What is Vascular Surgery?


Vascular surgery describes surgery on the arteries or veins, which are the “highways” of the body’s circulatory system. When a blockage to an artery or vein occurs, patients may need vascular surgery to repair the obstruction and restore normal blood flow to the area.

Vascular surgery frequently involves procedures to address blockages in blood vessels that could occur anywhere throughout the body. When blood vessel issues occur in the heart or brain, they are generally handled by cardiac surgeons and neurosurgeons, respectively.

On the other hand, “vascular surgeons primarily deal with problems of arteries or veins in the arms, abdomen, neck or legs,” says Dr. James Bardgett, a general surgeon with St. Elizabeth Physicians.

Conditions That May Require Vascular Surgery

Patients with atherosclerosis, a disease that causes plaque to build up on artery walls – resulting in a hardening of the arteries and reduced blood flow – may require vascular surgery to correct arterial blockages.

Patients with aneurysms, the medical name for a bulge or enlargement in the wall of an artery, also frequently require vascular surgery, but only when the aneurysm reaches a certain size. Surgeons monitor smaller aneurysms during yearly exams to determine when surgery may be necessary – if at all – for treatment.

“The most common aneurysm that we see is in the aorta, which is the big artery in the abdomen,” Bardgett says. “These are known as abdominal aortic aneurysms, or AAA.” Because this condition is common in men over age 65, Medicare includes an initial ultrasound screening for abdominal aortic aneurysms when they start coverage at age 65.

While less common, aneurysms in smaller arteries behind the knees or in organs such as the kidneys or spleen may also require vascular surgery.

Types Of Vascular Surgery

Surgeons use a variety of vascular surgery techniques, depending on the condition being treated.

A relatively minor vein condition like varicose veins can be treated by a simple outpatient procedure such as laser ablation, which uses a laser to shrink the veins.

More serious issues can require endovascular surgery, in which surgeons insert a stent, a tiny mesh-wire tube, into the blocked blood vessel using a catheter. The stent remains in the artery or vein permanently to expand the blood vessel and improve blood flow. Endovascular surgery typically does not require large incisions or long hospital stays.

Patients with atherosclerosis, or hardening of the arteries, may be candidates for a vascular surgery known as atherectomy, which uses a laser attached to the end of a catheter to remove plaque build-up in the arteries.

Patients with severe arterial blockages could require open or traditional surgery, especially when the artery is not easily accessible through endovascular or other minimally invasive techniques.

For example, those with a blockage in one of their carotid arteries – the main blood vessels that carry blood and oxygen to the brain – may need a surgery called a carotid endarterectomy. In this procedure, surgeons make an incision in the patient’s neck, remove plaque from the carotid artery, and repair the artery. An overnight stay is usually required.

“When we’re treating blockages in arteries, if it’s done endovascularly, patients can have no other evidence other than a little puncture wound in their groin that’s about the size of the end of a pen. And, they can go back to doing normal things the next day,” Bardgett says

What If I Have Questions About Vascular Health?

If you’re wondering about your vascular health, talk with your primary care provider. They can conduct a physical exam and screen you for high cholesterol or other vascular health risk factors. If you have risk factors, your provider may refer you for further screening and evaluation by a vascular specialist.

Our expert physicians at the Florence Wormald Heart & Vascular Institute at St. Elizabeth are available to assist you with any vascular health condition.