Surgical Specialties

Vascular Surgery

Problems within the human body's 60,000-mile system of blood vessels often involve blockages or narrowing caused by fatty deposits, which reduces blood flow. Medication and changes in diet and smoking habits are the first line of defense against vascular disease, but the skills of surgeons experienced in vascular surgery are often necessary to treat these circulation problems.

One of the most common vascular problems is narrowing of the carotid artery in the neck, which carries blood to the brain. Temporary strokes, called transient ischemic attacks (TIAs for short), may warn a person of carotid artery narrowing that can lead to a potentially disabling or fatal stroke. By performing a surgical procedure called carotid endarterectomy, a surgeon can improve circulation through the artery by removing the fatty deposits from the inner wall.

Aneurysms, the ballooning out of an artery or vein, may occur in vessels throughout the body, but they are frequently found in the aorta, the large vessel that leads from the heart to the abdomen. Aortic aneurysms are particularly dangerous, as they can burst without warning and cause internal bleeding and death; they can often be repaired surgically with a synthetic graft, before rupture occurs.

Another common vascular problem involves blockage of blood vessels in the lower abdomen or legs that impairs circulation and causes pain or even gangrene. Surgeons can restore circulation to the lower limbs using a procedure called a peripheral arterial bypass, which involves stitching veins or synthetic grafts around the site of the blockage and removing the plaque. They also may open up the artery by performing angioplasty, which entails inflating a small balloon within the vessel.

CMMC radiologists, in conjunction with vascular surgeons, perform an innovative procedure called arterial stenting, in which metal latticework is slid into the impaired artery and a balloon expanded within.

A specialized vascular access procedure is required for people who lack kidney function and require periodic mechanical filtering of wastes from their blood by means of a hemodialysis machine. Dialysis requires the construction of a connection between an artery and a vein -- usually in the arm -- to create a high-flow system of circulation between the patient's own system of vessels and the hemodialysis machine, through which the blood is pumped and filtered, then circulated back into the body. A piece of synthetic material is attached to both the artery and the vein. This vascular access is critical to the success of dialysis.

Vascular surgeons in the Lewiston-Auburn area use a range of non-invasive tests, including ultrasound studies and pulse tests, to determine the precise location of vascular problems.