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Endovascular Revision

Endovascular revision is performed inside your blood vessels using very thin, long tubes called catheters. Endovascular revision is normally done on an outpatient basis. It can result in a faster recovery time and fewer complications than open surgery. Many patients can go home one or two days after surgery and return to their normal activities in two to four weeks.

Endovascular procedures are less invasive than traditional open surgical techniques and can offer benefits such as:

  • Less pain.

  • No incisions.

  • Shorter hospital stay.

  • Shorter recovery time.

  • Lower risk of complications.

The latest kinds of endovascular revision procedures include:

  • Cardiac ablation: Use of intense heat to seal off varicose veins.

  • Coronary artery bypass grafting: Use of a graft (plastic tube or section of blood vessel from the patient’s body) to reroute blood flow around a section of a blocked artery.

  • Balloon angioplasty and stenting: Inflation of a tiny balloon at the end of the catheter to open narrowed or blocked arteries, often with a stent (tiny wire mesh tube) implanted to keep the artery open.

  • Blood clot procedures: Removal of a large blood clot or injection of medications that dissolve the clot.

  • Carotid endarterectomy: Removal of plaque in neck arteries that carry blood to the brain.

  • Embolization: Use of medications or synthetic substances to block blood flow to a small, specific area to treat aneurysms, vascular malformations, or cancerous or noncancerous tumors.

  • Exclusion: Repair an aneurysm by blocking off the artery's weakened section and rerouting blood flow.

  • Vena cava filter placement: Implantation of a filter in the vena cava, the body’s largest vein, prevents blood clots from getting into the lungs.

Why choose Presbyterian for your endovascular revision?

Presbyterian Heart and Vascular Care has a skilled vascular care team who can provide a wide range of services from diagnosis to treatment. Their surgeons are trained in many different techniques and procedures, many of which can provide you with a shorter recovery period and less hospital time.

Who is eligible for an endovascular revision?

You may be eligible for endovascular revision if you need vascular repair. To determine whether you can be treated with endovascular revision, you will need to take tests, including a CT scan and angiography, which allow your doctor to view your blood vessels.

What conditions can be treated with an endovascular revision?

Vascular specialists use endovascular procedures to treat a variety of conditions, including:

  • Carotid occlusive disease: Narrowing or blockage of arteries that supply blood to the brain.

  • Conditions of the aorta (the body’s largest artery), such as aneurysms or dissection.

  • Cardiovascular diseases such as atherosclerosis, cholesterol, and other fats (plaque) inside artery walls cause narrowed or blocked arteries.

  • Chronic venous insufficiency: Damaged valves and/or weakened veins unable to efficiently send blood from limbs back to the heart.

  • Critical limb ischemia: Narrowing or blockage of arteries that carry blood to the arms or legs.

  • Deep vein thrombosis (DVT): Blood clots develop in large, deep veins, usually in the legs.

  • Peripheral vascular disease: A complication of diabetes caused by atherosclerosis.

  • Pulmonary embolism: Blood clots that develop in leg or arm arteries and travel to the lung arteries.

  • Renal vascular disease: Narrowing or blockage in arteries and veins of the kidneys.

  • Stroke: Partially or completely blocked blood flow to the brain.

  • Tumors: Cancerous and noncancerous lesions.

  • Varicose veins: Enlarged, bulging veins, typically in the legs.

  • Vascular malformations: Clusters of abnormal, enlarged arteries, veins, or lymph vessels caused by hereditary disorders.

How do I prepare for endovascular revision?

Your doctor will discuss endovascular revision with you and answer any questions you may have.

When you get ready to go to the hospital or the outpatient surgery center, be sure to wear loose-fitting, comfortable clothing.

A member of your surgical team—such as a nurse—will advise you on exactly when to stop eating and drinking fluids before your surgery.

A member of your surgical team will review your medications with you to decipher which ones you should stop taking before surgery.

If you smoke, stop smoking before your surgery. The sooner you quit, the better.

What should I expect during my endovascular revision?

This procedure lasts about an hour. It usually does not require an overnight stay in the hospital. Here are the steps:

  • A nurse will give you a sedative, but you’ll be awake during the procedure.

  • You'll be given a local anesthetic to numb the puncture site.

  • The doctor will puncture through your skin and into a large blood vessel with a needle. A small tube (sheath) will be inserted and the catheter threaded through to the heart. A video screen will show the catheter.

  • In endovascular revision, the catheter might be used to:

    • Clear an artery (angioplasty or a percutaneous coronary intervention (PCI)).
    • Treat an aneurysm.
    • Widen a narrowed heart valve (valvuloplasty).
  • The doctor will remove the catheters and the sheath.

  • After the procedure, you will go to a recovery room and lie in bed for a few hours. You will keep your leg straight. Applied pressure at the puncture site will help stop bleeding.

  • Your heartbeat and other vital signs will be checked.

  • A small bruise at the puncture site is normal. If the site starts to bleed, lie flat and press firmly on top of it for a few minutes. Then, recheck to see if the bleeding has stopped.

  • Most people can return to their normal activities the day after the procedure.

When you can go home, you may take sponge baths but should not soak the area around your incision until it has completely healed.

How do I care for myself after my endovascular revision?

One to two weeks after surgery, you will have a follow-up appointment with your doctor to check your recovery progress. One and six months following surgery, you will have imaging tests to ensure that the revision was successful.