Treatment of vascular disease has undergone tremendous change over the past decade. Non-surgical, catheter based, minimally invasive approaches to the treatment of vascular disease have evolved which allow patients to undergo therapy with less discomfort and minimal impact on daily activities.
The physicians at Vascular Associates of San Diego are specially trained to perform minimally invasive endovascular procedures to treat the full spectrum of arterial and venous disease states. Unlike other specialties, Vascular Surgeons are the only specialists who have undergone comprehensive, accredited training in the care of the vascular patient.
Our goal at Vascular Associates of San Diego is to provide each patient with a treatment plan that is individually designed to improve your quality of life and functional outcome without a significant adverse impact on your daily life.
ENDOVASCULAR ANEURYSM REPAIR FOR THORACIC (TEVAR) OR ABDOMINAL AORTIC ANEURYSMS (EVAR)
Modern treatment of aortic aneurysms involves placement of an endovascular stent graft which is a metal scaffolding covered with fabric that is inserted through two small incisions in the groin. The aorta is effectively re-lined preventing blood from entering the aneurysm and thereby decreasing the pressure within it and subsequent growth and/or rupture. These techniques afford patients lower operative risk, less discomfort, shorter hospital stay, and a faster return to daily activities compared to traditional open aneurysm surgery.
Patients are first evaluated with a CT scan to determine the precise size and shape of their aneurysm. Once patients are deemed appropriate candidates for a stent graft, the device is selected and the procedure performed in the hybrid endovascular operating room suite. Most patients are able to be discharged home in 1-2 days.
FENESTRATED ENDOGRAFTS (FEVAR)
Standard endografts are available on the shelf to treat most types of aneurysms. Occasionally patients will have large aneurysms, with very complex anatomy that are not able to be treated with standard grafts. At Vascular Associates, we are specially trained and experienced in designing custom endografts that allow us to treat very complex anatomy that would otherwise require extensive open surgery and in some cases preclude surgery at all.
Our surgeons have some of the most extensive experience available in Southern California in treating complex aneurysms with custom fenestrated endografts.
ENDOVASCULAR TREATMENT OF PERIPHERAL ARTERY DISEASE
The endovascular specialists at Vascular Associates are specially trained to perform all aspects of peripheral arterial disease diagnosis and management. This includes diagnostic angiography which is placing a catheter inside the artery and injecting a contrast dye to clearly visualize and document arterial disease. Angioplasty is a procedure where a balloon is placed inside the artery at the diseased segment to dilate it. Frequently we use drug coated balloons for this treatment as a way to decrease the risk of the narrowing returning. In some circumstances, stents (a tube of metal scaffolding) are required to open up a blocked area. These can also be coated with a drug to decrease the risk of recurrent narrowing. Finally, atherectomy technology can be used as way to debulk and remove the plaque inside the artery prior to ballooning or stenting.
ENDOVASCULAR TREATMENT OF CAROTID ARTERY DISEASE
Carotid Stenting
We specialize in endovascular treatment of carotid artery disease with angioplasty and stenting of the carotid arteries to treat and prevent stroke. Our endovascular specialists are certified to perform carotid angioplasty and stenting using FDA approved devices.
TransCarotid Artery Revascularization (TCAR)
The surgeons at Vascular Associates of San Diego were the first in San Diego County to perform an innovative treatment for carotid artery disease called TransCarotid Artery Revascularization (TCAR). The technique allows us to safely place a stent into the carotid artery directly through a small cut above the collar bone. The brain is protected from debris during the placement of the stent by a novel device that temporarily reversed blood flow from the brain. We now have the most experience in Southern California with this remarkable technique.
Endovascular Treatment of Venous Disease
Endovascular techniques can also be applied to the treatment of deep venous thrombosis (blood clots). In appropriate patients, a catheter can be placed directly into the clot and used to dissolve the clot. We also use a technique called “percutaneous mechanical thrombectomy” which allows us to safely remove the clot using small catheters. Additionally, inferior vena cava filter placement is used at times to prevent life-threatening clots from traveling to the lungs (pulmonary embolism).
Surgical treatment of varicose veins has, for the most part, been supplanted by modern techniques which involve placement of a radiofrequency probe (VNUS) or laser into incompetent or poorly draining veins allowing functional removal of the abnormal veins. In our Vein Clinic, we use state-of-the-art technology to treat varicose veins and many other venous disorders within the office setting with little to no recovery required.
