Blood vessel surgeries

There is a range of surgical procedures used to treat blood vessel problems. These are done by a vascular surgeon who specialises in blood vessels.

Types of surgery

You may need surgery on an artery or vein to:

  • clear a blood clot
  • remove plaques (fatty deposits) that have caused your artery to narrow
  • place a stent (tube) to keep blood flowing easily through your artery
  • create a bypass for a damaged or blocked blood vessel.

Which surgery you need depends on your condition. Most are completed under a local anaesthetic, where you are awake and given a numbing injection so you do not feel any pain.

Sometimes the surgeon may need to make a larger cut to get better access to where they need to operate. In this case you will need to be put to sleep with a general anaesthetic.

Angioplasty

Angioplasty is when a surgeon uses a tiny balloon to widen arteries to improve the blood flow. It is used to treat vessels that are blocked by atherosclerosis and other blood vessel problems.

The surgeon attaches the balloon to a small tube (a catheter). They pass the catheter through a small cut in your leg or arm artery and move it to where the artery is blocked. They inflate the balloon, causing the artery to widen. Then they deflate and remove the balloon.

At the same time, they may insert a stent (a small plastic or metal tube) and leave it in place to keep the artery open.

Arterial bypass

An arterial bypass may be done to treat aneurysms, atherosclerosis, or other conditions that block your blood vessels. 

In an arterial bypass, a surgeon redirects the blood flow around a blockage in your blood vessel. The surgeon often uses a plastic tube for the bypass but sometimes they use part of a healthy blood vessel from another part of your body.

Atherectomy

An atherectomy is an alternative to an angioplasty. In an atherectomy, a surgeon removes plaque from the inside of your artery, which improves the blood flow.

During an atherectomy, the surgeon uses a small tube (catheter) to insert a tiny cutting device into the blocked artery. They then use the cutting device to shave or cut off the plaque from the affected area in your blood vessel.

Carotid endarterectomy

A carotid endarterectomy is when a surgeon removes plaque from the carotid arteries in your neck.

The surgeon opens your carotid artery by making a small cut in your neck artery and then removes the plaque. This restores the blood flow to your brain, which can help prevent a stroke. The surgeon then closes the cut in the artery.

Embolectomy

An embolectomy is a procedure used to remove a blood clot.

The surgeon inserts a small tube (catheter) into a large vein in your groin or neck. They then move the catheter through your vein until it reaches the clot.

They may use suction to remove the clot. This is called an aspiration embolectomy. Or they may inflate a balloon at the end of the catheter and slowly pull it out of the vein bringing the clot with it. This is called a balloon embolectomy.

Endovascular repair

Endovascular repair is used to treat an aneurysm, or a bulge in the wall of your artery.

A surgeon inserts a small tube (catheter) into your artery. This is usually an artery in your groin but sometimes they insert it into an artery in your upper arm. They move the catheter through your artery until it reaches the aneurysm. They then place a stent (a small plastic or metal tube) in the artery. This allows blood to flow through the stent instead of the aneurysm.

Endovascular coiling and microsurgical clipping

Surgeons use endovascular coiling or surgical clipping for brain aneurysms. They will advise which is the best for your specific condition.

Microsurgical clipping — the surgeon will access your brain through a small hole in the skull and place a small clip across the base of the aneurysm. This stops blood from entering the aneurysm and making it bigger, while allowing blood to flow through your artery.

Endovascular coiling — in this technique a small tube is threaded up from an artery in your groin to reach the aneurysm in your brain. The surgeon guides the tube using an x-ray. They then put the tiny (usually less than a hair's width) soft metal coil into the aneurysm to block it.

Endovenous treatment

Endovenous treatment is used to treat varicose veins.

The treatment can be thermal (using heat from a laser for example) or non-thermal. You are usually given the treatment while you are awake.

The surgeon delivers the treatment through a small needle hole in your vein. This closes it and seals it shut. Your body redirects your blood flow to healthier veins.

Radiofrequency ablation

Radiofrequency ablation is used to treat varicose veins. A surgeon heats the walls of your varicose veins, causing them to collapse. This closes them and seals them shut. Your body redirects your blood flow to healthier veins.

Sclerotherapy

Surgeons use this on small varicose veins. They inject a chemical into the vein which irritates the vein wall. This causes it to get inflamed, which makes it close up and fade away. Your body redirects your blood flow to healthier veins.