By MARK HUTCHISON, Associated PressVascular surgery has become one of the most sought-after surgical procedures in the United States.
The surgery, which involves removing blood vessels, is also one of only a handful of procedures in which anesthesia is used.
But the risk of complications is a concern.
The American Heart Association recommends that patients undergo one of two surgical procedures for a procedure that can be lifesaving: a major surgery called an angioplasty (a large artery being narrowed to relieve pressure) or a minor surgery called a minimally invasive (a small artery being opened) bypass.
It’s the latter that is typically done on patients with a history of coronary artery disease, such as diabetes and congestive heart failure.
But it’s not always safe to do, said Dr. William G. Brown, a cardiologist at the Cleveland Clinic and the director of cardiovascular surgery at Mount Sinai Hospital in New York City.
“The most common complication in vascular surgery is venous thromboembolism (VTE), which occurs when blood vessels in the arteries become clogged and block the blood vessels.
This can lead to heart attack or stroke,” Brown said.
The most commonly seen complication is VTE when the blood supply to a vein or artery is blocked and the veins and arteries are not able to pass blood through them.
The blood vessel may rupture, causing bleeding.
This results in a blood clot and is usually fatal.
In the rare case of VTE, the arteries in the heart may also burst, creating a pulmonary embolism, a condition that results in serious bleeding in the lungs.
If there is no treatment, the patient may die.
In contrast, bypass surgery can be more safe and less invasive.
The procedure is a relatively straightforward surgery that typically involves removing large blood vessels and removing blood clots, and is considered relatively safe.
The main risks are venous clots and blood clogs in the blood.
If done correctly, bypass may be the safest surgical option for patients with coronary artery diseases, Brown said, but it should be done carefully.
“In general, there is not a lot of literature showing that bypass is as safe as other types of vascular surgery, but this is not the case in most cases,” he said.
Vascular bypass is performed by cutting a small, closed tube through the artery that leads to the heart, usually with a surgical incision.
The bypass tube is placed under the skin of the heart and is left open to allow the blood to drain.
The tube then is closed with a bandage or a suture.
The patient is then given anesthesia to allow blood to flow normally.
After the surgery, patients usually stay home for a few days, usually two to three weeks, to heal.
After that, the body usually regains normal blood flow and they return to work, although some may need a little extra time.
Patients with VTE may need to go through another surgery for the procedure to be performed.
There are other complications, such a clot in the lung and the risk that blood clog will build up in the patient’s arteries.
If this happens, the doctors may need blood transfusions to get the blood clot out, Brown explained.
“Vascular patients have a much higher chance of developing an infection,” Brown added.
A large majority of patients who have a bypass surgery will return to the office within four to six weeks, but some may be more likely to return after a year or two, said Brown, who is a member of the board of directors for the American Heart and Stroke Association.
If the patient does return, they can expect to need a blood transfusion and blood products to help control the infection, Brown added, and they may need another operation to open up the artery.
A small number of patients will need to have another bypass surgery, usually just a couple of months after their first one, Brown noted.
Patient outcomes are less clear, but studies have found that bypass surgery is not associated with an increased risk of death, heart attack, stroke or sudden death.
The risks are higher with the use of medications that slow or stop the bleeding.
Medications called angiotensin blockers and beta blockers can also slow or slow blood flow to a lesser degree.
There is no data showing that the medications are any more or less safe than other medications for treating cardiovascular disease, Brown and other cardiologists said.
But patients should be advised to discuss any complications with their doctor, they added.
Brown said that if patients do decide to go ahead with bypass surgery because of VTD, he would recommend waiting two to four weeks before starting the procedure.
“There is a very good chance that the surgery will go well and that the patient will recover,” Brown told the AP.