Cardiovascular surgeon doctor what treats. Who is an angiosurgeon?

Great amount people today suffer from various problems with vessels. Such problems can be caused by the most various factors, but they require mandatory proper treatment under supervision qualified specialist. Today there are several doctors who can help patients with vascular diseases. Angiosurgeon and phlebologist are just such doctors. Let’s try to figure out what such specialists treat, and what is the difference in the activities of these doctors.

Angiosurgeon - what does he treat?

In short, an angiosurgeon is a specialist who deals with surgical and sometimes conservative treatment of vascular diseases - both arteries and veins.

Basically, such doctors use minimally invasive interventions in their work. In other words, when treating, they resort to influences with a low degree of trauma, which are combined with maximum efficiency.

Angiosurgeons can treat vascular diseases of the different types, both congenital and acquired. This also applies to tumor formations that are located near veins and arteries and provoke various Negative consequences – cosmetic defects, pain, dysfunction of organs and systems, as well as the formation of trophic ulcers, etc.

In addition, angiosurgeons also perform microsurgery. This category includes surgical treatment that is used for injured surfaces that cannot be successfully healed over a long period of time. The profile of their activity is replantology - reattaching severed limbs with the maximum possible restoration their functions.

Most common cause calls to an angiosurgeon today are considered atherosclerosis, in which there is a deposition cholesterol plaques in the lumens of blood vessels. As a result of this pathological process, a narrowing of the lumen of the veins and arteries occurs, which leads to impaired blood supply. In this case, the specialist can offer several treatment options, for example, organizing the blood supply to an organ or system bypassing the area affected by atherosclerosis.

The profile of an angiosurgeon's activity may also include the removal of congenital forms some pathological formations, in which vascular damage is observed. Examples include hemangiomas and arteriovenous malformations.

Also, the angiosurgeon is a specialist in the prevention and treatment of varicose veins, thrombophlebitis, diabetic angiopathy, lymphostasis, trophic ulcers, telangiectasia, etc. His help can be useful in the treatment of strokes and heart attacks, ischemic heart disease, angiopathy, arteriovenous marlrmation, disculatory encephalopathy and many other conditions. The main task of such a specialist is to treat blood and lymphatic vessels, while therapy can be both conservative and operative.

You should consult an angiosurgeon if you experience symptoms of burning and tingling, cramps and pain in the limbs, as well as increased swelling. In addition, a visit to him is necessary if there is redness and hardness in the legs, or if there is a loss of sensation or movement. An angiosurgeon helps patients with necrosis and blackening of the feet and toes, with long-term non-healing ulcerative lesions and gangrene. His consultation may be necessary in case of sudden swaying, loss of consciousness and falls. It is also worth making an appointment with him for headaches, noises in the head and dizziness.

A phlebologist - what does he treat?

A phlebologist is a more specialized specialist in the field of pathological conditions of the veins. Thus, he is engaged in diagnosis and correction, as well as development preventive measures in relation to ailments of such vessels.

As practice shows, most often vein ailments affect the legs, since it is the lower extremities that suffer especially heavy load. Most often, people turn to a phlebologist when they develop varicose veins veins, but in addition, his profile also includes the therapy of thrombophlebitis, phlebitis and phlebothrombosis. This specialist also treats post-thrombic disorders, venous insufficiency and bleeding from varicose veins. He is also consulted when it is necessary to treat trophic disorders.

You should come for a consultation with a phlebologist if you are predisposed to the development of the listed diseases, as well as during pregnancy, when working related to constant sitting, at sedentary and strongly active image life. This doctor may also be useful if you have excessive body weight and unhealthy image life.

Of course, you cannot do without a visit to a phlebologist if vein diseases have already begun to develop. So you need to make an appointment with him if you encounter pain along the surface lower limbs, heaviness in the legs, cramps, swelling of the legs and bulging veins.

A phlebologist can offer his patients methods conservative treatment, as well as methods of surgical correction. Therapy is selected exclusively on an individual basis after a full diagnosis.

So, having examined the activities of such doctors as angiosurgeon and phlebologist, what is the difference between them, we can finally summarize. Thus, the main difference between an angiosurgeon and a phlebologist is that the first specialist deals with the correction of problems with all blood vessels, while the second treats only diseases of the veins.

