Doctors often can address vascular diseases without surgery, utilizing methods such as medications or physical therapies. Some patients do better with surgical vascular disease treatment, however. There is a difference between vascular and endovascular procedures.
Vascular surgery refers to a medical procedure in which a vascular surgeon makes incisions to address problems with arteries, veins or both. Vascular surgery is a common treatment for conditions such as aneurysms, varicose veins and carotid stenosis, as well as vascular trauma. In comparison to vascular surgery, endovascular treatments have the same focus and purpose, but it relies on needle punctures and sheaths rather than traditional incisions and, therefore, is less invasive. Most physicians consider endovascular surgery to carry lower risk.
A person undergoing either vascular or endovascular surgery will require anesthesia for the procedure, but the type a surgeon recommends depends on the health of the patient. The general tendency is for physicians to use regional anesthesia instead of general anesthesia when they can, as it offers fewer side effects and additional benefits, such as avoidance of endotracheal intubation.
Length of Hospital Stay
Although individual cases vary, a typical vascular surgery requires an individual to stay in the hospital for two to three days. By contrast, individuals generally receive endovascular treatment on an outpatient basis. The main reason is that, because endovascular procedures are not as invasive, they typically result in less tissue damage and, subsequently, less pain, reduced infection or complication risk and an overall faster recovery time.
Vascular surgery often is more expensive than endovascular surgery due to its more invasive nature and need for a longer hospital stay. For this reason, despite the fact that most insurance companies cover a wide range of surgery types, many are more supportive of endovascular procedures. Even so, endovascular surgery can require more expensive imaging equipment or specialty tools, and in some cases, this reduces cost savings significantly.
History and Specialization
Vascular surgery has been around for several decades and began getting real recognition as a specialty area in the 1970s, led by pioneers such as Nikolai Korotkov, Charles Theodore Dotter, Robert Paton and Edwin Wylie. As technology improved and surgeons began developing less invasive procedures for the benefit of their patients, endovascular surgery evolved as a subset of vascular surgery. Both types of surgery require that a doctor have more extensive training compared to a general surgeon, but some physicians focus on one type more than the other, making the content of their practice clear through their advertising.
Both vascular and endovascular surgeries treat problems with the veins and arteries, but vascular procedures involve traditional incisions, are more invasive, require longer hospital stays and typically cost more. Endovascular surgeries evolved out of vascular work. Doctors may use specific types of anesthesia for vascular or endovascular surgeries depending on the individual needs of their patients, but regional anesthesia is popular, especially for endovascular procedures that don’t damage as much tissue.