Articles on vascular surgery

Brain Aneurysms: What Everyone Should Know

Dr. sudheerambekar
What is a Brain Aneurysm?A brain aneurysm is a focal bulging of the wall of an artery that supplies blood to the brain. While most brain aneurysms remain silent, a few burst, leading to bleeding within the brain. The bleed may be so devastating that almost half of the people die and do not reach the hospital. Since most of the aneurysms rupture in the fourth through sixth decades of life, a significant part of productive life is lost due to long-term disability and death. Hence it is important for the people to know about the symptoms of brain aneurysms and possible treatment options. It is also important for general practitioners to be aware so that they can refer their patients to treatment centers that are capable of managing brain aneurysms.What causes Brain aneurysms?In most of the people, aneurysms are acquired. This means, that most people with brain aneurysms are not born with these and during their lifetime, the aneurysms form. High blood pressure, smoking, excessive alcohol intake are some of the risk factors that predispose an individual to aneurysm formation. Women are more likely to develop aneurysms than men and African-Americans and Finnish are more likely to have an aneurysmal rupture than people belonging to other races. An individual with a strong family history (at least 2 close relatives with brain aneurysms) also is a risk factor.Rare hereditary conditions such as polycystic kidney disease are associated with brain aneurysms.What are the symptoms?Most aneurysms do not cause any symptoms. They are discovered incidentally during MRI or CT imaging for an unrelated cause. However, aneurysms can cause symptoms when they burst or occasionally when they become big in size and press upon the surrounding brain structures. The most common symptoms of aneurysm rupture aresudden severe headacheneck painnausea and vomitingloss of consciousnessintolerance to lightseizures (fits)Other symptoms may include blurred vision, double vision and changes in speechHow are aneurysms diagnosed?There are several tests that the doctor may do to diagnose brain aneurysm rupture. CT scan, MRI, lumbar puncture (in which a needle is inserted into the spinal canal in the back and spinal fluid is drawn to look for blood products) and cerebral angiography. A cerebral angiogram is a test where a catheter is inserted into an artery in the groin and advanced all the way up to the neck. Dye is injected through the catheter and X-ray pictures were taken.How are aneurysms treated?There are two ways in which aneurysms are treated. First, "Clipping", in which an aneurysm is closed from the outside with a metal clip through open surgery. Second, "Coiling" in which thin metal threads called 'coils' are inserted into an aneurysm using a catheter in the same way as an angiogram is done. Both these treatment options are complimentary to one another and, depending upon the characteristics, the aneurysm may be suitable for clipping or coiling. If an aneurysm is very small and not ruptured, your neurosurgeon may also recommend observation depending upon the risk of rupture.

