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Vascular Surgery

Carotid Artery Disease

The carotid arteries in the neck carry blood from the heart to the brain. Carotid artery disease results from a build-up of plaque that hardens the artery, a condition called atherosclerosis. This blockage can narrow the artery and restrict blood flow, increasing stroke risk. A piece of the blockage can also break off and lodge in the artery or in a smaller vessel.

Carotid artery disease does not always cause symptoms. But some people experience warning signs in the form of transient ischemic attacks, or TIAs. During a TIA, you may have tingling, weakness, numbness or loss of control on one side of your body; loss of vision in one eye; or a slurring of speech. These symptoms are temporary and usually disappear within an hour. Nevertheless, they should be reported to your doctor immediately. If these symptoms last more than a day, you may have had a stroke.

Carotid Surgery

Carotid surgery is performed to clear a blockage in the carotid artery and restore blood flow to the brain. Carotid surgery procedures may take the form of an endarterectomy or an angioplasty with stent placement.

A carotid endarterectomy surgically removes diseased material and clogged deposits from the inside of the carotid artery to restore normal blood flow. By keeping blood flow open to the brain, a carotid endarterectomy helps prevent the occurrence or recurrence of stroke.

Central Venous Access

Central venous catheters are hollow tubes used for the efficient delivery of chemotherapy drugs, fluids, blood or other medications, or for regular blood sampling, over the course of a few weeks or months. One end of the catheter is placed in the largest vein in the chest, called the Superior Vena Cava or SVC, while the other end may be tunneled just beneath the skin's surface or surgically implanted (portacath or "port"). Catheters called PICCs (Peripherally Inserted Central Venous Catheters) may be inserted via a peripheral blood vessel.

Dialysis Access

Short for hemodialysis, dialysis is the most common treatment for chronic kidney failure. When the kidneys fail, they can no longer filter waste from the blood. Dialysis does the kidneys' job for them: blood is removed from a vein in the patient's arm or leg, circulated through a filtering machine and returned to the body through an artery.

Because veins tend to have weak blood flow, doctors often connect one of the patient's nearby arteries to the vein being accessed for dialysis. This increases blood flow and strengthens the vein, which in turn allows more blood to flow. The vein's increased strength and capacity helps create a durable access site and provide ample blood flow for patients undergoing long-term dialysis.

The artery-to-vein (arteriovenous, or AV) connection can be created in one of two ways: with a graft or with a fistula. A graft is an artificial tube; an AV fistula is a direct surgical connection of one vessel to the other using the patient's own tissues. Although fistulas typically take three to six months to mature while grafts only take two to six weeks, doctors prefer to use fistulas because they tend to be stronger than grafts and have a lower risk of infection. Grafts may be recommended for patients with small, blocked or scarred veins. If the patient needs immediate treatment, a tube called a venous catheter may be used for a few weeks or months until the fistula or graft is ready.

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