Vascular & Endovascular Surgery

Vascular & Endovascular Surgery

The department has acquired endovenous ablation equipment with radiofrequency and laser ablation for the treatment of varicose veins (removal of veins without scars). With the addition of the technique of implantation of spinal cord stimulator a new dimension was added as a pain relief option for intractable ischaemic pain. The department holds the distinction of being the few vascular surgery units in India, which has a fully functional extensive Vascular Lab, Duplex colour doppler machine, Cath lab and angiography suite with dedicated vascular operation theatre. The department is known for performing endovenous aneurysm repair for aortic aneurysm, angioplasties for iliac, femoral and below the knee vessels, IV filters, venous angioplasties, venous and arteriovenous malformation therapies, stroke prevention by Carotid endarteretomies, AV access solution and vascular trauma management.

New updates

Diabetic foot Care Center

Teaching Programme

Ours was the first institution in India to get recognition from the National Board of Examinations, as a teaching and training centre for a post-doctoral fellowship programme and diploma course in Peripheral Vascular and Endovascular Surgery. The Department has the unique distinction of offering training in vascular surgery, endovascular procedures and non-invasive duplex scanning.

Research Programme 

The department has a few research projects running simultaneously like JTCS study for Peripheral Arterial Disease.

INFRASTRUCTURE

• Non-invasive Peripheral Vascular Lab/Equipiment
• Diagnostic Peripheral Doppler Scans
• Therapeutic Compression
• ABI Tonometry
• Foot Scan
• Mat Scan
• Segmental Pressure Analysis
• Radiofrequency ablation for varicose veins
• Venous Laser Ablation
• Ultrasonic Debridement

Endovascular Surgery

• Endovascular aneurysm repair for Thoracic Abdominal Aortic Aneurysm.
• Carotid/Renal/ Subclavian angiography and angioplasty with stenting.
• Peripheral angiography with angioplasty of arm or leg arteries.
• Aorta and Visceral artery angioplasty.
• Venous angiography with IVC filter placement and angioplasty of stenotic veins.
• Management of Deep Vein Thrombosis (including placement of IVC filters/stents).
• Covered Stent Grafts for Trauma, Arterio-Venous Fistulae and Aneurysms.

Vascular Surgery

• Carotid endarterectomy - Surgery for Stroke Prevention.
• Bypass Surgery for Leg Arteries.
• Management for gangrene of limbs to prevent amputation.
• Robotic Vascular
• Surgery for Aorto Iliac Disease(only Centre in Asia Pacific) Surgery for Aortic Aneurysm/ Aortic occlusion.
• Emergency surgery for vascular injury in Accident and Trauma Vascular control for bleeding vessels/Vascular control/tumor embolisation.
• Injection treatment for Varicose Veins and Leg Ulcers.

KNOW VASCULAR DISEASES

• Management of Swollen Legs/DVT:
  Swollen legs due to deep vein thrombosis are a fairly common presentation. These are effectively treated by catheter directed thrombolysis, compression stockings and compression therapy. A rare but serious complication of DVT is dislodgment of the clots from the legs to the lungs
• Angiography, Ballooning (Angioplasty) and Stenting:
  Angiography is a special dye test of the blood vessels. It is done under local anaesthesia, on a mobile X-ray machine in our vascular Cath Lab. Angiography of the legs, arm or neck vessels is done regularly.
• Doppler Scan:
  The blood vessels can also be studied by a non invasive method - Doppler. It is similar to an ultrasonography (USG) examination. This investigation also helps to detect peripheral vascular (PVD) or arterial blockage, DVT, etc.
• Surgery for Varicose Veins:
  Varicose veins are prominent and tortuous veins in legs, which can cause pain, ulcer and swelling. They are managed by injection sclerotherapy, endovenous ablation or operation depending on the severity. These procedures are carried out as day care procedures.
• Surgery for Stroke Prevention:
  Stroke or Brain attack usually occurs due to blockage of arteries in the neck, which carry blood to the brain (carotid artery). This blockage can be cleared by an operation called Carotid Endarterectomy.
• Surgery for Aortic Aneurysms:
  An aortic aneurysms is ballooning of the main artery of the body, usually in the abdomen. It is a major risk to life if it leaks or ruptures. An open surgery with a tube graft is performed to prevent this complication. This is an alternative to Endovascular surgery which is also performed routinely at this centre.
• Leg bypass Surgery:
  Leg arteries are blocked due to atherosclerosis, hardening of the arteries. Eventually, as the process progresses, your blood vessels can no longer supply the Oxygen demands of your organs or muscles and symptoms may develop. During a bypass, the Vascular Surgeon creates a new pathway for blood flow using a graft or bypass. A graft is a portion of one of your veins or a man-made synthetic tube that your surgeon connects above and below a blockage to allow blood to pass around it.

