Tessa Quinn
Buffalo Endovascular & Vascular Surgical Associates (BEVSA) in Buffalo, NY, offers thrombectomy treatment to patients at Buffalo General Hospital and their outpatient facility, AccessCare Vascular. Thrombectomy is a minimally invasive procedure that removes blood clots from veins or arteries. Patients are discharged from the hospital on the same day as the procedure and are usually prescribed blood thinners to prevent further clots from forming.
| Characteristics | Values |
|---|---|
| Hospitals/Centers offering thrombectomy in Buffalo | Buffalo Endovascular & Vascular Surgical Associates, Buffalo General Hospital, AccessCare Vascular |
| Procedure | A device is used to break the clot and collect it in a wire-structured bag to physically pull and remove the clot from the vein |
| Pre-procedure | Patients arrive 1-2 hours before the procedure and are administered medication and fluids. A sedative is also given to relax them and numbing medication is applied behind the knee to prevent any pain with the incision. |
| Post-procedure | Patients are monitored for 2-4 hours and then discharged on the same day. They are usually prescribed blood thinners to prevent any further DVT formation. |
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What You'll Learn
Minimally invasive treatment at Buffalo General Hospital
Buffalo General Hospital is a large teaching affiliate of the University at Buffalo School of Medicine and Biomedical Sciences. The hospital offers a wide range of clinical inpatient and outpatient services, including minimally invasive surgery. The Center for Minimally Invasive Surgery is located at the D3 Suite of Buffalo General Medical Center.
Minimally invasive surgery is an advanced surgical approach that uses tiny incisions, resulting in quicker recovery times and less pain for the patient. One example of a minimally invasive procedure offered at Buffalo General Hospital is thrombectomy, which is used to treat deep vein thrombosis (DVT). DVT is a blood clot that can occur in the veins of the legs, causing symptoms such as swelling, skin tightness, and heaviness.
During a thrombectomy, surgeons use a device to break up the clot and collect it in a wire-structured bag, physically removing it from the vein. This procedure can be performed at Buffalo General Hospital's outpatient facility, AccessCare Vascular, with patients often being discharged on the same day. Prior to the procedure, patients arrive at the hospital, where their vital signs are monitored, and they are given medication and fluids. A sedative is administered to relax the patient, and numbing medication is applied to the area where the incision will be made to prevent pain.
After the procedure, patients are transferred to a recovery area for monitoring by the nursing staff. They are typically discharged on blood thinners to prevent further DVT formation and will require someone to drive them home. In some cases, a stent may be placed in the vein to keep it open and improve blood flow, reducing the risk of additional blood clots. This stenting procedure is also considered minimally invasive, as it involves a small puncture made behind the knee to guide a catheter and stent into the vein.
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Outpatient facility at AccessCare Vascular
AccessCare Vascular is an outpatient vascular care facility in Buffalo, New York, that has been providing high-quality, minimally invasive vascular procedures since 2011. The facility was founded on the principles of patient-centred care, teamwork, and compassion, with a focus on making outpatient procedures safe and painless.
The facility is equipped to help patients alleviate leg pain and swelling, treat varicose veins, and fix dialysis accesses, among other services. The team at AccessCare Vascular comprises talented nurses and vascular specialists with over a decade of experience. The facility is conveniently located in Amherst, with easy access from anywhere in Buffalo and free parking.
The centre offers spacious, warm, and clean waiting areas for patients and their families, with multiple TVs, educational materials, and patient success stories. The facility also boasts state-of-the-art imaging machines and surgical equipment, ensuring optimal care and diagnoses for its patients. Procedures at AccessCare Vascular range from 15 minutes to 2 hours, depending on the treatment. Throughout the procedure, patients are closely monitored by the surgeon and support staff to ensure their comfort.
The thrombectomy procedure at AccessCare Vascular is a minimally invasive treatment for patients with deep vein thrombosis (DVT). It involves making a small incision behind the patient's knee and guiding a catheter (a long, thin tube) through the puncture to reach the clot. The clot is then broken up and collected in a wire-structured bag, which is used to physically pull and remove it from the vein. After the clot is removed, a stent may be placed in the vein to keep it open and improve blood flow. Patients undergoing a thrombectomy are usually discharged on the same day and will require someone to drive them home. They are typically prescribed blood thinners to prevent further DVT formation.
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Venous stenting for DVT patients
Deep vein thrombosis (DVT) is a condition where a blood clot forms in the limbs, usually the legs. This can cause serious health complications, including pulmonary embolism, where the clot breaks off and travels to the lungs. DVT is usually treated initially with anticoagulation, which reduces the risk of clotting. However, in some cases, more advanced procedures may be required, such as thrombectomy, which involves removing the clot to restore blood flow.
