Vascular surgeon

Vascular surgery or angiology is a branch of clinical surgery.

The field of angiology is diseases of the blood vessels of the human body, that is, arteries and veins. Who is a vascular surgeon? He is also an angiologist or phlebologist - a doctor who specializes in the diagnosis, treatment and prevention of vascular diseases. Only an angiologist specializes in arteries, and a phlebologist - veins.

When should you see a vascular surgeon?

It is necessary to contact a vascular surgeon in case of any hemodynamic disturbances that are accompanied by the following symptoms:

• pain in the calf muscles (gastrocnemius muscles) while walking;
• a feeling of “cast iron” legs that occurs towards evening;
• night leg cramps;
• a feeling of cold and numbness in the limbs or certain parts of the body;
• intense pain in the feet (even at rest);
• weakness in the arms during physical exertion;
• darkening (or blueing) and soreness of the fingers, change in skin color on the legs or arms;
• the appearance of capillaries on the skin in the form of vascular "stars";
• a feeling of pulsation in the abdominal area;
• prolonged aching or throbbing pain in the chest, lower back or side, often radiating to the groin, buttocks and legs.

What tests should be taken when visiting a vascular surgeon?

To objectively assess the condition of blood vessels and make a correct diagnosis when contacting a vascular surgeon, you will need the results of a laboratory study of some blood parameters, in particular:

• clinical blood test;
• biochemical blood test;
• coagulogram (blood clotting test);
• platelet aggregation (analysis of blood platelet activity);
• lipidogram (in chronic pathology of peripheral arteries)
• 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 vascular pathologies is carried out on the basis of examination of patients, blood test results, ECG data, and special vascular studies.

Special diagnostic methods used by a vascular surgeon include:

• ultrasound duplex scanning (the resulting two-dimensional image of the vessels allows one to see the structure of the vessel walls, the size of the vessels, their patency and the nature of the blood flow in the vascular bed);
• ultrasound Dopplerography (USDG, allows for an objective assessment of the functional state of the main arteries and peripheral circulation, including determining the ankle-brachial index, that is, the state of arterial blood flow in the lower extremities);
• angiography (X-ray examination of blood vessels to determine the exact location of narrowing or blockage of the vessel);
• cerebral angiography (X-ray examination of the blood vessels of the brain);
• 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 radiocontrast phlebography (X-ray examination of veins);
• CT angiography (computed tomography of the vascular bed);
• MR angiography (magnetic resonance imaging of blood vessels).

What does a vascular surgeon do?

Armed with comprehensive knowledge of the structure, characteristics and pathology of the functioning of the human vascular system, the vascular surgeon - when each patient comes to see him - must evaluate all endogenous or exogenous factors in the occurrence of the disease.

After conducting an angiological examination, the vascular surgeon determines the cause of the vascular pathology and makes an accurate diagnosis. Depending on the specific diagnosis, the doctor selects the optimal treatment tactics. As a rule, the therapy of vascular diseases is combined and includes not only drug treatment, but also phlebosclerosing techniques (sclerotherapy), compression treatment. Physiotherapy is also widely used - electrical neurostimulation, darsonvalization, magnetic and cryotherapy, pneumomassage and therapeutic exercise.

In many cases, when there is a risk of disease progression, the vascular surgeon resorts to surgical treatment (phlebectomy, miniphlebectomy, intravascular laser coagulation, etc.).

What diseases does a vascular surgeon treat?

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;
• varicose veins;
• venous or arterial embolism;
• venous thrombosis, including thrombophlebitis;
• damage to the brachiocephalic vessels (vessels that supply blood to the brain).

Advice from a vascular surgeon

According to the latest data from the International Society of Phlebologists (Union Internationale de Plebologie), 35-65% of people in industrially developed countries suffer from chronic venous insufficiency. The most common vascular pathologies include varicose veins, which are especially common in women. Statistics show that more than 60% of women over 45-50 years of age have symptoms of this disease. Deformed veins, visible under the skin as twisting blue "cords", not only spoil the appearance. Without treatment, varicose veins develop very severe vascular complications, primarily thrombophlebitis, as well as trophic ulcers and thromboembolism.

Among the factors predisposing to the development of varicose veins, the following should be noted:

• genetically determined weakness of the vein walls and dysfunction of the venous valves (i.e. hereditary predisposition);
• excess body weight;
• positional venous outflow disorders (in people who are in forced orthostasis for a long time during “sedentary” or “standing” work, as well as during frequent and long flights);
• smoking;
• high heels;
• excessive physical activity and overheating (sauna, hot baths, solarium, beach);
• pregnancy and childbirth;
• intensive hormone replacement therapy or long-term use of hormonal contraceptives).

All these factors can cause a disruption of blood flow through the veins, its stagnation and an increase in venous pressure, which leads to expansion, deformation and partial or complete dysfunction of the vessels of the legs.

Varicose veins therapy should be carried out at the first symptoms. Since thrombophlebitis, which this disease leads to, is already an inflammation of the vein walls with the formation of blood clots. Often, blood clots break away from the vessel wall and migrate along the vascular bed. And if it gets into the pulmonary artery, then a deadly pulmonary embolism occurs. So venous thrombosis is a real threat to life.

The advice of a vascular surgeon regarding the prevention of varicose veins is as follows: carefully read the previous paragraph of these notes again and try to minimize the risk factors for this disease. Especially if there are patients with varicose veins among your relatives. And pregnant women with a tendency to this vascular pathology are recommended to wear special compression hosiery.

There is an effective treatment for varicose veins and a possibility to prevent its further development. But for this, you need to pay attention to the first signs of the disease in time and promptly contact a specialist. And this specialist is a vascular surgeon.

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