Vascular and Endovascular Surgical Experience
Multiple studies have documented the critical role that volume plays in successful patient outcomes. In terms of volume, technical complexity, improved patient management and successful outcomes, Mass General has some of the most extensive vascular and endovascular surgical experience of hospitals nationwide:
- Our vascular surgeons established the first stent graft program for aortic aneurysms in New England and have the largest cumulative stent graft experience in the region.
- The
Vascular
Division has the only program in the area of thoracic aortic stent grafting. To date, some 900 abdominal and nearly 100 thoracic aortic implants have been performed with favorable results.
- The Vascular Division performs the largest number of aortic aneurysm and carotid artery repairs of any hospital in Massachusetts.
- The Vascular Division has the largest practice in the Northeast for complex (involving thoracic and/or abdominal aorta) aortic aneurysm disease and has developed a unique technique for spinal cord protection.
- Through a recent programmatic expansion of endovascular surgery, the Vascular Division continues its steadfast commitment to remain at the forefront of the newer percutaneous procedures with the largest group of vascular surgeons practicing endovascular techniques in the region.
Vascular Disorders Treated
Cerebrovascular Disease
The Vascular Division performs some 300 carotid endarterectomies annually. This surgical procedure is used to relieve symptoms caused by poor blood flow to the brain and to reduce the risk of stroke by increasing blood flow to the brain. A small incision is made in the neck just below the level of the jaw. The narrowed carotid artery is exposed. The blood flow through the narrowed area may need to be temporarily rerouted (shunted). Rerouting is done by placing a tube in the vessel above and below the narrowing. Blood flows around the narrowed area during the surgery. The artery is opened and the plaque is carefully removed, often in one piece. A vein from the leg may be sewn (grafted) on the carotid artery to widen or repair the vessel. The shunt is removed, and the artery and skin incisions are closed.
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Stent Graft Program for Aortic Aneurysms
Stent graft repair of aortic aneurysm was first performed in New England at Mass General Hospital in 1994. Mass General is the largest stent graft program in the Boston area. Our surgeons have amassed considerable experience in the treatment of complex cases. We have a 98% initial implantation success rate, with less than two percent of our patients requiring conversion to open repair.
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Complex Aneurysm Disease/Thoracic Aortic Center
The Mass General Thoracic Aortic Center is a regional referral center that offers innovative strategies for the evaluation and treatment of thoracic aortic diseases. Center faculty includes physicians from the fields of cardiology, cardiac and vascular surgery and vascular radiology. We have the largest experience in the region with stent graft repair of thoracic aortic lesions, including protocol investigation of thoracic aortic dissections.
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Percutaneous Endovascular Therapies
In conjunction with cardiology/vascular medicine, the Division has made a significant programmatic expansion of its percutaneous endovascular therapies. With the opening of the state-of-the-art endovascular suite in early 2003, 27% of our vascular interventions are now performed percutaneously. Four staff vascular surgeons offer the spectrum of endovascular interventions including:
- Carotid stenting
- Aortic arch branch endovascular therapy
- Renal/mesenteric vascular disease
- Lower extremity occlusive disease
- Venous disease
- Thrombolysis of occluded arteries, veins & graphs
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Venous Disease
There have been many developments in a variety of minimally invasive techniques for the treatment of superficial and perforator venous disease. These procedures are increasingly applied on an outpatient basis for both cosmetic and symptomatic venous disorders, with potential aggressive use for thrombosis management and thromboysis strategies for patients with symptomatic deep venous thrombosis. We have two staff members whose full-time practices are devoted to minimally invasive therapies for lower extremity venous disorders.
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Vascular and Endovascular Surgery
Programs and Centers
The Vascular Department works closely with multidisciplinary teams to bring our patients an unparalleled level of sophistication in managing the spectrum of vascular disease.
Mass General multidisciplinary initiatives include the MGH Vascular Center with a new site at Mass General West on Rt. 128 and the MGH Thoracic Aortic Center.
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Physician-to-Physician Communication
At Mass General Hospital, we place critical importance on communication and the flow of appropriate patient-related information between referring physicians and the Mass General
Vascular and Endovascular Surgical
team.
In order to avoid duplicate tests, our physicians review all relevant referral information, procedures and tests before ordering additional studies. We maintain excellent contact with referring physicians, consulting with them whenever appropriate and provide timely updates about the progress of their patients by telephone, fax, mail, or email.
It is our goal to return the patient to the care of the referring physician as quickly as possible, with complete post-discharge education given to the patient and their family and clinical information provided promptly to the referring physician.
In the spectrum of vascular disease, longitudinal follow-up by our surgeons is often desirable and constitutes a tradition of the Division of Vascular and Endovascular Surgery.
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