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Vascular surgery is a speciality of medicin focusing on diseases of the arteries, veins, and lymphatic vessels not associated with the brain or the heart.
Typical patient groups and treated conditions
Claudication and critical lower limb ischemia are the most common conditions requiring vascular surgery. Other common indications for vascular surgery include disorders of the cerebral circulation due to carotid artery disease,, aortic and other arterial aneurysms, acute arterial occlusions, and venous diseases (leg ulcer, varicosis). Vascular surgery is also used in the construction of vascular access when treating renal insufficiency.
Emergency care
Vascular emergencies include ruptured aortic aneurysms, acute arterial embolisms in the lower limbs, disorders of the cerebral circulation of carotid origin. Also ichemic tissue necrosis and associated infection may require emergency treatment.
Typical forms of treatment
Arterial operations are performed by open surgical or endovascular procedures.
Open surgery is traditionally the preferred option when repairing aortic aneurysms (e.g. abdominal aortic aneurysm, AAA) with an artificial vessel. Many arterial occlusions are also treated in open surgery. The decision between open surgery and an endovascular operation is made depending on the location of the occlusion or aneurysm. For many patients, open surgery continues to be the better alternative.
The endovascular tenchique is used to treat aneurysms and occlusions. The method is used when placing a stent graft inside an abdominal aortic aneurysm, and in balloon angioplasty or stenting for stenoses and occlusions.
Vascular injuries are increasingly treated using endovascular methods, although open surgery is the only plausible method when treating large vascular injuries and the associated serious injuries, or open wounds (e.g. open bone fracture) in connection with the surgical treatment of other tissue needing repair.
Vascular surgery in the HUS area
In the HUS area, all patients needing arterial surgery are treated at the HUCH Department of Vascular Surgery in the Meilahti Tower Hospital. Emergency, aortic, and carotid artery surgeries are performed exclusively at the Meilahti Tower Hospital.
In the HUCH Hospital Area, venous operations are performed at Surgical Hospital. In other parts of the HUS area, Länsi-Uusimaa, Lohja, Hyvinkää, and Porvoo hospitals perform superficial venous operations.
Patients requiring extremely demanding procedures within the HUS area and the HUCH specialist medical care area (the HUS area and the hospital districts of South Karelia and Kymenlaakso) are treated exclusively at the HUCH Department of Vascular Surgery.
In Finland, isolated limb perfusions (ILP), where chemotherapy is administered to the limb while blood flow is separated from the rest of the body to treat malignant melanoma, are performed exclusively at HUCH. Isolated Limb Perfusion (ILP) can also be used in the treatment of soft tissue sarcomas.
Patients suffering from tumours invading major vessels, as well as demanding aortic aneurysms are often referred to the HUCH Department of Vascular Surgery from all over Finland. Patients needing surgical treatment of aortic artificial blood vessel infection are referred to HUCH from all parts of Finland. Also patients with demanding aneurysms or tumors involving the carotid arteries are commonly referred to HUCH.