Division of Vascular Surgery

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Specialists in Vascular surgery at SCTIMST offer state-of-the-art diagnosis and comprehensive treatment of diseases of Aorta and the arteries. At SCTIMST's superb facilities, vascular surgeons perform procedures that produce excellent outcomes and rapid recovery for life threatening vascular afflictions.

SCTIMST Vascular Surgery Clinic's unique and efficient system allows vascular surgeons to work closely with other specialists in Cardiovascular Diseases and Vascular Medicine, Neurology, and Diagnostic and Interventional Radiology to care for patients with common vascular diseases, complex illnesses and complicated vascular problems.

Nationally recognized for their expertise in traditional open surgery for diseases of the Aorta, SCTIMST's Vascular surgeons are eminently qualified to provide the most appropriate treatment to each patient.

Evolution of Vascular Surgery at SCTIMST

The hospital records indicate that the foundation stone for vascular surgery was laid down on 20th May 1977, when Prof. Valiathan repaired a symptomatic iliac artery aneurysm in a 37- year old male patient using a prosthetic graft. Those were the days of conventional angiograms. Only woven or knitted prosthesis, braided sutures for anastomosis, and whole blood and plasma were available. No injectable vasodilators, no duplex scan sonography, no low molecular weight heparin, no supporting or adjunct angioplasty or thromholysis, to name a few. Standard operative procedures included repair of aortic aneurysms mainly ascending, arch and decending thoracic aorta, not to mention the commonest form of infrarenal abdominal aortic aneurysm. Aortoiliac occlusive disease, being a common clinical condition , was regularly in the operation list of aorto- femoral bypass graft procedure with great success, and hardly any major or minor complications ensued.

The 1980's saw vascular radiology progressing pari pasu with world trends. Sree Chitra achieved an incredible success rate with the new modality of percutaneous transluminal angioplasty of aortic, peripherial visceral and renal artery obstructive lesions . With Dr. Neelakandhan joining the vascular team, complex aortic aneurysm surgery was standardized and number of vascular procedures climbed to unprecedented levels taking the lead in performing vascular surgery in India. Also during the late 1980's research work commenced towards developing a prosthetic vascular graft - first of its kind in our country - at the Biomedical Technology Wing of Sree Chitra , as an offshoot of artificial cardiac valve prosthesis.

The next decade witnessed two cornerstone events namely commencing of imaging complex including state - of - the - art duplex scanner on one hand and intense efforts at vascular graft development on the other. Like elsewhere in the world, diagnosis of arterial and venous diseases garft surveillance and following up of patients became much more objective and accurate. Computed tomographic (CT) reconstruction of aorta and major arteries especially in aneurysmal disease could be performed replacing angiograms on several occasions. However, in our experience, magnetic resonance angiogram (MRA) has not risen to clinical help as yet.

Services

Our team provides comprehensive state-of-the-art diagnostic and therapeutic interventions for the entire spectrum of circulatory disorders, including:

Aortic aneurysms, aortic ulcers and dissections

Repair of Aortic Arch Aneurysms and Dissecting Aortic Aneurysms - Type III
Conventional open surgery of Thoracic and Thoracoabdominal aortic aneurysms
Abdominal aortic aneurysm repair
Endovascular abdominal and thoracic aneurysm repair with stent grafts and state of art Hybrid procedures.
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Coarctation of Aorta

Surgical repair in adults & children
Aorta

Acute blood clots

Embolectomy, thrombectomy

Carotid, vertebral and aortic arch vessel disease

Carotid endarterectomy
Carotid
Operations for carotid body tumors
Surgical repair of Subclavian and Innominate artery pathology

Mesenteric vascular disease

Mesenteric and celiac artery bypass
Mesenteric aneurysms
Mesenteric

Peripheral vascular disease (PVD) and critical limb ischemia

Endarterectomy and bypass procedures like
o Aorto-Femoral Bypass
o Femoro-Popliteal Bypass
o Femoro-Distal Bypass

 

Renovascular disease

Renal artery endarterectomy and bypass
Ex-vivo renal artery reconstructions for renal aneurysms and fibromuscular dysplasia (FMD)

Thoracic outlet syndrome

Thoracic outlet decompressionwith or without Subclavian artery aneurysm

Treatment of vascular infections and complications

Surgery for vascular graft infections
Surgery for aortoenteric and aortocaval fistulas

Venous diseases

Vena cava reconstructions
Deep Vein Thrombosis and sequelae

Vascular access surgery for renal failure patients

Arteriovenous fistulas for Hemodialysis access
Areas of Expertise
Aortic Arch Aneurysms
Thoracic and ThoracoAbdominal Aortic Aneurysms
Abdominal Aortic Aneurysms
Carotid Endarterectomy
Carotid Body tumors
Reconstruction of occluded Peripheral limb arteries
Coarctation of Aorta
Endovascular aneurysm repair
Lung resection
Resection of mediastinal mass
Thoracic Surgery

The Vascular Division also performs standard and indexed Thoracic procedures with very high success rate. These procedures include lobectomy, Pneumonectomy, Mediastinal mass reaction apart from Regular Thoracic work and complex tracheal carinal resection.

