Elective (Non-Emergency) Vascular Surgery

Vascular surgery is a specialized field of medicine that focuses on the diagnosis and treatment of diseases affecting the body’s arteries and veins, excluding those of the heart and brain. These conditions often involve blockages, narrowing, or weakening of blood vessels, which can lead to life-threatening complications if left untreated. With the advancement of minimally invasive and open surgical techniques, vascular surgery today offers a wide range of solutions—from restoring blood flow to preventing strokes and saving limbs from amputation.

This branch of surgery plays a critical role in maintaining circulatory health, particularly in patients with chronic vascular disorders or complex systemic diseases that compromise blood flow. Vascular surgeons are trained to assess not only localized vascular issues but also how these conditions impact the entire circulatory system. Their expertise extends beyond the operating room to encompass preoperative planning, postoperative care, and long-term disease management, often in collaboration with cardiologists, nephrologists, endocrinologists, and wound care specialists. This multidisciplinary approach ensures continuity of care and improves both functional outcomes and overall quality of life for patients affected by vascular disease.

Vascular surgical procedures may be classified as elective or emergency, depending on the severity and urgency of the condition. Elective vascular surgeries—such as treatment for varicose veins, peripheral artery disease, or non-ruptured aneurysms—are planned interventions aimed at preventing progression or complications. In contrast, emergency vascular surgeries are performed in response to acute, life-threatening events like ruptured aneurysms, acute limb ischemia, or severe traumatic vascular injury, where immediate intervention is necessary to preserve life.

FOR PATIENTS REQUIRING EMERGENCY VASCULAR TREATMENT, IT IS ESSENTIAL TO SEEK IMMEDIATE MEDICAL ATTENTION AT THE NEAREST EMERGENCY FACILITY FOR URGENT CARE.

Why Cuba

Vascular surgery in Cuba is guided by a commitment to preserving circulatory function, preventing progression of vascular disease, and reducing the risk of severe complications such as stroke, limb loss, or organ damage. Each case is approached with careful consideration of the affected vessel, the extent of disease, and the patient’s overall health profile to determine the most effective and safest surgical solution.

Cuban medical teams conduct thorough vascular assessments using modern diagnostic tools to ensure accurate surgical planning. Emphasis is placed on using minimally invasive techniques when appropriate, allowing for precise intervention with less disruption to surrounding tissue. When traditional open surgery is necessary, it is performed with equal expertise. Patients benefit from coordinated, multidisciplinary care and structured post-operative follow-up designed to support recovery, improve long-term outcomes, and restore independence as efficiently as possible.

Conditions Treated by Vascular Surgery

Elective (non-emergency or semi-urgent) vascular surgeries are performed to manage chronic or progressive vascular conditions that are not immediately life-threatening, but still require timely intervention to prevent complications. Included are:

Arterial Procedures

• Carotid Endarterectomy

Removal of plaque from the carotid arteries to prevent stroke in patients with carotid artery stenosis.

• Carotid Artery Stenting

Minimally invasive placement of a stent to open a narrowed carotid artery.

• Peripheral Arterial Bypass Surgery

Bypass of blocked leg arteries (e.g., femoral-popliteal bypass) to improve limb blood flow in Peripheral Arterial Disease (PAD).

• Angioplasty and Stenting (Peripheral or Renal Arteries)

Widening of narrowed arteries using a balloon and/or stent in cases of PAD or renal artery stenosis.

• Endovascular Aneurysm Repair (EVAR)

Minimally invasive repair of abdominal or thoracic aortic aneurysms that are not ruptured.

• Open Aneurysm Repair

Traditional surgical repair of aneurysms when minimally invasive methods are not suitable.

• Mesenteric Artery Revascularization

For chronic mesenteric ischemia causing abdominal pain and weight loss.

• Renal Artery Revascularization

To restore kidney perfusion in renovascular hypertension or ischemic nephropathy.

• Subclavian or Axillary Artery Bypass or Stenting

To manage upper limb ischemia or subclavian steal syndrome.

Venous Procedures

• Varicose Vein Surgery

Includes vein stripping, radiofrequency ablation (RFA), or endovenous laser treatment (EVLT).