An angiosurgeon is a doctor specializing in diseases of the vascular and lymphatic systems. System blood vessels consists of arteries and veins, and the lymphatic system is responsible for delivering blood components from the veins and arteries to the cells. An angiosurgeon performs operations on all issues related to vascular surgery, with the exception of the vessels of the brain and heart, this is the field of activity of neuro- and cardiothoracic surgeons. Until the 70s. In the 20th century, vascular surgery was the activity of surgeons general practice. However, over the next 10 years, innovators from the UK, Australia and the USA successfully developed and launched a training program for specialized surgeons - angiosurgeons.

If you feel constant feeling heaviness and fatigue in the legs, a swollen vein or spider veins, then you need to consult an angiosurgeon.

What diseases does an angiosurgeon treat?

The most common conditions an angiosurgeon has to deal with are aneurysms abdominal aorta or carotid artery. This specialist is able to prevent a possible stroke or heart attack if a blood clot circulating in the bloodstream is found in time. Then the angiosurgeon surgically removes the clot from the arteries in the neck or chest and clears the blocked vessel. The vascular surgeon also treats patients with trauma. vascular system when it is necessary to redirect blood flow from damaged vessels to healthy veins and arteries in order to improve circulation in patients with diabetes and disease peripheral vessels.

Patients suffering from atherosclerosis need to be examined by an angiosurgeon at least twice a year.

Patients with diseases of the lymphatic system, such as lymphedema, may also require the help of an angiosurgeon. With lymphedema, there is a retention of fluids that deliver blood components from the vessels to the cells. Patients suffering from scleroderma also turn to the angiosurgeon ( autoimmune disease, causing tissue thickening) or Raynaud's syndrome (a disease of the extremities in which spasm of blood vessels occurs and blood circulation is impaired).

Quite often, if there are no indications for urgent surgery, angiosurgeons prescribe drug treatment. For example, diseases such as intermittent claudication are treated with tablets. A small abdominal aneurysm or narrowing cervical arteries medium degree can be treated in a non-contact manner. And even in cases where intervention is required, available innovative technologies, allowing to avoid abdominal surgery. Manipulations carried out inside arteries using special balls and catheters can restore blood circulation or the integrity of the vessel walls without the need to open the vessel. Since angiosurgeons have the knowledge to carry out various kinds treatment from medication to abdominal surgery, they always suggest that the patient begin with the type of treatment in which he will be susceptible minimal risk complications.

(phlebologist) is a specialized doctor involved in the diagnosis, prevention and treatment of pathological development of the vascular system.

You should contact an angiosurgeon if you are concerned about fatigue and heaviness in your legs, swelling, or appearance on your legs. spider veins or asterisks, increased venous pattern, pain, the appearance of varicose veins, inflammation of the vein, the presence of a trophic ulcer.

An angiosurgeon is a specialist in the prevention and treatment of:

reticular varicose veins;
thromboangiitis;
varicose veins;
thrombophlebitis;
postthrombotic disease;
telangiectasia;
varicose veins in the lower extremities;
diabetic angiopathy;
aortoarteritis;
obliterating endarteritis;
lymphostasis;
trophic ulcer.

What is the competence of an angiosurgeon?

The main task of an angiosurgeon is to study blood and lymphatic vessels, their structure, ability to function, as well as diseases and any pathological conditions. The method of treating diseases can be conservative and operative (with surgery).

The angiosurgeon studies and examines:

atherosclerosis;
angiopathy;
arteriovenous fistula;
arteriovenous marlration;
varicocele;
phlebeurysm;
gas embolism;
Wright's syndrome;
dyscirculatory encephalopathy;
diabetic angiopathy;
stroke;
coronary heart disease
Goodpasture's syndrome;
heart attack;
heart failure;
myocardial infarction;
subarachnoid hemorrhage;
phlebitis;
thrombophlebitis;
thrombosis;
carotid artery stenosis;
Morphan's syndrome;
marbling of the skin;
scurvy.

What organs does the Angiosurgeon deal with?

Veins, blood vessels, arteries, heart, legs.

When should you contact an angiosurgeon?

with cramps, burning, tingling;
for pain in the legs;
for swelling;
with redness and thickening in the legs;
with loss of sensation and movement;
with necrosis and blackening of the foot and toes;
for long-term non-healing ulcers, gangrene;
with sudden swaying, falling and loss of consciousness;
for headaches;
with noises in the head and dizziness.

