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Vascular and Endovascular Surgery Areas of Expertise

Endovascular Surgery
Endovascular surgery allows physicians to treat a variety of medical disorders without open surgery by using x rays and other imaging techniques to guide small tubes (catheters) and devices through the blood vessels, thereby reducing the risk of complications and shortening the recovery period.

Endovascular surgery is used to treat abdominal aortic aneurysms and peripheral vascular disease, as well as to perform carotid angioplasty/stenting (as an alternative to carotid endarterectomy). As technologies continues to develop, more and more procedures are likely to become available through this exciting minimally-invasive surgery.


  • Abdominal Aortic Aneurysms
  • Carotid Artery Disease
  • Peripheral Vascular Disease

Carotid Artery Disease
Carotid artery disease is a common problem and a major cause of stroke. Patients are at increased risk for developing carotid artery disease and stroke if they already have coronary artery atherosclerotic heart disease, or if they have a family history of heart disease or stroke. Carotid artery disease is caused by the same factors that contribute to coronary artery atherosclerotic heart disease, but carotid artery disease tends to develop later in life. Fewer than 1% of adults in their 50's have significant narrowing of their carotid arteries. But 10% of adults in their 80's have extensive narrowing.

Atherosclerosis cannot be prevented altogether, but progression of the disease can be slowed and the risk of developing atherosclerosis can be reduced through changes in lifestyle and diet. The best preventive measures are exercising regularly, eating a diet low in cholesterol and saturated fat, and maintaining a healthy weight. A class of drugs called statins can reduce the amount of cholesterol in the bloodstream and may limit the growth of plaque.


  • Carotid Endarterectomy (open surgery)
  • Carotid Stenting (minimally invasive)

Peripheral Arterial Disease (PAD)
Peripheral arterial disease (PAD) affects millions in the United States, most of whom are not aware that they have the disease. PAD interferes with lifestyle by decreasing walking ability and affecting cardiovascular health. Left untreated, PAD increases the risk of heart attack, stroke, amputation of lower extremity limbs, and death.

Arteries carry blood from the heart to all areas of the body and, when healthy, have a smooth lining that promotes blood flow and helps to prevent blood clots. PAD is a condition in which fatty deposits (called plaque) build up along the walls of the arteries that carry blood to the arms and legs. This is also known as atherosclerosis, or hardening of the arteries. The arteries slowly narrow and may even become blocked, affecting blood circulation especially in the legs and feet.

Types of Peripheral Arterial Disease 

  • Bypass Surgery (open)
  • Endovascular Therapy (angioplasty/stent)

Aortic Aneurysm
An aneurysm is an enlarged portion of a weak area of an artery. Over time, blood flow can cause the weak area to bulge like a balloon. An abdominal aortic aneurysm (AAA) occurs in the abdominal section of the aorta, the main blood vessel that carries blood away from the heart.

Aneurysms can burst or rupture, causing serious internal bleeding and, if not treated, death. More than 15,000 people die of AAA ruptures in the United States each year. Aneurysms can also unleash potentially life-threatening blood clots.

The risk for complications increases with the size of the aneurysm. In general, abdominal aortic aneurysms that are slightly larger than 2 inches (about 5.5 cm) in diameter should be considered for treatment. Smaller aneurysms should be monitored carefully for any enlargement.


  • Endovascular Stent Graft
  • Open Surgical repair

Varicose Veins
Varicose veins are a common condition. They occur in at least 30% of the American population. They are unnaturally and permanently distended veins that are visible through the skin on the legs, and typically appear as blue, bulging, and twisted veins. When varicose veins become prominent, unsightly, painful, or inflamed, treatment is indicated, especially when skin irritation or ulcers develop.

Following an initial evaluation, which generally includes an ultrasound exam in our vascular laboratory, a treatment plan is developed and individualized for each patient. We offer a variety of surgical and minimally invasive treatments for varicose veins, including sclerotherapy, the Closure Procedure, vein stripping, small incision stab phlebectomy, and the TRIVEX® Procedure.

Vascular Disease Screening
A Simple Test Can Save Your Life 

Most people in the United States know about heart disease, the importance of prevention, detection, and treatment, and the huge impact it can have on health. But most people know very little about vascular diseases outside the heart, despite the fact that many vascular diseases can lead to heart attack, stroke, leg amputation, or other disability. An estimated 20 to 30 million Americans are at risk for various vascular diseases including stroke, peripheral arterial disease (PAD), carotid artery disease, and aortic aneurysms. Vascular disease causes almost as much death and disability as heart disease, although most people who were screened didn't know they had a problem and had never been tested for vascular disease.

The Importance of Early Detection
In most cases, vascular disease can be treated effectively following early detection. Several simple screening tests, all of which are non-invasive and painless, can be used to detect vascular disease.

Who Should be Screened for Vascular Disease?
Anyone over the age of 55-60 has a higher risk of atherosclerosis and, therefore, would have a greater chance of developing vascular disease. Other well-recognized risk factors include:

  • Diabetes
  • High blood pressure
  • Smoking
  • High blood cholesterol
  • Family history of atherosclerotic problems and circulatory problems

We offer a full range of noninvasive tests, including tests for:

  • Peripheral Arterial Disease (PAD)
  • Aortic Aneurysms
  • Cerebrovascular Disease
  • Venous Diseases (varicose veins)
  • Deep Venous Thrombosis (blood clots in the veins that can travel to the lungs)
  • Renal Artery Disease (circulatory disorders of the kidney)
  • Abdominal Aortic Aneurysms
  • Carotid Artery Disease
  • Peripheral Vascular Disease

We offer comprehensive diagnostic vascular studies for detection of stroke risk, abdominal aortic aneurysms, peripheral arterial disease (PAD), vascular access, and venous diseases. Our in-office studies include high-resolution duplex ultrasound imaging, as well as non-invasive studies performed under the direction of a skilled technologist and a highly experienced vascular surgeon. Our office has convenient on-site access to state-of-the-art computerized tomography (CT) and magnetic resonance imaging (MRI). Using this high-tech equipment, our specialists can detect and treat vascular disease, often on an outpatient basis.


The Hoffman Heart and Vascular Institute of Connecticut
114 Woodland Street
Hartford, CT 06105