Vascular Surgery — Colorado Cardiovascular Surgical Associates, P.C.

Carotid Artery Disease
The carotid arteries lie on both sides of the neck and travel into the skull, bringing blood to the brain. Cholesterol and calcium-laden plaque can build up in these arteries, leading to obstruction of blood flow to the brain. More importantly, pieces of these plaques can break free, causing blockage of arteries within the brain, causing a stroke. If a very tiny artery is blocked off, or if the plaque in this artery dissolves, the symptoms may be temporary, known as a transient ischemic attack, or TIA.

Symptoms can include numbness or tingling on one side of the face or arm or leg. There can be associated weakness or paralysis on one side of the body or face. Some patients have the sensation of a black curtain falling over one eye, causing blindness. Sometimes victims lose the ability to speak or slur their words. The surgical treatment for this condition involves either local or general anesthesia.

Carotid Endarterectomy Procedure
While the patient is under anesthesia, surgeons make an incision in the neck, at the location of the blockage. A tube is inserted above and below the blockage to reroute blood flow. Surgeons can then open up the carotid artery and remove the plaque. Once the artery is stitched closed, the tube is removed. The surgeon may also use an alternate technique that does not require blood flow to be rerouted. In this procedure, the surgeon stops the blood flow just long enough to peel the blockage away from the artery.

Endarterectomy surgery is a treatment that has been proven safe and effective in providing long-term benefits to patients.

Aorta and Abdominal Aortic Aneurysm Surgery, open and Endografts (Stent Grafts)
An aneurysm is a localized dilation or bulge in a blood vessel. Abdominal and thoracic aneurysms occur when the aorta dilates more than 150% of its normal diameter at a particular point. The larger the bulge becomes, the greater the risk that the aorta will burst, causing an internal hemorrhage.

Congenital abnormalities, infections, atherosclerosis or hypertension can lead to a weakening of the blood vessel wall, allowing an aneurysm to develop. Lifestyle habits such as smoking and a poor diet can also be contributing factors.

Many times physical exam results will be normal and patients may be asymptomatic; however, symptoms can include back, chest or abdominal pain. Some other symptoms include hoarseness, wheezing and difficulty swallowing. Patients typically experience hypotension (low blood pressure), tachycardia (fast heart beat) and shock if the aneurysm ruptures.

Almost six in 100,000 people will develop and aortic aneurysm. Men are two to four times more likely to be affected than women and the average age at the time of diagnosis is 60-70 years of age.

Blood work, contrast-enhanced CT scans, magnetic resonance imaging (MRI), contrast angiography, chest radiography, transesophageal echocardiography, or an electrocardiogram may be performed to determine a diagnosis.

If an aneurysm is detected, it is typically treated surgically with a synthetic portion of blood vessel patching the area where the aneurysm was. Small aneurysms may be monitored for a period of time to see if they enlarge.

Endovascular Repair
Endovascular repair was developed after the more invasive open aneurysm repair. In this procedure, your vascular surgeon inserts catheters into an artery in your groin and guides them to the blockage. The surgeon will watch the procedure on a video screen to assure proper placement of the stent. Once in place, the stent will allow blood to flow through, keep the artery open and prevent additional pressure on the damaged artery walls, thus preventing the aneurysm from rupturing.

With this procedure, patients have a shorter hospital stay and recover much more quickly than with the open aneurysm repair. Post-operatively, it is important for patients to have regular check-ups to make sure that the stent is in the proper position and that it is functioning correctly.

Open Aneurysm Repair
The open aneurysm repair requires your surgeon to make an incision in your chest or abdomen, where a graft will be inserted into the aorta at the aneurysm site. The graft is a fabric tube that allows blood to flow through, but protects the damaged arterial walls from pressure.

Angiography
If your physician suspects an obstruction in an artery, you may need to have an angiography, which enables the physician to exam the blood vessels through an X-ray examination. Prior to the test, patients are typically given a mild sedative and a local anesthetic is applied where the catheter will be inserted.

In conjunction with the X-ray, a contrast dye is injected through a catheter that is inserted into an artery in your arm or groin. The dye is then visible on the X-ray pictures, called angiograms, which allow the physician to see the blood flow.

The angiography will show how many arteries are blocked and the location of each blockage, as well as how severe each blockage is.


