WAKEFIELD – Open procedures needed to address vascular-related health problems — which can include aortic aneurysms, blood clots and atherosclerosis — involve large incisions to the body, long hospital stays and longer recovery times. In the past two decades, however, strides in the medical field have allowed these procedures in some cases to be condensed, simplified and yet remain just as effective. Now, South County Hospital is partnering with the country’s largest vascular surgery practice to bring these new methods and procedures to local residents.
“Vascular surgeons in this day and age have been trained much differently,” said Dr. Stratton Danes, a surgeon with The Vascular Experts, which has begun a partnership with South County Hospital. “What we do and what we bring is dramatically different. Aneurysms used to only be done as [open procedures]. We’re now doing them through puncture holes as opposed to any type of incision. We used to leave big clots in people’s veins and hope they would get better and now for the bigger clots we’re going in and using clot-busting drugs like they use for strokes and trying to decrease them so they have less swelling. The aggressiveness with which we’re treating vein disease has gone up because we’ve seen some great results with that.”
Vascular disease consists of artery or vein problems not involving the heart or inside the brain – blockage, clots, atherosclerosis, aneurysms and more, mostly in the arms, stomach, intestines and lower extremities. Procedures and treatments coming to South County Hospital include thrombolysis, which can dissolve clots in blood vessels, percutaneous endovascular aneurysm repair (PEVAR), a minimally invasive, fast-track approach to treating pathology of the aorta and advanced aneurysm stenting, among others. The uniform goal of the changes in addressing vascular complications and problems is a quicker, more effective and often cheaper, procedure, along with reduced hospital stays and recovery times for patients.
“In the past, say 15 or 20 years ago, if you needed your arteries opened up, a lot of times that meant cutting of the skin meaning removing the blockage and doing what is a called a bypass where you might take a piece of vein out of somebody and use it to come around the blockage,” said Dr. Danes. “We still do that and I’ve been trained in these open procedures, but now we have much better balloons, stents and devices to actually drill through blockages.”
“We’re hoping to bring all of those to South County Hospital,” he added. “Essentially, we’re providing more tools on the tool belt.”
In many cases, the differences in surgical technique comes down to the size of the incisions made to a patient’s body in order to undergo the necessary surgery. Whereas previously vascular complications required open surgery, meaning large incisions, now some can be accomplished just as effectively via smaller punctures.
“Most of our procedures now to work on veins and arteries are done through what we call a ‘puncture,’ basically a big intravenous therapy access point in the body,” said Dr. Danes. “A lot of patients are going home the same day.”
Additionally, technology and advances in treatments have allowed for advanced intravascular ultrasounds (IVUS), which can travel through arteries and veins to produce clearer, more accurate pictures. Vascular surgeons are now trained to place their own balloons and stents to remove or address blood clots. Finally, procedures can be combined.
“Sometimes you can look at things and see that both [open procedures] and [the placement of a balloon or stent] need to be done and you can do them at the same time and save the patient an extra trip,” said Dr. Danes.
The benefit of bringing the practices to the local population is that a patient in need of these procedures will not have travel far to receive them, which can often be a daunting barrier to having the work performed and can raise questions of access for lower-income or elderly patients, the latter of which are most often affected by vascular disease.
“There’s very few procedures in terms of what the scope of vascular surgery is that need to leave this area,” Dr. Danes said. “People can get treated in their hometown hospitals and not have to drive to Providence, Boston, Yale or New York City. It’s a great thing.”
“Artery disease is a function of risk factors, just like anything else,” he continued. “The older you get, I mean high-blood pressure, high cholesterol, family history and smoking all play a role, but it’s a cumulative process. It’s kind of a wearing down of the body that can take years.”
Vascular problems can occur in younger populations but typically in people with multiple issues – smoking, diabetes, bad overall healthcare, not seeing a doctor on a regular basis and poor diet. Most importantly, these treatments and procedures improve overall health and save lives.
Doctors from The Vascular Experts are now available at South County Hospital three days a week with hopes to expand in 2021.
“We’re building a vascular surgery practice here that will provide for this community for the foreseeable future,” Dr. Danes concluded. “You don’t have to go to the big city to get excellent care. We’re willing and able to deliver that kind of care right here.”