What is Vascular Surgery?
Vascular surgeons provide both medical and surgical care for the blood vessels of the body. This includes arteries, veins, capillaries, and lymph vessels, but not usually the heart or large vessels immediately surrounding the heart -- those are cared for by cardiologists or cardiothoracic surgeons.
Some of the blood vessel disorders that might require treatment by a vascular surgeon include:
Atherosclerosis, or hardening of the arteries
Venous thrombosis, or clots in the veins
Peripheral arterial disease, where narrowed arteries reduce blood flow to the legs
Carotid artery stenosis, or narrowing of the arteries leading to the brain
Vascular surgery is an unusual surgical specialty because it offers medical care, testing, and non-invasive procedures, as well as complete surgical care. So depending on the diagnosis, a vascular surgeon may offer care or treatment that is non-invasive (such as imaging, diet, or exercise), minimally invasive (such as catheter procedures), or traditional surgery.
When vascular disease disrupts oxygen and nutrients from being delivered efficiently within the body, a vascular surgeon can help restore the flow of health.
What is Interventional Cardiology?
Interventional cardiology is the treatment of heart disease without surgery, through the use of catheters. Primarily this is via a procedure called cardiac catheterization, where a long, thin, flexible tube, called a catheter, is threaded through a vein or artery up towards the heart. The catheter can be used to inject dye for x-rays, open narrowed artery walls, widen heart valves, place stents, or perform other tests and procedures.
Cardiology is a large specialty, and covers many diseases and disorders of the heart as well as several different kinds of treatments. What makes interventional cardiologists special is their ability to use minimally invasive procedures to treat heart disease. Interventional cardiologists may treat coronary artery disease and peripheral artery disease, where blood vessels become narrowed or blocked. They also may repair or replace damaged heart valves.
During a cardiac catheterization, the interventional cardiologist inserts the catheter into a blood vessel through a small incision in the groin or arm. It is then threaded to the blocked artery or into the heart, where tiny tools can be passed through the tube. These tools are used to perform percutaneous coronary interventions, or procedures done to the heart and arteries via catheter. Procedures may include:
Angioplasty, or opening of blocked arteries, often via the inflation of a balloon
Atherectomy, the physical cutting away of plaque buildup
Stenting, the placement of metal springs to hold artery walls open
Heart valve repair or replacement
Closure of holes in the heart
That these procedures can be performed without the pain and recovery time of traditional surgery is truly amazing.
What is Vascular & Interventional Radiology?
Vascular and interventional radiology, sometimes just called interventional radiology or abbreviated “VIR,” is a type of minimally invasive treatment done using only needles or catheters (tubes) and very tiny incisions in the body. Imaging, such as x-rays or ultrasound, is done from outside the body and used to guide the surgeon. Because the incisions are so small, this type of surgery offers less risk, less pain, and a faster recovery time to the patient.
Interventional radiology was first developed in the 1960s to treat blocked arteries, as an alternative to open bypass surgery. The technique was originally used only on blood vessels, which is where the word ‘vascular’ in the name comes from. These days it is still often used to treat blood vessel disorders, but also many other types of problems. Interventional radiology may be used to perform, among others:
Vascular treatments, such as the placement of stents or balloon angioplasty
Minimally invasive cancer treatments, such as biopsies, tumor ablation, or chemoembolization (delivering chemotherapy directly to a tumor via a catheter)
Uterine fibroid embolization
Varicose vein ablation
The device used for imaging during the surgery may be x-ray, ultrasound, fluoroscopy, or CT scan. Imaging allows the surgeon to see exactly what is happening without having to cut into a patient. Not only is recovery easier without major surgery, but outcomes are better with the precise detail that modern imaging can offer.
What is Cardiology?
Cardiology is the study of the heart and blood vessels, and a cardiologist makes sure they are functioning well. Patients see cardiologists for many issues affecting the circulatory system, including:
Hypertension, or high blood pressure
Heart attack prevention and treatment
Congestive Heart Failure, where the heart cannot pump enough blood to meet the needs of the body
Heart transplant evaluation and care after surgery
Peripheral vascular disease, where arteries in the limbs narrow and reduce blood flow
Aneurysm, or a swelling in the blood vessels
Coronary Artery Disease, where the blood vessels delivering oxygen and nutrients to the heart become blocked
After performing a physical exam, a cardiologist may order a number of imaging tests in order to get a better understanding of what disease or complication might be causing problems in the heart and blood vessels. Some of these might include:
An electrocardiogram, which checks the heart’s electrical activity
X-rays to see tissues more clearly
Cardiac catheterization, where a small tube is directed into the heart to test pressure, oxygen levels, and blood flow
Although some cardiologists provide primary care, cardiologists more typically work as consultants to primary care physicians when a heart issue comes up. Cardiologists do not perform surgery, but they can perform “interventional” procedures, such as balloon angioplasty (where a balloon is used to stretch open narrowed veins) or stent placement to keep blood flowing.
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