March 2015

The human vascular system is a network of arteries, veins, and capillaries that transport blood throughout the body. The blood carries oxygen and essential nutrients to all of the living cells in the body, and also carries waste products from the tissues to the systems of the body through which they are eliminated.

Clearly, the vascular system is a critical component of the human anatomy. It is also an extensive and complicated system, which makes it vulnerable to problems, such as aneurysms, blockages and other dysfunctions.

At Middlesex Hospital, Drs. Joseph Coatti and Bart Muhs specialize in the diagnosis and treatment of the complete realm of vascular diseases and conditions.

Both of these surgeons have a keen focus on “endovascular” procedures of the vascular system. In other words, the surgery they often perform is done using a minimally invasive approach, rather than the traditional “open” method.

This technique is especially useful in the treatment of abdominal aortic aneurysms (AAAs). According to the Centers for Disease Control and Prevention, aortic aneurysms were the primary cause of 10,597 deaths and a contributing cause in more than 17,215 deaths in the United States in 2009.

About two-thirds of people who have an AAA are male. The condition is caused by weakening of the aortic wall due to arteriosclerosis (hardening of the arteries). Damage resulting from the plaque buildup inside the wall of the aorta causes weakening, which results in the formation of a bulge. If unrecognized and untreated, the aneurysm (or bulge) can grow large enough to rupture and cause death. AAA repair formerly required a large incision in the abdomen, with a significant risk of death from the procedure and an extended recovery time.

During an endovascular repair of an AAA, the surgeon threads a guidewire into one of the femoral arteries (the large arteries in each leg) that extend up into the area of the aneurysm. A stent is then inserted within the aneurysm. Blood then flows through the stent, taking pressure away from the aneurysm to prevent any further enlargement or rupture. The stent becomes a permanent structure in the artery as cells begin to grow around and through it within minutes after it is put in place. Stents can also be used in this way to treat blockages of the carotid arteries in the neck and in other arteries in the body.

This type of procedure has significantly less risk than traditional surgery and the typical length of hospital stay for the patient can be as little as a day or two. Patients return to full activity within a week after the procedure.

To contact Dr. Coatti or Dr. Muhs:
Joseph A. Coatti, M.D.
400 Saybrook Road
Suite 110
Middletown, CT 06457
Phone: (860) 347-9167

Bart E. Muhs, M.D., Ph.D.
540 Saybrook Road
Suite 210
Middletown, CT 06457
(860) 740-2280

For more information on both Dr. Coatti and Dr. Muhs, please see the “Meet our Vascular Surgeons” section in this issue.

The information contained within is not meant to substitute for the advice of your physician.