Angie's LIST Guide to
Vascular surgery

A vascular surgeon diagnoses and manages diseases affecting any part of the vascular system, which includes the arteries, veins and lymph glands that run throughout the body. This type of surgeon does not handle arterial issues affecting the heart or the brain, which are generally reserved for cardiac surgeons and neurosurgeons, respectively.

Vascular surgeons have completed arduous training before being permitted to practice. After earning a four-year bachelor's degree, a prospective specialist must complete four years of medical school and one of several types of residencies for five to six more years. After completing their training, prospective specialists must pass tests to become board certified in general surgery and in their specialization. Upon obtaining certification by the American College of Surgeons, a surgeon may add FACS after his or her name. Each state determines its own physician licensing requirements.

At a typical first appointment, a vascular surgeon will gather your patient history, conduct an exam and order tests. While the physician can sometimes do simple tests during the first appointment, many tests must be scheduled for a later date. Among the most common vascular tests are pulse volume recordings (PVRs), duplex ultrasounds, magnetic resonance angiographies (MRA) and computed tomography (CT) scans.

It might take several weeks for the surgeon to check test results and recommend the best type of treatment. You should expect your doctor to go over the alternatives, discuss the risks and benefits of each and be generally helpful in the process of making an informed decision.

You should leave the surgeon's office with a good idea of what will happen on the day of surgery and during recuperation, as well as with important financial information.

The complexity of a vascular procedure generally dictates where a surgeon performs it. Simpler surgeries might even occur in the office. The trend is toward the use of free-standing facilities.

The success of a vascular operation varies depending on many factors. For example, the success rates are very good for arterial bypass and peripheral bypass surgeries, whereas most people with a ruptured aortic aneurysm do not survive.

Due to the increasing number of people with atherosclerosis, angioplasty and stenting are the two most common vascular procedures. Patients should expect the surgeon to explain potential complications, such as reactions to contrast dye or any risk factors linked to disorders such as kidney disease. This combination of procedures often takes several hours to complete.

The type and the amount of anesthesia required depends on the patient's circumstances. An anesthesiologist normally conducts an interview shortly before surgery.

While the simplest vascular procedures result in a patient returning home the same day, a person with a complex problem such as an aneurysm might go to intensive care and stay in the hospital for more than a week.

Before going home after vascular surgery, you should receive any required prescriptions and the surgeon's instructions about exercise and diet, if applicable. The information should also state when to see the surgeon for a follow-up appointment.

• As many as 10 million people in the United States, including 5 percent older than 50, are affected by peripheral vascular disease, a disorder that often requires surgery.