Vascular Surgery in 60 Seconds: Aorta, Arteries and Veins Explained
A vascular surgeon is a specialist in the blood vessels that carry blood around the body. In my 60-second video, I describe us as circulation doctors: we assess and treat problems affecting arteries and veins, using a range of medical, minimally invasive and open surgical approaches.
I am Dr Andrew Choong, a vascular surgeon in Singapore. Understanding the scope of vascular surgery can help you recognise why symptoms as different as walking pain, swollen legs and a wound that will not heal may need a circulation assessment.
What is the difference between an artery and a vein?
Arteries carry blood away from the heart towards the tissues. Veins return blood towards the heart. They are parts of the same circulation, but the conditions affecting them—and the tests and treatments they need—can be very different.
An artery narrowed by disease may not deliver enough blood to a muscle or wound. A vein with faulty valves may allow blood to pool in the leg. A blood clot can cause another kind of obstruction. The first job is to identify which problem is present.
Which conditions does a vascular surgeon treat?
Vascular surgery covers a broad range of circulation problems. The examples in my video include:
Aortic disease: aneurysms and dissections affecting the body’s main artery.
Leg artery disease: narrowed or blocked arteries that may cause walking pain, rest pain or poor wound healing.
Venous disease: varicose veins and deep vein thrombosis.
Carotid artery disease: selected artery problems in the neck relevant to stroke prevention.
Dialysis access: creating and maintaining suitable access to the circulation for haemodialysis.
Wound care and limb preservation are also important parts of vascular practice. When poor blood flow contributes to a foot or leg wound, addressing the circulation may be one part of a wider treatment plan.
Is vascular surgery the same as cardiology?
The specialties are related, but their focus differs. Cardiologists primarily assess and treat the heart. Vascular surgeons mainly manage blood vessels outside the heart and brain, including the arteries in the neck and vessels throughout the body.
Some techniques overlap. Balloons, wires and stents can be used in both heart and peripheral vascular procedures. The presence of a stent does not, by itself, tell you which specialty or condition is involved.
Complex aortic and other vascular conditions may also involve several specialties working together. The appropriate team depends on the part of the circulation affected and the treatment required.
Does seeing a vascular surgeon mean I need an operation?
No. An assessment may lead to advice, medication, monitoring or further tests. For example, management of peripheral arterial disease can include cardiovascular risk reduction and structured exercise, with a procedure considered when clinically indicated.
For some patients, endovascular treatment offers a way to work inside a blood vessel through a small access site. Depending on the problem, this may involve a balloon, stent or another device. Other patients are better served by open surgery, such as a bypass or repair.
The decision starts with the diagnosis, symptoms, scan findings and goals of treatment. A procedure should have a clear purpose that the patient understands.
When should I seek a circulation assessment?
Persistent leg pain when walking, troublesome varicose veins, unexplained swelling or a wound that is not healing deserve medical attention. These symptoms have several possible causes, so an examination is more useful than assuming that every leg problem is vascular.
Some changes are emergencies. A suddenly cold, pale, painful or weak limb, sudden severe chest or back pain, or sudden breathlessness with collapse needs immediate emergency assessment. In Singapore, call 995 for severe emergency symptoms.
Where can I discuss vascular symptoms in Singapore?
You can contact Andrew Choong Vascular Surgery for a non-emergency consultation to discuss your symptoms, relevant scans and treatment options. My aim is to explain the circulation problem and the reasons for any proposed next step.
Current clinic location: Mount Elizabeth Novena Specialist Centre, #09-22, 38 Irrawaddy Road, Singapore 329563.