The vascular services program at Cookeville Regional has grown from one vascular surgeon in 1994 to a current total of five vascular surgeons. With a dedicated angiography suite and a full range of other imaging procedures available, our vascular specialists are able to evaluate, diagnose and treat a wide range of vascular disorders. Our surgeons perform more than 500 vascular surgeries annually.

Some of the most common vascular conditions we treat include:

  • Aortic Aneurysm
  • Carotid Artery Disease
  • Peripheral Arterial Disease

EKOS Endovascular System

Cookeville Regional has a new innovative technology that helps dissolve blood clots in lungs and elsewhere. The EKOS Endovascular System has been shown to be very effective in removing clots and improving patient outcomes. The cardiologists are able to place a catheter inside the lungs that dispenses a clot-busting medication right there where the clot is instead of administering an IV or taken it by mouth where it affects the entire body. This also produces ultrasound waves to further dislodge and break apart the clot to help dissolve it.


An angiogram is a study that assesses blood vessels, either arteries or veins, for abnormalities such as narrowing or blockage. These abnormalities can be caused by conditions like atherosclerosis and hardening of the arteries. For this study, liquid contrast dye is injected into the vessels to make them visible on X-ray images. The images are obtained as the dye passes through the vessels. The physician evaluates the images to determine the type and extent of any blockage or narrowing in the vessels. He or she will also determine if the abnormality would be best treated by angioplasty and/or stenting, or by medical or conventional surgical treatment. This decision is based on the appearance and location of the narrowing or blockage on the angiogram, and your overall medical condition. Angioplasty and stenting can often be performed at the same time as the diagnostic angiogram, and are discussed in the next section, called angioplasty and stenting.

During the exam

This exam is performed in a hospital setting with specialized equipment and a team of highly skilled nurses and technologists. The physician will then find an appropriate blood vessel in which to start the study. This starting site is most often in the groin area or arm, and may be a distance away from the blood vessel of concern. The skin above the starting vessel is numbed with an anesthetic. You may also receive conscious sedation to make you sleepy and relaxed. After the skin is numbed, a small needle is used to guide a catheter through the skin into the blood vessel. The catheter is advanced through the blood vessels of the body to the area of concern, and contrast dye is injected. The contrast agent may make you feel warm for a very brief period of time after the injection, but the feeling passes quickly. X-ray images are obtained during the injection. The physician will review the images to see if there is any abnormality, such as narrowing or blockage that might require treatment. If no treatment is indicated, the catheter is removed and pressure is applied at the skin entry site to stop any bleeding. You will most likely be sent home the same day of your diagnostic angiogram after being monitored for a few hours following the procedure.

Preparation for the exam

You may continue your usual activities the day before the exam. Depending on the time of the scheduled procedure, you may be asked to not eat or drink anything for breakfast on the day of the procedure. If you take medication to thin the blood (anticoagulants), you may be asked to refrain from taking that medication for a period of time (depending on the medication) prior to the procedure.

How will I get my results?

An interpreting physician (usually a radiologist) will read your exam and make a final diagnosis. His interpretation will be converted to a written report, which will be sent to the physician who ordered your exam. Your physician should present the findings of your exam to you. You may also sign up for a patient portal account at to read your results online.