Vascular Surgery FAQs

Do Veins Grow Back After Treatment?

Veins do not grow back after treatment. At Mount Sinai, we have two common ways to treat varicose veins. The first is a minimally invasive laser treatment where we treat the vein through just a needle and a catheter. The second treatment option is open surgery where we make small cuts in the leg to physically remove the veins. Both of these procedures are very effective. More often than not, if veins do come back, they typically present years later and these are new varicose veins from alternate pathways since the initial vein was removed.

Can I Exercise After Varicose Vein Surgery?

After a venous ablation procedure—varicose vein removal surgery—we recommend that patients refrain from any heavy exercise for the first 24 hours after the procedure. But after that, generally, we recommend that you do what feels comfortable. For most patients, their leg feels back to normal after roughly one week and they can go about doing their regular exercise.

Can I Fly After Varicose Vein Surgery?

The most common procedure for varicose veins is endovenous laser ablation or radio frequency ablation, which is done in the office setting. Patients generally go home on the same day of the procedure. We do recommend that the patient returns a week later for a repeat ultrasound. Once we see that the procedure is healing appropriately, we will clear the patient to fly. We do recommend wearing compression socks if flying after surgery as well as walking around as much as possible while on the flight.

What Are The Benefits of Minimally Invasive Surgery?

At Mount Sinai, we use minimally invasive techniques to open blood vessels using a simple needle stick with catheters and guidewires. Patients typically feel better right away and can go from walking less than one block to being able to walk an unlimited distance without pain by the next day.

What Is The Most Common Vascular Disease?

One of the most common conditions that we see at Mount Sinai is peripheral arterial disease. Patients with this condition present with cramping in their legs when they walk further, but subsides when at rest. The first course of treatment is medical management and exercise therapy. If the condition progresses,  there are minimally invasive options such as an angiogram catheter-based procedure or bypass surgery.

What Happens If I Don’t Treat My Varicose Veins

The symptoms of varicose veins can fluctuate over time. But without treatment, varicose veins typically will not go away on their own. Complications from varicose veins include phlebitis, where the vein becomes inflamed and in more serious conditions, a patient may experience bleeding or ulceration. Most of these complications, however, are not life-threatening. For patients who are hesitant about getting treatment, we recommend that they speak with a vascular surgeon who can discuss the conservative options available at Mount Sinai that will help alleviate symptoms and, potentially, avoid any invasive treatments.

Is Vascular Surgery High Risk?

The seriousness of vascular surgery depends on a few things, including: the procedure being performed, the medical problem, and the patient’s underlying health issues. The good news is, at Mount Sinai we use minimally invasive, endovascular treatments for vascular issues, where we are able to insert a needle and a catheter through a blood vessel to treat the problem. We recommend speaking with one of our vascular surgeons for a complete overview of the risks associated with your surgery.

What Are the Treatment Options for Vascular Conditions?

Generally, there are three ways we treat vascular problems. The first is through minimally invasive, endovascular treatments where we are able to insert a needle and catheter into a blood vessel to treat the issue without making any large incisions. The second option is a traditional, open surgical approach in which we make larger incisions to physically remove the blood vessel and fix it from the inside. Finally, your surgeon may recommend a more conservative, no-intervention approach. Generally, we recommend this for patients whose condition may not worsen or severely affect quality of life. Your vascular surgeon will decide which approach is best for you based on your specific conditions and health history.

What is an Aortic Dissection?

An aortic dissection is a tear within the aorta, which is the major blood vessel in the human body. There are two types of dissection: a Type A dissection which involves the aorta near the heart, most commonly treated by cardiac surgeons; and a Type B dissection, which extends from the aortic arch down the entire length of the aorta, and is most commonly treated by vascular surgeons.

Can an Aortic Dissection Heal Itself?

Typically, aortic dissections don't heal themselves. The first-line management for Type B aortic dissections is controlling the heart rate and the blood pressure to minimize the damage that occurs. Usually, if the aortic dissection is not immediately life-threatening, it can be observed for a period of time. There is a subgroup of patients that are at particularly high risk of future aortic complications. One of the most common late complications of an aortic dissection is the development of an aortic aneurysm which can be life-threatening.

What’s an Aortic Aneurysm?

An aortic aneurysm happens when the abdominal aorta expands to over twice its normal size. This “ballooning” of the aorta – if large enough – can rupture leading to death or significant morbidity. Most aneurysms do not cause symptoms until they get to the point of rupture. Most commonly, they are discovered during a physical examination or on radiographic studies.

Do Aortic Aneurysms Heal on Their Own?

Aortic aneurysms result from the weakening of the aorta; the major artery of the body. This is the vessel into which the blood is pumped by the heart. So, when the heart is pumping, the blood emerges into the aorta and acts like a tube, a conduit to carry the blood throughout the body. Aneurysms result when there's a weakening of the wall of the aorta, and under the pressure of the blood, expands like a balloon and can ultimately rupture or burst. If that occurs, it's a potentially fatal event, so we certainly want to prevent the rupture of these aneurysms. Aneurysms cannot be treated medically. Unfortunately, we've tried a variety of medical treatments for aneurysms, but they have been unsuccessful in preventing rupture and therefore we need to perform an intervention to correct these aneurysms. Typically, the intervention we perform is done percutaneously just with a needle stick through the skin. We place a stent or a new lining on the inside of the aneurysm and this takes the pressure off the wall to prevent its expansion and prevent rupture and that potentially fatal outcome.

