-resolution, cross-sectional images of blood vessels, allowing vascular surgeons to assess the vessel size, structure, and any abnormalities present. IVUS provides more detailed information compared to other imaging techniques.
Assessment of Atherosclerosis:
IVUS is commonly used in the evaluation of atherosclerosis, a condition characterized by the buildup of plaque inside the arteries. Intravascular ultrasound also helps determine the extent and composition of the plaque, identify areas of vessel narrowing or blockage, and guide treatment decisions.
Guidance for Interventions:
IVUS is often utilized during various vascular procedures, such as angioplasty or stent placement. IVUS provides real-time feedback to guide the placement of devices and assess their effectiveness in improving blood flow.
Assessment of Stent Deployment:
IVUS can evaluate the proper positioning and expansion of stents within the blood vessels. IVUS helps ensure that the stent is fully expanded and properly apposed to the vessel walls, reducing the risk of complications.
Research and Clinical Trials:
Intravascular ultrasound is also utilized in research studies and clinical trials to investigate new treatment approaches, assess the effectiveness of medications, and gather data on vascular conditions.
IVUS is a valuable tool in the field of vascular medicine. It helps vascular surgeons make accurate diagnoses, guide treatment decisions, and monitor the progress of interventions. The information obtained through IVUS enhances patient care by providing detailed insights into the condition of the blood vessels, allowing for personalized treatment plans and improved outcomes.
Endovascular surgery, also known as endovascular therapy or intervention, is a minimally invasive procedure performed to treat various conditions within blood vessels, typically in the arteries and veins. Unlike traditional open surgery, which requires large incisions, endovascular surgery involves accessing the affected blood vessels through small punctures or incisions.
What conditions do healthcare providers treat with endovascular surgery?
It is a condition characterized by the buildup of plaque within the arteries, narrowing the vessel and obstructing blood flow. Endovascular procedures like angioplasty and stenting can be performed to open up the blocked or narrowed arteries and restore blood flow.
An aneurysm is a weakened area in the blood vessel wall that bulges or balloons out. Endovascular techniques, such as endovascular aneurysm repair (EVAR) or endovascular coiling, can be used to reinforce the weakened vessel wall or fill the aneurysm with coils to prevent rupture.
PAD occurs when arteries supplying blood to the limbs (usually the legs) become narrowed or blocked. Endovascular procedures like angioplasty, atherectomy, or stenting can be performed to improve blood flow and relieve symptoms.
DVT is the formation of blood clots in the deep veins, typically in the legs. Endovascular techniques, such as catheter-directed thrombolysis or thrombectomy, can be used to dissolve or remove the blood clot and restore normal blood flow.
Endovascular treatments like endovenous laser ablation (EVLA) or radiofrequency ablation (RFA) can be used to close off and seal malfunctioning varicose veins, redirecting blood flow to healthier veins.
Endovascular surgery offers several advantages over traditional open surgery, including smaller incisions, reduced blood loss, shorter hospital stays, faster recovery times, and fewer complications. However, not all conditions can be treated using endovascular techniques, and the suitability of the procedure depends on the specific case and the patient’s overall health. It is essential to consult with a vascular surgeon to determine the most appropriate treatment approach.
How common is vascular disease?
According to recent data, there are approximately 200 million people affected by peripheral artery disease (PAD), one of the most common types of vascular disease. In the United States alone, PAD affects around 8 to 12 million people, with the incidence rising with age. Additionally, another prevalent vascular condition is deep vein thrombosis (DVT), which affects an estimated 900,000 individuals in the United States annually. When it comes to aortic aneurysms, statistics indicate that around 1.5 million people worldwide are living with this condition, with men over the age of 65 being particularly susceptible. These numbers show how common vascular disease is and emphasize the importance of awareness, early detection, and timely treatment to improve patient outcomes.
What happens before endovascular surgery?
