Baltic American Clinic in Vilnius performs operations on the veins and arteries of the legs, using surgical and minimally invasive methods to treat vascular diseases. We perform laser, bio-glue and surgical vein operations, leg artery bypass operations and the creation of arteriovenous fistulas. The treatment method is chosen after assessing the condition of the blood vessels, the severity of the disease and the patient’s individual indications.
Diagnosis and surgical treatment of vein and artery diseases, taking into account the patient’s health.
Laser, bio-glue and conventional surgical vascular operations.
The method and extent of the operation are decided after the necessary vascular tests.
Monitoring of healing, follow-up tests and recommendations for further recovery.
When may vascular surgery be needed?
Vascular operations are considered when vein or artery disease causes significant symptoms, circulation problems or a risk of complications, and tests confirm the indications for surgical treatment.
We recommend seeing a vascular surgeon if:
- The veins in your legs are enlarged and you have heaviness, aching, swelling or pain.
- Varicose veins cause changes in skin pigmentation, inflammation or venous ulcers.
- Leg pain appears when walking and you have to stop and rest.
- Leg or foot pain occurs at rest, especially at night.
- Wounds on the foot or lower leg do not heal and insufficient arterial blood supply is suspected.
- Significant peripheral artery disease has been diagnosed and restoring blood flow is being considered.
- Long-term haemodialysis is planned and an arteriovenous fistula is needed.
The need for an operation is not decided on symptoms alone. The doctor assesses the clinical condition, test results, the possible benefit and the risks of treatment.
Which vascular operations are performed?
Laser vein surgery
Laser vein surgery is a minimally invasive method of treating enlarged superficial veins, also known as endovenous laser ablation.
During the procedure a laser fibre is inserted into the affected vein under ultrasound guidance. The laser energy acts on the vein wall and closes the vein that is not working properly. Blood is redirected through other, properly functioning veins.
This method may be used to treat symptomatic varicose veins of the legs when an ultrasound examination confirms insufficiency of the superficial vein valves and venous reflux.
The procedure is usually performed under local anaesthesia. Patients can usually start walking on the day of the operation, but recommendations on physical exertion and compression therapy are given individually.
Surgical vein removal (phlebectomy)
Phlebectomy is the surgical removal of enlarged superficial veins.
During the operation the affected sections of the veins are removed through small skin incisions. Depending on the type of varicose veins, mini-phlebectomy of individual vein branches or more extensive surgical treatment may be performed.
Phlebectomy may be chosen when the veins are markedly enlarged or tortuous, or when their anatomy and the nature of the disease call for surgical removal.
In some cases surgical vein removal is combined with other methods of treating varicose veins. The extent of the operation is decided by the vascular surgeon.
Bio-glue vein surgery
Bio-glue vein surgery is a minimally invasive method of treating superficial venous insufficiency in which the affected vein is closed with a special medical adhesive.
During the procedure a catheter is inserted into the vein under ultrasound guidance, and the medical adhesive is precisely distributed through it. The adhesive seals the vein walls together and stops blood flowing through the affected vein.
This treatment method may be used for patients with superficial vein valve insufficiency whose anatomy is suitable.
The procedure usually does not require thermal ablation of the vein, and the need for anaesthesia is often lower than with thermal methods. Before the operation you must tell the doctor about any known allergies and previous hypersensitivity reactions.
Leg artery bypass
Leg artery bypass is a surgical operation to restore or improve blood flow in the leg when an artery is significantly narrowed or blocked.
During the operation a new route for blood flow is created that bypasses the damaged section of the artery. The patient’s own vein or a special vascular graft may be used for this.
Artery bypass may be needed in advanced peripheral artery disease, when poor blood flow causes severe symptoms, wounds do not heal or there is a risk of tissue damage in the limb.
Before the operation the nature of the narrowing or blockage of the arteries, the state of the circulation, the general surgical risk and possible other treatment options are assessed.
After the operation the restored blood flow must be monitored, the prescribed medication must be taken and follow-up visits must be attended.
Creation of an arteriovenous fistula
Creating an arteriovenous fistula is a surgical operation in which an artery and a vein are joined, usually in the arm.
Such a connection is created for patients who need or are expected to need long-term haemodialysis. Because of the increased blood flow, the vein gradually widens and becomes stronger, making it suitable for repeated dialysis procedures.
Before the operation the arteries and veins of the arm, their diameter and blood flow are assessed. The most suitable site for the fistula is chosen based on the test results.
