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Narayana Hrudayalaya Institute of Vascular Sciences

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					Narayana Hrudayalaya Institute
             of
      Vascular Sciences




  Narayana Hrudayalaya Hospital, Bangalore, India


Your Vascular Health is a Matter of Life and Limb
                          Narayana Hrudayalaya
                      Vascular & Endovascular Sciences

                          Providing World Class Vascular Care
Introduction
The Narayana Hrudayalaya Institute of Vascular & Endovascular Surgery is a premier tertiary level provider
of a complete range of Vascular and Endovascular Surgical services at Narayana Hrudayalaya Health City,
Bangalore, India.
The Department of Vascular and Endovascular Surgery is located on 2 sites: 1200 bed Narayana Hrudayalaya
Heart Hospital and 1400 bed NH Multispecialty Hospital, with its services encompassing all elements of
vascular care as detailed below:
1. Diagnostic screening, evaluations and medical management
2. Non- invasive vascular testing
3. Diagnostic angiography and endovascular therapeutics (minimally invasive procedures)
4. Surgical care including Inpatient services and critical care
5. Meticulous Follow-up and post – recovery rehabilitation



             Providing World Class Vascular Education & Training
Narayana Hrudayalaya Hospital is a deemed University. Narayana Institute of Vascular Sciences is affiliated
to Rajiv Gandhi Health University. The core strength of our Fellowship programmes is our emphasis on
minimally invasive treatments. Endovascular Interventions, hybrid procedures and cutting edge open
arterial and venous vascular surgery is taught to the Fellows to make them a “Complete” Vascular Surgeon.
Diplomate of National Board Fellowship in Vascular and Endovascular Surgery, Fellowship in Vascular and
Endovascular Surgery Rajiv Gandhi Health University and International Fellowship are offered at our centre.


Contact Us
Narayana Institute of Vascular Sciences, Narayana Hrudayalaya Hospital

#258/A, Bommasandra Industrial Area, Hosur Road, Anekal Taluk, Bangalore-560099, India

For Appointments :      Please call Vascular Secretary - Miss Sharmila

Phone : +918027835000 ext 1366           Fax +9127832648          For Vascular Emergencies :   9810868800

Email :         vascularinstitute@hrudayalaya.com

Websites :      www.narayanahospitals.com              www.vascularsurgeon.org
                    Treatment of Carotid Artery Disease
                            to prevent Stroke
Hardening of the arteries (Atherosclerosis) affecting the vessels in the neck can lead to strokes. Patients with
carotid artery disease and stroke are treated by a team of vascular surgeon and neuro- physician dedicated to
stroke prevention. We also have a certified vascular laboratory for the non- invasive assessment of the carotid
arteries. Depending upon the narrowing of the carotid artery, intervention may be recommended even in
patients who have no t yet had a stroke. The standard proven form of treatment for this problem is an
operation called carotid endarterectomy to remove the plaque. In patients who are very high- risk or
unsuitable for surgery a non- invasive treatment is available called carotid artery stenting with distal embolic
protection. Carotid Endarterectomy results are superior to Stenting procedures.




                                             How strokes are caused ?




                Carotid Plaque removal                     Carotid Endarterectomy with Shunt




               Carotid Angiogram               Distal Protection                 after Stenting

                                                                   distal bypass preventing amputation
    Treatment of Diabetic Foot and Peripheral Arterial
            Disease of Lower Limb Arteries
Arterial disease develops when cholesterol or other fatty inflammatory deposits build up inside the artery
walls and cause a narrowing or blockage. The arteries gradually narrow to the point where blood flow from
the heart to vital organs like brain, kidneys upper and lower limbs as well as to the bowel becomes
insufficient for survival. The legs and feet are often the first areas of the body to show the effects of this
disease, although other patients may have strokes from cholesterol formation in the carotid arteries in the
necks.
Lower extremity symptoms may include an aching, tired or heavy feeling in the calf of the leg, thigh or
buttock when walking or exercising. Patients may also experience discoloration of the toes or feet, cold or
pale feet and toes, numbness or tingling in toes or feet, decreased hair growth on legs and feet, and/or
persistent ulcers or infections on the feet, toes or legs. If left untreated this may cause Gangrene of the foot.
On a case by case basis, our vascular team has shown that these revascularization (endovascular and bypass)
procedures save limbs and ultimately provide a better quality of life for their patients. With appropriate care,
even patients considered high- risk can undergo these procedures safely and effectively. Our vascular
surgeons have documented hundreds of successful patient case histories that detail how complex
revascularizations using distal bypass operations and angioplasty techniques have achieved a healed foot and
avoided amputation. If even a small portion of the foot can be saved, it allows the person to walk effectively
and to lead a reasonably normal life.