When and what tests should be done?

clinical blood test;
lipid spectrum (triglycerides, total cholesterol, atherogenic index, HDL, VLDL, LDL);
blood chemistry;
serological blood test for infections (if indicated);
hemostasiogram (prothrombin time, prothrombin index, fibrinogen);
adrenaline, norepinephrine;
creatine kinase;
C-reactive protein;
D-dimer;
potassium/sodium/chloride;
homocysteine.

What main types of diagnostics does the Angiosurgeon usually perform?

Vascular Doppler (ultrasound);
Magnetic resonance imaging;
X-ray angiography;
Positron emission tomography;
Endoscopic examinations;
Echocardiography;
Daily ECG monitoring (according to indications);
Daily blood pressure monitoring (according to indications);
. Thyroid gland. (ultrasound of other organs according to indications);
Duplex sonography main arteries heads;
Duplex sonography of the vessels of the extremities (according to indications);
Anthropometry with calculation of body mass index.

VIDEO

To save healthy heart on for a long time Everyone needs to follow a number of necessary rules:

Keep blood pressure under control. If there are frequent changes or stable increases you need to examine yourself;
Normalize and diversify your diet (eat whole grain bread and various cereals, vegetables, fruits, meat, vegetable oils, fish, less sweets and fats) and watch your weight;

When you reach the age of 40, you should check your blood sugar and cholesterol levels;
More movement, better performance fresh air(walk at least 3 or 5 km a day at a brisk pace);
During dinner, it is advisable to drink a glass of red wine up to 3 times during the week.

Nowadays, diseases of the vascular system are quite widespread. In this regard, the help of an angiosurgeon is irreplaceable.

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Patients with serious illnesses vascular nature know who is this angiosurgeon and what he does. A doctor of this profile is also called a vascular surgeon.

An angiosurgeon deals with all pathologies of veins, arteries and lymphatic ducts that require surgical intervention.

Principles of therapy by an angiosurgeon

Not everyone can answer the question of what exactly a vascular surgeon does. A doctor of this profile performs the following tasks:

diagnosis of any pathologies associated with blood vessels and lymphatic system human body;
restoring the integrity of damaged traumatically veins and arteries;
fight against oncological diseases, affecting blood vessels, germinating in them or being dangerously close;
prosthetics of damaged vessels;
elimination congenital anomalies vessels, for example, hemangiomas or malformations;
microsurgical operations that are performed to restore the integrity of blood vessels and other tissues during traumatic amputation of limbs or their parts;
carrying out conservative therapy for diseases of the vascular system;
development and implementation of methods for the prevention of pathologies of their profile (as well as methods that prevent the development of complications of the disease and stop its progression).

In addition, an angiosurgeon and vascular surgeon is a specialist who develops new surgical techniques treatment vascular lesions. He conducts research studying new pathologies and atypical course old diseases, finding out the prerequisites for their occurrence and methods of therapy.

What diseases are treated by an angiosurgeon?

The angiosurgeon's specialization includes the following pathologies:

In addition to the listed diseases, the angiosurgeon treats rare vascular pathologies , more often of a systemic nature, for example, some types of vasculitis.

What symptoms should you see a doctor for?

People often come to an angiosurgeon by referral from other specialists, in particular a therapist. Also preventive examination at this doctor All people, especially diabetics, should undergo this periodically.

A person should go to an angiosurgeon if he is bothered by the following symptoms:

People who have similar symptoms, need to be examined by an angiosurgeon, so they need to know who he is and what he treats. An alternative to this specialist can become an angiologist or phlebologist.

Basic diagnostic methods

At the appointment with the angiosurgeon, a thorough examination of the patient is carried out. The doctor collects anamnesis, finding out what could cause the disease. At this stage, it is already possible to make a preliminary diagnosis, after which the patient is prescribed laboratory and instrumental studies.

The patient will have to do tests:

general blood analysis;
blood test for lipid spectrum;
biochemical parameters;
coagulogram;
hormonal studies (not always);
serology for infectious lesion(according to indications);
determination of C-reactive protein and other acute phase indicators (if a heart attack is suspected).

