Surgery
An Accurate Diagnosis
We have a fully accredited Non-Invasive Vascular Laboratory onsite, offering painless diagnostic testing employing such techniques as duplex ultrasound to examine your blood vessels and pinpoint any blockages, narrow areas, or blood clots. Our physicians provide these exams to patients who have been referred by their physicians or who come to us on an emergency basis because of suspected deep vein thrombosis (DVT, a blood clot that requires treatment).
Endovascular and Open Surgical Approaches
Our vascular surgeons are experienced in the use of special techniques and instruments to perform endovascular procedures, which require only a small puncture in an artery or vein. These techniques are associated with a shorter recovery time. Minimally invasive procedures are not the right choice for every person, so in some cases, surgeons may perform traditional open surgery to provide the best care.
Vascular Surgery Procedures
Abdominal Aortic Aneurysm
- If you have an abdominal aortic aneurysm (a bulge in the aorta in the abdomen) that requires treatment, we use minimally invasive endovascular abdominal aortic aneurysm repair (EVAR) whenever appropriate—inserting a synthetic tube called an “endograft” to the site of the bulge to provide reinforcement in the blood vessel. Most patients go home the next day and can resume their normal activities just one week after this procedure.
- Our team employs the latest endografts, such as a “fenestrated endograft,” for the repair of complex aneurysms near the kidney arteries. These grafts are not available in every hospital that performs this type of surgery.
- If you need open surgery, your surgeon will sew a graft in place using that approach.
Thoracic Aortic Disease
- Our vascular specialists repair thoracic aneurysms (bulges in the part of the aorta in the chest) and life-threatening type B aortic dissections (tears) using an endograft, inserted using a procedure called thoracic endovascular aneurysm repair (TEVAR).
- The vascular surgeons at Hackensack University Medical Center work closely with the Trauma Team and are able to treat life-threatening tears in the thoracic aorta (the main artery in the chest) using minimally invasive surgery.
Carotid Artery Disease
- We treat patients with carotid artery stenosis (narrowing of the vessels supplying blood to the brain) to reduce the risk of stroke. Ours is one of just two hospitals in New Jersey performing transcarotid artery revascularization (TCAR), a less invasive way to treat carotid artery disease. The surgeon places a stent through an access point in the neck. Using a special system, blood flow through the artery is reversed and any plaque fragments are caught in a filter, preventing them from traveling to the brain to cause a stroke. Normal blood flow is re-established once the stent is in place.
- Our team also offers conventional carotid stenting (where the stent is threaded to the artery through an access point in the groin) and carotid endarterectomy (surgical removal of plaque in a carotid artery through an incision in the neck)—all with excellent outcomes.
- Hackensack University Medical Center is the only New Jersey hospital participating in the national federally funded multicenter CREST II clinical trial, which is comparing surgery versus stenting for patient with carotid stenosis blocking 70 percent or more of an artery but not causing symptoms.
Peripheral Vascular Disease
- The vascular surgery team treats patients with poor circulation caused by fatty plaque in the arteries of the legs, feet, or abdomen—particularly in people with diabetes, obesity, high cholesterol, and high blood pressure. Early treatment for such peripheral vascular disease (PVD) is important to reduce your risk of amputation.
- Your doctors will first treat you with medication and lifestyle changes, such as eating a healthier diet and getting more exercise.
- If these approaches are not enough to control your PVD, we offer endovascular approaches such as balloon angioplasty (insertion of a tiny balloon into a narrowed artery to widen it), stenting (insertion of a tiny mesh tube to hold the artery open and maintain blood flow), and laser atherectomy (removal of plaque from the lining of a clogged artery using a laser applied through a catheter).
- If endovascular therapy is not an option for you, your surgeon may perform an open surgical procedure, such as peripheral artery bypass (rerouting the flow of blood around a blockage) or endarterectomy to remove the plaque.
Deep Vein Thrombosis and Pulmonary Embolism
- Blood clots in the legs require treatment before they break off and travel to the lungs, where they can impair breathing. Our vascular team performs thrombolysis: inserting a catheter in the affected vein and using a device to break up the clot, along with clot-busting medication.
- We have a multidisciplinary team that collaborates to treat patients with massive pulmonary emboli who need open heart surgery and thrombolysis, combining the skills of a cardiac surgeon, vascular surgeon, pulmonologist, cardiologist, and intensivist to treat this life-threatening condition.
Embolization for Orthopedic Tumors
We work with orthopedic oncologists to embolize tumors before they are removed, inserting a glue-like substance into the blood vessels supplying a tumor to reduce bleeding during the operation.
Dialysis Preparation
We offer access surgery for patients needing an arteriovenous fistula for dialysis.
Thoracic Outlet Syndrome
Thoracic outlet syndrome causes pain in the shoulder, arm, and neck and happens when the nerves or blood vessels just below the neck are squeezed. Our surgeons perform “first rib resection,” removing a part of the first rib to relieve this compression.
Vein Disorders and Venous Insufficiency
- Patients with varicose veins may undergo treatment with endovenous laser therapy (EVLT, which seals the abnormal vein closed), sclerotherapy (injection of a medication to close the affected vein), or phlebectomy (surgical removal of visible varicose veins).
- When valves in leg veins don’t work well, you might develop venous insufficiency. We break up blood clots in the legs to prevent venous insufficiency and use a variety of endovascular approaches to prevent the development of venous ulcers (open sores in the skin).
Wound Care
The vascular surgery team collaborates with the Center for Advanced Wound Care to treat our patients with slow-healing or complicated wounds.
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