The Division of Vascular and Thoracic Surgery has inter Departmental programmes performing carotid endarterectomy and maximal Thymectomy for carotid bifurcation stenosis and Myesthenia gravis With department of Neurology for over a decade.

Publications
  1. Cardiac herniation following completion pneumonectomy for bronchiectasis. Gadhinglajkar S, Siddappa S, Sreedhar R, Unnikrishnan M Ann Card Anaesth. 2010 Sep-Dec;13(3):249-52.
  2. Is collapse of the lung with increased lucency on a chest X-ray always a pneumothorax? Misra S, Koshy T, Unnikrishnan M, Siddappa S. J Cardiothorac Vasc Anesth. 2009 Dec;23(6):911-3
  3. Airway implications of post-ductal coarctation of the aorta and an aberrant right subclavian artery. Misra S, Dash PK, Koshy T, Manikandan S, Unnikrishnan M, Kapilamoorthy TR. Can J Anaesth. 2008 Sep;55(9):651-2.
  4. Pericardial cyst. Koshy T, Sinha PK, Misra S, Unnikrishnan M Ann Card Anaesth. 2008 Jul-Dec;11(2):129-30
  5. Experiences with carotid endarterectomy at Sree Chitra Tirunal Institute. Unnikrishnan M, Siddappa S, Anto R, Babu V, Paul B, Kapilamoorthy TR, Sivasankaran S, Sandhyamani S, Sreedhar R, Radhakrishnan K. Ann Indian Acad Neurol. 2008 Jul;11(3):170-8.
  6. Horseshoe lung secondary to hypoplastic left lung for pneumonectomy. Sinha PK, Misra S, Unnikrishnan M, Bhuyan RR. J Cardiothorac Vasc Anesth. 2007 Apr;21(2):250-2
  7. Extracranial carotid aneurysms in young patients. Theodore S, Unnikrishnan M, Neelakandhan KS. Ann Thorac Surg. 2006 May;81(5):1943;
  8. Cardiac tamponade: An unusual complication following left upper lobectomy for post-tubercular aspergilloma: A case report Suraj P, Anand PI, Chandrabhanu P, Unnikrishnan M Indian Journal of Thoracic and Cardiovascular Surgery 2006 Volume 22, Number 2, 143-144
  9. Outcomes of surgical management of ruptured abdominalaortic aneurysm Ritwick RB, Adil S, Sanjay T, MS, Neelakandhan KS, Unnikrishnan M, Jayakumar K Ind Thorac Cardiovasc Surg, 2006; 22:132-136)
  10. Surgical interruption of patent ductus arteriosus in a child with severe aortic stenosis: anesthetic considerations. Neema PK, Tambe S, Unnikrishnan M, Varma PK, Rathod RC. J Cardiothorac Vasc Anesth. 2005 Dec;19(6):784-5
Research
Developed indigenous large diameter Chitra vascular graft prosthesis (8mm-30mm; Internal diameter) involving 15 years of concerted, multi-institutional scientific endeavour. Chitra vascular graft prosthesis showing long term patency in controlled and multi centric trials.
Vascular Graft

Current Research Activities in progres

Implantation of 3-4 mm (Small diameter) graft endothelial precursor cell seeded grafts in sheep - Phase II
Hydrogel coated Large diameter, polyester Vascular graft in Pigs
Contact

For appointments or more information, call the SCTIMST reception at 0471-2524180, round the clock, 24x7, 365 days

To contact the Vascular Surgery OPD, call 0471-2524118, from 9am to 5pm on all working days

When to obtain advice at Sree Chitra Tirunal Institute:

Symptoms most likely due to Vascular illness

Cramps in leg muscles on walking
Sudden pain in your lower or upper extremity
Feeling of fainting or short period of loss of conscience
One sided weakness of your body
Chest or back or pain in your belly lasting more than 3 weeks and not getting better with symptomatic treatment given to you by your doctor
Uncontrolled hypertension despite > 3 medications

All the above symptoms occur in subjects more than 50-55 years of age especially if they are hypertensive or diabetic

It is necessary to meet your doctor and obtain appropriate Duplex scan and or CT scan evaluation and report to us with a letter of reference from your doctor

How soon are appointments available?

Appointment availability depends on the nature and urgency of the problem and SCTIMST's ability to help, as determined by the Vascular Surgeon but it is generally walk - in to our Vascular out patient clinic with referral letter from your doctor.

Refer a patient (for Medical Professionals)

Vascular surgeons at SCTIMST can be reached through e-mails at or

Get Directions

SCTIMS is situated within the Medical College campus

Why Choose Vascular Surgery, SCTIMST

For more than 25 years, people from all walks of life have found answers at SCTIMST. Here are some of the reasons why people each year choose SCTIMST for their medical care.

Top doctors

At SCTIMST, we assemble a team of medical experts who take the time to listen and thoroughly understand your health issues and concerns. Our doctors are carefully chosen based on their educational background, their medical skills, and their ability to work together. Because of the large volume of patients who come to SCTIMST for care, our doctors quickly gain extensive experience in treating patients with Vascular illnesses. The SCTIMST system supports doctors by making it easy for them to work together and by providing the best personnel, facilities and technology to help them deliver the best care to every patient every day.

When the patient meets with the physician, the examination is unhurried. Physicians spend the time they deem necessary to provide quality patient care.

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