Vascular Surgery Division

Vascular surgery treatment

Vascular surgery focuses on diseases and conditions of the arteries, veins, and lymphatic circulation, using both open surgical and minimally invasive (endovascular) techniques. This can help treat vascular diseases. The goal at AHN is to restore healthy blood flow, prevent complications like stroke or limb loss, and improve overall patient well-being. We provide tailored treatment options that are specific to your vascular needs and take into account your whole health to deliver positive outcomes.

Arterial conditions

These are problems or disease that affect the arteries. Arteries are the blood vessels responsible for carrying oxygen-rich blood away from the heart to the rest of the body. Arterial conditions are generally classified based on whether they involve a narrowing/blockage of the artery, a weakening/bulging of the artery, or inflammation/spasm of the artery. These diseases and conditions can include:

• Peripheral artery disease (PAD): Narrowing or blockages in arteries (most often legs) due to plaque buildup (atherosclerosis), reducing blood flow. Surgeons use endovascular procedures (angioplasty, stenting, atherectomy) to open narrowed arteries from the inside, or open bypass surgery to create a new path for blood around the blockage using a graft. This is crucial for critical limb ischemia (non-healing wounds, rest pain) to save the affected limb.
• Thoracic aortic aneurysms: A thoracic aortic aneurysm (TAA) is an aneurysm that occurs in the part of the aorta that runs through the chest (thorax). Treatment often includes thoracic endovascular aortic repair (TEVAR),  which is a minimally invasive procedure.
• Abdominal aortic aneurysms: A dangerous weakening and bulging of the aorta, the body's largest artery, which can rupture if untreated. Surgeons employs Endovascular Aneurysm Repair (EVAR) by deploying a stent-graft inside the aneurysm to reinforce the wall, or open surgical repair to replace the diseased section of the aorta with a synthetic graft.
• Carotid artery disease: Narrowing of the carotid arteries in the neck that supply blood to the brain, increasing the risk of stroke. Surgeons performs Carotid Endarterectomy (CEA), an open procedure to surgically remove plaque from the artery, or Carotid Artery Stenting (CAS), an endovascular procedure to open the artery and place a stent.
• Acute arterial occlusion: A sudden, complete blockage of an artery, usually by a traveling clot, causing immediate and severe lack of blood flow to a limb (a surgical emergency). Surgeons uses open surgical embolectomy/thrombectomy to directly remove the clot, or endovascular catheter-directed thrombolysis/thrombectomy to dissolve or extract the clot. Bypass surgery may be used if the artery is damaged.
• Mesenteric ischemia: Blockage in the arteries supplying the intestines, leading to severe abdominal pain and potential bowel damage. Surgeons use endovascular angioplasty/stenting or open bypass surgery to re-establish adequate blood supply to the intestines.
• Renal artery stenosis: Narrowing of arteries to the kidneys, which can cause difficult-to-control high blood pressure or kidney dysfunction. Surgeons primarily uses endovascular angioplasty and stenting to open the narrowed renal artery.

Venous conditions

These are conditions and diseases that affect the veins, which are the blood vessels responsible for carrying deoxygenated blood back to the heart from the rest of the body. Unlike arterial diseases which are often about blockages or weaknesses preventing blood from reaching tissues, venous diseases are primarily about blood pooling or being unable to return efficiently to the heart.

• Varicose veins and chronic venous insufficiency (CVI): Enlarged, twisted veins or damaged valves in leg veins, causing blood pooling, pain, swelling, and skin changes. Surgeons performs endovenous ablation (laser or radiofrequency) to close off diseased veins from the inside, phlebectomy (surgical removal of veins through tiny incisions), or sclerotherapy (injection to close small veins).
• Deep vein thrombosis (DVT): A blood clot in a deep vein, primarily managed with medication, but surgery can be involved for specific cases. Surgeons may perform endovascular catheter-directed thrombolysis/thrombectomy to remove significant clots, especially in cases threatening limb viability.
• Prevents pulmonary embolism: Surgeons can place an IVC filter (a device in a large vein) to catch clots before they reach the lungs in patients who cannot take blood thinners.