During an endovascular procedure, a vascular surgeon uses imaging guidance, such as fluoroscopy or ultrasound, to navigate thin, flexible catheters and medical instruments through the blood vessels to the targeted site. These instruments can be used for diagnostic purposes, as well as for therapeutic interventions.
What happens after endovascular surgery?
After your endovascular surgery, it’s important to continue with follow-up care to ensure your blood vessels heal properly. Before you leave the hospital, your healthcare provider will discuss your post-surgical plan with you. This plan includes regular visits to see your healthcare provider and undergo imaging tests. These visits are designed to check how your blood vessels are healing. Your healthcare provider will review the results of the imaging tests to make sure everything is progressing well. By following through with these follow-up visits and tests, you and your healthcare team can keep a close eye on your recovery and address any issues that may arise, leading to a successful outcome after your endovascular surgery.
Why are vascular ultrasounds necessary?
A vascular ultrasound study is necessary because it provides a non-invasive and painless way to evaluate your blood vessels. It helps identify blockages, narrowing, or abnormalities in the arteries and veins throughout your body. This detailed assessment aids in diagnosing various vascular conditions.
Early Detection of Problems:
By undergoing a vascular ultrasound study, potential issues can be detected at an early stage. Early detection allows for prompt intervention and treatment, helping prevent further complications and ensuring better outcomes.
Monitoring Vascular Health:
For individuals with existing vascular conditions, regular ultrasound studies are essential for monitoring disease progression and treatment effectiveness. This consistent monitoring enables vascular surgeons to make informed decisions and adjust treatment plans as needed.
Avoiding Invasive Procedures:
In many cases, a vascular ultrasound study can provide valuable information without the need for invasive procedures. It reduces the need for exploratory surgeries, minimizing risks, discomfort, and recovery time.
Customized Treatment Plans:
The results of a vascular ultrasound study help vascular surgeons develop personalized treatment plans tailored to your specific needs. This individualized approach ensures that you receive the most appropriate interventions, medications, or lifestyle modifications for optimal vascular health.
Preventing Serious Complications:
Conditions like deep vein thrombosis, arterial stenosis, aneurysms, and peripheral artery disease can have severe consequences if left untreated. A vascular ultrasound study aids in early identification, allowing for timely interventions to prevent potentially life-threatening complications.
Empowering Patient Education:
Undergoing a vascular ultrasound study gives you a clearer understanding of your vascular health. By seeing the images and discussing the findings with your vascular surgeon, you can actively participate in your care, make informed decisions, and take proactive steps toward better vascular wellness.
If you have risk factors such as diabetes, high blood pressure, smoking, or a family history of vascular disease, or if you’re experiencing symptoms like leg pain or swelling, it’s crucial to discuss the possibility of a vascular ultrasound study with your vascular surgeon. Don’t delay—early detection and prevention are key!
Why do I need a vascular surgeon?
If you have been diagnosed with vascular diseases such as peripheral artery disease (PAD), deep vein thrombosis (DVT), varicose veins, aneurysms, or carotid artery disease, a vascular surgeon specializes in the treatment of these conditions.
If you experience symptoms related to poor blood circulation, such as leg pain or cramping during walking or at rest, non-healing wounds or ulcers, or coldness in your extremities, a vascular surgeon can evaluate and provide appropriate treatment options.
In cases of traumatic injuries that involve blood vessels, such as a severe laceration or damage to arteries or veins, a vascular surgeon can perform surgical procedures to repair and restore blood flow.
If you have an abdominal or thoracic aortic aneurysm, which is a weakened and bulging area in the aorta, the main blood vessel in your body, a vascular surgeon may perform surgery to repair or replace the affected segment to prevent the risk of rupture.
Vascular surgeons are trained in minimally invasive endovascular techniques, such as angioplasty, stenting, and embolization, to treat various vascular conditions. These procedures involve using catheters and imaging guidance to access and treat the affected blood vessels from within.
