The American Medical Association defines the vascular surgery as a specialized field of surgery that diagnoses, treats, and performs research on diseases, trauma, congenital malformations, and tumors of the arteries, veins, and lymphatic ducts in the body, excluding intracranial vessels and vessels close to the heart. In practice of the vascular surgery, the aorta and splanchnic vessels running to the intra-abdominal organs, and arteries and veins of neck, upper and lower extremities are major targets for treatment.
Major areas of treatment / Clinics
The major areas of treatment of the Vascular Surgery can be divided into arterial diseases, venous diseases, and lymphatic diseases. Arterial diseases include diseases of the aorta, extremity arteries, and splanchnic arteries running into various intra-abdominal organs. Common venous diseases include deep vein thrombosis of the upper and lower extremities and varicose veins. Lymphatic diseases include lymphedema. In addition to regular outpatient clinic, we run unique clinic for patients with CVM or diabetic foot. In the special clinic, we try to do multidisciplinary approach for a patient with very specific and challenging vascular disease.
For the diagnosis and treatment of vascular diseases, we make sure to collaborate with other specialties and experts to maximize treatment efficiency and minimize complication rates.
1. Aortic disease
Broadly, there are two types of the aortic diseases. One is an aortic occlusive disease and the other is abdominal aorta aneurysm (AAA). Currently, the former is usually treated with endovascular means, while the latter is subject to endovascular aneurysm repair (EVAR) and surgical treatment. We have enough experiences to treat challenging cases of aortic disease with complex anatomy or coexisting morbidities. Surgical mortality rate after elective abdominal aortic aneurysm by our hands is at around 0.3%, which is one of the best results in the world.
2. Peripheral arterial diseases (PAD)
We have performed a variety of lower extremity bypass surgery and artery reconstruction as well as endovascular intervention. We have many patients with lower extremity arterial obstructive disease referred from other hospitals in Korea. Our treatment strategy for patients with atherosclerotic PAD is a customized therapy considering various coexisting morbidities or risk factors, various arterial anatomy and expected life style of an individual patient. Thanks to our surgical, endovascular and therapeutic angiogenesis with stem-cell, many patients with critical limb ischemia are successfully salvaged their limb avoiding major limb amputation.
3. Carotid artery disease
Carotid artery disease is defined as atherosclerosis of the carotid artery which is a major arterCarotid artery is neck artery that provides blood flow to the brain and carotid artery stenosis has known as a major cause of ischemic stroke. Recently in Korea, stroke is becoming more frequent, raising the awareness of the carotid artery disease. Treatment methods for carotid artery stenosis include carotid endarterectomy (CEA) and carotid artery stenting (CAS). In Vascular Surgery, we perform at least 100 or more cases of carotid endarterectomy or carotid artery stenting annually, and show excellent cumulative results with incidence of postoperative stroke rate as low as 1%.
4. Venous diseases
Lower extremity varicose veins and deep vein thrombosis (DVT) are the most common venous diseases, and in the practice of Vascular Surgery. We put much effort into the early diagnosis and treatment of acute DVT, which is common in inpatients particularly in surgery patients. We perform DVT treatment using catheter directed thrombolysis, venous stent insertion, and anticoagulation therapy with heparin, warfarin or new oral anticoagulants (NOAC). During the conventional anticoagulation therapy with warfarin, our hospital runs anticoagulation service (ACS) at the outpatient clinic to administer the precise amount of anticoagulants to maximize its effect and minimize adverse effects of the anticoagulating agent. Most varicose veins are treated by laser or radiofrequency thermal ablation.
5. Congenital Vascular Malformation(CVM) Clinic
The CVM clinic in the Samsung Medical Center has accumulated more than 20 years of experience since it opened in 1994, and has established an excellent organic collaborative system between the Vascular Surgery, Interventional Radiology, Plastic surgery, Orthopedic surgery, Anesthesiology, and Rehabilitation Medicine as an extraordinary specialized center in the world. It has approximately 3,000 or more registered patients with CVM, now. We have presented our experience and results in treating vascular malformations in well-known international medical journals in order to achieve a high academic performance. Currently, many foreign patients visit at our CVM clinic to get treated.
6. Stem Cell Clinic
Stem cells are the origins of all cells in the body and can infinitely self-regenerate and differentiate into any necessary cell. We inject adult stem cells into the ischemic limb in patients with Buerger’s disease (a kind of vasculitis usually affecting young smokers) to improve ischemic symptoms. This field is ever developing and is one of our future hope in treatment of ischemic limb.
7. Other rare vascular diseases
Other than the above-described vascular disease, we have sufficient experience in treatment of uncommon vascular diseases such as thoracic outlet syndrome, carotid body tumor, nutcracker syndrome, mesenteric artery ischemia, renal artery disease, Raynaud disease, Takayasu’s arteritis, and have achieved good treatment results.
Latest treatment methods
- Endovascular aortic aneurysm repair (EVAR) or other hybrid surgery (concomitant open surgical and endovascular procedures)
- Aortic reconstruction with cryopreserved human allograft to treat aortic infection.
- Lower extremity arterial reconstruction using arm vein graft
- Stem cell therapy for Buerger’s disease
- Catheter atherectomy of peripheral artery disease