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Frequently Asked Questions: Vascular Health

What Is Vascular Surgery?

Vascular surgery is the assessment and treatment of blood vessel diseases, including both arterial and venous disorders. It encompasses a wide range of diagnosis from simple spider veins to life-threatening abdominal aortic aneurysms. Treatment procedures are related to reestablishment of impaired circulation.

What Is a Vascular Surgeon?

A vascular surgeon is a physician who has met rigorous educational requirements including 4 hears of college, four years of medical school, five years of general surgery residency, and wo years as a vascular fellowship trainee. A vascular surgeon cares for patients with diseases that affect the arteries and veins throughout the body. This medical specialty first emerged in the early 1950s. Over the ensuing decades, pioneers in this specialty expanded our knowledge of the disease processes that affect blood vessels and helped to develop many of the diagnostic modalities and treatments that we use today.

What Conditions or Diseases Does a Vascular Surgeon Provide Care For?

A vascular surgeon provides care and performs procedures on patients with diseases, disorders, or inflammation of the veins and arteries. See Conditions for examples of these blood vessel diseases or conditions.

More Information

See the answers to more frequently asked questions.

Glossary of Vascular Terminology

A

Abdominal aortic aneurysm (AAA) - A weakness or bulge of the main artery in the abdomen (belly).

Amputation - Surgical removal of a limb or portion of a limb. Above knee, below knee, or partial foot are all varieties.

Amurosis fugax - Blindness or temporary loss of vision due to plaque blocking the blood supply to the eye.

Aneurysm - Abnormal weakening of the wall of an artery causing a “ballooning” appearance, enlarging to over twice normal size.

Angiogram - A specialized test using contrast injected into arteries to evaluated them for blockage.

Angioplasty (balloon) - A procedure that widens arteries narrowed by arterial disease. A catheter with a deflated balloon is threaded through the narrowed artery to the narrowed part and then inflated to break the plaque and expand the artery.

Ankle brachial index (ABI) - A non-invasive method for testing for peripheral arterial disease through the use of a Doppler probe and a blood pressure cuff on both the arms and ankles. Ideally these two blood pressures should be equal. An ABI of greater the .96 is considered normal.

Antiplatelet - Medication, including aspirin and newer agents used to prevent clumping together of platelets, one of the first things to occur in artery clotting.

Aorta - Main blood vessel in the chest and abdomen that transports blood from the heart.

Aortic bypass - A vein or plastic tube is sewn in place to redirect blood flow around a diseased part of the aorta.

Aortic occlusive disease - Development of atherosclerosis within the abdominal aorta with sufficient plaque build up to cause significant blockage of arterial blood flow to the abdomen and legs.

Aortic stent grafting - The insertion of a fabric graft through a blood vessel in the groin to the aorta. This is placed inside the aneurysm and the blood will flow through it, relieving the aneurysm of pressure.

Aortic surgery - Cutting the abdomen open to repair aneurysms or occlusive disease.

Arteriogram - An x-ray used to determine specific arterial blockages in the body, providing a road map of the arteries. The procedure involves inserting a small catheter into the artery that injects dye. Also called an angiogram.

Arteriovenous (AV) fistula - A direct surgical connection of a vein to an artery, usually in the arm, used for hemodialysis.

Arteriovenous graft - Connection of a vein to an artery using a man-made tube tunneled under the skin, used for hemodialysis.

Artery - A pipeline (blood vessel) carrying oxygen-rich blood from the heart to the rest of the body. When diseased, the organ supplied may become damaged due to lack of oxygen and nutrients. See Ischemia.

Aspirin - A medication used to thin the blood.

Atherosclerosis, arteriosclerosis - From the Greek words athero (gruel or paste) and sclerosis (hardness). The process within the arteries where deposits of fatty substances, cholesterol, calcium or fibrin are built up in the inner lining (called plaques). A normal consequence of aging where the arterial walls gradually thicken and arterial fibers decline. The arteries become stiff.

 

B

Balloon - A device used to open narrowed arteries.

Blood pressure - The force of blood pushing against blood vessel walls.

Blue toe syndrome - The result of a blood clot that lodges in the small arteries of the toes.

Buerger's disease - An inflammation of medium and small arteries in the arms and legs, most commonly in smokers.

