Thank you for choosing our group to
care for your vascular problem. We appreciate the opportunity
to meet your medical needs by providing quality care.
Our group is a division of the Department of Surgery of
the University of Pittsburgh Physicians. We, as vascular
surgeons, specialize in the evaluation and management
of conditions involving blood vessels (arteries and veins).
It is important for us to build a strong relationship
with our patients. We strive to provide the highest quality
of health care. If you have a question abut your care,
please do not hesitate to call us.
We offer medical consultation and a
variety of interventions to treat the following:
You may need to see a neurosurgeon for problems with blood
vessels in the brain or a cardiothoracic surgeon for problems
with blood vessels in the heart.
Office locations
Call 412-802-3333 to schedule an appointment (unless otherwise
noted).
Here is the information for 2 of the
topics above:
Information on aortic dissection
Aortic dissection is due to a partial tear in the main
artery from the heart (aorta), which causes a separation
(dissection) of the layers of the aortic wall and bleeding
into and along the wall of the aorta. Aortic dissection
is a life-threatening condition. Doctors also refer to
it as a dissecting aneurysm. Dissection usually occurs
within the chest in the upper part (ascending) or the
lower part (descending) of the thoracic aorta. But it
may also occur in the abdominal aorta. This condition
occurs more often in men than in women.
Causes of aortic dissection include:
- High blood pressure
- Abnormalities of the aortic wall
that are present at birth (congenital), such as in Marfan
syndrome or Ehlers-Danlos syndrome
- Blunt force trauma to the chest
Signs and symptoms usually include
sudden and severe chest or upper back pain. People often
describe the pain as "ripping" or "tearing."
In some people, signs and symptoms can be nonspecific,
such as anxiety, pallor, sweating and nausea. Aortic dissection
may be misinterpreted as a heart attack. But it can also
occur at the time of a heart attack, if the dissection
involves a coronary artery.
A chest X-ray or ultrasound examination
may identify a pre-existing abnormality of the aorta,
such as a widening (dilation) of the aorta, before dissection
occurs. But sometimes, an abnormality isn't found before
the dissection.
An ascending aortic dissection can also
cause blood to leak into the sac around the heart (pericardium)
- called cardiac tamponade. This can quickly cause death.
A tear in the aorta that results in massive bleeding into
the chest is usually fatal.
Treatment of an aortic dissection depends on the location
of the primary tear. Tears that involve the ascending
aorta usually need emergency surgery. For dissections
involving the descending aorta, treatments such as beta
blockers to control blood pressure and limit further tearing
may be effective without surgery.
Information on thoracic outlet syndrome
Thoracic Outlet Syndrome is a condition where nerves and/or
vascular structures are compressed in the shoulder region
by the first rib, accessory (cervical rib) when present,
muscles or abnormal fibrous bands resulting in various
symptoms such as pain, numbness, weakness and swelling
of the arm and hand. The most common variety is produced
by compression of nerves (brachial plexus) as they cross
over the first rib to enter the arm. The majority of patients
with this variety of thoracic outlet syndrome are treated
successfully with exercises and physical therapy alone.
Only 10-20% of these patients require surgical treatment
to relieve the compression by removal of the first rib,
abnormal muscles or fibrous band and/or accessory rib
when present. Approximately 85-90% of patients requiring
surgery obtain excellent relief of their symptoms. The
other, much more rare variety of thoracic outlet syndrome
is produced by compression of the vascular structures,
such as the subclavian vein or the subclavian artery leading
to the formation of blood clots. When the vein obstructs
with blood clots, the symptoms are pain and swelling of
the arm requiring emergency clot dissolving treatment
and later operation to remove the first rib to relieve
the compression. If the subclavian artery develops a clot,
it is usually due to its compression by an extra rib (cervical
rib), requiring an operation to remove it and some times
replacing the artery with a graft. Excellent results are
obtained if the diagnosis and treatment are instituted
early.
