The circulation of blood is one of the human body's most important functions. Blood carries both oxygen and nutrients to tissues throughout the body, and problems with the circulatory system can have serious health implications. Vascular surgeons are doctors who care for the network of veins and arteries that make up the circulatory system. They're the only specialists in the care of blood vessels, and use both surgical and nonsurgical techniques to manage vascular disease.
Vascular surgeons don't treat blood vessels in the brain or heart, which belong to the specialties of neurology and cardiology. Problems with the remainder of the circulatory system usually fall into a limited number of broad categories. Most conditions are caused by atherosclerosis, the buildup of plaque on the walls of blood vessels. Other types of vascular disease result from blood clots or sections of plaque that become lodged in a blood vessel, impeding or stopping blood flow. In some cases blood vessels become dangerously weakened and expand like a balloon, creating the risk of a life-threatening rupture.
Many of these conditions lend themselves to surgical repair, either through traditional open surgery or newer, minimally invasive laparoscopic and endoscopic procedures. Vascular surgeons make laparoscopic repairs using miniature instruments inserted through a small incision, while endoscopic procedures involve inserting a tube into the body and using that to guide small instruments to the damaged site. Some surgical procedures remove a damaged or blocked section and replace it with a graft or an artificial section of vein. Others remove clots or blockages, and vascular surgeons can implant wire-mesh stents to strengthen blood vessels and keep them clear. The surgeon's choice of techniques will vary according to the condition, its location and the patient's overall health.
In many areas of medicine, physicians and surgeons have complementary specialties. For example, cardiac surgeons perform heart surgery and cardiologists treat the heart through nonsurgical means. There's no such counterpart for vascular surgery, so the surgeons also provide nonsurgical therapies. These include the use of a variety of medications to prevent clots or to reduce levels of blood cholesterol and plaque. Vascular surgeons also coach patients in the management of lifestyle factors such as diet and exercise and refer them to other caregivers for complicating factors such as diabetes.
Vascular surgeons begin their careers in much the same way as other physicians, by completing a four-year undergraduate degree and then four years of medical school. Surgical training begins after graduation, with a five-year residency in general surgery. After successfully passing board examinations in general surgery, the newly certified surgeon spends another two years in a specialized vascular surgery fellowship. After learning the appropriate skills during that fellowship, and passing another set of board examinations, the candidate becomes a board-certified vascular surgeon.