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Treatments for blood vessel problems

Vascular surgeons are specialists who are trained to treat blood vessel problems. Vascular surgeons use the following treatments and procedures for blood vessel problems.

Angioplasty

Angioplasty is when a surgeon uses a tiny balloon to widen arteries to improve the blood flow.

The surgeon attaches the balloon to a small tube called a catheter. They pass the catheter through a small cut in your leg or arm artery, and move it to where the artery is blocked. They inflate the balloon, causing the artery to widen. Then they deflate and remove the balloon.

At the same time, they may insert a stent (a small plastic or metal tube) and leave it in place to keep the artery open.

Arterial bypass

In an arterial bypass, a surgeon redirects the blood flow around a blockage in your blood vessel. The surgeon often uses a plastic tube for the bypass but sometimes they use a length of your own vein.

Atherectomy

An atherectomy is an alternative to an angioplasty. In an atherectomy, a surgeon removes plaque from the inside of your artery, which improves the blood flow.

During an atherectomy, the surgeon uses a small tube called a catheter to insert a small cutting device into the blocked artery. They then use the cutting device to shave or cut off the plaque from the affected area in your blood vessel.

Carotid endarterectomy

In this procedure, a surgeon removes plaque from the carotid arteries in your neck.

The surgeon opens your carotid artery by making a small cut in your neck, and removes the plaque. This restores the blood flow to your brain, which can help prevent a stroke. The surgeon then closes the cut in the artery.

Embolectomy

An embolectomy is a procedure used to remove a blood clot.

In an embolectomy, a surgeon inserts a small tube called a catheter into a large vein in your groin or neck. They then move the catheter through your vein until it reaches the clot.

They may use suction to remove the clot. This is called an aspiration embolectomy. Or they may inflate a balloon at the end of the catheter and slowly pull it out of the vein bringing the clot with it. This is called a balloon embolectomy.

Endovascular repair

In this procedure, a surgeon inserts a small tube called a catheter into your artery. They usually insert it into an artery in your groin but sometimes they insert it into an artery in your upper arm. They move the catheter through your artery until it reaches the aneurysm. They then place a stent (a small plastic or metal tube) in the artery. This allows blood to flow through the stent instead of the aneurysm.

Endovascular coiling or surgical clipping

Surgeons use this for cerebral (brain) aneurysms. They place a small clip across the base of the aneurysm. This stops blood from entering and making the aneurysm bigger, while allowing blood to flow through the artery.

Endovenous laser therapy

Endovenous laser therapy is used to treat varicose veins.

In endovenous laser therapy, a surgeon uses a laser to heat the vein. This closes it and seals it shut. Your body redirects your blood flow to healthier veins.

Endovenous treatment

Endovenous treatment is used to treat varicose veins.

The treatment can be thermal (using heat from a laser for example) or non-thermal. You're usually given the treatment while you're awake. The surgeon delivers the treatment through a small needle hole in your vein.

Each type of treatment has advantages and disadvantages and not all types of treatment are possible for each vein. Your vascular surgeon will tell you what the best type of treatment is.

Traditional surgery

In some cases, traditional surgery is still performed and takes place in an operating theatre. With traditional surgery, you're put to sleep with an anaesthetic. The surgeon makes a cut in your chest or stomach to provide access for surgery to your arteries. You may or may not need to stay in hospital after your surgery.

Radiofrequency ablation

In radiofrequency ablation, a surgeon heats the walls of your varicose veins, causing them to collapse. This closes them and seals them shut. Your body redirects your blood flow to healthier veins.

Sclerotherapy

Surgeons use this on small varicose veins. They inject a chemical into the vein which irritates the vein wall. This causes it to get inflamed, which makes it close up and fade away. Your body redirects your blood flow to healthier veins.

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Written by HealthInfo clinical advisers. Endorsed by clinical director, Vascular Surgery, Canterbury DHB. Page created July 2018.

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Review key: HIBLV-403653