Crozer-Keystone Health System's vascular and endovascular specialists treat the following vascular disorders:
Abdominal Aortic Aneurysm
Carotid Artery Disease
Peripheral Vascular Disease
Vein Disorders
Dialysis Access
Wound Management
Abdominal Aortic Aneurysm
An abdominal aortic aneurysm is caused by progressive weakening of the wall of the aorta, the main artery of the chest and abdomen. Over time, this results in aneurysm, or “ballooning,” of the blood vessel. The aneurysm will grow larger and eventually rupture if not properly diagnosed and surgically repaired. Specialists can diagnose this life-threatening condition using non-invasive outpatient exams such as ultrasound or a CT scan.
Treatment requires surgical replacement of the weakened part of the aorta with a graft made of durable surgical fabric. The physician will carefully evaluate each patient to identify the most appropriate type of surgery. In carefully selected patients, the physician may use the less invasive stent-grant procedure, inserting the graft through the arteries of the lower extremity and guiding it into place using X-ray. For other patients, open surgery is the best option.
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Carotid Artery Disease
The carotid arteries are the main blood vessels to the brain. If these arteries develop a build-up of plaque caused by atherosclerosis, or “hardening of the arteries,” blood flow to the brain is impaired. A severe plaque build-up may result in a stroke. Specialists can usually diagnose this disorder using ultrasound, or other non-invasive outpatient exams.
To prevent stroke, many patients with severe plaque benefit from surgical reconstruction of the carotid artery with an operation called carotid endarterectomy. We can perform this surgery through a small neck incision, in some cases under local anesthesia. Angioplasty and stenting of carotid artery disease is a rapidly emerging new alternative to carotid endarterectomy for high risk patients.
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Peripheral Vascular Disease
Peripheral vascular disease affects the circulation to the legs and feet, often resulting in pain and disability. It is most often caused by atherosclerosis, which narrows and occludes the blood vessels. This disorder is associated with smoking, diabetes, elevated cholesterol, and high blood pressure. We diagnose this disorder using history and physical examination, and non-invasive testing in the vascular laboratory. In some cases, this condition will improve with medication, regular exercise, and control of blood pressure and diabetes.
However, patients with severe peripheral vascular disease may require more aggressive diagnosis and treatment to prevent loss of a limb. Diagnosis may require test such as MRI (MRI), CT scan, and/or arteriogram, a procedure in which we inject contrast, or “dye,” into the bloodstream and examine the arteries under X-ray. When it comes to treatment, we help patients choose the least invasive solutions that will fix their problem. This often means using balloon angioplasty and stenting to open up blood vessels. When this is not feasible, surgical bypass may be required.
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Vein Disorders
Vascular surgeons are also experts in the management of disorders of veins, including chronic venous insufficiency, varicose veins, and deep vein thrombosis. The physician provides comprehensive care from procedural and medically to the most minimally invasive therapies. The surgeon works with the patient to choose the best therapy for each individual patient.
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Dialysis Access
Patients with advanced renal disease who receive kidney dialysis require a connection between the bloodstream and the dialysis machine. The surgeon will work with specialist in kidney disease to choose the best type of dialysis access for each patient: hemodialysis via a natural “fistula,” artificial graft, or peritoneal dialysis.
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Wound Management
Difficult wounds of the limbs may result from vascular disease. Specialists work with the patients’ primary care physicians to care for these wounds and prevent complications.
For more information about wound management and hyperbaric medicine, go to Center for Wound Healing and Hyperbaric Medicine.
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