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Vascular surgery is used to resolve problems with the vascular system (arteries and veins), such as varicose veins. At London Bridge Hospital vascular surgery is carried out, wherever possible, using peripheral arterial interventions. This is a minimally invasive technique designed to facilitate recovery.
Vascular surgery can be used to treat the following problems.
Usually treated by an operation on the abdomen where the aneurysm is replaced with an artificial artery. However, where possible the treatment, ("endovascular aneurysm repair") where a special stent graft is, is threaded into the aortic aneurysm through a small incision in each groin. This results in a shorter stay in hospital and a much quicker recovery period.
In micro-injection sclerotherapy (MIST) an irritant solution is injected into the thread veins - also called spider veins and telangiectasias. This causes inflammation and destruction of the venule and, with time, the body's scavenging cells - the macrophages - clear the area leaving a very gratifying cosmetic result - as soon as six weeks with the fine thread veins but, occasionally, with the larger thread veins or reticular veins, there may be brownish skin-staining which can take up to two years to clear. Indeed, with larger varicose veins, the staining may never clear completely.
The very latest technologies will be used to minimise patient discomfort. The consultants are proponents of minimally invasive therapies for occlusive disease (pelvis and leg arteries) and carotid disease (neck arteries).
Varicose veins are prominent superficial veins which may present as a purely cosmetic problem but may also cause symptoms which include pain, aching, cramp, restlessness and ulceration. Principle investigation is duplex ultrasound imaging which identifies deep superficial vein problems. Based on these investigations, the most appropriate form of treatment can be offered. Treatments offered include surgical treatment, junctional ligation and removal of superficial veins, laser ablation of superficial veins, ultrasound guided foam sclerotherapy and microsclerotherpy. One or a combination of these treatments would produce a good cosmetic and functional result. Laser technology can now be used for treatment. The consultants can offer a one-stop diagnosis using a Duplex scanner which means only one visit to the clinic is necessary before treatment. Most patients will be suited to this laser treatment which can be performed under local anaesthetic and involves a much shorter recovery time. General anaesthetic under theatre conditions can still be used if preferred by the patient.
The principle is exactly the same as for Laser except that a gentler heat is used - it is generated by radiofrequency waves.
When carried out by an experienced surgeon and with intra-operative ultrasound guidance, this is still considered by most experienced vascular surgeons to be the gold-standard.
The London Vascular Group at London Bridge Hospital is now able to offer AAA screening to all. Abdominal aortic aneurysms (AAA) kill over 4000 in the UK every year. Screening for AAA is proven to save lives. The AAA screening is a simple ultrasound scan of the abdomen that is painless and takes only a few minutes. Further advice if required or treatment, including endovascular (minimally invasive) repair of AAA is also available by the vascular surgeons at the London Vascular Group.
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