Endovascular surgery is a form of minimally invasive surgery that was designed to remove blocks
in major blood vessels using balloons and stents.
Basic techniques involves introduction of a catheter percutaneously into a large blood vessel
(Seldinger technique). Typically the blood vessel chosen is the femoral artery or a vein found in the groin or brachial artery at the elbow.. A needle is inserted
into the artery and a wire is passed inside.A small catheter is passed over the wire and negotiated to the artery to be studied.. The catheter is injected with a
radio-opaque dye that can be seen on live X-ray or fluoroscopy. As the dye courses through the blood vessels, characteristic images showing the vessel lumen,blocks
and the circulation beyond the block.This serves as a road map to plan further treatment.
Nowadays angioplasty is offered as the treatment of choice for treating limb ischemia.
Advantages of angioplasty include
- It can be done without anesthesia.
- There is no long incision and wound problems
- No Pain
- Patient can be mobilised early
- Patient can be discharged after a day or two
- It can be repeated if the block comes back
- The disadvantages are that it is less durable than a bypass and the block tends to comeback