Jaw Surgeries for a Proportional Face

Dr. N Srinivas, Dentist
It may take more than a new smile to help you look your very best.Having a great smile is undoubtedly an asset, regardless of other aspects of your appearance. However, your smile is only one part of the whole composition of your face. Once you have improved your smile, you may be inspired to make a few other changes to look your very best, and it may be necessary to look beyond your dentist to help.If you are unhappy with your facial profile,the condition of your skin, or specific facial features such as your lips, nose or chin. An oral and maxillofacial surgeon reveals how repositioning the jaws can improve not only your bite but also your entire facial appearance, especially in profile.What is orthognathic surgery?Orthognathic surgery involves dividing and repositioning the jawbones to bring them into better alignment. It is typically used to correct bite problems that cannot be fixed by orthodontics alone.Often bone or soft tissues may be removed or augmented to further enhance facial esthetics. Orthognathic surgery can bring about significant changes in your appearance.Is orthognathic surgery right for me?Orthognathic surgery is typically performed by an oral and maxillofacial surgeon and can achieve dramatic improvement in facial esthetics. Orthognathic surgery may be the best option if you:1. Have jaw problems that can be treated only by surgery.2. Can pay for the procedure, as its a bit expensive.3. Feel strongly that your condition is inhibiting your success and happiness.4. Are willing to experience some discomfort and inconvenience.5. Understand and accept all associated risks.Communication is critical to success!1.It's important that you tell your doctor exactly what you want to correct.He or she may zero in on a particular problem,and you need to be sure that problem is also your primary concern.2. Your surgeon will design a highly specialized treatment plan for you based on information gathered by obtaining casts of your teeth, photographs,video images,and special x-rays.3. It's highly important that you know what results to expect from treatment.Some surgeons will use digital imaging to give you a good idea of what you'll look like after surgery;others may show you tracings of your new profile based on your x-rays.4.It's also essential that you understand each step of the surgical procedure that you're to undergo.The main risks and possible outcomes should be explained thoroughly, and it's then up to decide which procedures you wish to have performed.What can orthognatic surgery do?Problems that can be addressed using orthognathic surgery include. Recessive or protruding lower jaw and/or chin.. Chin that is too short,too long,or otherwise unattractive.. Open bite(teeth do not meet). Lower and/or upper jaw positioned to one side or a narrow arch. Discrepancies in upper and lower facial height (gummy smile or lack of enough tooth or gums showing)What does an oral and maxillofacial surgeon do?Oral and maxillofacial surgeons do more than just tooth extractions and jaw surgeries.If  you're interested in cosmetic procedures to enhance the appearance of your face and neck,talk to your surgeon about including them your overall treatment plan.

5 Steps to Prevent Clots in Veins

Dr. Saurabh Joshi, Vascular Surgeon
We all love zipping around on a flight. It saves us a lot of time and  flying is a fun way to travel. But did you know that taking long haul flights increases the risk of developing clots in the Veins ? This is called Deep Vein Thrombosis.Here's how you can prevent clots in the veins, called Deep Vein Thrombosis.Exercise your calf and foot muscles regularly:Every half hour or so, bend and straighten your legs, feet and toes when you are seated.Press the balls of your feet down hard against the floor or foot rest every so often. This helps to increase the blood flow in your legs.Take a walk up and down the aisle every hour or so, when the aircraft crew say it is safe to do so.Make sure you have as much space as possible in front of you for your legs to move. So avoid having bags under the seat in front of you, and recline your seat where possible.Take all opportunities to get up to stretch your legs, when there are stops in your journey.Drink plenty of water to avoid a lack of fluid in the body (dehydration).Do not drink too much alcohol. (Alcohol can cause dehydration and immobility.)Do not take sleeping tablets, which cause immobility.People with untreated Varicose Veins have a higher risk of DVT. We are the premier Vein Treatment center, specializing in Vein Laser Treatments.These are our distinguishing features :Super-Specialty Consultation: Post-Doctorate Vascular Interventional Radiologists with international recognition. Colour Doppler Ultrasound done at same sitting. Short Treatment Cycle: Investigations are usually done on the same day of your first visit. If required, laser treatment can be done as soon as the next day.Reputation: We are regularly featured as a leading authority on varicose veins on TV and Press. Insurance Accepted: Laser Treatments are covered by reimbursement and cashless insurance. Corporate Health insurance is also covered.

Have You Been Ignoring That Swelling on Your Feet?

Dr. Saurabh Joshi, Vascular Surgeon
The blood in veins of our legs normally moves from bottom to top, or from the foot to the thigh and then up towards the heart. Leg veins have one-way valves that enable them to push the blood up the leg against gravity.When varicose veins appear, it's often because these one-way vein valves are not functioning normally. The valves are not able to resist the constant push of gravity downward, and backflow occurs. As the backflow persists, venous blood settles in the lower leg. Hence, the leg swells up as the result of this elevated pressure in the veins, and the swelling tends to be most prominent after you've been standing for a long period of time. Endovenous laser therapy is an alternative and more cosmetic way of dealing with varicose veins. A fine laser fibre is passed up the vein under ultrasound guidance. The ultrasound guidance ensures that only the correct vein is treated. The vein wall is gently heated permanently shrinking and destroying the vein.The Key Benefits of Endovenous Laser TherapyScar-free procedure that can be performed entirely under local anaesthetic the majority of cases.It is applicable to nearly all patients including those with pre-existing medical conditions. Patients who have previously had unsuccessful varicose vein stripping can also have endovenous laser therapy.Cosmetic outcomes from laser are far superior to stripping. Patients report minimal to no bruising, swelling or pain following the procedure. Many return to normal within a few days. 