Brachial artery - An artery in the arm, commonly used to create AV fistulas for dialysis.

Bypass - An open surgical procedure done to redirect blood flow around a blocked artery.

 

C

Calcified vessels - When an artery becomes hardened from calcium deposits in the wall. Often seen in diabetes. Affects the ability to make accurate pressure measurements in the legs.

Carotid artery - The carotid artery is the major artery providing blood flow to the brain from the heart. It is located in the front of the neck. Carotid artery disease may develop when sufficient plaque development builds up in the neck. This can break free from the artery (embolism) and travel upstream to the brain, potentially causing a stroke.

Catheter - A tiny flexible tube inserted in a blood vessel to inject dye, assist with the removal of a blood clot, or inject medication.

Celiac artery - The artery that supplies blood to the stomach and other internal organs.

Cellulitis - A serious infection in the skin and tissue under the skin.

Cerebral vascular accidents (CVA) - Lack of blood supply to the part of the brain which can cause loss of speech, blindness, paralysis or weakness.

Chronic venous insufficiency (CVI) - A disease in the veins that causes leg swelling, pain and varicose veins.

Claudication - Occurs because a blocked artery is interfering with the amount of oxygen-rich blood that can reach the muscles in one or both of the arms or legs, resulting in cramps or fatigue with exercise.

Collateral circulation - The slow development of smaller peripheral arteries to allow some blood flow around the narrowed/blocked area of an artery. This occurs as an adaptation when an artery is slowly blocked with plaque over time.

Compression therapy - The use of tight wraps or special stockings to control swelling in leg or arm.

Contrast dye - A radiopaque liquid injected into arteries during an angiogram to evaluate the arteries for blockages.

Coumadin - A medication used to thin the blood.

 

D

Deep vein thrombosis (DVT) - Clotting within the vein caused from an injury, immobility or abnormal clotting factors. Usually in the leg.

Diabetes mellitus - A metabolic disorder in which the body does not produce insulin (type 1) or when the body does not make enough or cannot properly use insulin (type 2).

Diabetic foot ulcer - A painless ulcer that usually develops on the bottom of the foot in diabetics caused by an injury and worsened from lack of normal sensation (neuropathy).

Diabetic neuropathy - A disease of the nerves in the hands and feet of people with diabetes that causes altered feelings of pain, heat or cold, often diminishing normal sensation.

Dialysis - A mechanical means to clean the blood, when the kidneys are not functioning.

Dialysis catheters - Plastic tubing placed into a vein in the neck for hemodialysis, usually temporarily until access has been surgically created.

Digital gangrene - Sores or ulcers can develop on the fingertips of the hand related to loss of blood flow or tissue injury. The presence of digital gangrene may imply several serious medical disorders.

Doppler - A diagnostic tool that uses low-intensity ultrasound to visualize and detect blood flow velocity in arteries or veins. Duplex is a diagnostic tool that combines Doppler and ultrasound.

 

E

Edema - Swelling or fluid collection in the tissues.

Endarterectomy - The removal of plaque from the inner wall of a diseased artery by surgery.

Endograft -A graft placed inside the blood vessel to treat aneurysms.

Endovascular - Repair or reconstruction of an artery from within using minimally invasive techniques.

 

F

False aneurysm - An injury to the layers of the artery that allows blood to leak outside of the vessel and is held by the surrounding tissues.

Femoral artery - The large artery in the leg which extends from hip to knee. Often the bypass grafts start at this point.

Fibromuscular dysplasia (FMD) - Narrowing of an artery due to spasm in the thin muscle layers in the artery wall.

Fenestrated endograft (FEVAR)- A specialized stent graft used to repair aneurysms in the aorta, particularly when the aneurysm is near important arteries that supply the kidneys or other organs. The graft has custom-made openings called fenestrations that align with these arteries, allowing blood to continue flowing to them while reinforcing the weakened aortic wall.

 

G

Gangrene - Dead tissue due to a lack of blood supply.

Graft - A small synthetic tube used for bypass surgery and AV fistulas.

 

H

Hemodialysis - Filters blood using a man-made filter attached to a machine. Blood travels from your body, is cleansed by the machine, then returned to your body.

