VASCULAR & ENDOVASCULAR SURGERY
The institute of vascular and endovascular surgery at Ramaiah Memorial Hospital provides top of the line vascular and endovascular & advanced wound care. We have a tradition of excellence in clinical care, innovative methods of evaluation and treatment of arterial, venous & diabetic foot diseases. It is the one of the first clinics in Bangalore for the management of vascular diseases.
Our team provides comprehensive, latest, diagnostic and therapeutic interventions for the entire spectrum of circulatory disorders – from medical management to minimally invasive endovascular therapy to conventional open surgery.
Our team of surgical interventionists has some of the most extensive vascular and endovascular surgical experience from hospitals across the country.
MULTIDISCIPLINARY COLLABORATIVE CARE
The vascular surgery team collaborates with other concerned specialities in order to offer each patient a multidisciplinary, yet individualized, diagnostic assessment and therapeutic plan.
We are equipped with advanced, non-invasive diagnostic facilities for both vascular disease & diabetic foot disorders like PVR, ABI, podia scan, Tcpo2 evaluation, pedography & neuropathic assessment. We offer customised therapeutic footwear with offloading provision.
We offer the full spectrum of diagnostic and interventional procedures, including non-invasive vascular laboratory testing, advanced wound care facilities, and the latest minimally invasive therapies.
ADVANCING IN THE FIELD OF VASCULAR AND ENDOVASCULAR SURGERY
At Ramaiah, we are equipped with an Advanced Learning Centre (ALC), where we conduct innovative laboratory and clinical research, aimed to improve patient care & treatment outcomes. We constantly upgrade our skills & actively enhance the skills of our junior colleagues. Our surgeons also serve in leadership positions at several medical societies, address national and international conferences, publish technical papers frequently, and teach the essentials of vascular and endovascular surgery.
“OUR MOTTO IS TO OPTIMIZE & MAINTAIN PATIENT’S CIRCULATORY HEALTH”
- State-of-the-art facility – Ramaiah Institute of Vascular Sciences & Wound Care Centre
- Pioneers in newer advances of limb salvage through minimally invasive surgery with atherectomy and stem cell treatment for non-reconstructible vascular disease
- Diabetic foot screening with podia scan, evaluation for neuropathy & footwear services
- Peripheral Arterial Disease (PAD) – Treated with medical, endovascular & open bypass surgeries
- Varicose veins and venous ulcers treated with laser, radio frequency ablation, open surgery & venous stenting
- Aneurysms – Open & EVAR
- Vascular screening services
- Hemodialysis access ( arteriovenous fistula, arteriovenous grafts ) and salvage procedures through angioplasties
- Provide training and fellowship programmes on Advanced Wound Care management for doctors and nurses
PATIENT INFORMATION FOR VASCULAR DISEASES
- Bulging or spider veins due to damaged valves within veins
- Usual symptoms include dull aching pain and swelling of legs which increases by evening, with colour changes in the leg
- Risk factors include obesity, long standing work, lack of movement, pregnancy, family history
- Can lead to chronic leg ulcers, bleeding, pain & blood clots in the veins
- Diagnosis is by clinical examination and ultrasound doppler
- Treatment options available in addition to lifestyle changes include oral medications, compression stockings, laser ablation, radio frequency ablation, open varicose vein surgery, sclerotherapy
- Our team of experts will discuss the plan of treatment accordingly and provide you with the best treatment
- DVT is a condition of having blood clots in the deep veins of the legs. It can also develop in the arms. Symptoms include sudden onset of swelling & pain
- Risk factors include lack of movement, long travel history, major surgeries, bedridden patients, cancer, pregnancy, hormone therapy & tobacco usage
- If not treated these clots can dislodge and travel to lungs causing pulmonary embolism which can be life threatening
- Diagnosis is by duplex ultrasound
- Treatment is by blood thinning medications / endovascular thrombolysis
- Most commonly affects legs. Symptoms include pain on walking for a short distance, non-healing severely painful legs and foot ulcers, gangrene of toes or fingers
- Risk factors include smoking, diabetes, old age, high BP, high blood cholesterol, kidney problems
- Diagnosis is by physical examination, vascular lab testing like ABI, Duplex USG, CT/MR angiography or conventional angiography
