Treatment

Treatment

Indraprastha Apollo Hospital is a leading center of excellence in India in the provision of:

• Treatment of Diabetic Foot and Peripheral Arterial Disease: Arterial disease develops when cholesterol or other fatty inflammatory deposits build up inside the artery walls and cause a narrowing or blockage. The arteries gradually narrow to the point where blood flow from the heart to vital organs like brain, kidneys upper and lower limbs as well as to the bowel becomes insufficient for survival. The legs and feet are often the first areas of the body to show the effects of this disease. Lower extremity symptoms may include an aching, tired or heavy feeling in the calf of the leg, thigh or buttock when walking or exercising. Patients may also experience discoloration of the toes or feet, cold or pale feet and toes, numbness or tingling in toes or feet, decreased hair growth on legs and feet, and/or persistent ulcers or infections on the feet, toes or legs. If left untreated this may cause Gangrene. On a case by case basis, our vascular team has shown that this revascularization (endovascular and bypass) procedures save limbs and ultimately provide a better quality of life for their patients. With appropriate care, even patients considered high-risk can undergo these procedures safely and effectively. Our vascular surgeons have documented thousands of successful patient case histories that detail how complex revascularizations using distal bypass operations and angioplasty techniques have achieved a healed foot and avoided amputation. If even a small portion of the foot can be saved, it allows the person to walk effectively and to lead a reasonably normal life.
• Laser Treatment of Varicose Veins and Management of Venous Disease: Varicose veins are a known cause of severe physical and psychological discomfort including discoloration of the leg skin & ulcers. The superficial veins stretch and bulge under the skin and create pronounced, bumpy “cords” on the legs. They are more common in women and in people who sit or stand in the same position for long periods of time. Endovenous Laser treatment EVLT in conjunction with sclerotherapy can in 90-97% afflicted patients treat varicose veins quite effectively. This is a minimally invasive procedure that doesn’t require general anesthesia or cuts, is virtually painless allowing return to normal active life within 24-48 hours. We have added one more advanced minimally invasive technique i.e radiofrequency ablation (RFA) of varicose veins. Conventional surgery of varicose vein is also performed, whenever required.
• Deep vein thrombosis (DVT) DVT is a serious condition where blood clots develop in the deep veins of the legs. These have the potential to dislodge and travel to the heart and lungs and cause sudden death. These cases may need thrombolysis (fast dissolution of the clot) in emergency, filter placement in the inferior vena cava and angioplasty –stenting of the veins, which we perform regularly. Advanced and chronic cases may need complicated surgical operations like venous bypass of which we have a large experience.
• Management of Thoracic and Abdominal Aortic Aneurysms: Weakening of the aortic vessel wall in the chest or abdomen leads to ballooning of aorta with the blood pressure and eventually leads to its expansion and rupture. Rupture of aortic aneurysms can cause rapid exsanguinations of blood in the chest or abdominal cavity leading invariably to death in majority of patients. Our Vascular Surgeons tackle all the routine and complex aneurysm problems, and specialize in hybrid procedures for difficult and re-do abdominal and thoracic aneurysms. Our vascular team advocates endovascular aneurysm repair for ruptured aortic aneurysms, which is known to significantly reduce mortality in these patients.
• Vascular Access Surgery for Dialysis of Kidney Failure and Cancer Chemotherapy: We routinely provide expert advice and treatments of complicated access related procedures (AV Fistula, Grafting, Permacath & CAPD) and also deal with all the complications resulting in such patients. We also routinely place chemo-ports for cancer patients needing chemotherapy.
• Treatment of Carotid Artery Disease to prevent Stroke: Hardening of the arteries (Atherosclerosis) affecting the vessels in the neck can lead to strokes. Patients with carotid artery disease and stroke are treated by a team of vascular surgeon and neuro-physician dedicated to stroke prevention. We also have a certified vascular laboratory for the non-invasive assessment of the carotid arteries. Depending upon the narrowing of the carotid artery, intervention may be recommended even in patients who have not yet had a stroke. The standard proven form of treatment for this problem is an operation called carotid endarterectomy to remove the plaque. In patients who are high-risk or unsuitable for surgery a non-invasive treatment is available called carotid artery stenting with distal embolic protection.
• Treatment of Complex Abdominal Vascular Problems: Lots of patients suffer from lack of blood supply to the intestines, which can be life-threatening if sudden & if slow, result in severe pains and weight loss. We have salvaged many such patients with complex procedures including operations and endovascular means, who are now eating normally. Certain cases of high blood pressure are because of narrowing of the kidney arteries. They may need to treated surgically or more commonly with renal artery angioplasty.
• Thoracoscopic Cervical Sympathectomy & Laparoscopic Lumbar Sympathectomy: There are patients who suffer from severe sweating of the palms and/or soles. These are best managed by a simple keyhole procedure. Patients of Raynaud’s disease and other upper limb vascular problems are also managed comprehensively. We are the centre which performs lumbar sympathectomy through laparoscopic method which can be done on a daycare basis as it is very patient-friendly operation.
• Vascular malformations Some patients have abnormally developed blood vessels that may be disfiguring or disabling. Our surgeons have a considerable experience in the successful & gratifying treatment of these vascular malformations (surgical, endovascular, laser & sclerotherapy)
• Elephantiasis Elephantiasis or Lymphedema is a condition that results in gross swelling of the legs and feet. Such cases need specialist management as they are difficult to treat. Some of these would ultimately need complex surgery to make the legs functional and relieve gross disfigurement.
• Vascular Trauma Many young people who are victims of accident, end up losing their limbs from loss of blood supply. Timely intervention within the golden period of 6 hours can save these limbs. We, at Apollo have a huge experience in limb salvage of trauma patients.

When Do I Need A Vascular Surgeon?

If you have any of the following, you should seek advice from a vascular surgeon

• Ache or pain in the legs, feet, thighs or buttocks that is brought on by walking or exercise
• Constant pain in the legs
• Blue or black discoloration of the toes or fingers
• Diabetes with ulcer or any problem in the foot.
• Cramps, pain, fatigue and restlessness in the legs at night
• Have bunch of blue lines going up on your legs
• Swelling in the legs
• Itchiness or eczema in the legs, especially with brown-grey colour on ankles
• Have mini strokes or have recovered from a stroke
• Been detected to have any problem of the aorta or any other blood vessel
• Any swelling in the body with pulsation (pulsatile swelling)