Homocysteine - An amino acid in the blood. Elevated plasma levels may lead to increased risks of PAD.

Hypertension - When the pressure in the arteries is consistently above the normal range, leading to increased risk of stroke or heart attack. Also known as high blood pressure.

 

I

Iliac artery - The artery deep inside the abdomen that carries blood from the aorta to the pelvis and legs.

Insulin - A hormone produced by the pancreas essential for the body’s use of sugars.

Intermittent claudication - Symptoms that occur when the leg muscles do not receive the oxygen-rich blood required during exercise, thus causing cramping in the hips, thighs or calves.

Ischemia - An organ (heart, brain, kidneys, or foot, for example) that is not getting adequate blood flow and lacks vital oxygen and nutrients, preventing normal function.

 

J

Jugular vein - Large vein in the neck, often used to place dialysis catheters for hemodialysis.

 

K

Kidney failure - The inability of kidney to filter toxic bodily byproducts.

 

L

Laser - Concentrated light beam, sometimes used in the treatment of varicose veins.

Leg bypass - A vein or plastic tube is sewn in place to redirect the blood flow around a diseased portion of a blood vessel in the leg.

Leg ulcers - Open areas that can occur when blood flow is impaired causing skin breakdown. Arterial ulcers usually affect the toes and feet. Venous ulcers usually occur around the ankles and up to the knees.

Lipids - Another term for fats that can be broken down into fatty acids.

Lipoproteins - Proteins that transport cholesterol and other fats to and from cells. LDL is the subtype most dangerous for peripheral arterial disease. HDL is beneficial in prevention.

Lymphedema - Swelling that occurs as a result of blockage within the lymphatic vessels of the limbs. There are multiple causes of lymphedema. Compression is the usual mainstay of therapy.

 

M

Mesenteric artery - An artery that supplies blood to the intestines.

Mesenteric ischemia - Decrease in blood flow to the small bowel and colon. Symptoms may include sudden abdominal pain, abdominal distention, blood in your stool, vomiting or diarrhea. Chronic changes can include weight loss and fear of eating.

Mini-stroke - See transient ischemic attack. A small stroke that lasts a short time.

 

N

Noninvasive - Medical procedures or exams which do not involve needles, dye or x-ray to diagnose arterial diseases

 

P

Percutaneous access - Going through the skin with a needle and or catheter to access an artery or vein.

Peripheral arterial disease (PAD) - A common disorder that occurs in the artery segments of the circulatory system (legs, pelvis, neck, brain). The artery wall linings slowly become narrowed by irregular clots formed due to build up of cholesterol or plaque. It has major implications on a patient’s life due to association with blockages in the heart and brain with potential for death from heart attack and stroke.

Peritoneal dialysis - Uses the natural lining of the abdomen. A fluid is placed into your abdomen through a peritoneal dialysis catheter and the lining helps to clean the blood.

Phlebitis - Inflammation in a vein, usually caused be a clot.

Plaque - The build up material on the inner lining of an artery made up of cholesterol and fatty substances.

Popliteal artery - The artery behind the knee that supplies blood to the lower leg.

Post phlebitic syndrome - A combination of leg pain, infection of the skin, hardening of the skin with a dark coloring, and open areas caused by abnormal pressure in the veins.

Pulmonary embolism - On the vein side of the circulation, a blood clot which has broken free of its attachment site and traveled to the heart and lungs (embolism). This may result in immediate cardiac arrest.

 

R

Raynaud's syndrome - A condition where an exaggerated response to temperature can produce extreme blanching of the hands or feet in response to an environmental or systemic stress.

Renal artery - Artery that supplies blood to the kidney.

Renal artery stenosis - Narrowing of the artery to the kidney.

Renal failure - The inability of the kidneys to filter toxic bodily byproducts.

Renal vascular disease - Atherosclerotic plaque build-up within the arteries leading to the kidneys that may produce a severe increase in blood pressure and make treatment with blood pressure medicines difficult.

Rest pain - The onset of constant leg pain that occurs at rest. This may be due to severe lack of blood flow to the limbs.

Revascularization - Surgical procedures to restore blood flow within the artery.

Ruptured aneurysm - When the enlarged vessel leaks, typically in the abdominal aorta.

