Vascular surgery or angiology is a section of clinical surgery.
The sphere of angiology is a disease of the blood vessels of the human body, that is, arteries and veins. Who is a vascular surgeon? He is an angiologist or phlebologist - a doctor who specializes in the diagnosis, treatment and prevention of vascular disease. Only the specialization of the angiologist is the artery, and the phlebologist is the vein.
When should I go to a vascular surgeon?
Referring to a vascular surgeon is necessary for any violations of hemodynamics, which are accompanied by such symptoms:
pain in the muscles of the calf (calf muscles) during walking;
feeling of "cast-iron" legs, which appears later in the evening;
nocturnal cramps in the legs;
sensation of cold and numbness in the limbs or parts of the body;
intense pain in the area of the feet (even at rest);
weakness in the hands during physical activity;
darkening (or blueing) and tenderness of fingers, changes in the color of the skin on the legs or hands;
the manifestation of capillaries on the skin in the form of vascular "stars";
sensation of pulsation in the abdomen;
prolonged aching or throbbing pain in the chest, waist or side, often giving up in the groin, buttocks and legs.
What tests should I take when I contact a vascular surgeon?
For an objective assessment of the condition of blood vessels and the establishment of the correct diagnosis, when referring to a vascular surgeon, the results of a laboratory study of certain blood parameters will be required, in particular:
clinical blood test;
coagulogram (blood clotting analysis);
aggregatogramma of platelets (analysis of the activity of blood platelets);
lipidogram (for chronic pathology of peripheral arteries)
a blood test for C-reactive protein and immunoglobulins IgG and IgM (also for chronic peripheral arterial diseases).
What diagnostic methods does a vascular surgeon use?
Diagnosis of pathologies of blood vessels is carried out on the basis of examination of patients, on the results of blood tests, ECG data, as well as special studies of blood vessels.
Special diagnostic methods used by a vascular surgeon include:
ultrasonic duplex scanning (the resulting two-dimensional image of the vessels allows you to see the structure of the walls of the vessels, the size of the vessels, their patency and the nature of the blood flow in the vascular bed);
ultrasound dopplerography (UZDG, allows you to objectively assess the functional state of the main arteries and peripheral circulation, including the ankle-brachial index, that is, the state of arterial blood flow in the lower limbs);
angiography (radiographic examination of vessels to determine the exact location of narrowing or clogging of the vessel);
cerebral angiography (X-ray examination of cerebral vessels);
Coronary angiography (X-ray examination of the coronary arteries and chambers of the heart);
plethysmography (study of vascular tone and blood flow in small vessels);
radionuclide or radiopaque phlebography (X-ray examination of veins);
CT angiography (computed tomography of the vascular bed);
MR angiography (magnetic resonance imaging of vessels).
What does a vascular surgeon do?
Armed with comprehensive knowledge of the structure, features and pathology of the functioning of the human blood vessel system, a vascular surgeon - when addressing each patient - must evaluate all endogenous or exogenous factors of the onset of the disease.
After the angiologic examination, the vascular surgeon determines the cause of the vascular pathology that has arisen and makes an accurate diagnosis. Depending on the specific diagnosis, the doctor chooses the optimal treatment strategy. As a rule, the therapy of vascular diseases is combined and includes not only medical treatment, but also phlebosclerosing techniques (sclerotherapy), compression treatment. Widely used and physiotherapy - electroneurostimulation, darsonvalization, magneto- and cryotherapy, pneumomassage and physiotherapy.
In many cases - with the threat of disease progression - the vascular surgeon resorts to surgical treatment (venectomy, mini-phlebectomy, intravascular laser coagulation, etc.).
What diseases are treated by a vascular surgeon?
The list of diseases treated by a vascular surgeon includes:
aneurysm of the aorta and other arteries;
atherosclerosis, including obliterating atherosclerosis of the vessels of the extremities;
embolism of veins or arteries;
thrombosis of veins, including thrombophlebitis;
defeat of brachiocephalic vessels (vessels supplying blood to the brain).
Advices of a vascular surgeon physician
According to the latest data of the International Society of Flebologists (Union Internationale de Plebologie), chronic venous insufficiency affects 35-65% of the inhabitants of the industrially developed countries of the world. The most common vascular pathologies include varicose veins, which is especially common in women. Statistics show that more than 60% of women have symptoms of this disease after 45-50 years. Deformed veins, twisting blue "bundles" translucent under the skin, not only spoil the appearance. Without the treatment of varicose veins, very severe vascular complications develop, primarily thrombophlebitis, as well as trophic ulcers and thromboembolism.
Among the factors predisposing to the appearance of varicose veins, the following should be noted:
genetically determined weakness of the vein walls and dysfunction of the venous valves (ie hereditary predisposition);
excessive body weight;
positional disturbances of venous outflow (in people who are for a long time in forced orthostasis with "sedentary" or "standing" work, as well as during frequent and prolonged air travel);
excessive physical activity and overheating (sauna, hot tub, solarium, beach);
pregnancy and childbirth;
intensive hormone replacement therapy or long-term use of hormonal contraceptives).
All these factors can cause a violation of blood flow through the veins, its stasis and increased venous pressure, which leads to an expansion, deformation and partial or complete dysfunction of the vessels of the legs.
Therapy of varicose veins should be carried out at the first of its symptoms. Since thrombophlebitis, to which this disease leads, is already an inflammation of the walls of the veins with the formation of thrombi. Often clots break away from the vessel wall and migrate along the vascular bed. And if it enters the pulmonary artery, then there is a deadly thromboembolism of the pulmonary artery. So, venous thrombosis is a real threat to life.
The advice of a vascular surgeon's doctor regarding the prevention of varicose veins is as follows: once again carefully read the previous paragraph of these notes and try to minimize the risk factors for this disease. Especially if among your relatives there are patients with varicose veins. And pregnant women with a penchant for this vascular pathology are recommended to wear a special compression jersey.
Effective treatment of varicose disease and the ability to prevent its further development exist. Only for this purpose it is necessary to pay attention to the first signs of the disease in time and to turn to a specialist in time. And this specialist is a vascular surgeon.
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Medical expert editor
Portnov Alexey Alexandrovich
Education: Kiev National Medical University. A.A. Bogomolets, Specialty - "General Medicine"