Endovascular Surgery at Apollo Vascular Centre is a premier provider of a complete range of Vascular and Endovascular Surgical services at Indraprastha Apollo Hospital, New Delhi. It provides world-class vascular care and is dedicated to providing comprehensive and interdisciplinary care to patients. It promotes collaboration among the different specialties involved, which allows established and emerging diagnostic and therapeutic methods to be applied, improving patient-care. Among the specialties involved in the care of our vascular patients are cardiology, endocrinology, nephrology and interventional radiology.
What is Vascular and Endovascular Surgery
The vascular system also called circulatory system. It consists of arteries, veins, nerves and lymphatics that carry blood throughout the body. The role of artery is to transmit oxygen-rich blood from heart to the body, whereas veins transmit the deoxygenated or poor oxygenated blood from different parts of the body to the heart. If any problem occurs in blood circulation, then it can cause following disorder or symptoms:-
- Pain in lower extremities
- Ulcers in legs
- Venous disorders such as a varicose vein, deep vein thrombosis, Deep Vein Occlusion, venous insufficiency, Venous Tumor, Venous ulcer
- Arterial disorders like aortic aneurysm, blockages in the carotid artery, the carotid artery disease, Arteriosclerosis/ Atherosclerosis, Blood clots, stroke, dysfunction of the end organ, heart attack, poorly controlled hypertension, Renal aneurysm, Renal artery stenosis and other severe diseases as a complication.
Vascular and Endovascular surgery use to treat if this vascular system gets disturbed by blockage of a blood vessel by deposition of plaque/fat particles or molecules or can be blood clot. So the passage of blood flow becomes narrower in the vessels. Both these surgeries are used to treat vascular diseases by dissolving the obstruction or plaque to make a clear or precise way for the circulation of blood. Vascular surgery is the more invasive, involves more incisions, reconstruction based surgery, and requires 2-3 days or some times more than 4-5 days to stay in the hospital. In contrast, endovascular surgery is more minor invasive, with minimum or fewer incisions, and is commonly done through the needle puncture and sheath, typically done as an outpatient. Endovascular surgery used to treat patients with Peripheral Arterial Disease. This disease is also known by its short name, PAD. The circulation of blood becomes slower in Peripheral arterial disease due to the collection of plaque or fat molecules in the wall of blood vessels. So they block the proper flow of circulation and this condition called Atherosclerosis.
Procedure for Vascular and Endovascular Surgery
Vascular surgery is more invasive and an incision also required in this surgery. In contrast, endovascular surgery is the more minor invasive surgical procedure in which fewer incisions or sometimes incisions do not require in the whole surgical procedure. The surgery done by using a catheter inside the blood vessel. The catheter is guided by the surgeon to area where blockage occurs in the blood vessel. Open Heart Bypass surgery, carotid or balloon angioplasty, endovascular aortic repair, stent-graft, Eversion Carotid Endarterectomy, and thromboendarterectomy, dialysis access surgery, varicose vein treatment, thrombolytic therapy, and Aneurysm repair are the standard procedure performed by the surgeons.
Open Heart Bypass Surgery
When obstruction or blockage becomes severe in the artery of the principal vital organs or extremities, then bypass surgery is performed by the surgeon to clear the circulation. It is done by surgeon using a unique tube or graft that helps to clear the blockage and restart the flow of blood in the right direction.
Carotid or Balloon Angioplasty
Carotid angioplasty used by the surgeon to open the blocked or narrow carotid artery. Angioplasty is used to widened the narrow part of the carotid artery so that more blood can get through. It is used to reduce the chest pain or angina from the blockage in the carotid or coronary artery and to prevent or limit the damage during and after cardiac arrest. It is done by the surgeon by using a catheter or a small hollow tube that is place into blood vessel of the arm/wrist or groin to the carotid artery. A balloon is attached to this catheter. The balloon may be inflated to open the carotid artery and the narrow channel of blood flow, where plaque has deposited. The inflation of balloon will push the obstruction or plaque against the artery wall, widening the lumen and improving the blood flow.
Stenting or Stent graft
Surgeons use a stent, which is a small hollow tube to open the plaque in the blocked carotid artery. It has a lower risk than a conventional or an open surgery and is generally well tolerated. Sometimes surgeons use medicated coated stents that release medicine over the plaque to clear off the passage of blood flow.
