OUR SPECIALTIES

Vascular Surgery

GVS offers a wide variety of services and an extensive array of the latest surgical techniques, including minimally invasive surgery to provide care for the many facets of general and vascular surgery. Our doctors will discuss with you the best options available for your care.

Vascular Surgery is the branch of medicine that addresses problems associated with the circulatory system. The circulatory system consists of the arterial system (Delivers oxygenated blood to the organs) and the venous system (carries blood away from the organs.) Common disorders include blocked arteries in the extremities, abdomen, and neck, aneurysms, endstage renal disease, and varicose veins.

Abdominal Aortic Aneurysm

An aneurysm is a portion of a blood vessel wall that is enlarged and weakened. The commonly form in the aorta, the body’s largest artery that runs from the heart down into the abdomen. Most people do not feel any symptoms while others may feel a pulsating feeling in the abdomen, deep pain in the abdomen or low back.

Your surgeon may recommend surgical repair of the aneurysm to prevent rupture of the aneurysm. Surgical repair of an abdominal aortic aneurysm is major procedure. It can be performed in a traditional manner. This involves opening the abdomen and replacing the weakened area with a fabric tube.

An alternative approach is the Endovascular Graft Repair and is performed by Dr. Hillmann. The endovascular stent graft repair allows a physician to implant a synthetic tube supported by metal into the aorta. The tube is threaded into the aorta using a catheter inserted through a small incision in the groin. The stent graft allows blood to flow through the aorta without putting pressure on the damaged wall of the aneurysm.

Carotid Endarterectomy

The carotid arteries carry oxygenated blood from the heart to the brain. Over time, plaque can build up in the arteries causing the arteries to become stiff and narrow. This blockage can prevent sufficient blood flow to the brain. If blood flow is blocked long enough, a stroke can occur.

Carotid endarterectomy is usually only done when the amount of partial blockage is severe enough to threaten stroke. No surgery is performed on a completely blocked artery.

Dialysis Access

Dialysis access is critical for patients whose kidneys have failed and must undergo hemodialysis. Dialysis access creates a portal into the bloodstream so the blood can be cleansed by dialysis. This access is generally created in the arm or neck, but may be created in the thigh.

A common type of access is a fistula, whereby your surgeon joins and an artery and a vein, typically in the forearm The vein must be large enough or the procedure will fail. Some patients are not good candidates for fistulas due to small vein size. Vein size may be determined pre-operatively with vein mapping.

If a fistula is not feasible or has failed, a dialysis graft may be offered. A graft connects an artery to a vein via synthetic conduit.

Peritoneal Dialysis Catheters (PD Catheters) are implanted in the abdomen and allow dialysis solutions to flow in and out of the body without the need for a new injection site before each session. PD Catheters also allow patients greater flexibility with dialysis sessions but come with unique needs.

Temporary dialysis may be performed using a catheter inserted into a large vein in the patient’s neck, chest, or groin.

Our doctors and your dialysis doctors will discuss with the best treatment available to you.

Chemotherapy Catheters

Patients requiring chemotherapy treatment often request a catheter or port to allow easier delivery of chemotherapy agents in to the blood stream. Chemotherapy catheters allow direct venous access and are inserted directly into a vein in a patient’s arm, neck or chest. Your oncology physician will discuss which style of access will best suit your needs.

Vascular Bypass

Vascular bypass is performed to improve blood flow in the legs by rerouting blood around the portion of an artery that is blocked or narrowed by plaque. Common terms for vascular disease are peripheral vascular disease (PVD), peripheral arterial disease (PAD), and atherosclerosis. These disease processes can result in claudication (pain with exercise), rest pain, and ulcerations on the legs and feet. These conditions are a result of plaque build-up in the arteries causing decreased circulation to the legs.

During vascular bypass, doctors make a new connection between arteries using a synthetic conduit (graft) or vein. Alternatives may also include angioplasty and/or stent. This allows blood to bypass the existing blockage, thus restoring circulation to tissue. Depending on testing results, your surgeons will discuss treatment options available. A cornerstone longterm success is lifestyle changes such as smoking cessation, regular exercise, and changes in diet.

Varicose Vein Treatment

Varicose veins are a result of venous insufficiency. Veins, unlike arteries, have one-way valves that channel oxygen- depleted blood back to the heart. If the valves don’t work properly, blood will not travel back toward the heart in a normal manner. The veins will be under pressure and become congested with blood.

There are several terms used to describe this condition: Varicose veins, venous insufficiency, valvular insufficiency, and reflux. Unlike spider veins which appear on the surface of the skin, varicose veins are located deeper. Valvular insufficiency is often hereditary and is more common in women than men. Hormonal fluctuations and pregnancy can exacerbate the condition, as can occupations or lifestyles that involve prolonged periods of standing. Once the valves no longer function properly, they cannot be fixed. However the symptoms caused by venous insufficiency are treatable.

Treatment options may include:

• Leg Elevation
• Compression Hose
• Endovenous Ablation: This procedure involves a thin catheter inserted into a small incision. The catheter is heated causing the vein wall to collapse and seal shut. This method eliminates pressure on the smaller surface veins, thus reducing recurrent varicose veins. It can be done as a supplemental procedure to a ligation and stripping. Only one leg can be treated at a time.
• Ligation and Stripping: This procedure involves the large veins and their branches (tributaries) being removed through small incisions. While this is a highly effective means of treating varicose veins, scarring may occur due to the number of required incisions.
• Sclerotherapy: This procedure is performed in our office. Your physician injects a chemical substance into the affected veins, causing the veins to harden (sclerose) from the inside out. The veins are no longer able to fill with blood and form a hardened cord. This procedure is most commonly performed for treatment of spider veins.

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