Publications

• R.Gupta, N.Chobdar, V.Arya, A.Satwik, A.Yadav, S.Agarwal, V.S.Bedi. Assessment of abdominal aortic diameter in the Indian population. The ganga ram journal Vol.3, No-2, 2013 page – 68-73.
• V.Arya, N.Chobdar, R.Gupta, A.Satwik. Technology Medicine: Doppler ultrasound, The Ganga Ram Journal 2012; Vol.2, No. 3:151-157.
• A. Laddha, R.Gupta, A. Satwik, A. Yadav, S. Agarwal. Use of a vascular plug for transcatheter embolization of a idiopathic high flow renal arteriovenous fistula, The Ganga Ram Journal 2012; Vol.2, No.1:28-31.
• A. Laddha, R.Gupta, A. Satwik, A. Yadav, S. Agarwal . Color flow duplex ultrasound for non invasive rapid diagnosis of peripheral arterial trauma, Indian Journal of Surgery.
• Surg Capt J D'Souza, Surg Capt VS Bedi, NM, Surg Cdr Ik Indrajit, Surg Cdr R Pant. “Non-Surgical Management Of Pseudoaneurysms,” Pg: 162-165, MJAFI 2008: 18.
• D’Souza J, Kapoor AK, Bedi VS, “Endovascular Management in Venous Diseases Indian Journal Radiology Imaging 2008.
• Prakash Singh M Ch, S Rai MS, VS Bedi MS, C Mohan MD,. “Traumatic Thrombosis of Internal Carotid Artery,” Departments of Neurosurgery, Vascular Surgery and Interventional Radiology. Indian Journal of Neurotrauma(IJNT). 2007, Vol. 4, No. 1, pp. 45-47.
• I K Indrajit, J D’Souza, V S Bedi, R Pant. “Multi Detector CT Evaluation in Arterial Stenting,” 252-257 MJAFI 2006: 62.
• Rajiv Parakh, Sumit R, Ishita Sen, Sandeep Agarwal, Tarun Grover and Ajay Yadav. Pulmonary embolism: A frequency Occurrence in Indian Patients with Symptomatic Lower Limb Venous Thrombosis. Asian Journal of Surgery Vol. 29, No. 2, April 2006.
• Dr. Rajiv Parakh. Vascular Access and Specialized Technique of drug delivery. Practical Pediatric Hematology. Indian Academy of Pediatrics Presidential Action Plan 2006.
• Parakh R, Kapadia S, Agarwal S, Bukhari S. Carotid Stenting for Post- Irradiation Carotid Stenosis. Bombay Hospital Journal, Vol. 47, No. 1, 2005.
• Rajiv Parakh, Ajay Yadav. Diabetic Foot: A Vascular Surgeon’s View Point. Journal International Medical Sciences Academy. Oct-Dec 2005 Vol. 18 No. 4.
• Sumit R. Kapadia, Rajiv Parakh, Sandeep Agarwal, Tarun Grover, Ajay Yadav. Carotid Stenting for Post-Irradiation Carotid Stenosis. Bombay Hospital Journal Vol. 47, No. 1, 2005.
• Parakh R, Kapadia S, Agarwal S, Bukhari S. Case report: Cervical Asymmetry. Vol 118 No 1218 ISSN 1175 8716. The New Zealand Medical Journal. NZMJ 15 July 2005, Vol 118 No. 1218.
• Parakh R, Kapadia S, Agarwal S, Bukhari S. Isolated Iliac Artery Aneurysm with Ilio Caval Fistula. The Indian Practitioner Feb 2005 Vol. 58 No.2.
• Rajiv Parakh, Sumit Kapadia, Ajay Yadav. Limb Salvage angioplasty in vascular surgery practice. Letter to the Editor. Eur J Vasc Endovascular Surgery 2005;29:620-7.
• Parakh R, Kapadia SR, Agarwal S, Grover T. Side to side aorto mesenteric anastomosis for management of abdominal angina. Case Report. Indian Journal of Gastroenterology 2005; 24: 256-257.
