Operative Treatment is divided into two categories: endovascular and open. Most patients will start with endovascular options.

Endovascular Surgery

This starts with angiogram (also called arteriogram), which is done by placing a small thin catheter through a needle hole in the skin directly into your arteries. This is usually done through the groin into your femoral artery. These catheters can be steered throughout your arteries, and, using X-rays, a temporary dye is injected to map out your arteries and the blockages.  These same catheters can then be used to deploy angioplasty balloons (hard balloons that force open the plaque blockages) or stents (small metal mesh tubes that spring open and keep the blockages open).

Endovascular surgery is considered minimally invasive. It is often done as an outpatient and you can return home several hours after the procedure is done, with minimal restrictions to your activities afterwards.

Open Surgery

Not all blockages can or should be fixed with angioplasty balloons or stents. We know some simply cannot be opened with catheters, or are in bad positions for balloons or stents (such at the knee or hip joints). Patients with these types of blockages will require open surgery, such as bypass grant surgery or an endarterectomy.

Bypass surgery involves operating on your arteries and grafting a new “artery” to bypass around the blockage. The replacement “artery” can be one of the “spare” veins in our legs (long veins in our legs that are “extra” or redundant veins) or artificial arteries (made usually from synthetic materials). An endarterectomy surgically removes the blocked lining from the artery while keeping the outer wall of the artery in place.

While open surgery does require a stay in the hospital (usually 2-5 days), and involves more recovery time than endovascular surgery, this is still an excellent option that can be done on almost all blockages with very good long-lasting results.