What Does a Vascular Surgeon Do?

Going to see a surgeon for any reason can seem daunting. However, surgeons do more than just perform surgery, and in the case of surgical specialties, they can make sure you get the most precise care you need for your medical condition. If you have any issues involving blood vessels, a vascular surgeon can give you the best treatment available. Read on to find out everything you need to know about this type of surgeon.

What Is a Vascular Surgeon?

The vascular system in the body is also known as the circulatory system, and it is comprised of the body’s blood vessels — arteries, which carry blood away from the heart, veins, which carry blood to the heart, and capillaries, smaller blood vessels between the two. A vascular surgeon is a doctor who specializes in treating conditions that affect the vascular system. While these treatments can involve surgery, vascular surgeons are also skilled in non-surgical treatment options. Rather than seeing a patient for one procedure and then being finished, they are also more likely to be doctors that you will see over a long period of time, as many vascular diseases can be lifelong or long-lasting.

“Vascular Surgeons treat all disease processes that occur within the arteries and veins outside of the heart and brain,” said Clifford Sales, MD. “Since many of the disease processes they treat are the result of hardening of the arteries (atherosclerosis), they are well schooled in the management of this disease entity wherever it may occur in the body.”

Reasons to See a Vascular Surgeon

The reasons to see a vascular surgeon are varied, with different conditions of different severities affecting the body’s circulatory system. Usually, seeing a vascular surgeon will first require seeing your primary care physician and getting a referral.

People who smoke, or who have medical conditions such as high cholesterol, diabetes, or high blood pressure, are more susceptible to developing vascular problems.

Some of the conditions that may necessitate treatment by a vascular surgeon are:

  • Carotid artery disease and peripheral artery disease, in which arteries narrow or become blocked
  • Blood clots, such as those causing deep vein thrombosis, pulmonary embolism, or stroke
  • Spider veins, which are “webs” of blood vessels just under the skin
  • Varicose veins, which are painful, enlarged veins in the legs
  • Vasculitis, conditions that involve inflamed blood vessels
  • Venous ulcers, which are leg wounds that do not heal for months or longer, often caused by another medical condition
  • Atherosclerosis, when arteries harden due to plaque buildup
  • Aneurysms, weakenings in artery walls that cause the artery to expand and potentially rupture if untreated
  • Nutcracker syndrome, which occurs when arteries surrounding the left renal vein compress this blood vessel
  • Thoracic outlet syndrome, the compression of blood vessels in the upper chest

According to Dr. Sales, “the most common disease processes treated by a Board Certified Vascular Surgeon will be circulatory problems of the leg (Peripheral Arterial Disease or PAD), stroke prevention (carotid artery disease), Abdominal Aortic Aneurysms (AAA) and varicose veins.”

What Does a Vascular Surgeon Do?

A vascular surgeon specializes in the diagnosis and treatment of conditions affecting the circulatory system. These treatments can be surgical or nonsurgical in nature, and they can perform one procedure or provide long-term medical care, depending on what the issue needing attention is. The only vascular conditions they do not treat are those located in the heart or the brain. For those concerns, you would need to see a cardiovascular surgeon or a neurosurgeon, respectively.

Some vascular conditions are life-threatening and require treatment as soon as possible. Others are more chronic conditions, for which you might need a long-term plan to take care of the health of your blood vessels. A vascular surgeon can help with either of these things. Aside from helping you form a treatment plan for a circulatory issue, some of the procedures that a vascular surgeon perform are:

  • Immediate surgery, if necessary, for a condition such as a stroke, or keeping an eye on the problem to see if surgery will be required later
  • Repairing an aneurysm or a damaged blood vessel
  • Inserting a stent into a weak or narrow artery, a procedure that is done by threading a catheter into a small opening in the artery so the stent can be placed
  • Sclerotherapy, a treatment for spider veins and varicose veins, that involves injecting a salt solution into the affected blood vessels

Certification

According to the Society for Vascular Surgery, there are several different paths towards becoming a vascular surgeon. However, as is the case with any surgical specialty, they all require extensive training and experience, as well as a degree from medical school. The possible tracks are as followed:

  • 0 + 5 Track: This track is the newest offered for potential vascular surgeons. For those who qualify during medical school, it is a fast-tracked, integrated program that bypasses the previous requirement of becoming licensed as a general surgeon before becoming a vascular surgeon. It involves a residency of two years working on basic surgical skills and three years working in vascular surgery. Those who take this track will only be eligible for board certification in vascular surgery.
  • 5 + 2 Track: This track is the most traditional track towards becoming a vascular surgeon. It involves a five-year residency in general surgery, followed by two years training specifically as a vascular surgeon. People who take the 5 + 2 track are eligible to be certified both as a general surgeon and a vascular surgeon.
  • 4 + 2 Track: Similar to the 5 + 2 track, the 4 + 2 track allows those in accredited Early Specialization Programs to let what would have been one year of their general surgery training go towards their vascular surgery training instead, shaving one year off the process. They can also become certified as a general surgeon and a vascular surgeon.
  • 3 + 3 Track: The 3 + 3 track allows those who qualify to have a three-year residency in general surgery, followed by three years focusing on vascular surgery. However, despite those initial three years, those who take this track are only eligible to become board-certified vascular surgeons.

Board certification in vascular surgery has two test components: a qualifying exam (QE) and a certifying exam (CE). The QE is a standardized, multiple-choice test, and the CE is an oral exam. Both are offered only once a year, and they must be completed within seven years of finishing training, with four chances within four years to pass the QE and three chances within three years to pass the CE. Skipping a year of taking the exam, or not beginning the process immediately after finishing training, forfeits one of the chances to take it.

“Patients should expect board certification in Vascular Surgery,” Dr. Sales advised. “There are many physicians who treat vascular disease but none as comprehensively as the Board-Certified Vascular Surgeon.”

Referral and Research

Unless under emergency circumstances, most visits to a vascular surgeon will require a referral. One set of criteria for when seeing a vascular surgeon is necessary and how soon a patient should be seen by one can be found on the Santa Clara Valley Medical Center website. Some ailments can first be treated by your primary care doctor before a specialist’s intervention is necessary, and sometimes prompt surgical care is needed. The American Board of Surgery has a database that will let you check a vascular surgeon’s certification status.

“Patients must be somewhat savvy in their search for vascular surgeons,” said Dr. Sales. “Much as they would choose a specialist for anything—heating, carpentry, window washing—they should look for the physician who limits their practice to vascular surgery.”

Your First Appointment with A Vascular Surgeon

“An initial visit to a vascular surgeon will vary based on the problem for which a patient may be seeking advice,” said Dr. Sales. “Typically, a history and physical examination will be accompanied by a noninvasive ultrasound in the Vascular Surgeon’s accredited Noninvasive Vascular Laboratory. This will allow the technologist and the surgeon to see the blood flow inside the body and determine if disease exists that is causing the problem and, if so, how severe it is.”

As is the case with any medical condition, especially one that might necessitate surgery, it is important to fully understand any procedures you may have to undergo and what your options are. At your appointment with a vascular surgeon, consider asking some of these questions to make sure you get the best care possible and know what your treatment will involve.

  • Do you recommend surgery?
  • What are any potential risks of having this procedure? What will happen if I don’t have this procedure?
  • What will my recovery process be like?

Vascular surgery is a broad specialty, and whatever track a surgeon has taken towards becoming certified, they will have had extensive experience in the field. Whether your condition is one that requires surgical treatment or not, your vascular surgeon should be able to help you find the option that is right for you.