As per GOI's circular on price capping of Orthopaedic Knee implant by NPPA (National Pharmaceutical Pricing Authority), new prices of knee implants have been implemented effective 16th August 2017. For details on knee implant pricing across our hospitals.CLICK HERE | As per GOI’s circular dated 29th March 2019 on price-capping of stents by NPPA (National Pharmaceutical Pricing Authority), new prices of coronary stents are revised with effect from 01st April 2019. For details on stent pricing, CLICK HERE
Vascular Surgery Hospital Chennai


A sub-specialty surgery that is utilised to treat disorders and conditions affecting the vascular system along with arteries, veins and lymphatic circulation via medical therapy, minimally-invasive catheter techniques, and surgical reconstruction is referred to as vascular surgery. 


What is Vascular Surgery?


Vascular surgery is proposed by the consulting healthcare provider only if a patient that is currently experiencing a type of vascular disease cannot receive treatment by any less invasive or non-surgical methods. The objective of vascular surgery is to be treat vascular diseases which also includes the arteries and the veins. 
When blood clots, arteriosclerosis, and other vascular conditions develop in the arteries, the condition is known as arterial disease. However, if the issue is initiated in the veins, then it is known as venous disease. There are vascular conditions that affect only the veins or the arteries, or both of them together. 


Vascular surgery is performed by a trained vascular surgeon who is able to diagnose and manage diseases impacting every part of the vascular system, excluding the heart and the brain. These expert surgeons also treat extracranial cerebrovascular disease too. 


Types of Vascular Surgery


There are multiple surgical techniques that fall under the purview of vascular surgery including:

  • Balloon angioplasty and/or stenting
  • Aortic and peripheral vascular endovascular stent/graft placement
  • Thrombolysis
  • Adjuncts for vascular reconstruction


What is the Vascular System?


The vascular system is actually a complex system of blood vessels whose primary function is to circulate the blood to and from the heart and the lungs. The heart, arteries, veins, capillaries, and the circulating blood, together make up the circulatory system in the body that plays a vital role of providing nourishment to the cells in the body. It has acts in tandem to remove any waste products from the body too. 


The arteries too have an important function of carrying oxygenated blood from the heart to the body’s cells. The process of reoxygenation and recirculation by the heart is performed by the veins that return the blood from the cells to the lungs. 


The largest artery leaving the heart is known as the aorta. It then sub-divides into smaller arteries which then reaches every other part of the body. The narrow arteries then subsequently link with capillaries which are smaller vessels. Oxygen and nutrients are then released from the blood into the cells in these capillaries. It also collects all the cellular waste during its return trip. Connecting to the veins, the capillaries return the blood back to the heart.  


Stemming from the heart, the aorta moves upward and subsequently proceeds down to the abdomen via the chest. Smaller arteries that branch out of the aorta are known as iliac arteries are able to provide blood to the legs and the pelvis regions. The upper body receive blood that is supplied by the thoracic section of the aorta which then continues towards the chest. The lower body gets its blood supply by the abdominal section of the aorta. 


What causes Vascular Diseases?


Conditions that clog or weaken the blood vessels, impair the valves that regulate blood flow in and out of the veins, depriving them of the essential nutrients and oxygen leads to the development of vascular diseases. Some of the common vascular conditions particularly affecting the arteries are:

  • Peripheral vascular disease or PVD
  • Carotid artery disease
  •  Aortic aneurysms or AAA


Specific diseases of the arteries such as atherosclerosis may be treated with the help of a surgical procedure that goes a long way in:

  • Minimising the risk of heart attacks or strokes
  • Relieving and enhancing hypertension or angina
  • Removing aneurysms
  • Improving claudication that helps avoid amputation of the legs


By performing a surgical procedure, the surgeon may opt to either repair the artery, bypass or replace it completely. 
With maturing age, a common phenomenon is hardening of the arteries, a condition known as atherosclerosis. This development happens as a result of the blood continuously passing through the arteries and the plaque which is basically the fatty material containing cholesterol or calcium gets deposited on the innermost layer of the artery. The diameter of the blood vessel automatically narrows due to this eventually leading to the artery becoming so narrow that the blood begins to clot. This creates a blockage prevent blood flow to all parts of the body. This condition is known as peripheral arterial disease or PVD. 


A rough region or ulcer occurs in the diseased interior of the artery, which is another form of atherosclerosis. Blockage of the arteries happens when the blood clots develop on this ulcer, break off and the move further along to narrow down the arterial passage. This form of blockage caused from a blood clot formed in another part of the body is known as embolism.


Whoare most at risk of developing Vascular Diseases?


