Blood Vessel Conditions
Aortic Aneurysms and Dissections
Aortic Aneurysms are bulges – almost like a balloon – in the aorta, which is the largest blood vessel in the body. Dissections occur when the layers of the aorta start to separate or tear and blood flows between these layers. Both aneurysms and dissections can cause the wall of the aorta to burst, which can be deadly.
Mount Sinai’s team of interventional radiologists leads the way in treating complex aneurysms and dissections that occur in the chest, or thorax, and the abdomen. Our team uses the following techniques:
- Endovascular Aortic Aneurysm Repair (EVAR) — A minimally invasive procedure where your Mount Sinai interventional radiologist inserts a thin wire, or catheter, into the groin and places a piece of mesh, supported by a framework, into the aneurysm. The mesh and framework, which is called a stent, allows for blood to flow through the aorta and prevents the aneurysm from bursting.
- Thoracic Aortic Aneurysm Repair (TEVAR) — This type of repair is specifically for aneurysms that occur in the chest or thorax. Like EVAR, the TEVAR procedure is minimally invasive.
- Fenestrated Endovascular Aneurysm Repair (FEVAR) — When aneurysms occur lower in the abdomen where the vessel branches off to the kidneys, we use FEVAR, a relatively new procedure. With FEVAR, the stent we use has holes that fit into the branches of the aorta.
Physicians often refer their patients with aortic aneurysms for treatment at Mount Sinai because we offer the newest therapies. In addition, our patients have the opportunity to participate in clinical trials, which investigate the most cutting-edge treatments.
Peripheral Arterial Disease (PAD) and Limb Salvage
Peripheral Arterial Disease, or PAD, occurs when the arteries in your arms or legs become blocked by a buildup of plaque. If the buildup blocks too much blood flow, patients have something called ischemia, which can lead to gangrene, a type of tissue death. Gangrene can require amputation.
The Mount Sinai vascular and interventional radiology team are considered thought leaders in the field of minimally invasive treatment for PAD, critical ischemia in the arms and legs, and gangrene caused by ischemia. We use minimally invasive procedures to open the blocked arteries, so patients can walk comfortably again. We treat blocked arteries from the head to the toes with the latest technology and techniques, including:
- Angioplasty — We insert a balloon to open the blocked artery.
- Stenting — We insert a rigid tube called a stent to open the artery and keep it open.
- Atherectomy — We shave away the plaque from inside the artery wall with tiny rotating blades or a laser.
- Drug-Coated Balloon Angioplasty and Stenting — We use balloons and stents that release medications to prevent blood clots and plaque from forming.
- Lithoplasty — We use this sound wave technology to break apart plaque in the arteries in the same way we break apart kidney stones.
Blood Clots and Leg Swelling
Mount Sinai’s vascular and interventional radiologists are leaders in the field of removing blood clots from patients’ arteries, lungs, and veins, also known as deep vein thrombosis, or DVT. In fact, our team has pioneered new procedures that use thin wires called catheters inside the blood vessels to remove blood clots. These catheter-based procedures are less invasive than surgery. We also use these procedures to treat leg swelling caused by chronic blood clots, narrowed veins, or blocked veins, as well as lymphedema.
- Thrombectomy — Using imaging to guide the physician, we insert a catheter through the vein into the blood clot. Then, using a devices that utilize suction or a coring element, the physician catches the clot and pulls it back through the vein to remove it.
- Venous Ballooning and Stenting — Again, using imaging to guide a catheter through the patient’s vein, we place a tiny balloon or rigid tube called a stent inside the vein. These open the vein to allow blood to flow freely. We can also use a catheter to apply clot-dissolving medicine.
Inferior Vena Cava Filter Management
The inferior vena cava is an important vein that returns blood from the legs to the heart and lungs to replenish the blood with oxygen. Some people have higher risks of forming blood clots in their legs, and these clots can break off and travel through the vena cava to the heart or lung, which can be deadly. Most people can take medication to prevent these clots from forming, but some people need a different approach.
