Vascular Surgery Clears a Path in the Veins

“The goal of everything is to allow the patients to return to their lives.” Kevin D. Martin, M.D., on controlling the turbulence of blood and how his profession has changed.
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Kevin D. Martin, M.D.
Vascular Surgery
St. Elizabeth Healthcare

Most people think of vascular surgery as varicose veins. But we take care of all the vessels in the body unless they’re inside the skull, which is neurosurgeons, or on the heart or immediately adjacent to the heart—those are for the cardiothoracic surgeons. Virtually everything else is part of our domain.

In the Northern Kentucky/Cincinnati area, we’re dealing with occlusive arterial disease. You may call that cholesterol, plaque, or hardening of the arteries. There are a bunch of different terms. They’re all talking about the same stuff—buildup inside the arteries blocking them so blood flow doesn’t go where it needs to. A lot of those blockages are asymptomatic and don’t need to have anything done medically.

[For patients who need treatment], we do all sorts of things, from getting them to quit smoking to exercise to taking certain medications to improve blood flow. If that doesn’t work, we can do angioplasties, stints, bypasses. There are a whole lot of complex procedures we do.

Carotid arteries get a lot of attention for needing to be improved to prevent strokes. For the carotids, most everybody understands if you put your thumb over a garden hose, the tighter you make it, the farther and faster the water flies. The same thing goes on in the neck. The tighter or narrower the artery, the faster blood flows. The faster the blood flows, the more turbulence and the more likely it is to knock something loose and take it upstairs into your brain and cause a stroke. That’s one of the more common causes of strokes in the U.S. If we find people who are high risk, we intervene.

Vascular surgery has changed dramatically. There is little I do nowadays that I was taught 40 years ago in medical school. All of the drugs are new, except aspirin. All of the procedures are basically new. The endovascular, minimally invasive stuff now makes up 80 percent of what we do. That’s a good thing. Patients get out faster and return to their lives. The goal of everything is to allow the patients to return to their lives to do what they wish.

At St. Elizabeth, we offer patients the gamut of procedures—a full range of [treatments for blocked] carotids to problems in the toes and everything in between. There’s very little we don’t offer. But everything we do really has to be individualized for the patient. There are no two patients who are exactly the same. We have all these studies telling us in general what works better, but at end of the day, the patient in front of you is who you’re taking care of. —As told to Michele Day

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