The treatment of vascular problems can usually be placed in three categories:
1. MEDICAL OR NON-SURGICAL
- Stopping Smoking
- Weight Loss
- Anti-clotesteral Medication
- Diabetes Control
- Blood Pressure Control
All of the above listed methods should be used as initial treatment; unless we are dealing with an urgent or emergency problem.
2. OPEN SURGERY
This is the classic or traditional way of doing vascular surgery. Scalpel, scissors and other sharp instruments are used to open the patient and get to the affected blood vessel. Many of these procedures involve using artificial tubes or the patient’s veins to replace or bypass (get around) diseased blood vessels.
3. ENDOVASCULAR SURGERY
In the last 20 years techniques have been developed which allow correction of vascular problems without making large incisions. Sometimes only a needle puncture is required. Names like balloon angioplasty, stents and stentgraft have increasingly become part of the vascular language. In some parts of the world 80% of vascular procedures are endovascular.
There is a trade-off. Although endovascular techniques are less invasive and may have shorter hospital stay, they can be technically difficult and up front, are more expensive.
In the opinion of most experts, these techniques are the future, if not the present, means of treatment for vascular problems.
* Abdominal aortic aneurysms less than 5cm in diameter rarely rupture and surgery is usually not recommended. Current recommendation is that in women, abdominal aortic aneurysms 5cm or wider should be treated, while in men, many surgeons will intervene at 5cm. However, recent evidence is suggesting that the threshold in men could be 5.5cm