Dialysis access

For patients with end-stage renal disease (ESRD), whose kidneys have failed and can no longer filter waste products from their blood, dialysis is a life-sustaining treatment. Hemodialysis, the most common type, requires repeated access to the patient's bloodstream to filter their blood. A vascular surgeon is essential in creating and maintaining these vital access points.

• Hemodialysis access creation and maintenance: Patients with kidney failure need a reliable access point for hemodialysis treatments. Surgeons constructs an Arteriovenous (AV) Fistula (connecting an artery and vein) or places an AV Graft (a synthetic tube) to provide durable access.
• Maintains access: Surgeons perform angioplasty and stenting to repair stenoses (narrowings) in existing fistulas or grafts to keep them functional.

Thoracic outlet syndrome

Thoracic outlet syndrome (TOS) is a group of disorders that occur when blood vessels or nerves in the space between your collarbone and your first rib (thoracic outlet) are compressed. This can cause pain in your shoulders and neck, numbness in your fingers, and other symptoms.

There are three main types of thoracic outlet syndrome:

• Neurogenic TOS: This is the most common type and occurs when nerves leading from the brain and spinal cord are compressed.
• Venous TOS: This type occurs when a vein is compressed, which can lead to blood clots.
• Arterial TOS: This is the least common and most serious type, occurring when an artery is compressed.

Symptoms of TOS can vary depending on which nerves or blood vessels are affected, but common symptoms include:

• Pain in the neck, shoulder, or arm
• Numbness or tingling in the fingers
• Weakness in the arm or hand
• Swelling or discoloration of the arm
• Cold hands or fingers

Vascular surgery specialists

Our team of vascular surgery specialists at AHN are dedicated to treating the various conditions and diseases affecting the arteries, veins, and blood vessels. This specialized care is focused on improving individual patient health outcomes using tailored approaches and minimally invasive procedures when available. By working in a multidisciplinary manner and pursuing continuing training and education, this team is dedicated to fostering an environment of continuous learning and information sharing to collectively advance the quality of care and improve patient outcomes in vascular surgery.

How to get care

If you have not been evaluated for or diagnosed with a heart condition, call (412) DOCTORS 412-362-8677 to schedule an appointment with a general cardiologist. 

To schedule a procedure with a vascular surgeon, call 412-359-8820.

Clinical trials and research

Clinical trials and research are critical to advancing breakthroughs in vascular surgery. AHN participates in numerous clinical trials and research designed to bring patients new options for care. Your AHN care team will be able to help you identify potential treatment options and connect you with clinical trials.

If you would like to participate in a clinical trial and help our innovative team discover groundbreaking solutions, ask your doctor if you’re eligible to participate in one. Find currently active clinical trials that are open for participation.

What is a clinical trial?

Clinical trials are studies that try to answer questions about new ways to treat with medications, radiation, or surgical techniques. You participate in a clinical trial only if you volunteer to do so and meet criteria for inclusion in the study, and you can stop participating in a trial at any time.

Who can join a clinical trial?

The plan for the trial, called a protocol, explains what the trial will do and how the study will be done. Based on the questions the research is trying to answer, each clinical trial protocol outlines specific criteria necessary to be eligible to join the trial. Common criteria for entering a trial are:

• Having a certain type of disease.
• Having received a certain kind of therapy in the past.
• Being in a certain age group.
• Federal rules help ensure that clinical trials are run in an ethical manner, with your rights and safety protected. It’s to ensure that you’re not put at increased risk by participating in the trial, and that the results of the study are accurate and meaningful.

Refer your patient to an AHN specialist

There are two ways for medical professionals, who are not a part of Allegheny Health Network, to refer their patients to an AHN specialist and request their first appointment. You can:

1. Call (412) DOCTORS 412-362-8677.
2. Go to Find Care to find the right AHN specialist and the most convenient location. Then refer your patient, provide relevant patient details, and request an appointment directly from the doctor's profile. 

For more information about referring your patient to an AHN specialist, read the Independent Physician Referral FAQs.