Vascular Surgery Health Information

Vascular disease includes any condition that involves your circulatory system: the network of veins, arteries, lymph vessels that carry blood and fluids to and away from your heart. Below are some frequently asked questions about vascular disease and how it is treated.

An artery is a blood vessel that carries blood away from the heart to provide oxygen and nutrition to the body’s organs and tissues. Veins carry blood back to the heart. Lymphatics return extra fluid in the tissues to the veins. Vascular disease may affect arteries, veins or lymphatic vessels. Different treatments are needed for artery, vein or lymphatic diseases.

There are a number of factors that contribute to the development of vascular disease. The most important are smoking, diabetes, high blood pressure, high cholesterol and older age. Genetics can also be important in the development of vascular disease.

Open surgery is surgery performed through an incision in the skin while endovascular surgery is performed through catheters usually introduced through a needle in the groin. Depending on individual circumstances patients may be best treated with open surgery, endovascular surgery or no surgery at all!

Vascular surgeons have extensive training with most having 7 to 8 years of training beyond medical school. Vascular surgeons are the only physicians providing the full spectrum of care for patients with vascular disease including medical management of vascular disease, noninvasive and invasive diagnosis of vascular disorders, as well traditional open surgical management of vascular disease and minimally invasive (endovascular) procedures for diseases of the arteries, veins and lymphatic vessels. Vascular surgeons differ from general surgeons in that they have taken 2 to 3 years of additional training beyond general surgery training with this additional training specific only for evaluation and treatment of patients with vascular disease. Vascular surgeons differ from radiologists and cardiologists treating vascular disease in that vascular surgeons have more training specifically directed to the care of patients with vascular disease and vascular surgeons can treat vascular disease patients with either open or endovascular procedures; whichever is most appropriate for the individual patient.

Noninvasive vascular testing refers to the diagnosis of vascular disease with diagnostic tests that do not require insertion of needles or injection of dyes into the blood stream. There are tests for diseases of arteries and veins throughout the body. Most noninvasive vascular testing involves the use of ultrasound. At OHSU noninvasive vascular testing is performed by skilled and highly trained vascular technologists with the studies reviewed and interpreted by a vascular surgeon.

Noninvasive vascular testing is crucial in the diagnosis of virtually all types of vascular disease. The OHSU vascular laboratory is among the most prestigious vascular laboratories in the country with many of the techniques used around the world for noninvasive diagnosis of vascular disease originally developed or refined in the OHSU vascular laboratory by OHSU vascular surgeons.

An aneurysm is an enlarged blood vessel, usually an artery. Aneurysms can occur in any artery but are most common in the main artery of the chest or abdomen called the aorta. Aortic aneurysms are dangerous and are prone to break if they reach a certain size. Depending on individual circumstances aortic aneurysms are repaired with either open or endovascular techniques.

The carotid arteries are the main blood vessels supplying blood to the brain. They begin from the aorta in the chest just beyond the heart and travel through the neck to the brain. Plaque can build up at specific locations in the carotid artery (most often in the neck). When the buildup of plaque is sufficiently severe pieces can break off and lodge in the brain or the artery in the neck may clot completely. Both mechanisms can lead to a stroke. Depending on individual circumstances patients with buildup of plaque in the carotid artery in the neck can be treated by direct surgical removal of the plaque (carotid endarterectomy) or by placement of a carotid artery stent (carotid artery stenting).

PAD is short for peripheral arterial disease. The term is usually used to indicate the presence of artery disease limiting blood flow to the lower extremities. Patients with PAD may have no symptoms, pain in their calves or buttocks with walking, severe pain in their feet at rest or nonhealing wounds of the foot. Depending on individual circumstances PAD is treated with medicines alone or combinations of medicines with either open or endovascular techniques.

Many patients with varicose veins have no symptoms and seek treatment primarily for cosmetic reasons. Other patients experience swelling of the legs or leg pain and aching caused by their varicose veins. In the most extreme cases varicose veins can cause open sores around the ankle area. Varicose vein treatments are very effective in improving symptoms resulting from varicose veins. Whether to treat varicose veins is a decision best made after discussing the advantages and disadvantages of varicose vein treatment with a physician experienced in the treatment of varicose veins.