Diseases

Examples of Diseases We Treat

Arterial Blockage and Narrowing (Occlusion/Stenosis)

Arteries can become blocked or narrowed from a variety of causes including;

Atherosclerosis or hardening of the arteries. Calcium, cholesterol, and fatty deposits build up in the wall of the arteries reducing blood flow to the legs, brain, kidney and other organs.

Fibromuscular dysplasia
Trauma and/or dissection: Direct injury from accidents
Sudden blood clot or thrombosis

If the blocked artery supplies a patient’s leg, then the leg may ache while walking (claudication), or sores or gangrene may develop. If the blocked artery is in the neck, supplying the brain, the patient may have temporary stroke-like symptoms (Transient Ischemic Attacks). If the narrowing is in the artery that supplies the kidneys, the patient’s blood pressure may be high or erratic and difficult to control.

In many cases these blockages can be treated without surgery. A small nick is made in the groin and a catheter (a small tube) is inserted and gently guided into the damaged artery. Acute blood clots can often be dissolved with medications infused through the catheter (thrombolysis). Severe narrowings (stenosis) may be opened with small balloons (angioplasty) and kept open longer in some cases with implanted metallic stents. Newer options that we are using in some cases include atherectomy, in which the build up of plaque is actually removed from within the artery, and covered stents which act like internal bypass grafts. Some blockages require an open surgical bypass (a vein or synthetic conduit is used to “go around” the blocked artery). Each method has advantages and disadvantages that we can discuss and explain in detail.

Arterial treatment options for blocked arteries:

Angioplasty: A balloon is advanced through a small nick in the groin. A balloon is inflated opening the artery. Occasionally a metallic stent is placed to help the artery stay open. Patients usually have the procedure in the morning and go home the same day. Stents are very often added to the angioplasty to provide more durable and lasting results.

Atherectomy: A small device with a rotating blade cuts the plaque out from within the blood vessel and stores the material in a reservoir for removal.

Bypass: A blocked artery is “bypassed” by placing a length of vein or synthetic material around the blocked artery. Bypasses are used to treat vessels that are too extensively diseased for interventional radiology techniques. It is a more involved procedure as it requires surgery and a hospital stay. However, in many cases it may provide a more durable result.

Endarterectomy: An open surgical technique for the removal of plaque from the artery. This is particularly applicable to disease in the carotid arteries.

Thrombolysis: A catheter is advanced into the blood clot within the artery and a thrombolytic drug is infused over a period of hours which dissolves the blood clot. This procedure requires admission to the Intensive Care Unit.

Combination: Many patients need a combination of the above procedures. We are able to provide these to you seamlessly with the combination of radiology and surgical specialists.

Specific Examples:

PVD (Peripheral Vascular Disease) Reno-vascular (Kidney Blood Vessels) Carotid Stenosis Abdominal Aortic Aneurysms