Endovascular Surgery and Limb Preservation

If you are at risk or suffering from vascular disease, a vascular doctor in West Palm Beach, Florida may be able to help you. Some people might be at risk of developing vascular diseases due to aging, genetic disorders passed from generation to generation and health conditions caused by high blood or cholesterol levels.

St. Mary’s Medical Center in West Palm Beach, Florida has an experienced team of surgeons and physicians to provide our patients with minimally invasive vascular interventional procedures. We also have specialized procedures to repair damage, spare tissue and maintain and restore function in limbs instead of amputating them.

We are excited to expand our endovascular surgery offerings to now include a Limb Preservation Program and Hybrid Endovascular OR suite. Here are some of the conditions we can treat:

• Aortic aneurysm
• Carotid artery disease
• Deep vein thrombosis/pulmonary embolism
• Diabetic peripheral neuropathy
• Diabetic ulcers/wounds
• Mesenteric and renal disease
• Pelvic congestion syndrome
• Peripheral vascular disease/peripheral arterial disease
• Vascular malformations
• Venous disease

Vascular Diseases

The vascular or circulatory system consists of the heart, arteries, veins and capillaries. Certain conditions can affect the vascular system and threaten a patient’s life if left untreated. Here are some of them:

• Aneurysm – a bulging in the artery wall that may grow large and burst.
• Atherosclerosis – a reduction of blood flow throughout the body due to plaque buildup in the arteries.
• Deep vein thrombosis (DVT) - when a vein becomes damaged or the blood flow slows down or stops, a blood clot forms. A rare condition called pulmonary embolism can develop when this blood clot breaks free, travels through the bloodstream and blocks the blood flow to the lungs.
• Coronary artery disease – plaque buildup can narrow or block blood flow in the arteries, weakening the heart muscle. Over time, this may lead to heart failure and arrhythmias.
• Raynaud’s disease – a condition that causes vasospasm or the narrowing of the blood vessels, resulting in restricted blood flow. It usually affects the toes and fingers.
• Stroke – a medical emergency wherein brain cells die within minutes of blood flow blockage to the brain, preventing it from getting nutrients and oxygen from the blood. It can result in long-term disability, brain damage or death.
• Varicose veins – the swelling and twisting of veins due caused by damaged or weak vein walls and valves
• Vasculitis – happens when the body’s immune system mistakenly attacks the blood vessel. Medicine, infection or another disease may cause this.

The following imaging tests are used to diagnose circulatory or vascular system diseases:

• Cardiac CT – also known as a CAT scan, this noninvasive diagnostic test uses X-rays to take detailed images of the heart and blood vessels.
• Cardiac MRI – uses magnets, radio waves and a computer to create detailed images of the heart. This can give an accurate picture of a person’s heart muscle, function, chamber size and connected blood vessels.
• Coronary angiography – uses X-ray images and contrast dye to detect coronary artery blockages due to plaque buildup.
• Echocardiogram – soundwaves create moving pictures of a person’s heart.
• Magnetic resonance angiography (MRA) - an MRI of the blood vessels; this diagnostic test may take an hour or more.
• Stress tests - usually involve physical exercise such as walking on a treadmill. The doctor will measure heart activity and blood pressure changes through the electrodes, blood pressure cuff and pulse monitor attached to the patient.

What Is Endovascular Surgery?

Endovascular surgery is a less invasive procedure designed to treat problems affecting the blood vessels, such as an aneurysm. The surgeon will work within the blood vessels by accessing them through a small incision near the hip. A catheter will be used to insert an endovascular graft through the arteries. This graft is a device made with a fabric tube framed with stainless steel. It will expand and seal the affected artery to prevent blood flow into the aneurysm.

What Is the Difference Between Endovascular and Vascular Surgery?

Vascular surgery is more invasive than endovascular surgery. A patient may undergo vascular surgery if nonsurgical or less invasive treatments cannot treat their vascular disease. A vascular doctor can perform the following procedures:

• Arterial bypass grafts
• Endarterectomies
• Aneurysm repair in the aorta and its branches

How Long Does Endovascular Surgery Take?

An endovascular surgery procedure can take 1 to 1.5 hours. The endovascular graft will hold open the blood vessel wall and allow blood to flow, much like in a healthy artery. Tissues and cells will grow over the graft until they cover its inner surface, making it a permanent part of the artery.

There is a lower risk of major complications with endovascular repair. However, doctor follow-ups are still needed to ensure that the graft does not slip. Most patients stay in the hospital for 1 to 3 days. After that, patients may take pain medication for a few weeks after.

How Long Does It Take To Recover From Endovascular Surgery?

Some endovascular aneurysm repair (EVAR) patients can recover in about two weeks. Still, some can take longer and may take several months before returning to their state of health before the surgery. A patient of open aneurysm surgery may fully recover after 3 to 6 months, while the recovery may only be 2 to 4 weeks for an EVAR patient. Age and general fitness can also affect the speed of recovery.

How Can Endovascular Surgery Help My Prognosis?

The Journal of Vascular Surgery studied the long-term survival difference between two abdominal aortic aneurysm repair groups: open and endovascular. More than 50% of the endovascular surgery subjects are still alive 10 years after inclusion in the study.

Overall, the study did not find a significant difference in the overall survival between individuals who underwent open or endovascular surgery. In another study in the Journal of Vascular Surgery, 85 years was the median age of 42% of the individuals who survived more than 10 years after EVAR.

Nevertheless, your lifestyle and habits can help you live healthily and recover properly after your endovascular surgery. Here are some ways you can help yourself:

• Stop smoking.
• Do gentle exercises to improve your overall fitness level.
• Get your blood pressure regularly checked.
• Maintain healthy blood sugar levels.
• Regulate cholesterol levels in your body by eating a healthy and balanced diet and reducing any excess body weight.

Find a Vascular Surgeon

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