Vascular diseases are very common in the elderly. With little or no symptoms, most patients have no knowledge of having developed a vascular disease at all. However, those who most at risk of developing vascular diseases are:

  • Maturing age results in the veins and their valves losing elasticity
  • If there is an existing family history of vascular diseases
  • If the patient is suffering from an illness or injury
  • If the patient is pregnant
  • If the patient has long periods of inactivity, such as, sitting, standing or on bed rest
  • If the patient is a smoker
  •  If the patient is obese
  •  If the patient suffers from hypertension, diabetes, high cholesterol, or other conditions that affect the health of the cardiovascular system
  •  If the patient follows little or no exercise routine


Symptoms


Until the blood clot grows significantly and blocks the blood flow through the vein, there may not be any symptoms to indicate a vascular disease. 
The symptoms that may suddenly come to light include:

  • If you experience pain
  • If you notice sudden swelling in the affected limb
  • If there is reddish blue discoloration
  • If you note an enlargement of the superficial veins
  • If the skin is warm to the touch


Diagnosis 


A vascular surgeon has to perform a clinical evaluation of the patient diagnosed with a vascular disease, prior to recommending vascular surgery. 
Physical Evaluation


This evaluation comprises of a physical examination and discussing the medical history of the patient. 
Atherosclerosis, thrombosis, embolisms, or aneurysms produce variable symptoms depending on which artery has been affected. In many cases, the patient may experience some pain. However, in the majority of cases, there are no symptoms at all. 


The healthcare provider has several methods of understanding, measuring and even accessing visual images of the arterial blockages. Several arteries in the body are felt or palpated. By feeling the pulse in a specific area, the healthcare provider can feel id the it is afflicted. If the arteriosclerosis has advanced, then the pulse from that specific area will be less.


If the artery is blocked already, it generates a noise which the doctor is able to listen to, either directly or via special amplification systems. 


Diagnostic Screenings


Your healthcare provider may request other diagnostic screenings to confirm is the blood flow from the arteries is normal. These tests may include:

  • Ankle-brachial index (ABI) test
  • Arteriogram
  • Segmental pressure test
  • Ultrasound scan
  • Magnetic resonance imaging
  • Computed tomography scan
  • Angiography
  • Lymphangiography
  • Lymphoscintigraphy
  • Plethysmography
  • Duplex ultrasound scanning


Treatment


The types of vascular surgical treatments performed are:
    Peripheral vascular disease or PVD may be treated by angioplasty where the blood vessel is opened, and a balloon is placed at the end of a catheter. To keep the artery open, a stent is often used with angioplasty. However, the type of vascular surgery performed is determined by the location and size of the impaired artery. Possible surgical techniques that may be used for severe cases of PVD are:

  • Bypass surgery
  • Aortobifemoral bypass
  • Thromboendarterectomy
  • Resection
  • Bypass graft
  • Tibioperoneal bypass
  • Femoropopliteal (fem-pop) bypass surgery
  • Embolic clots on the wall of the artery may be removed with a technique known as Embolectomy
  • If the blood clot is beyond the affected artery, a procedure called Thrombectomy is used 

 Lymphatic obstruction involves blockage of the lymph vessels is known as lymphedema in most cases do not require surgery. However, if the removal of the tissue is required, then surgical therapy for lymphedema may be suggested. Bypass of abnormal lymphatic tissue may be attempted using vein grafts in the rarest of cases
Other examples of vascular surgery include:

 

  • Cerebral aneurysm
  • Acute arterial and graft occlusion
  • Carotid endarterectomy
  • Endovascular grafting
  • Vasculogenic erectile dysfunction
  • Renal artery aneurysm
  • Surgery on varicose veins
  •  Lower extremity amputation


About the Department


The Department of Vascular Surgery at Fortis Hospitals in Chennai is a leading centre that offers primary vascular surgeries for all patients in the region. Our expert team of surgeons are able to treat all types of vascular conditions including complicated and specialist cases.  Our hospital has state-of-the-art facilities and amenities where patients have access to specialist investigative and diagnostic services, like, vascular ultrasound scanning and advanced radiological techniques that provides accurate diagnosis for both arterial and venous diseases.


With several years of experience, our team of surgeons have placed over thousands of stents and are heavily involved in researching modern and innovative technologies for treating aneurysms of the thoracic aorta (largest artery in the chest), and renal (kidney) and visceral arteries, which supply blood to the intestines, spleen and liver.
Fortis Hospitals, Chennai and the department of vascular surgery is dedicated to 100% patient care. With a multi-level approach in place, the team aims to quicken the recovery process so that patients are able to go back to their normal lifestyles as fast as possible. 


 

Meet Our Doctors

Dr. Balakumar

Dr. Balakumar

Consultant Vascular Surgeon

Book An Appointment