Leg ulcers that won't heal. Stroke. Heart attack. Vascular disease can strike in lots of different ways. You may not even know that you have it. But if you find yourself one of many victims of this serious condition, a surgeon specialist at Middlesex Hospital is ready to help.

Surgeon Joseph Coatti, M.D., of the Middlesex Hospital Center for Vascular Surgery, has a particular passion for surgical treatment of vascular disease, and performs a variety of "endovascular" procedures on blocked arteries in various parts of the body. These may include the carotid arteries in the neck, (to prevent stroke) and the arteries to the legs, to improve the ability to walk, and prevent possible amputation. Thanks to major advances in the field, there are now much more progressive and safer ways to treat conditions causes by blocked arteries. Dr. Coatti has expertise in all these procedures and a special interest in one that treats a vascular condition called an abdominal aortic aneurysm.

About 200,000 people in the United States are diagnosed with abdominal aortic aneurysms (AAAs) every year. AAAs, which affect nearly 5% of men over the age of 60, are caused by weakening of the aortic wall due to arteriosclerosis (hardening of the arteries). Damage resulting from 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.

According to Dr. Coatti, "AAA repair formerly required a large incision in the abdomen, with a significant risk of dying from the procedure (5% to 8%),
and an extended recovery time. New treatments for the condition offer an entirely different picture."

During an "endovascular" repair of an AAA, Dr. Coatti makes two small incisions in the groin area, which allows him to access the femoral arteries (the large arteries in each leg) that extend up into the area of the aneurysm. A stent-graft is then inserted within the aneurysm. Blood then flows through the stent-graft, taking pressure away from the aneurysm to prevent any further enlargement or rupture (right). 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.

Dr. Coatti says that this type of procedure has significantly less risk and the typical length of stay for the patient can be as little as two days. Patients return to full activity within a week after the procedure.

For more information about The Center for Vascular Surgery at Middlesex Hospital, go to www.middlesexhospital.org.

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