Endovascular surgery is a form of minimally invasive
surgery that is designed to remove blocks in major blood vessels, using balloons and stents. Basic techniques involve 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 the brachial artery at the elbow. A needle is inserted into the artery and a wire is passed inside. A small catheter is then 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, it images the blocks in the vessel 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:
Advantages of angioplasty include
- It can be done without anesthesia.
- There is no long incision and wound-related issues.
- 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 recur.