Vascular Medicine
Vascular Medicine and Surgery
Whether your vascular disease is genetic, a part of the aging process or the result of high cholesterol and high blood pressure, the vascular care program at MetroWest Medical Center is ready to help with innovative technology and compassionate service. Our doctors are dedicated to providing effective treatment for venous or arterial conditions and giving you back your confidence and wellbeing.
You can find treatment procedures for your vascular disease with help from the vascular surgeons at MetroWest Medical Center. Our Vascular Surgery Department utilizes advanced technology to deliver high-quality care for patients suffering from non-heart-related vascular problems. Our treatment offerings range from laser technology to treat veins to endovascular technology to treat aneurysms.
The department’s clinical services include all elements of vascular care:
- Diagnostic evaluations and medical management
- Non-invasive vascular testing
- Surgical care
- Diagnostic angiography and endovascular therapeutics (minimally invasive procedures)
- Inpatient services and critical care
Vascular System
The vascular system is a network of blood vessels that includes the arteries, veins and capillaries. The arteries carry oxygen-rich blood from your heart throughout your body, while the veins carry the blood and waste products back to your heart. The capillaries are thin and leaky blood vessels that connect the arteries to the veins, allowing the exchange of materials between tissue and blood.
Common Vascular Diseases
Arterial Disease
Learn about symptoms, risk factors and treatment of Peripheral Arterial Disease (PAD).
Healthy leg veins contain valves that open and close to assist the return of blood back to the heart. Venous reflux disease develops when the valves that keep blood flowing out of the legs and back to the heart become damaged or diseased. This can cause blood to pool in your legs and lead to symptoms such as pain, swelling, swollen limbs, leg heaviness and fatigue, skin changes and skin ulcers, and varicose veins.
Spider veins, medically known as telangiectasis. They are small, blue to red appearing blood vessels that lie close to the surface of the skin and occur either in lines or web-like patterns. They can ache, burn or itch now and then, but they are usually not symptomatic. Spider veins are not harmful and are simply unsightly.
Varicose veins are ropy appearing blue vessels under the skin. They are most often branches from the saphenous trunk veins and have enlarged due to the excess pressure in the saphenous system. Varicose veins are unsightly and often painful. A clotted varicose vein causes the classic phlebitis, hot and red and painful skin at the site of the clot. Besides the visible symptoms, physical symptoms are tiredness, restless legs at night, heaviness in the leg, pain, aching, itching, throbbing, and swelling, burning or a cramping sensation.
May-Thurner syndrome is when your right iliac artery presses on (compresses) your left iliac vein. Your right iliac artery is the main blood vessel that carries blood to your right leg. Your left iliac vein is the main blood vessel that carries blood from your left leg back to your heart.
Deep vein thrombosis (DVT, also called venous thrombosis) occurs when a thrombus (blood clot) develops in veins deep in your body because your veins are injured or the blood flowing through them is too sluggish. The blood clots may partially or completely block blood flow through your vein.
Pelvic congestion syndrome — also called pelvic venous insufficiency — is a chronic pain condition associated with blood flow problems in your pelvic veins. “Chronic” means pain lasting longer than six months that isn’t associated with either your menstrual cycle or pregnancy.
Venous Disease
Symptoms include pain, swelling, swollen limbs, leg heaviness and fatigue, skin changes and skin ulcers, and varicose veins.
Healthy leg veins contain valves that open and close to assist the return of blood back to the heart. Venous reflux disease develops when the valves that keep blood flowing out of the legs and back to the heart become damaged or diseased. This can cause blood to pool in your legs and lead to symptoms such as pain, swelling, swollen limbs, leg heaviness and fatigue, skin changes and skin ulcers, and varicose veins.
Spider veins, medically known as telangiectasis. They are small, blue to red appearing blood vessels that lie close to the surface of the skin and occur either in lines or web-like patterns. They can ache, burn or itch now and then, but they are usually not symptomatic. Spider veins are not harmful and are simply unsightly.