	Cardiac Surgery Thoracic Surgery Minimally Invasive Vascular Surgery PAD Sclerotherapy VNUS/Varicose Veins What to Expect Insurance and Costs Compliance New Patient Forms

PROCEDURES Cardiac Surgery Thoracic Surgery Minimally Invasive Techniques Vascular Surgery PAD Sclerotherapy VNUS PHYSICIANS Cardiothoracic Surgeons Myles S. Guber, M.D. Randolph Kessler, M.D. Bradley O. Hofer, M.D. Daniel L. Smith, M.D. Vascular Surgeons Roy E Carlson, M.D. Eric S. Weinstein, M.D. Sharon Hammond, M.D. Michael A. Cooper, M.D. HOSPITAL AFFILIATIONS Porter Adventist Hospital Swedish Medical Center Rose Medical Center Skyridge Medical Center Littleton Adventist Presbyterian/St.Luke's	Vascular Surgery Carotid Artery Disease The carotid arteries lie on both sides of the neck and travel into the skull, bringing blood to the brain. Cholesterol and calcium-laden plaque can build up in these arteries, leading to obstruction of blood flow to the brain. More importantly, pieces of these plaques can break free, causing blockage of arteries within the brain, causing a stroke. If a very tiny artery is blocked off, or if the plaque in this artery dissolves, the symptoms may be temporary, known as a transient ischemic attack, or TIA. Symptoms can include numbness or tingling on one side of the face or arm or leg. There can be associated weakness or paralysis on one side of the body or face. Some patients have the sensation of a black curtain falling over one eye, causing blindness. Sometimes victims lose the ability to speak or slur their words. The surgical treatment for this condition involves either local or general anesthesia. Carotid Endarterectomy Procedure While the patient is under anesthesia, surgeons make an incision in the neck, at the location of the blockage. A tube is inserted above and below the blockage to reroute blood flow. Surgeons can then open up the carotid artery and remove the plaque. Once the artery is stitched closed, the tube is removed. The surgeon may also use an alternate technique that does not require blood flow to be rerouted. In this procedure, the surgeon stops the blood flow just long enough to peel the blockage away from the artery. Endarterectomy surgery is a treatment that has been proven safe and effective in providing long-term benefits to patients. Aorta and Abdominal Aortic Aneurysm Surgery, open and Endografts (Stent Grafts) An aneurysm is a localized dilation or bulge in a blood vessel. Abdominal and thoracic aneurysms occur when the aorta dilates more than 150% of its normal diameter at a particular point. The larger the bulge becomes, the greater the risk that the aorta will burst, causing an internal hemorrhage. Congenital abnormalities, infections, atherosclerosis or hypertension can lead to a weakening of the blood vessel wall, allowing an aneurysm to develop. Lifestyle habits such as smoking and a poor diet can also be contributing factors. Many times physical exam results will be normal and patients may be asymptomatic; however, symptoms can include back, chest or abdominal pain. Some other symptoms include hoarseness, wheezing and difficulty swallowing. Patients typically experience hypotension (low blood pressure), tachycardia (fast heart beat) and shock if the aneurysm ruptures. Almost six in 100,000 people will develop and aortic aneurysm. Men are two to four times more likely to be affected than women and the average age at the time of diagnosis is 60-70 years of age. Blood work, contrast-enhanced CT scans, magnetic resonance imaging (MRI), contrast angiography, chest radiography, transesophageal echocardiography, or an electrocardiogram may be performed to determine a diagnosis. If an aneurysm is detected, it is typically treated surgically with a synthetic portion of blood vessel patching the area where the aneurysm was. Small aneurysms may be monitored for a period of time to see if they enlarge. Endovascular Repair Endovascular repair was developed after the more invasive open aneurysm repair. In this procedure, your vascular surgeon inserts catheters into an artery in your groin and guides them to the blockage. The surgeon will watch the procedure on a video screen to assure proper placement of the stent. Once in place, the stent will allow blood to flow through, keep the artery open and prevent additional pressure on the damaged artery walls, thus preventing the aneurysm from rupturing. With this procedure, patients have a shorter hospital stay and recover much more quickly than with the open aneurysm repair. Post-operatively, it is important for patients to have regular check-ups to make sure that the stent is in the proper position and that it is functioning correctly. Open Aneurysm Repair The open aneurysm repair requires your surgeon to make an incision in your chest or abdomen, where a graft will be inserted into the aorta at the aneurysm site. The graft is a fabric tube that allows blood to flow through, but protects the damaged arterial walls from pressure. Angiography If your physician suspects an obstruction in an artery, you may need to have an angiography, which enables the physician to exam the blood vessels through an X-ray examination. Prior to the test, patients are typically given a mild sedative and a local anesthetic is applied where the catheter will be inserted. In conjunction with the X-ray, a contrast dye is injected through a catheter that is inserted into an artery in your arm or groin. The dye is then visible on the X-ray pictures, called angiograms, which allow the physician to see the blood flow. The angiography will show how many arteries are blocked and the location of each blockage, as well as how severe each blockage is.
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