Endovascular Aortic Repair
This kind of surgery is used by the surgeon to repair the aortic valve or aortic aneurysm and other aortic diseases such as aortic dissection, ascending or abdominal aortic aneurysm and Thoracic aortic aneurysm. It is a minimally invasive surgery that involves inserting a graft or catheter within the aneurysm through a small incision in the groin, and x-ray is used to guide the catheter into place.
Eversion Carotid Endarterectomy
It is the technique used by the surgeons to limit the chances of stroke from carotid artery stenosis in which plaque forms in the inner layer called intima of two carotid arteries on each side of the neck. In this procedure, the lumen of the internal carotid artery opened by giving an incision on the midline side of the sternocleidomastoid muscle and plaque substance is removed. A patch is use to increase the size of the lumen, and the artery is closed by the suture .This whole procedure is done under general or local anesthesia.
Thromboendarterectomy is a vascular surgical procedure in which a thrombus or a blood clot removed by opening the artery by giving an external incision rather than through blood vessel. This thrombus can be a fat particle or blood clot deposited in the inner layer of the artery. It can be useful to prevent stroke even among those patients who had no any warning signs of stroke. It generally involves a minimum stay in hospital and well-tolerated too.
Dialysis Access Surgery
Dialysis is mostly used in Acute and Chronic Kidney Failure. Dialysis is a life saving treatment in patients with kidney failure. It can be done either hemodynamically (Hemodialysis) or peritoneal. In this procedure, a machine used to send the patient’s blood outside the body through a filter. This surgery is use to perform just before dialysis therapy begins. Ateriovenous Fistula (A-V fistula) can be used in hemodialysis for long term access. It is using for good blood flow in dialysis.
Varicose Vein Repair
A Varicose vein is the condition in which large veins are affected in the body and appearing as blue or purple under or beneath the skin. This condition predominantly occurs in the legs and feet. A varicose vein causes pain, discomfort and some severe problems. Varicose vein surgery is the best opinion to treat the ailment. The following surgeries can be used for Varicose vein repair:-
1. Endovenous Laser/ radiofrequency ablation- It is the simplest, painless and incision-less surgery. Laser rays use to reduce the swelling in the affected vein.
2. Stripping of the vein and high ligation
3. Sclerotherapy- A solution injected in to a varicose vein which helps to reduce the swelling
4. Glue treatment– A Surgical glue called cyanoacrylate glue is inserted in to the varicose vein to seal it.
Aortic aneurysm repair
It is a minimally invasive endovascular surgery in which repairing is done of the weakened area of the aortic wall or aortic blood vessels with the guidance of imaging stent graft through a small incision.
Thrombolytic agents or drugs use to clear the thrombus or blood clots in the vessels of the heart or lungs.
The Vascular Center’s clinical services encompass all elements of vascular care as detailed below:
- Diagnostic evaluations and medical management
- Non-invasive vascular testing
- Diagnostic angiography and endovascular therapeutics (minimally invasive procedures)
- Surgical care including Inpatient services and critical care
- Meticulous Follow-up and post – recovery rehabilitation
We offer comprehensive management of patients with a wide range of vascular surgical problems mentioned below. This is backed with effective support of a state-of-the-art non-invasive diagnostic lab and DSA lab for interventional procedures. We are performing advanced angioplasty and stenting.
- Varicose Veins & Leg Ulcers treatment- Laser Ablation (EVLT) Radio frequency Ablation(RFA) and conventional surgery
- Deep Vein Thrombosis–Thrombolysis, Thrombectomy & IVC Filter
- Diabetic Foot & Non-healing ulcers- comprehensive treatment
- Peripheral Vascular Disease, Buerger’s disease, aortoiliac disease, gangrene
- Vascular Trauma
- Aortic aneurysm Stenting & Surgery
- Arterial and Venous Bypass of limbs
- Congenital angiomatous malformation- Comprehensive treatment
- Carotid Artery stenosis- Stenting & Surgery for Stroke
- All sorts of Dialysis Access (Fistulas, Shunts & Permacath, CAPD)
- Raynaud’s syndrome & Hyperhydrosis (Thoracoscopic Sympathectomy)
- Thoracic outlet syndrome- cervical rib
- Arterio-venous malformations
- Mesenteric & Renal ischemia
- Swelling of the legs- Lymphedema – Diagnosis & treatment
- Chest Trauma
- Lung infection with Empyema
- Carcinoma Lung