Cardiothoracic and Vascular Surgery

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Carotid Angioplasty and Stenting

Narrowing of the carotid arteries, which deliver oxygen- and nutrient-rich blood to the brain, can increase the risk for the most common form of stroke, known as an ischemic stroke. In carotid angioplasty, your doctor inserts a thin tube known as a catheter into a blood vessel (usually in the groin or wrist) and threads it to the carotid artery that’s narrowed or blocked by arterial plaque. Then, your doctor will inflate a small balloon at the tip of the catheter to reopen the narrowed artery. In most cases, a small mesh tube called a stent will be inserted into the artery to keep it open.

As an alternative to carotid angioplasty, we may recommend carotid endarterectomy. In this procedure, your surgeon makes an incision on the neck along the blocked section of a carotid artery, then removes the plaque that has caused it to narrow. Sometimes, a stent will be inserted to reduce the risk of the artery re-narrowing.

Interventions for Peripheral Artery Disease

Vascular disease can reduce blood flow to the extremities, especially the legs, and interfere with blood return to the heart. Riverside Heart & Vascular Institute has an array of solutions for peripheral artery disease, including:

• Balloon angioplasty: The same catheter-based treatment used for coronary and carotid arteries can effectively clear blocked arteries in the legs.
• Laser angioplasty: A light-based device attached to the tip of a catheter is used to “vaporize” an artery blockage.
• Atherectomy: Using a tiny device attached to the tip of a catheter, the surgeon “shaves” away the blocked area inside an artery.
• Stents: These tiny mesh tubes are sometimes inserted to keep a cleared artery open.
• Vascular surgery: Your surgeon may harvest a blood vessel from another part of the body to create a bypass graft or use a tube made of synthetic material to reroute the blood flow around a blocked artery.
• Traditional surgical techniques: These may also be used to treat some forms of peripheral artery disease, including varicose veins, which are bulging blood vessels in the legs that may cause pain and cosmetic concerns.

Abdominal Aortic Aneurysm Stent Grafts

A common condition known as an abdominal aortic aneurysm (AAA) causes a weak spot in the body’s largest blood vessel that may rupture, causing a life-threatening emergency. In this preventive procedure, a device called a stent graft is delivered by catheter to the site of an aortic aneurysm. A stent graft is a tube made of a thin metal mesh covered with a thin polyester fabric. This stent graft is opened inside the aorta and fastened in place, allowing blood to flow through it. It protects that segment of the aorta and prevents the aneurysm from bursting.