Vascular Surgery Division

The Surgical Clinic has specialized surgeons who focus on treating all vascular and endovascular issues. Our network of board certified vascular surgeons and vein specialists are able to help patients with everything from common spider veins to carotid artery disease. Search for the best vascular surgeon near you or learn more about our vascular services below.

Your vascular surgery options

Your body is fed by a network of arteries and veins. With the exception of the Pulmonary Artery, all of your arteries are larger tubes that let blood travel away from your heart. This blood has just been filled with oxygen and nutrients, the fuel source for your entire body. As blood travels around your body, it deposits fuel and picks up your body’s trash, like carbon dioxide and it disperses into veins which are smaller than arteries and have the job of carrying blood back to your lungs to be refilled with oxygen, shipped to your heart and pumped back out again. A single droplet of blood will make this complete tour of your body every minute.

In order for the pump to work properly, the tubes have to be able to be elastic enough to withstand the pressure of the pump of blood, but they can’t become saggy or blood will accumulate in your extremities – not returning properly to your lungs. If veins or arteries have stretched or weak spots develop or they become clogged or lose their elasticity, surgery is needed to eliminate or circumvent the area that is diseased. In areas outside the intracranial and coronary arteries, specialized vein surgeons will surgically treat arterial, venous and lymphatic system concerns. Some vascular conditions will occur only in arteries, while others occur only in veins. There are some disease processes that will affect both arteries and veins.

When you come in for vascular treatment, a trained specialist will perform a vascular ultrasound to examine the condition of your veins. The ultrasound will also help your surgeon know the exact position of your veins, making your treatment more effective as a result.

TransCarotid Artery Revascularization (TCAR)

The Surgical Clinic is pioneering the use of a breakthrough technology called TransCarotid Artery Revascularization (TCAR) to treat patients with carotid artery disease who are at risk for open surgery. While any repair of the carotid artery carries some risk of causing a stroke because of the repair itself, TCAR was designed to help minimize that risk by keeping potential stroke causing fragments away from the brain.

Like the open surgery, carotid endarterectomy (CEA), this new procedure involves direct access to the carotid artery, but through a much smaller incision at the neckline just above the clavicle instead of a longer incision on the neck. During the TCAR procedure, a tube inserted into the carotid artery is connected to a system that temporarily directs blood flow away from the brain to protect against dangerous debris from reaching the brain during the procedure. Surgeons then filter the blood before returning it to a vein in the groin, and a stent is implanted directly into the carotid artery to stabilize the plaque and prevent future strokes. The entire procedure is performed in less than half the time of CEA – limiting the stress on the heart and significantly cutting the risk of the patient having a stroke or heart attack during the procedure.

TCAR to treat leading cause of stroke, carotid artery disease

Patients who undergo the TCAR procedure recover quickly (typically spending just one night in the hospital) and almost always go home the next day to return to full and productive lives with less pain, smaller scars and a reduced risk of future strokes.

Your physician may recommend the TCAR procedure if you’ve been diagnosed with carotid artery disease and are not a suitable candidate for CEA. This may depend on your age or other existing medical conditions. For more information about TCAR, call us to schedule a consultation with one of our best vascular surgeons.

For more information about the TCAR procedure and essential prescribing information, please visit For more information about carotid artery disease and the risks involved with any intervention (e.g. bleeding, death, myocardial infarction, restenosis, stroke, TIA, vessel dissection, vessel occlusion, etc.), please visit

Vascular Surgeons

Choose your surgeon below to learn more about their specilaties, reviews, locations, hours and contact information.


Aneurysms are asymptomatic conditions that can lead to severe and life-threatening problems. Thankfully, there is treatment available and our expert vascular surgeons know how to identify your risks and symptoms. To learn more about this condition and how it can be treated, watch the following video from Dr. Adam A. Richter, MD, RPVI.