With many years of extensive vascular experience, Western Vascular Institute’s providers are able to provide unparalleled diagnosis & management for all venous & vascular diseases as well as exceptional patient care.
Stroke Awareness & Prevention
A stroke is a medical emergency that occurs when blood flow to a part of the brain is interrupted or reduced, depriving brain cells of oxygen and nutrients. This can cause brain cells to die, leading to serious and potentially life-threatening consequences. In this blog post, we will explore the causes, symptoms, types, and treatment options available for stroke.
Stroke can be caused by a variety of factors, including high blood pressure, high cholesterol, smoking, diabetes, and heart disease. Other risk factors include age, family history, obesity, and a sedentary lifestyle. Some strokes occur spontaneously without any apparent cause, while others are the result of a specific event, such as a blood clot or bleeding in the brain.
The symptoms of stroke can vary depending on the type of stroke and which part of the brain is affected. Some of the most common symptoms include sudden weakness or numbness in the face, arm, or leg, especially on one side of the body; sudden confusion, trouble speaking, or difficulty understanding speech; sudden vision loss in one or both eyes; sudden dizziness, loss of balance or coordination; and sudden severe headache with no known cause.
There are two main types of stroke: ischemic stroke and hemorrhagic stroke. Ischemic stroke occurs when a blood clot or plaque buildup in an artery blocks blood flow to the brain. Hemorrhagic stroke occurs when a blood vessel in the brain ruptures, causing bleeding in the brain. A transient ischemic attack (TIA) is a mini-stroke that occurs when blood flow to the brain is temporarily interrupted. TIAs usually last only a few minutes and do not cause permanent brain damage, but they are a warning sign of a possible future stroke.
A stroke is a medical emergency, and prompt treatment is crucial to minimize brain damage and prevent further complications. Treatment options depend on the type of stroke and may include medications to dissolve blood clots or lower blood pressure, surgery to remove blood clots or repair a ruptured blood vessel, and rehabilitation to regain lost functions and prevent future strokes.
Preventing stroke involves making lifestyle changes to reduce risk factors, such as maintaining a healthy weight, eating a balanced diet, exercising regularly, quitting smoking, and managing conditions such as high blood pressure, high cholesterol, and diabetes. Regular checkups with a healthcare provider can also help detect and manage risk factors before they lead to a stroke.
A stroke is a serious and potentially life-threatening condition that requires immediate medical attention. By understanding the causes, symptoms, types, and treatment options available for stroke, you can take steps to prevent stroke and seek prompt treatment if you or someone you know experiences a stroke. With prompt medical attention and appropriate treatment, many people are able to recover from stroke and regain lost functions, highlighting the importance of awareness and education about this medical condition.
What is Vascular Surgery?
Vascular surgery is a surgical specialty that deals with diseases of the blood vessels. It is a relatively new specialty, having been founded in the early 1970s. The first residency program was started at the University of Minnesota in 1973.
The specialty of vascular surgery is divided into two main branches: open surgery and endovascular surgery.
Open surgery is the traditional form of surgery, where the surgeon makes a large incision in the patient’s body in order to access the blood vessels. Endovascular surgery is a newer form of surgery that uses tiny instruments and a camera to access the blood vessels through small incisions.
Vascular surgery is a highly specialized field, and there are only a few hundred surgeons in the United States who specialize in it. The majority of vascular surgeons are based in large metropolitan areas, and there are few rural areas that have vascular surgeons.
Treating a variety of diseases and conditions, including:
- Arterial occlusive disease
- Carotid artery disease
- Venous thromboembolism
- Varicose veins
- Wound care
Vascular surgery is a life-saving procedure in many cases. For example, an aortic aneurysm is a life-threatening condition that can lead to a ruptured aorta. If the aneurysm is detected early, it can be treated with surgery. It is a highly specialized field, and patients should seek out a vascular surgeon who is experienced in treating the specific condition that they have.
