Procedures and Diseases
We treat other complex cerebrovascular problems such as carotid aneurysms, carotid
body tumors, and vertebrobasilar disease. These processes require a team of expert surgeons,
interventionalists, and neurologists all of whom work well together at
RWJUH.
- Carotid endarterectomy
The most common cause of a stroke is caused by a sudden blockage of blood flow
to the brain. A partial blockage of the carotid artery (one of the major blood vessels to the brain)
can be removed to prevent strokes and restore normal blood flow. We perform 150-180 carotid operations
a year. Most of our carotid surgeries are performed under general anesthesia and cerebral monitoring
(monitoring brain waves).
Our stroke rate is is lower than the national average and the average for the
state of New Jersey.
- Carotid subclavian bypass
- Carotid angioplasty and stenting
We have been performing carotid artery angioplasty and stenting with our
interventional radiologists for several years. Recent studies have demonstrated that the safety of the
procedure has increased substantially with the used of antiembolic devices. Now that the
FDA has
approved the procedure and the stent with its device, we are also able to perform this with even lower
risk of stroke than before.
For additional information, please call for an appointment or click here.
- Thoracoabdominal aortic aneurysm repair
A dilatation or bulge of the thoracic aorta (the major blood vessel
supplying chest and abdomen) more than twice its normal size is potentially dangerous. We
perform open repairs with expert anesthesiologists. Complex repairs occasionally require the
combination of two surgical teams (including cardiothoracic surgeons). Post-operative care
includes a team of critical care specialists whom are available 24 hrs a day.
- Abdominal aortic aneurysm repair (AAA)
A dilatation or bulge of the abdominal aorta (the major blood vessel
supplying the legs) more than twice its normal size is potentially dangerous. Smaller
aneurysms grow slowly, and larger aneurysms grow more rapidly. Surgical repair is performed
for larger aneurysms to prevent leakage or rupture. We perform approximately 55 open AAA
repairs per year. We perform the open AAA repair under general anesthesia. The aorta is
replaced with an artificial polyester tube, which is sewn in place. Hospital recovery
time is between 4 to 7 days.
For more information, please call for an appointment or click here.
- Thoracic aortic stent grafting
Minimally invasive techniques in vascular surgery are continuously improving. Soon
stent grafting for thoracic aortic disease will be available. Our vascular center is at the forefront of
utilizing such technology. Stay tuned!!
- Abdominal aortic stent grafting
With the advent of endovascular aortic stent grafting, patients can now get
their abdominal aortic aneurysm repaired under local anesthesia, and with minimal risks. We have
been performing this procedure for 5 years and currently perform about 60 endovascular aortic stent
grafts per year. We use all of the FDA approved devices and
have the lowest complication rate in NJ.
- Abdominal aortic angioplasty and stenting
- Renal artery bypass
- Renal endarterectomy
- Renal aneurysm repair
- Renal angioplasty and stenting
Treatment of the renal artery has also improved with technology. Balloon
angioplasty and stenting has changed. What once required multiple days in the hospital and an abdominal
incision, to a needle stick as an outpatient.
- Fistula creation for hemodialysis
- AV shunting for hemodialysis
- Percutaneous hemodialysis catheter placement
- Fistula, shunt, and catheter rescue
End stage renal disease is a process that is life-long. Often multiple surgeries
are needed for maintaining adequate access for hemodialysis. Our philosophy is to create the best
long-term access and to revise and rescue any access that may be failing. We use the non-dominant arm
and avoid using prosthetic materials. We also use
endovascular techniques for the salvage of failing
access sites.
- Mesenteric artery bypass
- Mesenteric endarterectomy
- Visceral aneurysm repair
- Mesenteric artery angioplasty and stenting
- Celiac artery angioplasty and stenting
- Aortofemoral bypass
- Femoral endarterectomy
- Femoral bypass
- Peripheral aneurysm repair
- Iliac and peripheral artery angioplasty and stenting
With the appropriate patient, minimally invasive techniques can increase the walking
distance and heal ulcers. Newer developments such as
cryoplasty and
atherectomy
are available and have also been used with minimal risk and excellent results.
Varicose veins are not only unsightly, but can also cause painful, swollen legs.
New, minimally invasive techniques have been developed that minimize discomfort and allow return to
normal activity immediately. Many procedures can be performed in the office and some as outpatient
procedures.
- Vein stripping
- Sclerotherapy
- Microphlebectomy
- Saphenous ligation
- Endovenous radiofrequency saphenous closure
This procedure is one of the newest forms of treatment for varicose veins. We
perform this minimally invasive procedure with a mild tranquilizer and no incision is necessary.
For more information, please call for an appointment or click here.
- Trivex excision of varicose veins
- Sub-facial endoscopic perforator ligation (SEPS)
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