Minimally Invasive Endovascular Procedures: What You Need to Know
Dr. Feliciano Serrano
Interventional Nephrologist
Endovascular procedures represent a revolutionary approach to treating vascular conditions. Instead of large incisions and lengthy recovery times, these minimally invasive techniques use small punctures to access blood vessels, delivering treatment from the inside. As the first ACGME-certified interventional nephrologist in the United States, I specialize in these cutting-edge procedures.
What Are Endovascular Procedures?
Endovascular means "inside the blood vessel." These procedures use catheters—thin, flexible tubes—inserted through a small puncture in the skin to navigate through blood vessels and treat problems from within. Guided by real-time imaging, physicians can repair or open vessels without major surgery.
Lower Risk
Fewer complications than open surgery. Lower infection risk, less blood loss, minimal scarring.
Local Anesthesia
Often performed with local anesthesia and sedation, avoiding risks of general anesthesia.
High Success Rate
Proven effectiveness with excellent outcomes for most vascular conditions.
Common Endovascular Procedures
Angioplasty and Stenting
The most common endovascular procedures. A balloon catheter is inserted into a narrowed artery and inflated to widen the vessel. A stent—a small mesh tube—may be placed to keep the artery open.
- Used for: Peripheral artery disease, dialysis access stenosis, renal artery stenosis
- Duration: 1-2 hours typically
- Recovery: Often same-day discharge
Thrombectomy and Thrombolysis
Procedures to remove blood clots from vessels. Thrombectomy physically removes the clot, while thrombolysis uses clot-dissolving medications delivered directly to the clot.
- Used for: Clotted dialysis access, acute limb ischemia, deep vein thrombosis
- Urgency: Often performed urgently to restore blood flow
Atherectomy
Removes plaque from inside arteries using specialized catheters with cutting or grinding devices. Particularly useful for calcified or hard plaque that's difficult to treat with balloon angioplasty alone.
- Used for: Heavily calcified PAD, in-stent restenosis
- Advantage: Can treat lesions unsuitable for standard angioplasty
Vascular Embolization
Deliberately blocks blood vessels to stop bleeding, treat aneurysms, or cut off blood supply to tumors or abnormal vessels. Uses coils, particles, or liquid agents.
- Used for: Internal bleeding, aneurysms, vascular malformations
What to Expect During an Endovascular Procedure
Pre-Procedure
Blood tests, imaging studies, medication review. You'll receive instructions about eating, drinking, and medications before the procedure.
During Procedure
Local anesthesia numbs the access site (usually groin or arm). You'll be awake but comfortable with sedation. The procedure is painless, though you may feel pressure.
Recovery
You'll lie flat for several hours while the puncture site heals. Most patients go home the same day with instructions to avoid strenuous activity for 24-48 hours.
Follow-Up
Regular imaging and check-ups ensure the treatment remains effective. Some patients need repeat procedures over time.
Potential Complications
While endovascular procedures are generally safe, possible risks include:
- • Bleeding or bruising at access site
- • Blood vessel damage
- • Allergic reaction to contrast dye
- • Kidney problems from contrast (rare)
- • Re-narrowing of treated vessel over time
Who Needs Endovascular Procedures?
- Patients with peripheral artery disease causing pain or wounds
- Dialysis patients with access stenosis or clotting
- People with kidney artery blockages causing hypertension
- Those who are poor candidates for open surgery
Expert Endovascular Care
As the first ACGME-certified interventional nephrologist in the U.S., Dr. Serrano brings specialized expertise in endovascular procedures throughout Southern California.
About Dr. Feliciano Serrano
Dr. Serrano is the first ACGME-certified interventional nephrologist in the United States, specializing in minimally invasive endovascular procedures for vascular and kidney conditions.
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