Narayana Hrudayalaya Institute of Vascular Sciences

Your Vascular Health is a Matter of andLife Limb

Narayana Hrudayalaya Hospital,Bangalore, India

Narayana Hrudayalaya Institute of Vascular & Endovascular Sciences

Providing World Class Vascular Care

Introduction

Providing World Class Vascular Education & Training

The Narayana Hrudayalaya Institute of Vascular Sciences is a premier tertiary level provider of complete range of Vascular and Endovascular Surgical services at Narayana Hrudayalaya Health City, Bangalore,

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

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. Various State level, National and International Fellowships in Vascular and Endovascular Surgery are offered at our centre.

Treatment of Carotid Artery Diseaseto 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 surgeons and neuro-physicians dedicated to stroke prevention. Depending upon the narrowing of the carotid artery, intervention may be recommended even in patients who have not 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. Other causes of stroke e.g Brain aneurysms are expertly looked after by our neurologist and neuro surgeons.neuroradiologists

How strokes are caused ?

Carotid Plaque removal Carotid Endarterectomy with Shunt

Carotid Angiogram Distal Protection After Stenting

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 legs and feet are often the first areas of the body to show the effects of this disease leading to Leg Attack: an aching, tired or heavy feeling in the calf of the leg, thigh or buttock when walking or exercising. Patients may also experience discoloration coldness, numbness and 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 maintain their independence.

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 exsanguination 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. The Division of Aneurysm Surgery has a combined experience of over 2000 open and endovascular Aneurysm Repairs to treat all the routine and complex aneurysm problems and specialize in hybrid procedures for difficult and re-do abdominal and thoracic aneurysms.

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

Abdominal Aortic Aneurysm Open and Endovascular Repair

Hybrid Repair Arch Aneurysm

Varicose Veins and Venous DisordersLaser Treatment of Varicose Veins

Varicose veins are a known cause of severe physical and psvyhological discomfort. The superficial veins stretch and bulge under the skin and create pronounced, bumpy "cords" on 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 or RF Ablation (RFAT) in conjuction with sclerotherapy can treat varicose veins quite effectively in 90-97% afflicted patients. 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.

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. Our Vascular Surgeons perform one of the largest numbers of deep vein valve repairs as well as deep vein reconstruction and stenting in the world, providing excellent healing rates for long standing venous leg ulcers.

The presence of a functioning Arterio-venous fistulae in patients needing dialysis has been demonstrated worldwide to be associated with greater life span and quality of life. We support nephrologists extensively in maintaining this service.

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.

Leg Ulcer and Deep Vein Valve Surgeries

Vascular Access surgery for Renal Failure

Sophisticated Diagnostic Imaging Services We have India's first totally integrated Hybrid operating theatre 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.

Dr Prof Tripathi is an internationally renowned leading opinion maker in Vascular and Endovascular Surgery. His experience as a Consultant Vascular Surgeon spans over 18 years during which he has performed in excess of 6000 Open Vascular, 4300 Endovascular Interventions and 1200 Endovenous Laser treatments of varicose veins.

He has made significant pioneering contributions to innovative, minimally invasive and new advances in Endovascular Surgery especially in the areas of in-situ fenestration of stent-grafts in the Endovascular treatment of Thoracic and Abdominal Aortic Aneurysms and Deep Venous Valve Incompetence.

He is credited for performing India's first Endovascular repair of Abdominal Aortic Aneurysm in 1998. He also performed the first Implant of Medtronic Xcelerant AAA stent graft in Australia and New Zealand at Wellington Hospital, New Zealand on June 2005. He has since then performed over 300 Endovascular repair of Aortic Aneurysms.

His areas of expertise include bypass surgery and endovascular procedures for peripheral arterial and venous diseases, thoracic and abdominal aortic aneurysms, stroke prevention by carotid interventions and RF / Laser treatment of varicose veins.

He is a Faculty Speaker at many prestigious International Vascular Conferences including VEITH Symposium (Vascular and Endovascular Issues Techniques andHorizons), ISET International Symposium on Endovascular Therapies, European Society of Vascular Surgery, Asian Vascular Society, CICE and International Congress of Endovascular Interventions. He is on the Board of Governors of Innovasc Endovascular Research Group, New Zealand and continues research initiatives with Thrombosis Research Institute at Narayana Hrudayalaya in developing Endovascular Vein Valves, Aortic Stent grafts and Bioabsorbable Polymer stents. He reviews publications for 9 Journals and is on the Editorial board of Journal of Phlebology.

Consultants

Dr Robbie George MBBS, MS, FRCS, FRCS(GLA), FRCS(VASCULAR SURGERY U.K)

Dr Robbie George is an alumnus of Delhi University where he did his MBBS, MS and DNB in General Surgery He is a state and national Gold Medal Winner in surgery. He trained in Vascular and Endovascular Surgery at Queen's University Belfast and University of Leeds. He has been a speaker of various national and international meetings and has published extensively in leading peer reviewed journals and chapters in vascular text books. He interests lie in open and endovascular surgery especially Limb Salvage, Cartroid Diseases and Renal access and protocol based vascular reaserch and training.

Dr Rajesh S MBBS, MS, MRCS (UK), FEVS (Germany)

Dr Rajesh is a Gold Medal winner in MS General Surgery from Davangere Medical College and subsequently trained in Vascular and Endovascular Surgery at MS Ramaiah Medical College and Kiel University Medical School in Germany. He worked as a Specialist Vascular and Endovascular Surgeon at M.S Ramaiah Medical College and King Fahd Specialist Hospital before joining Narayana Hrudayalaya. His interests lie in Open and Endovascular Surgery and Clinical Trials

Dr Ramesh TripathiMBBS (JIPMER), FACP, FICS, FRCS Edin., FRACS Vascular (Australia)

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No. 258/A, Bommasandra Industrial AreaAnekal Taluk, Bangalore - 560099Phone : +91 80 27835000/1816

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