Definition and Overview
A vascular surgery follow-up refers to several appointments with the vascular surgeon following certain surgical procedures performed on the arteries and blood vessels. The goal is to ensure the success of the procedure and that no complications have occurred.
Vascular surgery is an operation carried out on the blood vessels, namely the arteries and veins, and to a certain extent, the lymphatic channels.
Both the blood and the blood vessels are part of the body’s circulatory system, called as such by the way the blood moves around the body. The bloodstream carries not only nutrients but also oxygen, which are needed by various cells in the body. To deliver them, the body has an intricate network of blood vessels including the arteries and veins. The arteries are stretchable and are responsible for delivering oxygenated blood from the heart to capillaries, which are connected to the different tissues and organs. The bloodstream also picks up the deoxygenated blood and carbon dioxide, which is then exhaled by the lungs. The blood then travels back to the heart where it’s oxygenated once again. The cyclic process then continues.
The lymphatic system, on the other hand, is separate but is interrelated with the circulatory system since the lymph channels also contain a network of vessels. They are necessary for removing any toxins that can be generated during the metabolic processes of cells and by-products of infection. At least 90% of the fluids that penetrate the tissues (called the interstitial fluids) go back to the bloodstream through the veins.
Because of the significant role that the circulatory system plays in the sustenance of life, any problem that affects it requires immediate and expert attention. This can be provided by different health providers such as a vascular surgeon. Follow-up care is also an essential step to ensure the success of the procedure carried out.
Who Should Undergo and Expected Results
A follow-up care is carried out on patients who have undergone any procedures that are performed on any of the blood vessels mentioned above, although they are more commonly done in the arteries and blood vessels. Some of the well-known methods include catheter-guided surgeries. These are minimally invasive procedures since only a small incision is needed to insert the catheter, which serves as a guide and helps deliver the right treatment. For example, for stenting, which is a conventional approach to treating arterial stenosis (the narrowing of the arteries because of a blockage such as buildup of plaque deposits), the catheter is inserted to introduce a balloon, which is then pumped to expand the pathway before the stent is placed to keep the artery from collapsing.
The follow-up is also usually extended to family members and other carers like a private nurse who can help the patient cope with the possible effects of the surgery. While some procedures these days have only minimal downtime, some are still invasive and risky, requiring a longer rest period.
Follow-up care is an integral part of the treatment process and is, in fact, discussed prior to the operation. This is because it requires the commitment of the patient and his family or carers. With it, the risks and complications that are associated with vascular surgery including but not limited to ruptured vessels, undetected threat like embolism, or bleeding can be prevented or mitigated as soon as possible. It also ensures that the healing process of the patient will be as comfortable and as easy as possible.
During the follow-up, the surgeon will also be able to determine whether the procedure performed is enough to correct the problem or if more of it needs to be accomplished at a later date. If the ideal procedure is already complex or beyond the scope of the vascular surgeon, the doctor may refer the patient to another specialist.
How Does the Procedure Work?
The follow-up care is already discussed with the vascular surgeon before the operation is performed. It’s a common practice among doctors to provide patients with complete information so they know what to expect even after the operation. It’s also a good time for the surgeon to introduce the team that would assist the patient in the treatment process, such as radiologist and anesthesiologist.
The follow-up consultations begin as soon as the patient is wheeled out from the operation and into the recovery room. The surgeon takes note of any complications that may arise within the next 24 hours and up to a few days after the operation. He also helps monitor the intake of medications, if there are any, and the vital signs of the patient.
The follow-up continues in an outpatient setting, in which case the patient proceeds to the surgeon’s office. Different types of tests may be conducted to ensure that post-care management is implemented properly by the health providers, carers, and the patient. The results, whether normal or suspicious, will be discussed during this time.
The follow-up care is also a time to evaluate the mental health of the patient as surgeries and possible changes in lifestyle and mobility can significantly impact mood, behavior, or attitude.
Usually, this consultation occurs for about eight weeks or more, depending on the assessment of the surgeon during every consultation.
Possible Risks and Complications
Some patients may take follow-up care for granted, especially if they begin to show positive recovery. Surgeons must be able to stress the importance of post-surgical follow-up and even request for assistance from family members and their carers to at least remind them of their appointments.
- Arnold M, Perler BA. Carotid artery. In: Cronenwett JL, Johnston KW, eds. Rutherford's Vascular Surgery. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 100.