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Memorial Hermann Heart & Vascular Institute-Texas Medical Center
Vascular disease is complex, requiring a broad range of knowledge and expertise to ensure effective treatment. The Vascular Program at the Heart & Vascular Institute-Texas Medical Center has an outstanding record of success in the treatment of patients with aortic aneurysm, carotid artery disease, deep vein thrombosis, venous insufficiency and lower extremity arterial occlusive disease.
Scope of Expertise
Treatments
Aneurysm Repair
The surgeons at Memorial Hermann Heart & Vascular Institute-Texas Medical Center are world leaders in the reconstruction of aortic aneurysms. Their innovative techniques have resulted in critical advancements in the repair of these ballooning blood vessels – preventing rupture and significantly improving outcomes.
Carotid Endarterectomy
We perform carotid endarterectomy and stenting to repair stenosis of the carotid artery. Endarterectomy, used to strip atheromatous plaque from the carotid vessels, has been shown to reduce the two-year risk of stroke by 80 percent for patients who have severe stenosis of 70 percent to 99 percent. For patients who may not be candidates for endarterectomy, angioplasty and stent insertion provide a minimally invasive alternative.
Closure Procedure for Varicose Veins
Using ultrasound, the surgeon positions a closure catheter into the diseased vein through a small incision. The catheter delivers radiofrequency energy to the vein wall. As the catheter is withdrawn, the vein wall is heated causing collagen in the wall to shrink and the vein to close.
Outcomes are positive: 90 percent of treated veins have remained reflux free at two years. Patient benefits include less postoperative pain and bruising, return to normal activity within one day and return to work more than a week earlier than patients who undergo vein stripping.
Limb Salvage in Chronic Critical Limb Ischemia
Critical limb ischemia is manifested by pain in the limbs at rest, non-healing pressure ulcers and the presence of gangrene. Caused by multiple blockages at various levels in the limb vasculature, continuous ischemia at rest can indicate vascular insufficiency severe enough to present a threat to the affected limb.
Blockage location is isolated using Doppler ultrasound, CT, CT angiography, MR angiography and, when necessary, invasive angiography. Intervention varies according to diagnosis, and may include conservative therapy, revascularization or amputation.
When arterial openings are extremely narrow, balloon angioplasty is the preferred procedure for revascularization. Less frequently, deposits are removed by atherectomy using either a laser or a tiny, rotating knife inside a catheter to shave the obstruction from the arterial wall. The procedure is followed by stent placement, if required.
Patent Foramen Ovale (PFO) Treatment
The Amplatzer PFO Occluder is designed for nonsurgical closure of patent foramen ovale in patients with recurring stroke or cerebral vascular accident (CVA), with no apparent cause. The occluder functions as a plug to close the PFO, an abnormal opening in the wall defining the right and left atria.
Made of self-expanding wire mesh with double discs, the device contains inner polyester fabric patches that, along with the mesh, cause the formation of a blood clot that blocks the opening. The occluder is guided to the heart and advanced through the defect in the heart wall via a catheter threaded into a vein in the groin.
Tissue grows over the device, which becomes part of the wall of the heart. Closure prevents blood from passing through the PFO, reducing the risk of stroke.
Peripheral Artery Disease Treatment
Cardiologists at the institute collaborate with physicians from Memorial Hermann-TMC’s vascular lab, foot and wound service and cardiothoracic surgery department to open up smaller vessels to prevent threatened limb loss. Memorial Hermann-TMC operates one of the most active limb salvage programs in the country with a success rate that exceeds the national average at 80 percent.
Thoracic Outlet Syndrome (TOS)
Thoracic Outlet Syndrome is caused by compression of nerves, blood vessels, or both, as a result of trauma, disease or congenital deformity in the thoracic outlet between the clavicle and first rib. The result of that compression is often pain and numbness in the arms, hands and fingers.
Treatment begins with exercises to stretch and open the tissues associated with the thoracic outlet. If symptoms persist, surgery can become an option.
In the case of surgery, the surgeon makes an incision above the collarbone and removes scalene muscles along with the first rib, easing pressure on the brachial plexus nerves. About 80 percent of patients experience complete resolution of symptoms; 20 percent report significant improvement.
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