Varicose veins are ropy appearing blue vessels under the skin. They are most often branches from the saphenous trunk veins and have enlarged due to the excess pressure in the saphenous system. Varicose veins are unsightly and often painful. A clotted varicose vein causes the classic phlebitis, hot and red and painful skin at the site of the clot. Besides the visible symptoms, physical symptoms are tiredness, restless legs at night, heaviness in the leg, pain, aching, itching, throbbing, and swelling, burning or a cramping sensation.
May-Thurner syndrome is when your right iliac artery presses on (compresses) your left iliac vein. Your right iliac artery is the main blood vessel that carries blood to your right leg. Your left iliac vein is the main blood vessel that carries blood from your left leg back to your heart.
Deep vein thrombosis (DVT, also called venous thrombosis) occurs when a thrombus (blood clot) develops in veins deep in your body because your veins are injured or the blood flowing through them is too sluggish. The blood clots may partially or completely block blood flow through your vein.
Pelvic congestion syndrome — also called pelvic venous insufficiency — is a chronic pain condition associated with blood flow problems in your pelvic veins. “Chronic” means pain lasting longer than six months that isn’t associated with either your menstrual cycle or pregnancy.
Vascular Treatment and Surgery
Vascular surgeons treat diseases of the vascular system, which involves conditions that harden the arteries and create obstructions in the blood flow to any part of the body. Some vascular surgeons specialize in more than one vascular intervention, such as open, complicated surgery and minimally invasive, endovascular procedures.
Doctors diagnose vascular diseases through a physical exam, imaging tests and blood tests. Treatment depends on the vascular condition and how severe it is. Many vascular conditions are manageable if caught early. Types of treatments for vascular disease include:
- Lifestyle changes, such as subscribing to a heart-healthy diet and getting more exercise
- Medicines for managing blood pressure and cholesterol, blood thinners and clot-dissolving drugs
- Nonsurgical procedures, such as angioplasty, stenting and vein ablation
- Surgery
When more conservative options do not work, such as lifestyle changes and medicines, your doctor may recommend any of the following medical tests, procedures or surgeries:
- Carotid duplex scan
- Temporal artery duplex scan
- Renal duplex scan
- Lower extremity duplex scan
- Mesenteric duplex scan
- Venous duplex scan
- Vein mapping by duplex
- Noninvasive aortic iliac ultrasound
- Endovascular aortic aneurysm repair
- Peripheral endovascular angioplasty/atherectomy and drug-eluting stenting
- Carotid stenting to include transcarotid artery revascularization (TCAR)
- Renal artery angioplasty
- Mesenteric artery angioplasty
- Thrombolysis, endovascular venous intervention and stenting for deep vein thrombosis (DVT)
- Port placement
- Inferior vena cava (IVC) filter placement
Vascular Procedures
Some of the procedures that the Vascular Surgery Department performs include:
This procedure involves using a cylinder-like tube called a graft to repair the aneurysm. The graft is sewn to the aorta, connecting one end of the aorta at the site of the aneurysm to the other end. We offer both endovascular and open procedures to meet patient needs.
Most amputations are due to vascular disease. In some cases, removing the limb is the best option for preventing tissue death, leading to gangrene.
This procedure helps us evaluate vascular conditions like aneurysm, stenosis or blockages with an X-ray. During the arteriogram, we inject dye into an artery to make the arteries visible on the X-ray.
During this procedure, atherosclerotic plaque that has built up on the inside of the carotid artery wall is surgically removed through an incision on the side of the neck
This process removes waste substances and fluid from the blood that well-functioning kidneys would normally remove.
A surgical procedure used to treat severe lower extremity blockage due to plaque in the femoral artery.
Why Would You Need Vascular Surgery?
Your primary doctor may refer you to a vascular surgeon if the pain in your legs is associated with peripheral arterial disease. Also, if you belong to the high-risk category — a smoker, diabetic or have high blood pressure, it may help to see a vascular surgeon for preventative care.