ENDOVASCULAR SURGICAL TECHNIQUES
Vascular Institute surgeons offer an array of catheter-based, minimally invasive revascularization procedures where a tiny wire is inserted in a diseased blood vessel to remove dangerous plaque.

• Percutaneous, trans-luminal angioplasty is angioplasty of the peripheral vascular system.  The procedure involved placement of a wire that has been carefully guided to the narrowed or blocked area. The balloon stretches the artery and flattens the fatty deposits that cause narrowing. The inflating of the balloon can open a nearly closed artery and reestablish blood flow.


• Aortic Aneurysm – the aorta is the major artery leading away from the heart through the chest and down through the abdomen.


• Up to 47,000 people die each year from all types of aortic disease with few symptoms and little warning making aortic disease a silent epidemic.


• A family history of aneurysm is a significant risk factor for aortic aneurysm.  High blood pressure is another risk factor for aneurysm. It is important to tell your physician if there is a history of aortic aneurysms in your family to ensure that the best preventative screenings are completed.


• Abdominal aortic aneurysm (AAA): AAA is a bulge or weakening of the aorta, the main artery carrying blood from the heart through the abdomen. The aneurysm weakens the wall of the aorta and can rupture with catastrophic consequences.  People 60 or over are at higher risk for AAA and men are 5 times more likely than women to have an AAA.


• Thoracic Aortic Aneurysm (TAA) – Aneurysms that occur in the chest area are called thoracic aortic aneurysms. A thoracic aortic aneurysm is a serious health risk because it can rupture causing life-threatening internal bleeding. Thoracic aortic aneurysms affect approximately 15,000 people in the U.S. each year.


• Surgical Repair of Aortic Aneurysm - Surgeons at the Vascular Institute are the first in Oklahoma to offer a new less invasive procedure as an alternative to the more traditional open chest surgical repair of the TAA and AAA. 


• Endovascular Repair involves the use of tiny wires called catheters that are inserted through a small incision in the groin and guided to the site of aneurysm where a stent-graft can be deployed within the diseased segment of blood vessel to “reline” the aorta like a sleeve to divert blood flow away from the aneurysm.


• This endovascular approach is currently used to treat abdominal and thoracic aneurysms at the Vascular Institute.


• If the thoracic aortic aneurysm is large or causing symptoms, you will need prompt treatment to prevent a rupture from occurring. The weakened section of the vessel can be surgically removed and replaced with a graft of artificial material.


• Repairing the aneurysm with conventional open chest surgery is complex and requires an experienced thoracic surgical team, like those at the Vascular Institute. Repairing a thoracic aneurysm may require open-chest surgery, general anesthesia and a minimum hospital stay of five days.


• Aortic Dissection - Aortic dissection is an aneurysm that occurs when the layers of the aorta tear and separate from each other. If left untreated, about 33% of patients die within the first 24 hours and 50% die within 48 hours.   Aortic dissection can occur with little warning causing a severe, sharp, tearing pain in the chest or upper back.


• Popliteal Aneurysm -The popliteal artery is located behind the knee, the popliteal aneurysm is an abnormal widening of this artery. 


• Patients with a popliteal aneurysm often complain of a pulsating lump behind the knee or leg pain and swelling in the area. 

• The presence of a popliteal aneurysm in one leg make patients more likely to have additional aneurysms, such as a popliteal aneurysm in the other leg or an aortic aneurysm. Blood clots can form within a popliteal aneurysm, break loose and block arteries in the lower leg or foot.

• Often surgical bypass is the optimal treatment for a popliteal aneurysm constructing a new pathway for blood to flow around the aneurysm.


• Cryotherapy – Cryotherapy uses targeted rapid cold therapy combined with angioplasty to treat blow flow problems to the lower extremities.

Vascular Institute physicians deploy CryoPlasty® Therapy, with the use of the PolarCath Peripheral Dilatation System.  The uninflated PolarCath balloon is guided into the clogged part of the artery leading to the lower extremities and inflated using cold nitrous oxide to keep the vessel open and improve blood flow.
 
• Athrectomy - is a procedure to remove plaque from arteries. Again, a catheter is inserted into the body through a large artery near the groin of the leg and advanced to the spot where the vessel narrows.


• Peripheral Vascular stenting – When narrowing or blockage occurs in the arteries, angioplasty and vascular stenting are used to keep the treated artery from easily reblocking.  A tiny mesh scaffolding is transported via the catheter wire to the site of the peripheral vascular blockage and deployed to keep the vessel open and less vulnerable to reblockage.


• Thrombolysis - is a treatment to break up abnormal blood clots that are restricting blood flow in the peripheral arterial tree that is the major artery of blood flow from the heart to the lungs.Thrombolytic therapy dissolves these blood clots using various medications administered directly into the clot via wires during a catheter procedure.


• Vascular surgeons at Oklahoma Heart Hospital use the Silver Fox Hollow device - The SilverHawk™ Plaque Excision System is a device used to remove plaque that commonly blocks arteries and interrupts blood flow.


• The SilverHawk System uses a tiny rotating blade to shave away plaque from inside the artery. As it is excised, the plaque collects in the tip of the device and then is removed from the patient.


• Unlike stenting and other methods of opening the artery, the SilverHawk removes the source of the problem – plaque build-up – instead of simply compressing it against the vessel wall.


• Hundreds of milligrams of plaque are routinely removed from arteries treated with the SilverHawk.


• Multiple vessels and lesions can be treated with a single device, which reduces procedure time and cost.


• Early clinical data from a multi-center study and several single-center studies indicate positive safety and efficacy rates.


• Plaque excision is a minimally invasive procedure performed through a tiny puncture site in the leg or arm.