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What is an endovascular procedure?

An endovascular procedure typically consists of accessing the blood vessel or the artery. In this video, neurointerventional surgeon Samuel Hou, MD, of Los Robles Hospital & Medical Center, describes how this procedure is done. 
Bruce H. Gray, DO
Vascular Surgery
Endovascular procedures are done with a technique that uses catheters, wires, balloons, and stents. A needle is used to gain access to the artery, a wire is passed through the circulation over which a balloon catheter or stent can be delivered to a treatment site. After the treatment only a small skin nick is seen. No incision is necessary. 
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Mark J. Russo, MD
Thoracic Surgery (Cardiothoracic Vascular)

An endovascular stent graft repair is a treatment for aneurysms of the descending (thoracic and abdominal) aorta. It is similar to the approach used for a cardiac catheterization of the coronary arteries. This procedure requires only small incisions in the groin. Then the surgeon inserts a catheter through the femoral artery in the groin and with the use of x-ray guidance and specially-designed instruments, the aneurysm can be repaired from inside the aorta by inserting a tube, called a stent-graft. This is possible because the tube, or stent graft, is delivered through the catheter in a collapsed state and then expanded at the site of the aneurysm. 

The tube replaces and reinforces the diseased aortic wall, ensuring continuity of blood flow while preventing further expansion of the aorta, aortic rupture, and/or aortic dissection.  

The potential benefits of the procedure include greatly reduced risk, a shorter hospital stay, and a more rapid recovery.
To understand what an endovascular procedure is, it is helpful to look at what the word means:  “endo” means within, and “vascular” refers to the blood vessels. So, an endovascular procedure is any therapy performed inside the blood vessels. These procedures are often used to treat heart disease or peripheral artery disease (PAD), in part because they are less traumatic for patient than open surgery because major incisions are not necessary. One endovascular procedure is angioplasty, which is used to treat atherosclerosis - hardening of the heart arteries caused by the build-up of fatty deposits called plaque inside the arteries. Angioplasty opens arteries narrowed by plaque so that blood can flow as it should through the blood vessel.
 
Endovascular procedures are performed by specially trained doctors, including interventional cardiologists, vascular surgeons, interventional radiologists and vascular medicine specialists. There are also interventional neurologists and neurosurgeons, who specifically treat arteries going to and in the brain. The procedure, whether in the arteries of the heart or the legs, goes like this:
• The doctor makes a tiny incision in the upper leg or the arm and inserts a thin, flexible tube called a catheter into a blood vessel. The catheter is threaded through the vessel to the area of the blockage or narrowing. The catheter provides a channel for the doctor to introduce tools to clean blockages and widen the vessel.
• A tiny, uninflated balloon is then advanced through the catheter until it reaches the blockage. The balloon is inflated (often several times), and the force of the expanded balloon compresses the plaque to the walls of the blood vessel, which also widens the path for blood flow.
• Then the doctor may deliver through the catheter an expandable, metal mesh tube called a stent. The stent will prop open the newly cleaned vessel.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.