At Mount Sinai, we offer a solution where we insert a filter in their vena cava to catch any blood clots before they reach the heart or lungs. Our interventional radiologists have lectured at conferences around the world about our highly effective inferior vena cava filter management, and physicians from throughout the region refer patients to Mount Sinai for this specialized treatment.
Varicose Veins
Many people think varicose vein treatment is only for cosmetic purposes. However, varicose veins can be painful and cause difficulty walking or standing for long periods. As a result, many treatments at Mount Sinai for varicose veins are covered by insurance, including Medicare.
We offer state-of-the-art treatment for patients with varicose veins in the legs, as well as in other parts of the body. Our treatments include:
- Venous Sclerotherapy — We inject a solution into patients’ varicose veins, and the solution causes the veins to scar and ultimately fade away completely. This works for about 50% to 80% of patients.
- Venous Laser Ablation — We use a laser to seal off the vein, diverting blood flow to other vessels. The sealed-off vein eventually shrinks.
- Venous Stenting — Varicose veins can sometimes be caused by insufficient blood drainage from the legs. In these cases, we may insert a stent, which is a rigid tube, into the vein that is not carrying enough blood.
- Venous Recanalization and Reconstruction — Like venous stenting, recanalization and reconstruction seek to open veins that are blocked and not letting enough blood flow.
- Gonadal Vein Embolization — We use this procedure specifically for patients with pelvic congestion syndrome, which is a type of varicose vein in the pelvis that causes pain. To treat it, we use image-guided catheters to deliver heat that seals off faulty veins that cause the swelling.
Vascular Malformations
Vascular malformations are a rare, usually congenital condition where your arteries, capillaries, and veins may not form properly. These types of malformations can be hard to diagnose, and usually require imaging called an angiogram to see how the vessel is malformed. Once we diagnose the malformation, we use a procedure called percutaneous embolization to eliminate the malformed vessel. More specifically, we use imaging to guide a catheter to the malformed vessel, and then we destroy it with heat, chemicals, or extreme cold.
Abdominal Vascular Conditions
At Mount Sinai, our vascular and interventional radiology experts diagnose and treat diseased blood vessels affecting nearly every organ in the body, from blockages in the arteries supplying blood to the kidneys, to aneurysms in the artery that sends blood to the spleen.
- Renal Artery Stenosis Balloon Angioplasty and Stenting — Just like arteries in the heart that get blocked by plaque, arteries that supply blood to the kidneys can narrow and negatively affect the amount of blood reaching the kidneys. Using imaging, our Mount Sinai interventional radiologists and vascular specialists insert a catheter with a tiny balloon on the tip through the groin up to the renal artery. Then, they inflate the balloon within the narrowing artery to push the plaque out of the way and make room for more blood flow. In some cases, they also implant a rigid tube, or stent, to keep the artery open.
- Intestinal Artery Blockage Repair — When the arteries that supply blood to the intestine become blocked by blood clots or plaque, patients may require immediate intervention to prevent damage to the intestines. Our team of interventional radiologists and vascular specialists uses image-guided repair methods to address these blocked arteries, sometimes with balloon angioplasty and stents.
- Visceral Aneurysm Embolization — Aneurysms, which are bulges in the wall of a blood vessel, can occur in almost any part of the body, including the visceral arteries that supply blood to the spleen, kidney, liver, and intestines. If a visceral aneurysm bursts, it can lead to life-threatening bleeding. To prevent a visceral aneurysm from rupturing, our Mount Sinai interventional radiologists and vascular specialists insert a thin tube, or a catheter, guided by advanced imaging. Then, through the catheter, they inject a chemical or deliver a device to block blood flow to the bulging artery.
Stroke
Neurointerventional radiology is a subspecialty within the field of interventional radiology, where minimally invasive techniques are used to treat strokes and other abnormalities of the brain. Mount Sinai has been designated as a Comprehensive Stroke Center, and is prepared to perform interventions that can treat clots and other critical abnormalities of the brain.