Cosmetic and Plastic Surgeries

Dr. Parthasarathi Dutta Roy, Dermatologist
Being beautiful and charming is very important in every stage of today’s life. Most of people become upset for not receiving attractive physical structure, nose alignment, slim physic and many more. But medical science creates revolution for establishing two significant surgeries named cosmetic surgery and plastic surgery. These are very helpful for treating any kinds of physical disorders.Effectiveness of Cosmetic and Plastic SurgeryThrough cosmetic surgery anybody can change their facial or body structure which is not desired. Plus from ageing lines to wrinkles can be reduced through method of cosmetic surgery.Plastic Surgery is basically used for reconstructing the facial or body features. Any kinds of birth defects, injury imperfection and disease feature can beautifully be repaired by plastic surgery.Features of Cosmetic SurgeryTwo types of cosmetic surgery are categorized in medical science- addition and deletion. Through cosmetic surgery with collagen injection something can be added for giving proper shape and size of the body parts if one is not satisfied with their parts, size and shape of the body. Breast augmentation and lips plumping are the best examples. Alternatively excess mass on some parts looks ugly; the cosmetic surgery helps to delete the volume to give the perfect shape.Procedures of Plastic Surgery:Many procedures can be performed through plastic surgery. But here are some most popular procedures which is remarkable possible to treat are described below.Breast Augmentation: The women having small breast can get beautiful and attractive big breast through breast augmentation procedure of plastic surgery.Rhinoplasty: Defect of nose can be treated through rhinoplasty.Blepharoplasty: To give redesign and shape of the eye lids, blepharoplasty is just incomparable plastic surgery.Liposuction: Excess fat is cut down through this liposuction procedure for giving attractive body structure.

