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Veins, arteries and more: All about vascular surgery

| Healthy You | Heart Health

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If you have unexplained leg pain, talk with your PCP.

You might know someone who had pain or weakness in their legs and figured it was just a regular part of aging. (Or maybe that’s what you’re thinking right now!) 

In fact, it could be a sign of what’s known as a vascular condition, and you could benefit from a having a surgical procedure to manage it.

Vascular conditions are common

What’s a vascular condition? It’s a health concern that affects the arteries and veins that make up your circulatory system. More than 12 million Americans have some form of a vascular condition, according to the American Heart Association.

“People need to be aware that what causes blockages in your heart can cause blockages in your arteries in the neck, arms, legs, kidneys and other parts of the body,” says Manju Raju, MD, an interventional cardiologist at PeaceHealth’s Oregon Heart and Vascular Institute in Springfield, Oregon.

Seek treatment options

If you have an untreated vascular condition, your risk for stroke and heart attack goes up. It may not seem like a big deal to just live with your symptoms, but over time, some conditions can lead to the loss of a leg.  Sudden death is also possible.

The good news is that there are effective treatment options for a range of these conditions. 

Here are six types of common vascular surgery procedures:

  1. Angioplasty: Angioplasty is used to unblock or widen blood vessels that are too narrow. During the procedure, a small balloon is inserted into and inflated in the affected blood vessel. This allows the blood to move through the vessel more freely. Angioplasty is a minimally invasive procedure. This means a physician uses small cuts to reach the affected vein or artery instead of making large incisions to open the body and make repairs. Surgery with larger cuts is called open surgery.
  2. Stent placement: If the blood vessel needs more support than just angioplasty, a small metal or plastic tube called a stent, may be inserted into the affected blood vessel. The stent is left inside to keep the vessel open for blood to pass through easily.
  3. Endarterectomy: Surgeons use endarterectomy to remove buildup from inside arteries in the neck or legs. This buildup, called plaque, is made up of cholesterol, fat and other substances. It can block blood from flowing through your blood vessels. As much as you can, you want to reduce your blood cholesterol levels to lessen your chance of developing plaque.
  4. Aortic aneurysm repair: An aortic aneurysm is a bulge or weakness in the wall of the aorta, the body's largest artery. If left untreated, an aortic aneurysm can burst. This may cause life-threatening bleeding. Surgeons can repair an aortic aneurysm using open surgery (explained above). It might also be possible to fix the condition with minimally invasive techniques, using small cuts to enter the body. Then going through the blood vessels to make repairs inside.
  5. Varicose vein treatment: Varicose veins are enlarged, twisted veins. The condition can be painful. A handful of different treatments are used for varicose veins, such as compression stockings, removing the vein or closing it off.
  6. Hemodialysis access surgery: Hemodialysis is a treatment for kidney failure. It involves filtering the blood through a machine. In some cases, vascular surgery may be necessary to create an opening that will allow the blood to flow out to the filter system and back into the body.

Risks for vascular conditions

Many people with heart conditions may also have vascular conditions. Risk factors for heart and vascular conditions are very similar:

  • High blood pressure
  • High cholesterol
  • Diabetes
  • Smoking, which damages the lining of your blood vessels
  • Family history of having a heart attack or stroke

Symptoms of PAD

One common vascular condition is peripheral artery disease (PAD). People may have PAD without knowing it because most of them are not aware of the symptoms. 

But if you do have symptoms, you might notice:

  • Weak, tired legs.
  • Tight, aching or squeezing pain in some part of your leg.
  • Open sores or ulcers in your legs

One of Dr. Raju’s patients could hardly walk to the mailbox because of his PAD. After treatment, the patient felt good enough to begin walking long distances — well beyond the mailbox.

Don't blame old age

“It’s easy to blame pain or trouble walking on your age,” says Dr. Raju. “You think ‘it’s just old age.’ I encourage people to not give up.”

The reasons for your pain may be treatable. He encourages patients to participate in an exercise program so that they can walk longer distances.  Giving up smoking is also big step toward healing and recovering from already damages arteries and veins.

Talk to your primary care provider, podiatrist, cardiologist and vascular physicians if you have concerns about or symptoms of a vascular condition.

They can help you get treatment so you can get back to living with less pain and worry.

portrait of Manjunath G. Raju MD

Manjunath G. Raju MD

Cardiology
Nuclear Cardiology
Manjunath Raju M.D is an Interventional Cardiologist who joined PeaceHealth Sacred Heart Medical Center's Oregon Heart & Vascular Institute after completing fellowships in Cardiology/Interventional cardiology at Michigan State University and Vascular Medicine fellowship at the Cleveland Clinic Foundation, Cleveland OH. He graduated with Alpha Omega Alpha honor medical society from Michigan State University. Dr. Raju is the Medical Director of Vascular and Endovascular program at PeaceHealth's Oregon Heart & Vascular Institute. Dr. Raju is passionate about providing the latest and most effective therapies for his patients. He has a special interest in minimally invasive percutaneous approaches to treat heart disease, peripheral arterial disease, complex high-risk coronary intervention, left ventricular hemodynamic support devices, left atrial appendage occlusion/watchman device implantations, vascular ultrasound, peripheral vascular interventions, and critical limb ischemia. He leads the cardiology rotation preceptorship program for medical students from Oregon Health& Science University and University of Washington. For leisure, Dr. Raju enjoys spending time with family, watching movies, hiking, and playing golf.

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