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Vascular surgeon

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Vascular surgery is the branch of medicine focuses on the diagnosis, treatment and prevention of diseases of the great vessels and the lymphatic system.

Specialist in vascular surgery or angiosurgeon uses the methods of minimally invasive therapy for the treatment of vascular diseases. Referred to as minimally invasive methods in which the process of surgical treatment minimizes the size of incisions, making surgery less traumatic for the patient, facilitating the rehabilitation period, this maximizes the effectiveness of the treatment.


What cures a vascular surgeon?

Vascular diseases may be congenital or acquired, may develop on the background of other systemic diseases, hormonal imbalance, or occurs after traumatic vascular injury. The scope of activities of the vascular surgeon also includes cancer education, located close to large arterial vessels, which can create abnormal communication between the veins and arteries. Among the consequences of such diseases include both cosmetic defects and functional disorders in organs, which are responsible blood flow to affected vessels.

Microsurgery is the direction of the vascular surgery, which uses the optical system magnification, special instruments and suture material, which allows to perform operations even on vessels with a diameter less than 2 mm. Microsurgical techniques allow to perform the replantation of parts of extremities (hands and fingers, feet) after traumatic amputation, with partial or complete recovery of function. In the process of microsurgery can be sutured of the veins and arteries of small diameter, nerves and lymph vessels.

The most common problem, which apply to the doctor-registration is atherosclerosis and its complications. Previously it was thought that this disease occurs mainly among the elderly, but in the modern world suffer from atherosclerosis and younger patients. Atherosclerotic vascular lesions, the formation of cholesterol plaques leads to narrowing of the lumen, inhibiting blood flow. While there are circulatory disorders of the organ whose vesselstouched the disease, which can lead to loss of function and tissue necrosis.

In most cases, atherosclerosis is asymptomatic, because of the presence of atherosclerotic plaques can only be judged by the negative consequences of vascular lesions. So, if when blockage of the vessel atherosclerotic plaque is disrupted blood supply, and there are destructive changes in the tissues, pathology of the body can be assumed vascular disease. This situation is very dangerous, because often atherosclerosis is detected at a stage when there are irreversible pathological processes. For some patients the first symptom of atherosclerosis is both the latest – in case of heart attack or stroke, that is, the vascular lesions of the heart or brain.

The main activities of angiosurgeon:

  • Diagnosis of vascular diseases, disorders of the functionality of the main vessels;
  • Replantable – microsurgery for re-attachment of limbs after traumatic amputation;
  • Prosthetics of blood vessels after injury as a result of mechanical impact or surgical intervention;
  • Treatment of blood vessels damaged by the traumatic impact;
  • The treatment of cancer tumors, growing in large vessels;
  • Conservative treatment of damaged blood vessels, as well as preventive measures to prevent the occurrence of vascular diseases;
  • Treatment of congenital vascular malformations – hemangiomas and arteriovenous malformations.

Of the disease, treatment and diagnosis involved with the vascular surgeon:

  • Atherosclerotic lesions of the vessels – atherosclerosis of the lower extremities, thrombosis of renal artery, atherosclerosis of brain vessels;
  • Coronary heart disease;
  • Aortic aneurysm;
  • Arteriovenous malformation;
  • Myocardial infarction;
  • Congenital or traumatic arteriovenoznogo fistula;
  • Vessels that provide the brain blood circulation;
  • Trophic ulcerative lesions of the skin;
  • Carotid artery stenosis;
  • Diabetic angiopathy;
  • Scurvy;
  • Phlebitis, thrombosis and thrombophlebitis;
  • Stroke
  • Varicocele;
  • Embolism veins;
  • Arterial gas embolism;
  • Varicose veins;
  • encephalopathy;
  • Inflammatory thrombosis of small arteries and superficial veins;
  • Violation of the outflow of lymph – lymphedema;
  • Rupture of the aneurysm and subarachnoid hemorrhage;
  • Chronic cerebral ischemia, insufficiency of cerebral blood circulation;
  • Inflammation of the aorta and its branches – Takayasu's syndrome;
  • Impaired venous outflow of the liver – Budd-Chiari;
  • Autoimmune syndrome characterized by alveolar pulmonary hemorrhage and glomerulonephritis – goodpasture's syndrome or systemic capillary;
  • Transposition of the great arteries;
  • An aortic dissection in the Marfan syndrome;
  • Raynaud's disease – vascular lesions of the distal extremities, fingers and toes.

When to go to a vascular surgeon (angiosurgeon)?

In the preventive purposes it is recommended to undergo annual examination by a vascular surgeon, it allows to detect vascular disease at an early stage and prevent the occurrence of atherosclerosis.

