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Vascular and Endovascular Surgery

Clinical Expertise

For appointments and information, please call (646) 962-8450

Vascular Surgery

Physicians in the Division of Vascular Surgery are world-renowned leaders in the field. Among the vascular disorders they diagnose and treat are:

  • Aortic Aneurysm – A bulging or ballooning of a weakened part of the aorta – the largest artery in the body
  • Carotid Artery Disease – Over time, the carotid arteries-the two major arteries in the neck that provide most of the blood supply to the brain-may become narrowed or blocked and can obstruct blood flow, leading to a stroke or a "mini" stroke.
  • Deep Vein Thrombosis and Thrombophlebitis – Deep vein thrombosis and thrombophlebitis involve inflammation and blood clot formation in the veins, primarily occurring in the leg. Thrombophlebitis refers to blood clot formation occurring in the superficial veins closer to the skin surface and is generally caused by irritation to the lining of the vein.
  • Lower Extremity Arterial Occlusive Disease – Narrowing of the arteries in the lower extremities of the body decreases the blood supply to the muscles and tissues in the surrounding area (poor circulation) and is often present with carotid artery disease and heart disease.
  • Renal and Mesenteric Artery Occlusive Disease – Renal artery occlusive disease occurs when the arteries supplying blood to the kidneys become narrowed and interrupt blood flow to the organ; when the arteries supplying the intestines are affected, the condition is called mesenteric artery occlusive disease.
  • Varicose Vein Disease – Varicose veins are usually caused by valve deterioration in the veins of the leg. Blood flow in the veins must progress upwards, against the force of gravity. To overcome these difficulties, the veins contain a series of specialized one-way valves that open to allow the blood to flow upwards and then shut to keep the blood from flowing back downwards towards the feet. When the valves in the veins do not function properly, the blood leaks or flows backwards. Over time, this puts pressure on the veins, causing them to stretch and dilate.
  • Venous Insufficiency and Venous Ulcers – Venous insufficiency is a chronic condition in which blood does not flow normally through the veins from the feet back up towards the heart. When damaged vein valves allow blood to leak backwards and stagnate in the veins of the lower legs, blood pressure increases in the legs and causes chronic inflammation in the veins. Venous ulcers are a frequent outcome of long-term untreated venous insufficiency. The area where the blood pools has a tendency to ulcerate causing first the blood vessels to break down, and then the surrounding tissue. These ulcers appear mostly on the legs, just below the ankle. Left untreated, they can become quickly infected or even gangrenous.

Ultrasound Screening for Abdominal Aortic Aneurysm

A study conducted by our surgeons and published in the journal Surgery has shown that a simple, low-cost ultrasound screening is valuable to detecting abdominal aortic aneurysms and saving lives. Our physicians were instrumental in facilitating the passage of legislation requiring Medicare coverage of abdominal aortic aneurysm screening exams.

Angioplasty and Stenting for Blocked Vessels

Every day, patients with a wide range of vascular disorders seek the care of our physicians for such serious situations as strokes, threatened limbs and impending kidney failure. Whenever possible, we use minimally invasive procedures to treat these and other vascular disorders. Also referred to as endovascular surgery or treating vessels from within, minimally invasive procedures involve correcting the vascular problem through either a very short incision or no incision at all using catheters and implantable devices, such as stents or stent grafts. We have pioneered procedures to treat carotid artery disease and arterial insufficiency to the legs.

Angioplasty and stenting are being used nowadays more frequently than in the past for the treatment of vascular conditions, particularly when the diseased portion of the artery is relatively small and easily accessible with a catheter. Performed with a local anesthetic, these techniques are used to open blocked arteries to the brain, kidneys, intestines and lower extremities.

During angioplasty, a balloon tipped catheter is inserted through an artery in the groin via a needle puncture. The catheter is threaded through the artery to the point of the blockage and then the balloon is inflated, expanding the opening in the artery to improve blood flow. A stent is a synthetic or metal support structure similar to a spring and may be used to provide a reinforced channel through which blood can flow.

Endovascular Repair of Abdominal and Thoracoabdominal Aortic Aneurysms

For aortic aneurysm repair, a minimally invasive procedure called endovascular stent graft insertion is often used in patients whose overall health may make open surgery too risky. Studies of the procedure suggest that it carries a low risk of complications and has a very good success rate. It also has a shorter recovery time than conventional treatment using open surgery aortic aneurysm repair. With the use of a catheter inserted via an artery through a short incision in the groin, a stent graft (endograft) made of a synthetic material is inserted into the aortic artery. Using X-ray imaging, the surgeon guides the endograft through the catheter to the damaged area of the aorta. The endograft provides a reinforced channel for the blood to flow and thereby reduces the pressure on the damaged area (aneurysm) of the artery preventing rupture of the aneurysm.

Treatment for Varicose Veins

When varicose veins are particularly large or severe, accompanied by leaking valves in large veins in the groin, or have not responded to other treatments, surgery using ligation and stripping may be recommended. As an alternative to this surgery, our surgeons offer a newer procedure for varicose vein disease called endovenous laser therapy in which a laser is used to ablate or close the problem vein through little needle punctures. The procedure is less invasive than surgery and has a lower complication rate.

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Vascular and Endovascular Surgery
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(646) 962-8450
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        Phone: (212) 746-6006
        Fax: (212) 746-8753
        Address: 525 E. 68th Street
        Starr 8
        New York, NY 10065
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