- Treatment options include medical management, endovascular or open procedures including balloon angioplasty, stenting, endovascular atherectomy, open bypass procedures like aorto-bifemoral bypass, fem-pop bypass, fem-distal bypass, depending on disease type & level
- Abnormal dilatation of blood vessels in the body
- Commonly seen in Abdominal Aorta (AAA) and peripheral arteries
- Symptoms may vary from swollen, pulsatile swelling in the abdomen or affected arteries with sudden onset of severe pain, change in colour & coldness of limbs with decreased or absent movements
- Evaluation by duplex ultrasound & or CT/MR angiograms
- Managed by endovascular or open procedures including EVAR, endovascular stent graft, open repair/bypass procedures
- Carotid arteries found in the neck carry blood to the brain
- Narrowing carotid artery caused due to atherosclerosis, smoking & diabetes. It can lead to decreased blood flow to brain which can result in stroke
- Condition is diagnosed by carotid duplex ultrasound, CT/MR angiogram
- Treatment is by carotid endarterectomy/stenting
- With the rise in patients suffering from kidney diseases, securing an access for hemodialysis is paramount. Procedures such as AV fistula creation, AV graft insertion, permcath insertion are routinely done here
- Salvage procedures like thrombectomy, access angioplasty, USG guided angioplasty, central vein angioplasty/stenting are also performed in our institute
- Presentation can be from simple neuropathy (numb or insensate foot with burning sensation) to deformed foot with non-healing ulcers.
- Early evaluation & prevention is of utmost importance because 10-15% of diabetic patients develop ulcers & 40-60% of leg amputations are due to diabetes.
- Clinical evaluation with non-invasive diagnostic tests like ABI, neuropathy check-up & duplex ultrasound on regular basis can prevent 85% of amputations if proper & effective preventive care is adopted.
- Recognition & early consultation in foot infections can prevent progression of infection & limb salvage.
Advanced Wound Care Centre is equipped with the latest diagnostic equipment for early detection of diabetic neuropathy, lower extremity blood circulation. The centre also has a multi disciplinary foot care team to deliver comprehensive foot care.
Pedography helps in diagnosis of the foot function. It is used for early recognition of altered pressure patterns in individuals with diabetes and associated diseases.
The Ankle Brachial Index test is done to check for PAD — narrowed arteries that reduce blood flow, usually in your legs. Research indicates that PAD affects about 10% of people over age 55.
The TCPO2 monitoring tool provides specific information relative to leg ischemia. It helps screen vascular diseases & assess the success of revascularization at the site of incision.
In diabetes mellitus, diabetic neuropathy/poly-neuropathy is a major complication and should be diagnosed at the earliest, to prevent foot damages. Early detection of the level of neuropathy helps manage the complication with lower extremities with ease.
Therapeutic footwear has been used for decades as one of main solutions to prevent recurrent ulcers in patients with diabetes and foot risk factors. It is an assistive technology capable of reducing peak plantar pressures in elderly patients with neuropathy.
A complete foot assessment and counselling is provided by a foot health practitioner.
The foot & nail care service include,
- Medical pedicure
- Ingrown toe nail correction
- Corn/callus removal
- Abdominal Aortic Aneurysm Repair (AAA) Open & endovascular
- Surgical & endovascular management for stroke & its prevention
- Treatment of carotid body tumor
- Aortic reconstruction for aneurysm and occlusive disease
- Endovascular Aneurysm Repair (EVAR)
- Thoracic Endovascular Aortic Repair (TEVAR)
- Peripheral Arterial Disease (PAD) management.
- Diabetic foot management with international standard wound care materials
- Diagnostic angiography
- Catheter-based interventions and surgical reconstruction
- Limb salvage in diabetic patients.
- Minimally invasive access salvage procedures.
- Dialysis access
- Treatment of graft infections
- Renovascular disease management
- Varicose veins & venous ulcer management
- Peripheral arterial aneurysm
- Thoracic outlet syndrome
- Central venous angioplasty stenting for venous hyper tension
- Atherectomy procedures
- Vascular screening services
Dr Sanjay C Desai
MBBS, MS,FEVS (Germany), FEVS(Sin), FEVS(USA), Consultant – Vascular Surgeon
Dr Chandrashekar A R
MBBS, MS, FVES(RGUHS), FVES(IRELAND), FIES(GERMANY), Consultant – Vascular Surgeon
Dr Rajendra Prasad
MBBS, MS, DNB (Peripheral Vascular Surgery), FVES(Austria), Consultant – Vascular Surgeon