• Sclerotherapy

Injection of a solution to collapse small varicose or spider veins.

• Chronic Venous Insufficiency Treatment

May include vein ablation, perforator vein ligation, or ulcer management.

• Venous Stenting

Placement of stents in narrowed veins (e.g., iliac veins in May-Thurner syndrome).\

• Pelvic Congestion Syndrome Treatment

Embolization or surgical ligation of pelvic varicosities causing chronic pelvic pain.

• Deep Vein Reconstruction

For post-thrombotic syndrome with chronic leg swelling and ulceration.

Dialysis Access Procedures

• Arteriovenous (AV) Fistula Creation

Connecting an artery to a vein for hemodialysis access in patients with kidney failure.

• AV Graft Placement

Use of synthetic tubing for patients not suitable for a fistula.

• AV Access Revision or Repair

Fixing stenosed, thrombosed, or malfunctioning dialysis access sites.

Other Elective Vascular Surgeries

• Vascular Access Port (Port-a-Cath) Placement

Long-term venous access for chemotherapy or total parenteral nutrition (TPN).

• Surgical Debridement and Limb Preservation Surgery

For non-healing ischemic ulcers or diabetic foot lesions not requiring emergency amputation.

• Amputation (Planned, Non-Urgent)

In severe peripheral vascular disease when limb salvage is no longer viable but not acutely infected or necrotic.

Pre-Surgical Diagnosis

Before proceeding with vascular surgery, a comprehensive pre-operative evaluation is essential to confirm the diagnosis, determine the severity of disease, and tailor the treatment plan accordingly. This typically includes:

• Doppler ultrasound and Duplex scanning: To assess blood flow and vessel condition
• CT Angiography or MR Angiography: Advanced imaging to visualize arteries and veins in detail
• Ankle-Brachial Index (ABI): Non-invasive test to evaluate blood flow in the limbs
• Cardiac and anesthesia clearance: To assess surgical fitness, especially in older or high-risk patients
• Laboratory tests: To check for clotting disorders, kidney function, and other comorbidities

Qualification for Vascular Surgery

Not every patient is suited for vascular surgery, as eligibility depends on a range of factors including overall health status, surgical risk, and the potential for meaningful clinical benefit.

Patients Eligible for Surgery:

• Patients with confirmed vascular disease (arterial or venous) requiring intervention
• Individuals with non-healing ulcers, limb pain, or limited mobility due to poor circulation
• Patients with asymptomatic aneurysms that meet size criteria for elective repair
• Those requiring dialysis access creation (AV fistula or graft)
• Medically stable individuals cleared for surgery or endovascular procedures

Patients Not Suitable for Vascular Surgery:

• Patients with terminal illness or poor overall prognosis where surgery offers minimal benefit
• Individuals with active, uncontrolled infection or sepsis (until stabilized)
• Cases with advanced organ failure (e.g., heart, liver, or renal failure) without correction
• Patients with severe cognitive impairment or non-compliance with medical care
• Those with untreatable coagulopathy or high bleeding risk

Types of Vascular Procedures

Depending on the condition, vascular surgery may be performed either minimally invasive (endovascular) procedures or traditional open surgeries and maybe performed under local, regional, or general anesthesia, depending on the type and complexity.

Minimally Invasive (Endovascular) Procedures

• Angioplasty and stenting: Insertion of a balloon or stent to open narrowed arteries
• Endovascular Aneurysm Repair (EVAR): Placement of a stent-graft through a catheter to treat aneurysms
• Catheter-based thrombolysis: Dissolving blood clots in arteries or veins
• Venous ablation or sclerotherapy: Minimally invasive treatment of varicose veins

Open Surgical Procedures

• Carotid Endarterectomy: Surgical removal of plaque from carotid arteries
• Aorto-femoral or femoral-popliteal bypass: Rerouting blood around blocked arteries
• AV fistula or graft creation for dialysis access
• Surgical aneurysm repair: Removing or reinforcing a damaged section of the aorta
• Surgical debridement or amputation: In severe limb-threatening cases