Liposuction FAQs

Dr. Sreekar Harinatha
What exactly is the role of Liposuction?While liposuction is not a replacement for a healthy lifestyle, it can make you look and feel better. During the procedure, your surgeon uses a specially-designed surgical instrument known as a cannula to break up and remove excess pockets of fat. The procedure requires only small incisions and, with modern techniques, swelling and bruising during the recovery period can be minimized.It is important for plastic surgery patients to remember that this procedure is meant for body contouring and is not a treatment for obesity. You need to be close to your ideal body weight to be an ideal candidate. Beyond your weight, it is critical to have the right goals – contouring and reshaping rather than seeing a smaller number on the weighing machine.What are the types of Liposuction?Tumescent liposuction: A local anesthetic is used to numb the area of your body where the tube will be inserted. Next, a large amount of an anesthetic solution containing lidocaine and epinephrine is injected into the fatty tissue before traditional liposuction is done. Tumescent liposuction may require general anesthesia (which makes you sleep through the procedure) if a large area is being treated.Ultrasound-assisted liposuction: This technique uses ultrasound to liquefy the fat, which makes it easier to remove. This technique may be particularly helpful in removing fat from the upper abdomen, sides, and back.Power-assisted liposuction: This technique uses mechanically moving cannulas to hasten the procedure.What to expect after Liposuction?After the procedure, the area of the body that was treated is firmly wrapped to help reduce swelling, bruising, and pain. Elastic bandages and tape or another type of firm-fitting garment may be used, depending on which part of the body was treated. You may have to wear the compression garment or wrap for 3 to 4 weeks. Expect bruising and swelling for at least the first 7 to 10 days.Fluid may drain from the incision sites for several days. You may be given antibiotics to reduce the risk of infection.Most people are able to get up and move around as soon as the treatment is finished and after the effects of the anesthesia and any sedation have worn off. You can return to your normal activities as soon as you feel comfortable, although this may take several days. Most people can return to work within a few days. Recovery may take longer if large areas were treated.How effective is Liposuction?Liposuction is usually very effective at removing fat deposits in most areas. But if you regain weight after having liposuction, the fatty bulges that were removed are likely to appear in a different place.Some improvement in body contour is usually noticeable right after surgery. And improvement may continue for several weeks or even months as the swelling goes away. The full effects of having liposuction may not be visible for several months.After fat has been removed, the skin around the area may be somewhat loose. It may take up to 2 months for the skin to tighten around the treated area. Some people's skin is very elastic and retracts more quickly than other people's skin. Younger skin tends to have greater elasticity than older skin.What are the risks of Liposuction?Liposuction done by an experienced doctor in a properly equipped facility is usually safe. Having more than one area treated, or having a very large area treated, may increase the risk of complications during or after the procedure.Common side effects of liposuction include:Temporary swelling, bruising, soreness, and numbness in and around the treated areas.Irritation and minor scarring around the incision sites where the cannulas were inserted.Baggy or rippling skin. The skin will usually tighten and retract after a few months. But in some people the skin may remain somewhat loose.If you gain weight after having liposuction, your body may store the new fat in a different place than where you had fat cells removed. Who is the right candidate for Liposuction?Liposuction should be done only by a doctor who has special training in liposuction and plastic surgery and knows how to respond to complications during surgery. If you are trying to lose weight, liposuction is not a substitute for exercise and a balanced diet. In fact, most cosmetic surgeons agree that the best candidates for liposuction are healthy people who are at or close to a healthy weight but who have stubborn fat deposits that do not respond to exercise.

Do I Have Appendicitis? Do I Need Surgery?

Dr. Maruthesh Gowda, Bariatric Surgeon
First thing we need to understand is that appendicitis is an surgical emergency. When treated appropriately complications are very few.What are the symptoms of appendicitis?It has dull aching pain around the umbilicus and slowly localises to right lower side. It is associated with vomiting and anorexia (patient does not feel hungry). If ignored then might lead to temperature, high heart rate (tachycardia).How is appendicitis diagnosed? It's based on history and clinical examination. Blood tests will reveal infection (Increased WBC, CRP). Ultrasound of abdomen might help to confirm the diagnosis but negative ultrasound scan does not rule out possibility of appendicitis. Ultrasound is more important in females as problems in ovaries, fallopian tube and uterus might present in the similar way and ultrasound helps to rule out those possibilities. What is the treatment of appendicitis?  In short treatment of appendicitis is immediate surgery. It is not I am busy for next few days and will have surgery later and this might lead to serious complications.Now a days surgery is done laparoscopically (Key hole) and involves three small cuts which will be barely visible with time. Most patients go home 24 hours later being able to do regular activities. There will be no food restrictions. Only restriction being not to lift weights for 1 month. Can appendicitis be treated with medicines? if so what are the complications?There are times when patients want antibiotics and not surgery. While this is proven treatment it is logistically difficult to apply in Indian settings unless patients and affordable and ready to take risks.Medical proof so far tells us to treat appendicitis with antibiotics we need to do CT scan and prove that there is no collection of pus inside abdomen. Once this is done admit patient for Intravenous antibiotics (IV) for 48 hours. Regularly review patient to make sure infection is not spreading. If infection does not settle down or patient suffers complication then do complicated surgery with more risks involved.What we have to be very careful is young females with appendicitis as untreated or poorly treated appendicitis might lead to infertility in the future by affecting the movements of fallopian tubes.In all patients treated with antibiotics there is small risk of long term abdominal pain and very rarely appendicitis might recur needing surgery.