Dr. Steve Elias, Director, Columbia University Division of Vascular Surgery Vein Programs
|Dr. Steve Elias, Director, Columbia University Division of Vascular Surgery, Vein Programs, discusses the formation of the Columbia Vein Programs, the different types of treatments used, such as Closure, ClariVein and ELVT, how minimally invasive techniques have changed the vein procedures, as well as what patients should expect after treatment.|
If an adrenal tumor is over-secreting the adrenal hormone aldosterone, surgical removal of the tumor may cure a patient's aldosterone-induced hypertension. A procedure known as selective venous sampling confirms the need to remove such an adrenal tumor.
Pain in the legs or feet while walking should not be considered a normal part of aging. It could be a sign of peripheral vascular disease, or PVD the buildup of fatty deposits (plaque) in the arteries beyond the heart. This buildup can block blood supply throughout the body, but most dangerously to the brain, kidneys, and legs. Patients with even a moderate amount of arterial blockage may not have noticeable symptoms. Others may have symptoms, but not realize that their difficulty with walking is a result of PVD. Without the awareness of PVD, this problem may go undiagnosed, with patients suffering unnecessarily.
Endovascular procedures are widely performed to repair abdominal aortic aneurysms, weakened areas in the aorta that can enlarge and rupture. In such procedures, a small covered metal scaffold, or stent graft, is delivered via a catheter passed through a small incision in the groin, into the patient's arteries and into the abdominal aorta. This type of repair has been an option for patients whose aneurysms are located far enough from the kidney arteries that the stent can be securely attached to the aorta. For patients without sufficient space below the kidney arteries for stent graft implantation, the only options have been major abdominal surgery or no repair. The fenestrated aortic stent graft is making it possible for more patients with aortic abdominal aneurysms to undergo minimally invasive endovascular stent graft repair instead of major open surgery.
The Division of Vascular Surgery and Endovascular Interventions is participating in the first trial of a drug eluting stent to treat peripheral arterial disease (PAD), or blocked arteries in the legs. Once implanted, the stent releases a medication within the artery to prevent restenosis, or re-blockage, of the vessel.
Surgical techniques for treating major vascular diseases are rapidly evolving, becoming safer, and becoming available to more patients. What makes such advances possible is rigorous research to define which situations demand open or minimally invasive techniques; to examine public health issues such as cost, length of stay, and screening; and to monitor surgical techniques for complication rate, safety, and efficacy. As a leading institution in the quest to refine and advance open and minimally invasive procedures for major vascular disorders, NewYork-Presbyterian Hospital is currently conducting 16 clinical trials.