 

S

Saphenous ablation - A minimally invasive surgical procedure were special catheter in a vein heat seals the vein as a treatment for varicose veins.

Sclerotherapy - A treatment for small varicose or spider veins, sealing them by injection or the use of a laser.

Signs of infection - Redness, warmth, tenderness, foul smelling drainage, or elevated temperature.

Spider vein - A very small varicose vein. These are usually considered "cosmetic veins."

Stasis dermatitis - Inflammation in the skin, often caused by chronic swelling.

Stasis ulcer - A skin ulcer, usually caused by chronic swelling, varicose veins and chronic venous insufficiency.

Stenosis – A narrowing of a blood vessel, such as artery or vein.

Stents - Wire mesh tubes that are surgically placed within the artery (recently cleared through angioplasty) via a catheter threaded through the artery. It is opened to form a rigid support to hold the clogged artery open to potentially prevent recurrent narrowing.

Stroke - When blood flow to a part of the brain is stopped, even briefly. Symptoms can be numbness or weakness of the arms or legs, sudden changes in vision or loss of vision in one eye, slurring of words, or facial droop.

Subclavian artery - Artery that branches off of the aorta in the chest and supplies blood to the arm.

Superficial phlebitis - Inflammation in a superficial vein causing pain, redness and a hard lump. Usually due to a blood clot.

Swelling - Collection of excess fluid.

 

T

Thoracic aortic aneurysm - An aneurysm of the portion of the aorta coming from the heart to the diaphragm.

Thoracic outlet syndrome - A change in the sensation, color, and/or movement of an arm caused by pressure on nerves and blood vessels in the upper chest area. Symptoms may include pain, swelling, numbness and/or weakness associated with positioning of the arms. Diagnostic testing may include x-ray of the chest and neck, and physical evaluation of the arms in different positions. Management of this disease may include exercises, trigger point injections or surgery.

Thrombolysis - A radiology procedure that uses medication to help dissolve blood clots in the arterial or venous system.

Thrombosis - Blockage in an artery or vein.

Transcarotid stent - A stent placed in the carotid artery using a minimally invasive transcarotid artery revascularization (TCAR) procedure. Unlike traditional carotid stenting through the femoral artery, TCAR involves a small incision near the collarbone to directly access the carotid artery. This method allows for temporary blood flow reversal, reducing the risk of stroke by preventing plaque from traveling to the brain during the procedure. 

Transient ischemic attack (TIA) - A brief disturbance in vision described as "blurring" or "a curtain over the eye" that clears in several seconds to minutes. This is typically caused by plaque dislodgment.

Triglycerides - The chemical form in which most fats exist in foods.

 

U

Ultrasonic duplex scanning - The diagnostic test for peripheral arterial disease that produces images of arteries or veins on a screen via the use of ultrasound equipment. This test is used to locate blocked arteries or measure their size.

Ultrasound test - A test commonly used in the diagnosis of vascular diseases using special equipment that measure and evaluate structure under the skin, i.e.: arteries, veins, kidneys, aneurysm, etc.

Unna boot - A special medicated wrap used on the legs and feet to control swelling and treat skin ulcers.

 

V

Varicose veins - Enlarged superficial veins of the legs, which can produce heaviness, throbbing, or aching and may present an unsightly cosmetic appearance.

Vascular medicine - A branch of medicine that deals primarily in medical treatment of vascular diseases.

Vein stripping - A surgical procedure that involves removing the diseased vein through several small incisions.

Veins - Blood vessels that carry the blood from the body back to the heart.

Venous insufficiency - Deterioration of valve function within the veins of the legs, causing blood pooling in and around the ankle. This leads to heaviness of the leg, swelling and occasionally ulceration.

Vertebral artery - An artery in the back of the neck providing additional blood flow to the brain. Vertebrobasilar insufficiency may develop when these blood vessels are significantly blocked due to atherosclerosis or plaque formation. The symptoms that develop from this insufficient blood flow may mimic a stroke.

Vessels - The tube-like structures in the circulatory system that are responsible for circulating blood within the body. The three kinds of vessels are arteries, veins and lymphatics. Capillaries are the microscopic structures that connect arteries and veins at the tissues.

VNUS closure - A minimally invasive procedure to treat varicose veins using a special catheter to heat seal the veins

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