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Vascular Surgery

What is vascular surgery?

Vascular surgery deals with blood-vessel conditions. Our surgeons at Johns Hopkins Aramaco Healthcare (JHAH) treat a number of artery and vein diseases, from aneurysm or dissection of the aorta, to the narrowing or occlusion of vessels such as the carotid or the lower-extremity arteries. We also provide diabetic foot care, limb-salvage procedures, and consultations if you are suffering from renal failure and are in need of hemodialysis.

Vascular surgery treatments, services and procedures

An aneurysm occurs when factors such as ageing, smoking or genetics lead to the progressive dilation of the body’s main artery, the aorta. If it is not treated early, the artery can continue to expand, which can potentially lead to a life-threatening rupture. The standard method of treatment is open surgery. However, our endovascular technique is less invasive and could mean you are discharged within a day or two. Our team has the skills and experience to treat aneurysms in the chest, abdomen and other peripheral artery locations.

Progressive artherosclerosis (plaque build-up inside the arteries) can lead to significant narrowing and blockage of the distal aorta and extremity arteries. You may be suffering from symptoms that indicate reduced blood supply to the extremity muscles, such as pain in the calf or thigh muscles during exercise. Among the numerous procedures available to help salvage limbs and maintain quality of life, an open bypass or angioplasty with or without stents could be carried out.

Varicose vein disease is a common condition affecting both men and women. You may be suffering from lower-extremities disfigurement, or pain and fatigue, with or without skin changes. Once an examination has been carried out, a vascular surgeon can employ one of several techniques, including laser, radiofrequency and glue injection, in addition to chemical sclerotherapy.

A mini-stroke is an early symptom of problems with the blood supply to the brain, and can mean sudden loss of vision in one eye, speech disturbance or weakness/numbness on one side of the body. A vascular surgeon may recommend a surgical procedure to unblock the carotid artery (carotid endarterectomy) in order to remove the source of clots showering to the brain, and reduce the risk of stroke.

Diabetic foot occurs when plaque build-up inside the arteries destroys the internal architecture of the foot and causes gangrene. The vascular part of the condition can be managed by a vascular surgeon, who will try to improve blood circulation for quicker healing. Foot care will involve taking care of wounds and deformities using surgical procedures and wound-care products. The main goal is to maintain and improve the functionality of your foot, and limit the risk of amputation.

If you are suffering from renal failure, you will usually be advised by a kidney specialist to undergo renal-replacement therapy. Hemodialysis can be used but, in order to proceed, blood needs to be withdrawn from the body with adequate pressure and speed to run into the dialysis machine and back out again. A vascular surgeon will study the blood vessels of the upper and lower extremities, and plan the appropriate artery-venous access to enable this.

Find out more about our hemodialysis services

When examining for blood vessel diseases, a vascular surgeon will aim to use non-invasive methods, including pressure measurement of the extremities, waveform recording, and Doppler ultrasound. This is to minimize the risks to you associated with radiation and contrast used by conventional X-ray tests, for example a CT scan with contrast. Additional side effects of the X-ray and contrast can include allergies, tissue damage, kidney failure and cancer. The first step in checking for peripheral artery disease is to obtain an ankle-brachial index. Performed by a vascular laboratory specialist, this simple test will tell us the severity of artherosclerosis disease and can help us plan the appropriate therapeutic interventions.

What to expect from our vascular surgery services

Our Vascular Surgery Clinic is not a self-referral service, so your Primary Care physician or other specialist such as your cardiologist, kidney specialist or neurologist, will make a referral for you if they believe you need a vascular surgeon to evaluate your condition.

During treatment

When you arrive at the Vascular Surgery Clinic, you will be checked in, and within five minutes our surgical nurse will carry out an initial clinical screening. Wait times are around 15-20 minutes, and your appointment will usually last 20-30 minutes.

During your initial consultation, your vascular surgeon will learn about your symptoms, and perform a physical examination in order to determine the status of your blood vessels. Non-invasive vascular laboratory testing is usually performed next, and if this is inconclusive you may be asked to undergo further radiological testing. If your condition requires intervention, a consultation with our team will be arranged in order to prepare you for the procedure.

You will then be invited to a clinic, usually two to three weeks before your treatment, to ensure that you are well enough for the anesthetic and operation. This may involve blood tests, X-rays and a urine sample. Depending on your treatment, you may be invited to attend follow-up appointments, and recovery sessions may also be available. 

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