In the context of DVT treatment, venous stenting is a procedure that can provide support to the walls of veins after a blood clot has been removed. Stents are tiny metal mesh tubes that help keep narrowed or blocked blood vessels open, improving blood flow. They can be particularly useful in cases where the vein remains narrow, even after the clot is dissolved or removed. This narrowing, called stenosis, may have contributed to the development of DVT in the first place. Stents can also provide support in veins with scar tissue caused by long-term blockages.
The choice of access vessel for stent placement depends on the extent, location, and etiology of the venous disease. In acute DVT cases, stenting is often performed alongside thrombolysis or mechanical thrombectomy. The popliteal vein and posterior tibial vein are common access sites for acute interventions. Mid-femoral access is advantageous in avoiding prone positioning and jugular access if the femoral vein is diseased. In chronic DVT, the positioning of the venous sheath and stent is determined by the extent of the disease.
Venous stenting can be an effective treatment option for patients with post-thrombotic syndrome (PTS), which develops in around 20-50% of DVT cases despite anticoagulation. PTS causes symptoms such as chronic limb swelling, pain, venous ulcers, and leg pain, significantly impacting quality of life. Venous stenting helps alleviate obstruction symptoms, reducing the severity of PTS and aiding ulcer healing. Endovenous stenting is a safe and promising treatment option for PTS, with low morbidity and mortality risks.
Imaging techniques such as duplex ultrasonography, venography, intravascular ultrasound (IVUS), MRI venography, and multiplanar venography are used to diagnose DVT and guide stent placement. Venography, or venogram, involves inserting a catheter through the surface of the leg into the vein and injecting dye to capture X-ray images. Duplex ultrasound, the most common imaging technique, uses high-frequency sound waves to visualize blood vessels.
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Thrombolysis before thrombectomy
Thrombolysis is a procedure that uses thrombolytics, or clot-busting drugs, to dissolve acute (sudden) blood clots. Thrombectomy, on the other hand, is a surgical procedure that involves physically removing a blood clot from a blood vessel. In some cases, thrombolysis may be performed before thrombectomy to soften the clot, making it easier to remove during the thrombectomy procedure.
The decision to perform thrombolysis before thrombectomy depends on multiple factors, including the extent, location, and age of the clot. For example, patients with deep vein thrombosis (DVT) may require thrombolysis to dissolve the clot before undergoing a thrombectomy to remove any remaining clot fragments and improve blood flow. In the case of acute ischemic stroke, thrombolysis may be administered as an intravenous thrombolytic agent (such as alteplase) to improve the outcome of the thrombectomy procedure.
Several studies have investigated the use of thrombolysis before thrombectomy in patients with acute ischemic stroke. Some studies suggest that thrombolysis before thrombectomy can lead to significantly higher hospital costs without improving outcomes. However, other studies, such as the DIRECT-MT trial, have shown that endovascular thrombectomy preceded by intravenous thrombolysis can be safe and effective for treating acute ischemic stroke within 24 hours of symptom onset.
The use of thrombolysis before thrombectomy is still a subject of ongoing research, with trials aiming to expand the selection criteria for thrombectomy and identify additional populations who may benefit from this combined treatment approach. Ultimately, the decision to perform thrombolysis before thrombectomy is made by healthcare providers based on the specific circumstances of each patient.
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Post-thrombectomy medication
Thrombectomy is a surgical procedure to remove a blood clot from an artery or vein. The procedure can restore blood flow to vital organs, like the legs, arms, intestines, kidneys, brain, or other vital organs. A thrombectomy can be performed as an emergency procedure to prevent severe tissue injury or permanent organ damage.
Buffalo Endovascular & Vascular Surgical Associates in Buffalo, NY, offers thrombectomy treatment. The procedure can be performed at their outpatient facility, AccessCare Vascular, with discharge on the same day.
After a thrombectomy, patients may need to take medication for a short time to prevent blood clots from forming again. This medication could include blood thinners, which are given as a pill, shot, or through an IV. These can prevent a blood clot from getting larger and help prevent new clots from forming during surgery. Patients may also be given thrombolytics, or thrombolytic therapy, which are drugs that actively dissolve acute (sudden) clots.
In some cases, a stent may be placed in the vein to keep it open and improve blood flow, reducing the chances of a new clot forming. Patients may also be advised to wear compression stockings to help prevent the clot from forming again.
Following the procedure, patients will spend several hours in a post-anesthesia care unit (PACU) where their vital signs will be monitored. Depending on their condition, patients may need to stay in the hospital for a day or two. During this time, the medical team will advise on any changes to medication.
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Frequently asked questions
Yes, Buffalo Endovascular & Vascular Surgical Associates offers thrombectomy at their outpatient facility, AccessCare Vascular, as well as Buffalo General Hospital.
A thrombectomy is a procedure to remove a blood clot from inside a vein or artery.
The patient is given a sedative and numbing medication is applied to the area. The surgeon then makes a small incision and threads a catheter (thin plastic tube) through the blood vessel to the clot to remove it.
Patients are discharged from the hospital on the same day as the procedure and will require someone to drive them home.
