Vascular Surgery
Vascular Surgeons
The Surgical Clinic has specialized surgeons who focus on treating all vascular and endovascular issues including pulmonary embolism, spider veins and varicose veins.
Our network of board certified vascular surgeons and vein specialists are able to help patients with everything from common vein problems to serious conditions such as carotid artery disease.
Vascular Treatments
Your body is fed by a network of arteries and veins. With the exception of the pulmonary artery, all of your arteries are large tubes that let blood travel away from your heart. This blood is 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 that 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 diseased area. In areas outside the intracranial and coronary arteries, specialized vein surgeons will surgically treat arterial, venous and lymphatic system conditions. 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 in our Nashville or Middle Tennessee vein centers, a trained vascular 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 and make your treatment more effective as a result.
Vascular Surgeons
Roger A. Bonau, MD, FACS
Julia (Julie) Boll, MD, RPVI
Jeffery B. Dattilo, MD
Bryan T. Fisher, MD
JimBob Faulk, MD, FACS, RPVI
Dr. Brian Kendrick, MD
John E. Keyser, III, MD, FACS
Billy J. Kim, MD, FACS
Allen P. Lee, MD, FACS, RPVI
M. Caroline Nally, MD
James Richardson Jr., MD, FACS
Adam A. Richter, MD, RPVI
Dr. Todd Wilkens, MD
Dr. Patrick Yu, MD
Specialties
Carotid Artery Surgery
Imaging / Ultrasound
Spider & Varicose Veins
Peripheral Artery Disease
Thoracic Outlet Syndrome
Vascular Surgery
Wound Care
Testing & Diagnostics
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.
Raynaud’s Testing
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.
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 be able to return to your regular 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.
Procedure Centers
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).
Aortic Aneurysms
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.