Vascular Ultrasound

Vascular ultrasound and physiologic vascular procedures are booked for The Surgical Clinic patients in the Vascular Laboratory in Tennessee. This convenient and comfortable settings allow Registered Vascular Technologists (RVTs) to evaluate the blood supply to and from various parts of the body. This information is obtained without any invasive procedures. After an appointment, you will, therefore, be able to return to your regular schedule of activities. It is important to point out that your care will be delivered by a professional with an RVT certification. The RVT certification, not required in many labs, is the standard at The Surgical Clinics’ labs and helps to assure you that your tests are being conducted by people specialized in these diagnostic procedures.
The Surgical Clinic understands that many times patients will want to get things moving as fast as possible. Vascular Labs are part of The Surgical Clinic in the convenient locations of St. Thomas West, Downtown Clinic, Summit, Mid-South Surgeons (Columbia), Skyline and all three of the Vein Centres at Belle Meade, Mt Juliet and Cool Springs. These locations allow you to access advanced laboratory professionals without the congestion of a hospital setting. While appointments are required, it is often possible to make a ‘same-day’ appointment. Your test results will be sent to your Surgeon to help determine a recommended course of treatment.
The state-of-the-art laboratory is accredited by the Intersocietal Accreditation Commission 
and each of the RVT’s are registered through the American Registry of Diagnostic Medical Sonographers (ARDMS).

More Information

What to Expect 

What is Duplex Ultrasound?                                

Duplex Ultrasound: What to Expect

Understanding Thoracic Outlet Syndrome

Treatment for Thoracic Outlet Syndrome

Raynaud’s Testing                              



Physiologic (Non-Imaging) Testing

Physiologic arterial testing is the evaluation of the amount of blood flow to the arms or legs. If narrowing in an artery reduces the amount of blood flow to the arms or legs, we can detect this with physiologic testing. First we listen to the arterial flow and record waveforms of the flow pattern. We take blood pressures at different levels on the arms or legs, and we may have you walk on a treadmill for approximately five minutes to see if blood flow to the legs is reduced further with walking. All of this data helps your physician determine the overall significance of any narrowing and how much blood flow is getting to the legs or arms.

Ankle/Brachial Index

This is a simple physiologic test that involves taking a blood pressure from your arms and your ankles. We obtain a ratio of the ankle pressure to the arm pressure that tells us if the blood flow to your ankles is normal or abnormal. This test is the first step in evaluating the blood flow to your legs and is used to determine which further testing is performed. Arterial Doppler with Segmental Pressures Upper and Lower Extremities: This test involves taking blood pressures from different levels of your legs or arms. We also record waveforms of the blood flow to determine the quality of the blood flow. The blood pressures and waveforms help determine where any arterial narrowing is located.

Arterial Doppler with Treadmill

This test may assess your blood pressures in your arms and ankles after you have walked for 5 minutes on a Treadmill. This measures how exercise affects the blood flow to your legs. It is usually conducted after the Ankle/Brachial Index and Segmental Pressure testing is completed.

Vascular Health Screening

The key to excellent vascular care is proper diagnosis and treatment options. The Surgical Clinic’s ICAVL accredited vascular laboratory offers vascular screening services to assure that you receive proper diagnosis and treatment of your vascular condition. The state-of-the-art vascular ultrasound screening services are painless, fast and accurate. A vascular screening will help identify unnoticed vascular conditions; however, these screening do not take the place of a physical exam.



Referring physicians

Referring to The Surgical Clinic (TSC) ensures your patient receives exceptional surgical care, compassionate concern, and access to the most technologically advanced surgical practice in Middle Tennessee.

Why Choose Us


Experienced Doctors

The Surgical Clinic has over 40 board certified surgeons with clinical & business staff who are dedicated to serving our referring physicians & their patients.



Founded in 1997, The Surgical Clinic (TSC) represented a wide range of surgical speciliaties that has continued to expand throughout Middle Tennessee. TSC is committed to treating every patient with dignity and exceptional care.

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