Vascular Treatments

While most people associate narrowing of arteries or blockages with the heart, this phenomenon can occur anywhere in the body.  When it does, it is known as Peripheral Vascular Disease (PVD) or Peripheral Artery Disease (PAD).  This disease can damage the peripheral vessels in the neck, arms, legs and abdomen, affect the circulatory system, and lead to a stroke or loss of a limb-all life-altering experiences that often can be avoided with early and aggressive intervention.

With today's technology, sophisticated and detailed images of the body can be obtained, painlessly, from outside the body.  These diagnostic exams allow vascular physicians to pinpoint the precise locations and types of blockages and determine the most appropriate courses of treatment.

To accurately diagnose vascular disease, your primary-care physician or another specialist may request one or more non-invasive tests, such as Arterial Doppler/Arterial Duplex and Angiography.

These diagnostic tests are preformed in our Non-Invasive Vascular Lab, and can range from arterial stress tests to specialized vascular ultrasounds that zero in on the problem blood vessels.  Once the tests are complete, vascular physicians interpret the results and report back to you and your doctor.

TREATMENT OPTIONS

The treatment of vascular disease depends on the exact nature of each patient's condition.  One size does not fit all in managing the disease.

Treatment Of PAD

There are many treatments your doctor may recommend.

• Blood thinners to prevent blood from clotting.
• Angioplasty with a stent to expand and open the narrow and diseased artery.
• Bypassing the diseased region of the artery with a vein from another part of the body or with a synthetic blood vessel substitute.
• Endartarectomy - an incision made into the diseased vessel followed by the removal of the fatty deposit and blockage.

This is a new procedure that has proven to be an effective alternative for patients who would be at higher risks associated with the endarterectomy.  During a stenting procedure, a small catheter with a metallic spring-like device, called a stent, is inserted into the artery through the groin.  Using X-ray imaging as a guide, the stent is placed into the region of the artery with the blockage.  The stent is then put into place and left there.  It compresses the plaque against the artery wall, enlarging the vessel opening and increasing blood flow to the brain.

Surgery for Carotid Artery Disease

Carotid endarterectomy is the most common surgical procedure for carotid artery problems:

• A short incision is made just below the jaw.  The carotid artery is exposed and positioned for surgery.
• The artery is opened and plaque is carefully lifted off of the inner wall.  The artery is then stitched shut and the incision is closed.  The result is an artery through which blood flows easily.
• Surgery is often recommended as a means to prevent stroke before actual symptoms occur.

Surgery for Abdominal Aortic Aneurysm

During surgery for AAA, a hollow, man-made tube called a graft replaces the weakened aortic wall.  Again, this surgery should be performed whenever feasible before any symptoms appear.  Result are much better if done before an aneurysm ruptures.

St. Joseph vascular surgeons were the first in Berks County to repair abdominal aortic aneurysms from the inside of the aorta.  Called an Endovascular Graft, the procedure requires two small incisions in the groin and uses X-ray imaging to guide the graft to the aorta.  The graft contains metal hooks at either end that are used to secure it inside the aorta.  Once in place, the device allows blood to flow through the aorta without filling the aneurysm, reducing pressure on the aneurysm and keeping it from bursting.  This allows shorter hospital stays with a more rapid return to work or daily activities.