Medically Reviewed by David S. Bjerken, MD, FACS
Most people know that with a heart problem you turn to a cardiologist or a cardiothoracic surgeon. When do you need someone like McLeod Vascular Specialist David Bjerken, MD? He offers three key medical situations:
Here is a summary of Dr. Bjerken’s comments:
As a vascular surgeon, we get involved to help patients in three broad categories.
The first would be aneurysms. They are an enlargement of part of the artery system. The most common threat with an aneurysm is, of course, that it can grow and leak or rupture. When we diagnose aneurysms, we often are asked to treat them by repairing or removing the bulge. In the case of the most common type, an aortic aneurysm, we would place a graft material with stents to re-line that part of the artery and stop the threat of it growing or rupturing.
The second category is carotid artery disease. The threat of stroke occurs when there’s blockage in one of the carotid arteries (in the neck). It is one of the most common surgeries that we perform, cleaning out plaque and blockages and helping remove the risk of a stroke.
How does a patient get evaluated for carotid artery blockage? It starts off with a physical exam by their primary care physician. The physician will hear a characteristic sound (bruit, pronounced broo-ee), when they listen to the neck with a stethoscope. Once a blockage is suspected in that manner, then an ultrasound is performed. An ultrasound is a screening tool that tells us roughly what degree of blockage there is. If it shows more than 70% blockage, we proceed with a CT scan. That gives us a precise picture of the amount of blockage. Now, we make decisions with the patient about whether surgery is indicated and what it’s going to take to clean the artery out and reduce the risk of stroke.
The third health issue that we care for is blockages in the leg circulation. Particularly diabetics and people, who smoke or have high blood pressure, may find themselves with less circulation in their legs. Sometimes it becomes a threat for amputation. So, there’s a very common need to see a vascular surgeon to assess that and reopen blockages. It can involve stenting, angioplasty or even bypass surgery on the legs.
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