• Kapadia Sumit, Parakh Rajiv, Grover Tarun, Yadav Ajay. Catheter fracture and cardiac migration of a totally implantable venous device. Indian Journal of Cancer, Vol. 42, No. 3, July-September, 2005, pp. 155-157.
• Kapadia S, Grover T, Parakh R. Infrainguinal angioplasty deserves a place in limb salvage. Indian Journal of Surgery Vol. 67, No. 6, November-December 2005, pp.343.
• Seema Bhargava, R. Parakh, Dr. L.M. Srivastava. Studies on homocysteine demonstrating its significance as a possible tool for differential diagnosis in occlusive vascular disease. Journal -Indian Journal of Clinical Biochemistry, 2004 (1) 76-78.
• Venous Disorders and Evidence-Based Medicine. Medicagraphia Controversial Questions CEAP Classification. Medicographia Vol 26, No. 2, 2004.
• Abhay I Ahluwalia, VS Bedi, IK Indrajit, JD Souza. “Evaluation and Management of Peripheral Arterial Disease in Type 2 Diabetes Mellitus,” Indian Journal of Diabetes in Developing Countries, 2003 Volume: 23, Issue 2, Pg:62-66.
• Seema Bhargava, R. Parakh, Dr. L.M. Srivastava. Prevalence and treatment of Hyperhomocysteinaemia in occlusive vascular disease. Trends Clinical Biochem. Lab. Medicine 2003: 150-156.
• Rajiv Parakh, Sandeep Agarwal, Ashok Gupta, Tarun Grover. Carotid Endarterectomy for Stroke Prevention. Journal : Indian Journal of Surgery.IJS Vol. 64, No. 3, 2002.
• Tarun Grover, Ashok Gupta, Sandeep Agarwal, Rajiv Parakh. Upper Limb Ischaemia - A four year Experience. Journal : Indian Journal of Surgery. JS Vol. 64, No. 1, 2002.
• V S Bedi, Vascular Surgeon, INHS Asvini, Mumbai “The Diabetic Foot,”. Bombay Hospital Journal Special Issue 2001.
• R. Passey, A. Mehta, R. Parakh, S. Agarwal, A. Guptaq. Asymptomatic Coronary Artery disease in patients with symptomatic peripheral vascular disease - detected by dobutamine stress echo and coronary angiography. Journal : Journal of American college of Cardiology.
• Dr. K.M. Rai, Dr. Rajiv Parakh. Venous Disorders. Text book of Surgery (The Association of Surgeons of India).
• Isolated Iliac Artery Aneurysm with Ilio Caval Fistula. The Indian Practitioner.
• Endoavascular Management of Iliac artery to vein fistula after gunshot injury : A case report.Orthopaedics Update.
• Acute Limb Ischemia. Orthopaedics Update.

Faculty at International / National Conferences

• International Surgical Conference in December 2012 in Kathmandu, Nepal.
• LINC in December 2012 at Leipzig, Germany.
• Complications Meet in Feb 2013 at Bangkok Vascular CME in Feb 2013 at Medras Medical College, Chennai LINC 2013 in March 2013 at Hongkong.
• Vascular Conference in March 2013 at Brussels.
• Vascular CME in May 2013 at Stanley Medical College, Chennai.
• TEP 2013 in June 2013 at Baroda.
• Midterm VSICON 2013 Conference in June 2013 at Vizag.
• APVIC 2013 in June 2013 in New Delhi Vascular & Endovascular Surgery.

FELLOWSHIP IN THE INSTITUTE OF VASCULAR & ENDOVASCULAR SCIENCES - 6 MONTHS