Vascular and Endovascular Surgery

As part of King’s College Hospital in London, our doctors have a wealth of experience in performing vascular surgery and work closely with a wider team including cardiologists, neurosurgeons, diabetologists, trauma consultants, nephrologists and the renal dialysis service.

Our doctors can assess your clinical risks and your peripheral arterial circulation using non-invasive investigations such as Doppler pressure measurement, which measures blood pressure using ultrasound.

Conditions that we treat include:

  • Atherosclerosis (arterial narrowing): this potentially serious condition is caused when arteries are narrowed by fatty substances (plaques or atheroma). As they narrow, the arteries also harden and this reduces the flow of blood and oxygen which are essential to supply the vital organs. This also increases the risk of having a blood clot (blocking the flow of blood to the heart or brain).
    Treatments you may be offered to treat atherosclerosis include adopting a healthier lifestyle; taking statins to reduce your cholesterol; medicines for high blood pressure; medication to reduce the risk of blood clots; dietary changes (and mediation for diabetes); surgery that involves widening or bypassing an artery. This can include:
  • Coronary angioplasty: inserting a stent (a small wire-mesh tube) to hold the artery open
  • Coronary artery bypass graft: a procedure to divert blood around narrowed/blocked arteries. It involves using a blood vessel from another area in the body and attaching it to the coronary artery to ‘bypass’ the narrowed area
  • Carotid endarterectomy: a procedure to unblock the carotid artery and avoid the danger of a stroke or transient ischaemic attack (TIA) or ‘mini stroke’
  • Aortic (heart) disease including aortic aneurysms (swelling of the aorta, the main blood vessel that leaves the heart due to weakening of the wall) that can cause life-limiting problems. Large aneurysms are unusual but potentially serious; if an aneurysm bursts, it can cause internal bleeding which is life-threatening.

The abdominal aorta is the largest blood vessel in the body (around 2cm wide) but can swell to over 5.5cm during a large abdominal aortic aneurysm (AAA).

We offer regular screening for men aged over 65, who are more likely to be affected by AAA

  • Peripheral arterial disease: this is caused when an artery to a limb (often the leg) becomes blocked due to atherosclerosis (build-up of fatty deposits made of cholesterol and other substances), causing pain, hair loss on the legs and feet, weakness and numbness in the legs, leg ulcers.
    Treatments involve adopting a healthier lifestyle, losing weight if necessary, cutting back on alcohol, as well as medication to treat high blood pressure, high cholesterol and (in some cases) diabetes
  • Carotid disease, a common cause of transient ischaemic attack (TIA) or stroke. The underlying cause is normally atherosclerosis (build-up material inside the carotid artery). As the artery narrows, this restricts blood flow, and can cause a stroke if it blocks a carotid artery or if an area of plaque ruptures and damages the lining of the artery. Or a clot that forms on the plaque can break off and pass via the blood to the brain, blocking a brain blood vessel. Types of carotid disease include:
    • Symptomatic carotid stenosis, a common cause of stroke or transient ischaemic attack (TIA)
    • Carotid aneurysm (bulge or ballooning of the wall of a blood vessel that weakens the wall and can tear (rupture) an artery causing TIA or stroke
    • Carotid body tumours, located on the side of the neck where the large carotid archery branches into smaller blood vessels that carry blood to the brain
  • Varicose veins Varicose veins affect approximately 30% of the population and can cause itch, skin discoloration and ulcer in severe cases.  Treatments vary from minimally invasive thermal ablation to ultrasound-guided foam sclerotherapy to microsclerotherapy and laser of thread veins

We also offer Vascular access for haemodialysis: this makes dialysis possible for patients with kidney failure. It’s a connection of an artery to a vein, usually in the forearm or upper arm. The fistula causes extra pressure and extra blood to flow into the vein, so that it can provide easy and reliable access to veins.

Contact us for more information about the vascular and endovascular surgical procedures we can perform; or to arrange an appointment with one of our specialist consultants.

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