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 Vascular Surgical Associates, PC surgeons are offering the latest techniques in endovascular surgery including endovascular aortic stent grafting and peripheral arterial stenting, as well as all other arterial and venous reconstruction.
Vascular Surgical Associates, PC has noninvasive vascular labs which are ICAVL accredited to perform noninvasive studies such as carotid images to rule out carotid stenosis, aortic ultrasound to rule out aneurysm, and PVR to check circulation in the legs. In addition, we perform venous images to rule out blood clots in the legs. We also offer renal artery imaging to rule out renal artery stenosis. We have noninvasive labs in both our Marietta and Austell offices.
What types of treatments are performed at Vascular Surgical Associates, PC?
Vein treatments include Sclerotherapy and Vein Closure. An individual treatment plan is developed for each patient, taking into account his or her medical condition and/or cosmetic requirements.
Abdominal Aortic Aneurysm (AAA)
 An abdominal aortic aneurysm is the ballooning of the aorta (the aorta is the main blood vessel coming from the heart that supplies blood to all organs). Aneurysms may occur in any blood vessel in the body, but the most common place is in the abdomen below the renal arteries. Aneurysms may continue to grow larger until like a balloon, it can then burst or rupture. Aneurysm ruptures can be a life-threatening event. The goal of all aneurysm treatment is to prevent the aorta from rupturing.
Diagnosis: Routine physical examination of abdomen
Abdominal ultrasound
Abdominal CT (computerized tomography) scan
Treatment:
Observation - Asymptomatic small aneurysms less than 5 cm may safely be observed
Open surgery: This is a traditional surgical procedure with an incision made on the abdomen. Hospital stay is 5-8 days.
Endovascular: This is new minimally invasive endovascular procedure. Most of the time aneurysm is repaired by stent graft through two small groin incisions under regional anesthesia. Patient generally goes home in 24-48 hours.
Carotid Artery Stenosis
Carotid artery stenosis is one of the major causes of stroke or TIA. The carotid artery is the vessel that supplies blood to the brain and face. The artery becomes narrowed or blocked by a gradual buildup of fat within the artery wall, which reduces blood flow to the brain. This buildup is called “plaque”. The formation of plaque and the breaking off of clots may be responsible for stroke, TIA or transient blindness (amaurosis fugax). Treatment of carotid stenosis by a qualified, experienced specialist can significantly reduce the occurrence of stroke, TIA or transient blindness.
Diagnosis:
Carotid Bruit are sounds heard over the neck. This may indicate the building of plaque in the carotid artery. Diagnosis of a carotid bruit is made by listening over the neck with a stethoscope.
 Carotid Duplex scan: This test is done by using an ultrasound machine to estimate the degree of stenosis. This is the first step in diagnosing carotid stenosis. Since the test is technician dependent it is important that an experienced lab or ICAVL accredited lab performs the test.
MRA: This is noninvasive angiogram using MRI (Magnetic Resonance Imaging) a useful technique in confirming the degree of stenosis.
Contrast angiogram: This is a diagnostic procedure in which a catheter is introduced in the artery through the groin. Dye is injected into the artery and X ray pictures are obtained to identify the position and degree of narrowing of the artery. This test is also done prior to treating carotid stenosis by balloon angioplasty and stent.
Treatment options:
Anti platelet Medication: : Aspirin and Plavix reduces the binding of platelets (a component of blood). They have beneficial effects in preventing strokes in patients for whom surgery or angioplasty is not indicated.
Carotid Endarterectomy: A standard, durable, safe, and well-proven surgical procedure very effective in preventing stroke, TIA or transient blindness by removing plaque from the artery. The procedure is performed under general or regional anesthesia with minimal morbidity. Most patients go home the next day.
Peripheral Arterial Disease (PAD)
Saving Limbs Threatened by Atherosclerosis & Diabetes:
Frequently atherosclerosis is not confined to coronary arteries and may involve arteries of other areas. The same atherosclerotic plaque that causes coronary artery stenosis affecting the heart, or carotid artery stenosis affecting the brain, causes peripheral artery disease in the arteries of the limbs. Atherosclerosis causes narrowing of the lower extremity arteries. The results of low blood flow to the legs and can cause muscle cramping after walking. In severe cases it can result in gangrene and limb loss. The symptoms depend on how severely blood flow is reduced and what artery is affected.