After the operation the maturation and function of the fistula are monitored. The doctor decides when the fistula can start being used for haemodialysis.
How to prepare for vascular surgery
Preparation depends on the type and extent of the planned operation, the chosen anaesthesia and the patient’s health.
Before the operation the following is usually needed:
- A consultation with a vascular surgeon and an assessment of the indications for surgery.
- A vascular ultrasound examination and, if needed, additional blood flow and imaging tests.
- Pre-operative blood and other tests depending on the type of operation.
- A discussion with the doctor of the medicines you take, especially those that affect blood clotting.
- A discussion of the anaesthesia method and individual preparation recommendations.
Do not stop taking prescribed medicines on your own. If the operation is planned under sedation or general anaesthesia, the doctor will give you instructions on eating and drinking before the procedure.
How does vascular surgery take place?
The course of the operation depends on the surgical method chosen.
Test results, the extent of the operation and the anaesthesia plan are confirmed.
The patient is prepared for the operation and the necessary safety procedures are carried out.
The planned vascular treatment is performed using the chosen method.
After the operation the patient’s condition, blood flow and early healing are assessed.
Minimally invasive vein operations are often performed as day surgery. After more extensive artery operations, longer monitoring and inpatient treatment may be needed.
Recovery after vascular surgery
The length of recovery depends on the type of operation, the severity of the vascular disease, the patient’s age, other conditions and the individual response of the body.
After minimally invasive vein operations, patients can usually walk on the same day and gradually return to their normal activities.
After surgical vein operations there may be temporary swelling, bruising or tenderness in the operated area. The doctor explains how to care for the wounds and when physical activity can be increased.
After artery bypass, closer monitoring of blood flow, medication and a longer recovery period are needed.
After an arteriovenous fistula has been created, it is important to protect the operated arm, monitor how the fistula works and follow the doctor’s instructions on caring for it.
Frequently asked questions
Do all enlarged leg veins need an operation?
No. The need for an operation depends on the symptoms, the function of the vein valves, the ultrasound results and the risk of complications. In some cases monitoring, compression therapy or other non-surgical measures are enough.
What is the difference between laser and bio-glue vein surgery?
Both methods are used to close a superficial vein that is not working properly. In laser surgery the vein wall is treated with thermal energy, while bio-glue surgery uses a special medical adhesive. The most suitable method is chosen according to the anatomy of the veins, the test results and the patient’s condition.
Can I walk straight after laser vein surgery?
Usually yes. Walking after minimally invasive vein surgery is generally recommended, but intensive sport and heavy physical exertion may be restricted for a while. Exact recommendations are given by the doctor who performed the operation.
Do I need to wear compression stockings after vein surgery?
The need for compression stockings depends on the surgical method, the extent of the veins treated and individual circumstances. After surgical vein removal they may be recommended to reduce swelling and discomfort. After bio-glue treatment compression is not always necessary.
Can varicose veins come back after surgery?
Yes. Even after the affected veins have been successfully removed or closed, other superficial veins may become enlarged over time. This is related to the progression of the disease, heredity and other risk factors, which is why further monitoring of the blood vessels is important.
When is leg artery bypass needed?
Artery bypass is considered when significant narrowing or blockage of the arteries impairs blood flow in the leg, causes severe symptoms or threatens the tissues of the limb. The need for an operation also depends on whether other methods of restoring blood flow are suitable.
Can artery bypass surgery help leg wounds heal?
If wounds do not heal because of insufficient arterial blood supply, successfully restoring blood flow can improve the conditions for tissue healing. However, healing also depends on infection, diabetes, tissue damage and other health factors.
What is an arteriovenous fistula for?
An arteriovenous fistula is usually created for patients who need long-term haemodialysis. It provides adequate blood flow for dialysis procedures. The fistula usually needs several weeks or longer to mature.
Do I need a doctor’s referral for vascular surgery?
No, a doctor’s referral is not required to book a consultation with a vascular surgeon. The indications for surgery are determined by the doctor after assessing your condition and the results of the necessary tests.
Price of vascular surgery
The prices of vascular operations depend on the treatment method chosen, the extent and complexity of the operation, the medical supplies used and the patient’s health.
The consultation with a vascular surgeon, additional tests, anaesthesia, inpatient care, post-operative nursing and other services, if they are not included in the price of the operation, are charged separately according to the clinic’s current price list.
The specific extent of the operation, the preparation plan and the expected costs are discussed with the doctor before the operation.