Diabetes and Vascular Disease: Understanding the Connection and Taking Control
Diabetes is a chronic condition that affects millions of people worldwide. While most individuals are aware of the impact of diabetes on blood sugar control, many may not fully understand the profound effect it can have on the vascular system. Diabetes significantly increases the risk of developing various vascular diseases, emphasizing the importance of managing the condition effectively. Let’s delve into the connection between diabetes and vascular disease and explore strategies to minimize its impact.
Understanding the Link:
Diabetes is characterized by elevated blood glucose levels, which can damage blood vessels over time. The persistently high levels of glucose in the bloodstream can lead to the accumulation of fatty deposits in the vessel walls, causing a condition called atherosclerosis. Atherosclerosis is a significant contributor to various vascular diseases, including:
Peripheral Artery Disease (PAD):
Diabetes increases the risk of developing PAD, which affects the blood vessels supplying the legs and feet. Reduced blood flow to the lower extremities can result in pain, slow wound healing, and an increased risk of infections and amputations.
Coronary Artery Disease (CAD):
Individuals with diabetes are more prone to CAD, a condition that affects the blood vessels supplying the heart. Narrowed or blocked arteries can lead to chest pain (angina), heart attacks, and other cardiovascular complications.
Diabetes raises the risk of stroke by accelerating the development of atherosclerosis in the arteries supplying the brain. A clot or rupture in these arteries can result in a stroke, causing lasting damage or even death.
The blood vessels in the retina can be damaged by diabetes, leading to diabetic retinopathy. This condition can cause vision loss or even blindness if left untreated.
High blood glucose levels can impair the kidneys’ ability to filter waste products, leading to diabetic nephropathy. It is a progressive kidney disease that can eventually result in kidney failure.
Managing Diabetes and Vascular Disease:
While the connection between diabetes and vascular disease may seem daunting, it’s important to remember that taking proactive steps can significantly reduce the risks. Here are some strategies to manage diabetes and minimize the impact on the vascular system:
Maintain Blood Sugar Levels:
Consistently monitoring and managing blood sugar levels through a healthy diet, regular exercise, and appropriate medication or insulin therapy is crucial. Keeping blood glucose within target ranges helps minimize damage to blood vessels.
Control Blood Pressure and Cholesterol:
High blood pressure and elevated cholesterol levels further contribute to vascular disease. Regular monitoring and effective management of these factors through lifestyle modifications and medications are essential.
Adopt a Healthy Lifestyle:
Engage in regular physical activity, such as walking, swimming, or cycling, to improve circulation and maintain a healthy weight. Follow a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats while limiting sugary and processed foods.
Smoking damages blood vessels and significantly increases the risk of vascular disease. Quitting smoking is one of the most beneficial steps individuals with diabetes can take to protect their vascular health.
Maintain regular check-ups with healthcare professionals to monitor blood sugar control, blood pressure, cholesterol levels, and overall vascular health. Early detection and intervention can prevent or minimize the progression of vascular diseases.
Diabetes and vascular disease are intricately linked, underscoring the importance of proactive management. By effectively managing blood sugar levels, controlling blood pressure and cholesterol, adopting a healthy lifestyle, and seeking regular medical care, individuals with diabetes can significantly reduce their risk of developing or worsening vascular disease. Empower yourself with knowledge, take control of your diabetes, and prioritize your vascular health for a better quality of life.
Intrasight Mobile IVUS
Western Vascular Institute is excited and honored to announce that we have been chosen as 1 of only 6 locations globally to apply a new intravascular ultrasound technology, the IntraSight Mobile IVUS by Philips.
This amazing new technology provides smart, accurate images inside vessels allowing vascular surgeons the ability to more accurately visualize, plan, diagnosis, and treat peripheral vascular disease during interventional procedures.
We are grateful for this opportunity to be a part of the rollout of this new device. It is not only an incredible honor, but it also shows the caliber of Doctors and staff here at Western Vascular Institute.