Symptoms, detection of which is necessary to address to the expert:

  • Heaviness in legs and feet, swelling and burning sensation in legs;
  • Tingling and numbness of the distal extremities and other parts of the body;
  • Dizziness, tinnitus, impaired coordination and consciousness;
  • Darkening of the fingertips, they can turn black and acquire a bluish tinge;
  • Ulcerative lesions on the skin, prolonged healing of the damage;

  • Headaches not related to other diseases (see also: causes, signs and symptoms, consequences)

  • Spots and dark spots before eyes;
  • Pulsating sensation in the abdominal area;
  • Bleeding in any area of the body;
  • The occurrence of seizures even at rest, worse during exercise;
  • Dilated veins on the legs, and pain in the feet when walking;
  • Varicose grids or telangiectasia;
  • Seal, localized in the lowerthe extremities of redness and soreness or, on the contrary, loss of sensation;
  • Pain in the side, chest and in the lumbar region, which may spread down the buttocks and through the groin area to the feet.

The tests that need to pass from a vascular surgeon

To diagnose the state of the vascular system and identification of functional disturbances in blood flow must undergo a series of examinations.

  • Analysis on the biochemical composition of the blood allows to determine the functional state of the liver, pancreas, kidney, gall bladder and other organs, to detect metabolic disorders and diseases of the blood. This is a basic analysis necessary for the diagnosis of many diseases. Examines indicators of the level of glucose, bilirubin, liver enzymes and pancreatic protein and blood lipids. In the diagnosis of vascular diseases play an important role in lipid metabolism – cholesterol, triglycerides, low-density lipoproteins. That data can be used to identify predisposition to atherosclerosis and to prevent vascular lesions. The blood is examined for levels of homocysteine (an amino acid contributing to the depletion of the vascular walls, which causes the deposition of cholesterol plaques), creatine kinase, phosphatase and C-reactive protein.
  • General blood analysis – blood testing for hemoglobin levels, erythrocyte, platelet index and the level of other blood cells – leukocytes and erythrocytes. These data allow us to determine the quality of the blood and early detection of disease that can cause damage to blood vessels, thinning of the walls.

Other tests that determine the clinical picture:

  • Urinalysis is prescribed for the diagnosis of most diseases, the urine is examined for glucose, bilirubin, ketone bodies, is determined by its pH, the presence of blood cells, salts, parasitic organisms, bacteria and fungi;
  • Gemostaziogramma – is determined by the fibrinogen level, prothrombin time and prothrombin index;
  • Serological analysis of blood allows you to determine the cause of infectious disease, examines the blood serum for the presence of antibodies.

In the process of diagnosing the angiosurgeon, you may need additional studies for accurate diagnosis, the direction of the analysis gives the doctor.


The main methods of diagnosis of vascular surgeon

Diagnosis of vascular diseases is carried out on the basis of inspection and tests of the patient, carried out using instrumental methods.

The main methods of diagnosis:

  • MRI-angiography or ultrasound duplex scanning gives a two-dimensional image of the vessels on which you can assess the condition of the walls structure and permeability, to determine the characteristics of blood flow in the bloodstream;
  • X-ray angiography – using this method is determined by the location of the occlusion and reduction of its lumen;
  • Doppler ultrasound – a method of assessment of peripheral and major arteries, it determines the functional status of blood flow in the lower limbs, its speed and the narrowing or blockage of blood vessels;
  • Cerebral angiography – a method of research vessels, providing cerebral blood flow (cerebral blood vessels);
  • Coronal angiography – assessment of vessels, ensuring blood flow to the heart – the coronary arteries and the cardiac chambers;
  • Ultrasound of internal organs – primarily examines the organs of the endocrine system responsible for maintaining hormonal balance. These include the thyroid, kidneys and adrenal glands.
  • Electrocardiogram – assesses the work of the heart muscle in the daily dynamics;

  • Endoscopic methods of investigation of blood vessels or angioscopy allows to assess the state of their internal surface, to determine the susceptibility to the development of atherosclerosis; (see also: causes, symptoms, diagnosis and treatment of atherosclerosis)

  • Sonography of the vessels of the liver;
  • Echocardiogram–ultrasound of the heart muscle;
  • Anthropometry – calculating body mass index, measure body length by height chart, determine the circumference of the chest and abdomen to assess the General condition of the body based on anthropometric indicators;
  • Doppler sonography of the veins of the lower extremities allows to evaluate the state of blood flow in real time with sound and graphic display of indicators. This method is applied to study the great and small saphenous veins, deep veins of the lower leg, femoral, inferior Vena cava and iliac veins. Is determined by the condition of the vessels, the presence of an anomaly in their structure, kinks, andaneurysms, inflammatory processes, and compression.

Basic principles of treatment of a vascular surgeon

After evaluating all external and internal factors that triggered a vascular disorder, an angiologist appoints a course of treatment, which may include drug and compression therapy, surgery, sclerotherapy.

Sclerotherapy has been used in the treatment of varicose veins and vascular tumors, in a vessel introduced a special substance that causes agglutination of its walls and prevents the spread of the pathological process.

Other methods of treatment of vascular disease magnetic therapy, pneumomassage, cryotherapy, electro-neuro-stimulation exercises and physical therapy. If necessary, surgical intervention, assigns a registration venectomy, miniphlebectomy or laser coagulation of the vessel, depending on the type of pathology.