Some of the symptoms include:
Claudication
Dull cramping pain in the muscles of buttocks, thigh or calf on exercise and relieved by rest.
Rest Pain: constant pain in foot due to significant reduction blood flow
Non healing ulcer of foot or toes
Gangrene
Some of the conditions that aggravate the severity of PAD are called risk factors these risk factors include:
Smoking
Diabetes
Obesity
High blood pressure
Lack of exercise
Family history of disease
Diagnosis
Ankle brachial index (ABI): The noninvasive test done in the vascular laboratory that measures ratio of the blood pressure in your ankle to that in your arm. This ratio may indicate potential vascular problem and degree of vascular compromise.
Ultrasound Doppler test
This non invasive test uses sound wave to provide image of the blood vessel to determine plaque and/or occlusion
Angiogram Is performed by inserting catheter in the artery of the groin. Special dye is injected and X-ray is obtained to visualize blockage in the artery. This is helpful in planning treatment.
Treatment options
 Risk factor reduction: Cessation of smoking, regular exercise, maintaining ideal weight, controlling blood pressure and diabetes are some of the way to retard progression of disease.
Medications: Trental and Pletal are two approved medications for claudications. They must be taken under physicians direction
Angioplasty and stent: Minimally invasive therapy (Endovascular) like balloon angioplasty and stenting
Bypass surgery: Blocked artery is bypassed by vein graft or artificial graft to improve flow to leg and foot.
Intestinal Angina
Narrowing of the arteries supplying blood flow to intestine may cause pain after eating a meal. This is called intestinal angina.
Diagnosis
Duplex scan of visceral arteries
Angiogram
Treatment: Balloon angioplasty/stent (Endovascular)Aorto-mesenteric bypass
Preserving Kidney
When plaque is formed in the renal artery (artery supplying kidney) blood flow to the kidney is reduced. This may cause hypertension and also affect the functioning of the kidney. When kidneys stop functioning, patients will require dialysis or kidney transplant.
Diagnosis
Ultrasound
Renal angiogram
Treatment
Renal angioplasty and stenting (Endovascular Procedure)
Surgical bypass to the renal arteries
Venous Diseases
Treatment for leg ulcer and swollen extremities.
Blood clot in vein
A Blood clot in the vein of the legs causes pain and swelling. It may be accompanied by inflammation (phlebitis). If not properly diagnosed, blood clot may move to the lungs and cause pulmonary embolism Clotting in the vein destroys the valves of vein and in the long run causes swelling and ulceration (venous ulcer).
Diagnosis
Venous duplex scan
Venogram
Treatment
This condition is treated by anticoagulant (blood thinner) like cumadine and heparin.
Thrombolytic therapy
IVC filter when blood thinner is contraindicated.
Treatment for leg ulcers caused by venous hypertension and venous reflux, compression treatment to promote healing of ulcer.
Varicose Veins
Common in younger people especially women of child bearing age. The condition is caused by incompetence of the valves of the vein.
Diagnosis
Duplex examination is important for the diagnosis of reflux in veins.
Treatment
Laser treatment
Sclerotherapy
Venous closure procedure.
 Vein Closure Procedure (VNUS)
The Vein Closure procedure is an office-based (outpatient) alternative to stripping an ligation of the greater saphenous veins. It is a highly effective and safe method of treating serious varicose veins. This procedure involves inserting a catheter into the damaged vein through a small incision. The catheter delivers radio frequency energy to the vein wall to shrink and seal shut. Patients are satisfied with this procedure because it allows them to resume normal, activity immediately after the treatment.
With the use of the latest techniques, we can offer relief to patients who suffer "om different vein conditions and improve the quality of life.
Sclerotherapy
What is the cost for treatment?
The cost for treatment depends on which procedures are deemed appropriate for your condition and how many treatments will probably be needed to correct it.
Will my insurance cover the treatment?
Many insurance companies generally cover the cost of a procedure (after co-pay and deductible requirements are met) if it is considered medically necessary. Cosmetic procedures are generally NOT covered. The doctor or his assistant will discuss with you whether they feel your treatment is medically necessary or cosmetic. You can always contact your insurance carrier to review their policy and coverage limits.
How many treatments will I need for my condition?
The number of treatments needed for a patient's condition will depend on which procedure is considered to be the optimum for treatment. Generally, for Sclerotherapy, 3-5 treatments are needed for best results.
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