Minimally Invasive Procedures

By Gail M. Lassner - The Parklander

Painless new medical procedures make traditional surgery a thing of the past

A new and exciting trend in medicine offering minimally invasive surgical procedures has given local resident Franey Way the opportunity to ring in the New Year with a renewed sense of optimism.

It’s difficult to imagine her frustration when Way was told that she was considered too high-risk to undergo necessary surgery after being diagnosed with severe carotid artery stenosis. This disease is characterized as a build-up of plaque in the carotid artery which is the artery that supplies blood to the brain and when left untreated often results in a stroke.

Her frustration was soon replaced with an overwhelming sense of hope, as well as relief when she was introduced to Parkland resident Dr. William Julien, a Board-Certified Interventional Radiologist who practices full-time endovascular surgery in Margate. Dr. Julien told Way that she was a candidate for a new FDA approved minimally invasive life-saving procedure called Carotid Stenting. This procedure involves puncturing the femoral artery in the groin. Under x-ray guidance, a catheter device is then threaded through the blood stream into the carotid artery and then an angioplasty balloon and stent are inserted to hold the artery open.

Also employed is a novel technology involving the insertion of a filter device which stays in place during the procedure that catches particles which are often inadvertently dislodged during angioplasty, thereby minimizing the possibility of any complications which could occur during the surgery. Following her surgery, like so many others treated by Dr. Julien, Way is fully recovered after having undergone the hour long painless procedure. “Now I can enjoy my life,” she said gratefully.

Julien, on staff at Northwest Medical Center, was one of the original researchers of Carotid Stenting and was the first South Florida physician to implant the newly approved filter device. Presently, medicare coverage for this procedure is limited to patients like Way, who are considered too high-risk for traditional carotid endartectomy surgery. Dr. Julien sees this changing in the future. “I think ten years from now pretty much everyone will have carotid stenting procedures and very few people will have open surgery,” he said.

His practice is unique in that, unlike most interventional radiologists, Dr. Julien sees his own patients and treats many of them right in his office in a sophisticated endovascular surgery suite – one of the first of its kind in the country. He now performs minimally invasive varicose vein surgeries right in his office using local anesthesia. Traditionally, patients would have undergone surgery in the hospital under general anesthesia. The new procedure involves the use of an endoluminal laser guided by ultrasound which enters through the blood stream to close the abnormal vein. Patient's can immediately resume their non exertional activities.

Another new trend as we approach the New Year is a relief for the approximately 13 million American women who suffer from uterine fibroids. A new minimally invasive treatment option called Uterine Fibroid Embolization offers an alternative to having a hysterectomy. The procedure is performed with local anesthesia, again using interventional radiology catheter techniques rather than traditional surgery to destroy the blood supply to the fibroid tumors. As more women become aware of the availability of this procedure, Dr. Julien is confident that more will seek this new treatment option.

There are many benefits to minimally invasive endovascular surgery, according to Dr. Julien. Two-thirds of the surgeries are done right in his office, and procedures performed in the hospital are usually outpatient or sometimes a one night stay Also, because patients undergo local anesthesia, the surgeries are not painful and the risks associated with general anesthesia are eliminated. Additionally, these types of surgeries offer a significant savings to the health care system, especially since there is such a quick recovery time. Dr. Julien stresses that consumer awareness is critical. “Whoever performs endovascular surgery must be well trained and have a lot of experience,” he said. “Consumers should ask a lot of questions.” For more information visit

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