                                                    Healing after Tibial Bypass surgery




                                           Before           Improved blood flow after Tibial Angioplasty
Thoracic and Abdominal Aortic Aneurysms
Weakening of the aortic vessel wall in the chest or abdomen leads to ballooning of aorta with the blood
pressure and eventually leads to its expansion and rupture. Rupture of aortic aneurysms can cause rapid
exsanguinations of blood in the chest or abdominal cavity leading invariably to death in majority of patients.
Dr Devi Shetty and Dr Ramesh Tripathi combine Open/Endovascular and Hybrid procedures to provide one of
the largest experience of Aortic Arch, Thoracic and Abdominal Aneurysms including Dissecting aneurysm repairs
in India. The first- ever Endovascular Abdominal Aortic Aneurysm Repair (EVAR) in India was performed by Dr
Ramesh Tripathi in 1998. Our Cardiac Surgeons, Cardiologists and Vascular Surgeons have established a Division
of Aneurysm Surgery to treat all the routine and complex aneurysm problems and specialize in hybrid
procedures for difficult and re- do abdominal and thoracic aneurysms. Our Cardiac and Vascular surgeons are
leading opinion makers in this area of expertise and provides consultancy to bio- medical engineering companies
on many clinical aspects of minimally invasive vascular surgery and design of stent grafts.




                                                                                                                  QuickTimeª and a
                                                                             QuickTimeª and a             TIFF (Uncompressed) decompressor
                                                                      TIFF (Uncompressed) decompressor      are needed to see this picture.
                                                                        are needed to see this picture.




                       Abdominal Aortic Aneurysm Open and Endovascular Repair




                               QuickTimeª and a                        QuickTimeª and a
                           TIFF (LZW) decompressor                 TIFF (LZW) decompressor
                        are needed to see this picture.          are needed to see this picture.




                              Thoracic / ThoracoAbdominal Aortic Aneurysms
                             Open / Endovascular and Combined Hybrid Repairs




                                                                     Open Surgical
                                                                Thoracic Aneurysm Repair
                  Varicose Veins and Venous Disorders

Laser Treatment of Varicose Veins
Varicose veins are a known cause of severe physical and psychological discomfort. The superficial veins stretch
and bulge under the skin and create pronounced, bumpy "cords" on the legs. They are more common in women
and in people who sit or stand in the same position for long periods of time. Endovenous Laser treatment EVLT
in conjuction with sclerotherapy can in 90-97% afflicted patients treat varicose veins quite effectively. This is a
minimally invasive procedure that doesn’t require general anesthesia or cuts, is virtually painless allowing return
to normal active life within 24-48 hours.




                        QuickTimeª and a                                       QuickTimeª and a
                    TIFF (LZW) decompressor                                TIFF (LZW) decompressor
                  are needed to see this picture.                        are needed to see this picture.




Leg Ulcer and Deep Vein Valve Surgeries
In patients with venous ulcers (ulcers caused by venous disease only) there is abnormal reverse flow (reflux) in
the veins usually due to damaged or defective deep vein valves. One of our senior Vascular Surgeons, Dr.Tripathi
has devised the technique of ‘Trapdoor Internal Valvuloplasty’ and has one of world’s largest experience in this
area.


Vascular Access surgery for Renal Failure
We routinely provide support to our dialysis teams to provide expert advice and treatment of complicated
access related procedures and reconstructive surgeries in the form of Arterio- venous fistulae formation and
correction of complications as well as maintenance of permacaths.


Sophisticated Diagnostic Imaging Services
We have India’s first totally integrated Hybrid Cathlab to perform complex Hybrid Endovascular repair of Aortic
Aneurysms. In addition, the Radiology Department provides excellent support for our specialty including
Vascular Duplex Ultrasound, 64 slice state of art CT Scan, MR Angiography, Radionuclide Scintigraphy and Digital
Subtraction Angiography Lab allow for accurate diagnosis and follow- up of patient. In addition to Complex
Endovascular procedures in the DSA Lab, we are introducing exciting ultrasound based endovascular procedures
for patients with renal failure which include peripheral angioplasties and bedside Inferior Vena Cava filters.

				
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