Vascular Treatment

Vascular Treatment Options to Fit Each Patient

At University Health System, our vascular surgeons test and diagnose diseases of the vascular system and recommend treatment options tailored to your condition. Our partnership with UT Health San Antonio ensures you have access to the most advanced endovascular techniques, as well as traditional vascular surgery options.

Level I Vascular Emergency Program

Sudden aortic syndromes are life threatening and seconds matter when you have a circulatory system condition. Our Level I Vascular Emergency Program has resources and treatment options many outlying or referring hospitals don’t have in-house. Our physicians actively work to reduce treatment delays and provide the appropriate treatment for your needs.

In addition to sudden aortic syndromes, such as thoracic (chest) aortic aneurysms and abdominal aortic aneurysms, we treat a lack of circulation in the arms and legs (acute limb ischemia) and other vascular conditions with a wide range of treatments.

Angioplasty

During this procedure, your vascular surgeon inflates a small balloon inside a narrowed blood vessel. The balloon helps to widen your blood vessel and improve blood flow.

Dialysis Access

Your specialist may recommend creating an entryway into your bloodstream that lies completely under your skin, usually in your arm. This entryway, or "port," allows your doctor to remove and return blood quickly and safely during dialysis. [link to page ID 4.21.3] This is the most common treatment for kidney failure and requires minor surgery.

An arteriovenous fistula (AVF) can be surgically created and used for hemodialysis. Once created, the fistula is a natural part of the body. This is the preferred type of access because it’s completely natural. Once the fistula properly matures, it provides an access with good blood flow that can last for decades.

A hemodialysis reliable outflow – or HeRO – graft is another surgical option we provide. The HeRO graft removes the need for a catheter. It’s also useful if a fistula fails. Patients can be more comfortable with less likelihood of infection than with catheters.

Central venous obstruction is a common problem in patients with chronic kidney failure who undergo ongoing hemodialysis. Under certain circumstances, we perform central vein (CV) bypass surgery to reduce or avoid this kind of condition.


Endarterectomy

This is the surgical removal of plaque from a narrowed or blocked artery. A sticky substance called plaque can build up in your artery walls (atherosclerosis) and reduce or cut off oxygen to your organs or muscles. Your vascular surgeon makes an incision in the artery to remove the plaque and restore blood flow.

A carotid endarterectomy (CEA) may be used to treat your carotid artery disease. During this operation, your surgeon performs the procedure on the arteries on either side of your neck.

Endovascular Aortic Repair (EVAR)

We use endovascular aortic repair (EVAR) to treat certain aortic conditions, most commonly abdominal aortic aneurysm (AAA). During this minimally invasive procedure, we place an expandable stent graft within the aorta to treat aortic disease without operating directly on the aorta.

Endovenous Laser Therapy (EVLT)

Endovenous laser therapy, otherwise known as EVLT, is a minimally invasive treatment for varicose veins. To perform this procedure, we insert a laser probe into the vein using a small needle. We fire the laser through the vein. It delivers energy to the vein so it shrinks and closes off to eliminate blood flow. Blood diverts into normal veins to increase circulation and relieve your symptoms.

First Rib Resection

This surgical procedure is used to treat thoracic outlet syndrome (TOS). TOS often causes pain, numbness, tingling and weakness in the arm. A surgeon removes a segment of the first rib (under the collarbone) to alleviate nerve compression.

Inferior Vena Cave (IVC) Filter

This type of vascular filter is a medical device implanted into one of the large veins that carries blood to your heart called the inferior vena cava. An interventional radiologist or vascular surgeon implants the device to reduce your risk of a life-threatening pulmonary embolism. IVC filters are only recommended in some high-risk scenarios where patients are at increased risk for a pulmonary embolism and can’t be sufficiently anticoagulated.

Phlebectomy

Phlebectomy is a minimally invasive procedure during which your surgeon uses a small scalpel or needle to remove varicose veins on the surface of the leg. It's very effective for many patients.

Radiofrequency Ablation (RFA)

Radiofrequency ablation is similar to EVLT with one notable difference - instead of using a laser to treat your condition - we use radiofrequency energy. Both procedures are minimally invasive and highly successful for our patients.

Sclerotherapy

Sclerotherapy is used to treat varicose and spider veins. It's primarily used for small varicose veins. During the procedure, a solution is injected directly into the vein. The solution causes the vein to scar and collapse. Blood naturally reroutes through healthier veins and the collapsed vein fades as it’s reabsorbed into the tissue.

Stenting

During this procedure, your vascular surgeon inserts a slender, metal-mesh tube, called a stent, into an artery to increase blood flow in areas blocked by plaque. This plaque buildup may result from hyperlipidemia.

Carotid artery stenting (CAS) is a procedure where your vascular surgeon places the stent inside the arteries on either side of your neck.

Surgical Aneurysm Repair

Your vascular surgeon repairs or removes an aneurysm, an enlarged and weakened section of an artery, through an incision in your skin. An aneurysm is a serious health concern. It can rupture or allow blood clots to form.

Aneurysms can be repaired safely either by open vascular surgery or through an endovascular procedure using a stent graft.

Surgical Bypass

During a bypass procedure, your vascular surgeon creates a new pathway for blood flow using a graft. To bypass a blocked leg artery, for instance, a healthy vein from the same leg is used. It may be removed through one long incision or several smaller ones. In some cases, a synthetic graft is used. Once the graft is ready, your surgeon makes an incision near the damaged artery. The graft is stitched to the artery above and below the blockage. Once blood is flowing through the graft, the incision is closed with sutures or staples.

Thrombolytic Therapy

This treatment uses clot-dissolving medications for conditions such as acute mesenteric ischemia or thoracic outlet syndrome. The medications break up dangerous clots inside your blood vessels. In some cases, the medication reaches the clot through your bloodstream. In other cases, your physician uses a catheter with special attachments to break up the clot.

Thoracic Endovascular Aortic Repair (TVAR)

Many of our cardiothoracic and vascular surgeons are experienced in TVAR. We perform this surgery inside your aorta using thin, long tubes called catheters. The catheters are used to guide and deliver a stent-graft through the blood vessels to the aneurysm through small incisions in the groin. The stent graft is then deployed in the diseased segment of the aorta and "relines" the aorta like a sleeve to divert blood flow away from the aneurysm.

We also perform Fenestrated Endovascular Aortic Aneurism Repair (FEVAR) with grafts that are custom designed to fit each patient’s unique aortic anatomy. FEVAR is a minimally invasive surgical alternative to the traditional open aortic aneurysm repair.

Venous Access

This procedure allows your physician to deliver medicine directly into your bloodstream without repeated needle sticks. A catheter provides an entryway into your vein, usually in your arm, neck or chest. Sometimes the catheter may connect to a port under the surface of your skin.

Wound Care

We offer wound care for a wide range of vascular conditions. Foot ulcers are among the most common conditions we treat. Ulcers are wounds or open sores that will not heal or keep returning. The three most common types of leg and foot ulcers include:

  • Venous stasis ulcers
  • Neurotrophic (diabetic)
  • Arterial (ischemic ulcers)

Our vascular experts care for each of these conditions in our offices, provide instructions for wound care at home and give recommendations on prevention techniques.