Revascularization is the restoration or improvement of blood supply. A number of techniques can be used to revascularize an organ or area of the body in the wake of injury, disease, or other problems that interrupt the supply of blood. This procedure may be performed by a vascular surgeon or cardiothoracic surgeon in an operating room or clinic fitted for revascularization procedures.
The blood carries oxygen and vital nutrients. When the blood supply is interrupted, it can cause organ and tissue death. Some things that can cause disruptions in the blood supply include gangrene, blockages in blood vessels, and severe injuries. Using Doppler ultrasound and other medical imaging studies, a doctor can identify an area where the blood is not flowing and learn more about why.
One option is to remove a blockage. Medications can be used to break up blood clots and objects such as stents can be inserted to dilate vessels that are shrunken or blocked. This uses the existing vasculature to return blood to the area.
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Sometimes, however, vessels are too badly damaged for this to be an option. In these cases, they need to be replaced with grafts. Another way of handling revascularization is to install a bypass, skipping over a damaged or clogged area of a blood vessel to provide a new path for the blood to use.
A patient who is a candidate for revascularization is examined carefully to determine the extent of the damage to the blood supply and the underlying cause. A surgeon may order a number of diagnostic tests in addition to conducting a physical examination on the patient. Patients are also evaluated for risk factors that could rule out certain treatments such as specific drugs or surgical procedures. The goal is to find a safe, effective method to revascularize the area of concern and address the blood supply problem without putting the patient at risk of complications.
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Revascularization surgery can take place with local anesthesia and sedation or under general anesthesia, depending on the nature of the case. One example of revascularization surgery is coronary artery bypass surgery, where a graft is used to bypass a blocked or fragile coronary artery in order to treat a failing blood supply. Another form of surgery involving the heart is transmyocardial revascularization, a treatment used for some angina patients that involves creating small channels in the heart with a laser to improve the bloodflow.