How Do Aortic Aneurysms Happen?

Aortic aneurysms can be hereditary (genetic) with a higher incidence in men of Northern European descent, however, anyone can develop an aortic aneurysm. A previous history of cigarette smoking or current cigarette smoking with progressive atherosclerotic disease affecting the aorta can lead to the development of an aortic aneurysm. Aortic aneurysms in patients that have hypertension have been shown to more likely enlarge in size. There is also the potential in patients with connective tissue disorders such as Marfan's disease to have a higher incidence of aneurysmal disease and rupture. Less commonly, aortic aneurysms can result from trauma or infection (mycotic).

What are the Benefits of Stents in Aortic Dissections?

There is a subgroup of patients that may benefit from early placement of an aortic stent. Early placement of an aortic stent can actually cover the area of the aorta that's injured and allow the aorta to heal, which may prevent the formation of aneurysms in the future.

Are Aortic Aneurysms Hereditary?

There is a genetic predisposition for aneurysm formation. Any first-degree relative (mother, father, sister, brother, son, or daughter) of a patient with an aneurysm has a one-in-six chance of developing an aortic aneurysm themselves. Aortic aneurysms can involve the ascending aorta, the aortic arch, the descending thoracic aorta, and the abdominal aorta. Descending thoracic aortic aneurysms, peri-visceral aortic, and abdominal aortic aneurysms below the kidney arteries are treated by vascular surgeons.

Can Aortic Aneurysms Cause Bowel Problems, Heart Failure, and Memory Loss?

Your aorta is the largest artery in your body that travels from your heart through your chest, your abdomen, and down to your pelvis, where it splits off into two branches, one that supplies blood flow to your right leg and one that supplies blood flow to your left leg. An aneurysm is an expansion of the aorta, which can occur at any point along the aorta's path, from your heart to your pelvis. In regards to the symptoms that you may experience from your aortic aneurysm, it depends entirely on the location of your aneurysm, specifically for abdominal aortic aneurysms, which are below your chest and above your pelvis. These are often times asymptomatic, which means patients do not experience any symptoms related to their aneurysm. When patients are symptomatic, it is oftentimes a deep and diffuse pain in the lower abdomen or back. Once a patient is symptomatic, this is oftentimes an emergency and they should seek immediate care by a health care professional. Since most patients are asymptomatic, the Society for Vascular Surgery recommends that patients who are at high risk of developing an abdominal aortic aneurysm be screened with a one-time abdominal ultrasound. These patients are between the ages of 65-75 years old who have ever smoked or have a family history of abdominal aortic aneurysms, or patients 75 and older who are deemed otherwise in good health.

Aortic Tear Symptoms

An aortic dissection is a tear within the aorta, which is the major blood vessel in the human body. An aortic tear (dissection) can occur at any point along the path of the aorta, from your heart all the way down to your pelvis. While the symptoms may vary based on the location of the tear, oftentimes the first symptom is pain. It is described as a sharp stabbing pain in the chest, the back, or the abdomen and is often described as the worst pain someone has experienced in their life. Depending on the location and character of the tear, you may have compromised circulation to certain organs including your intestines, your kidneys, your legs, or lower extremities. In this case you'd have severe abdominal pain, flank pain, or potential numbness, weakness, or pain in your legs. One of the benefits of the Mount Sinai Health System is that we have an acute aortic emergency call system in which we are able to accept transfer patients from all over the NY metro area who are experiencing symptoms of an aortic dissection. We have an experienced team of cardiac, thoracic, and vascular surgeons, as well as critical care specialists and specialized nurses who work to take care of and manage these patients.

Aortic Aneurysm Screening and Treatment

The aorta is the largest artery in the body, carrying oxygen-rich blood from the heart to all the organs and tissues. Throughout its course, within the chest and abdomen, it can become enlarged, forming an aneurysm. Most aortic aneurysms are not associated with any symptoms, therefore increasing screening and public awareness is key to decreasing mortality resulting from a rupture. The strongest risk factor associated with developing an abdominal aortic aneurysm is smoking, therefore if you’re a male between the ages of 65-75 years old, you should receive a screening for an abdominal aortic aneurysm. Another important risk factor is family history. If you have a sibling or a parent who has had an aortic aneurysm, you should be screened as well, beginning at the age of 60. This screening is done with a simple, painless, non-invasive ultrasound of the abdomen. If you are diagnosed with an aneurysm that requires repair, there are several options. The vast majority of aneurysms are repaired with an endovascular, minimally invasive approach. What this means is that the vast majority of our patients can be discharged the following day with virtually no limitations.

What’s Aortic Atherosclerosis?

Atherosclerosis is the thickening or hardening of the arteries caused by the buildup of plaque within the inner lining of the artery. This occurs over many years and starts at a relatively young age. Risk factors for atherosclerosis include high cholesterol, high blood pressure, smoking, diabetes, obesity, physical inactivity, and eating a diet high in saturated fats. The presence of plaque within the aorta on its own is not dangerous, however, these can grow to a degree in which it limits blood flow which may then require treatment. Plaques can also become ulcerated which may also require an intervention.