Instrumental techniques can be the following:

Dopplerography of blood vessels;
angiography;
endoscopic examination;
electrocardiography;
daily ECG study;
echocardiography
sonography of the arteries of the head or vessels of the limb.

The tests will depend on what the specialist is treating. Sometimes additional consultation with related specialists who conduct their own diagnostics is required. Diagnosis is approached very carefully, since the health and even life of the patient will depend on the correctness of the diagnosis.

The content of the article

It is known that many patients with diabetes suffer from vascular diseases. How serious is this and is it possible to help in already advanced cases?

Unfortunately, patients with diabetes mellitus very often come to us and are already late stages development of the disease with its complications in the form of trophic ulcers. The course of atherosclerosis in diabetes mellitus is much more aggressive, the incidence of critical ischemia is approximately 5 times higher than in the rest of the population. Trophic disorders develop in 10% of elderly patients with diabetes. About 40-50% of lower limb amputations due to peripheral arterial insufficiency performed in diabetic patients. Major amputations are resorted to 11 times more often in diabetes mellitus than in other patients, and amputations are required in younger people.

What diseases do vascular surgeons treat?

Vascular surgeons are doctors involved in the diagnosis, prevention and treatment of diseases affecting blood vessels: arteries and veins. The most common vascular disease that vascular surgeons encounter in their practice is atherosclerosis. Fine inner wall Arterial blood vessels are smooth, which allows blood to flow to human organs without difficulty. With pathology, the inner wall of the arteries becomes uneven, due to deposits of cholesterol and other lipids, and it thickens. This pathological process called atherosclerosis, or “hardening” of the artery wall. As the atherosclerotic process progresses, narrowing or blockage of the arteries occurs, which leads to a significant decrease in the flow of blood to human organs. Significant narrowing or blockage of the arteries by atherosclerosis causes “vascular accidents” in human body: stroke, heart attack, gangrene of the lower extremities. The task of vascular surgeons is to prevent the formidable, disabling complications of atherosclerosis using modern capabilities medicine.

What are the first signs of atherosclerosis of the arteries of the lower extremities? What should you do when they appear?

Unfortunately, often the first symptoms of atherosclerosis are detected when there is already severe damage to the arteries. Even with significant narrowing or blockage of the arteries, the disease is often asymptomatic. A significant decrease in the flow of blood to the lower extremities with atherosclerosis is manifested by discomfort, cramps, and pain in the hips and legs when walking. Pain in the muscles of the thighs or legs that occurs when walking is called intermittent claudication. With the progression of the atherosclerotic process and more significant damage to the arteries of the lower extremities, pain in the leg muscles can also occur at rest. This symptom is called rest pain and is due to the fact that the arteries cannot supply adequate blood flow to the legs, even at rest. The pain at rest intensifies when raising the legs while lying in bed and at night. Patients find relief from pain when they lower their leg out of bed. Gangrene or "tissue death" can occur when the nutrition needed for normal height and tissue restoration cannot be ensured due to severe arterial narrowing or total block of the arteries of the lower extremities. If you or someone you know has these signs of atherosclerosis of the arteries of the lower extremities, you should urgently contact a vascular surgeon. Timely assistance allows you to save the limb and prevent the development of gangrene.

Tell us about new directions in the treatment of such a terrible disease as aortic aneurysm?

The aorta is the largest and most powerful artery in the entire human body. The aorta originates from the left ventricle, from where oxygen-enriched blood enters it. Next, the blood passes through the aorta, entering all the arteries departing from it, supplying all organs and tissues. One of the diseases of the aorta is aneurysm. An aneurysm of the aorta and other arteries is a sac in some part of the artery that forms as a result of a weakening of its wall. An aneurysm can take several years to form. A “sword of Damocles” hangs over a person with an aneurysm; in other words, at any moment, life can end as a result of a rupture of the aneurysm sac.

At our center there is a program for treating patients with aneurysms of the abdominal aorta using endovascular replacement. This became possible thanks to our cooperation with vascular surgeons from the USA, who have already repeatedly performed demonstration operations for diseases of the aorta and peripheral arteries. Endoprosthesis replacement of an abdominal aortic aneurysm can significantly expand the number of operated patients due to the minimally invasive technique, which in many cases allows the intervention to be performed under local anesthesia.

Please tell us about your Center.

Vascular Surgery Center named after. T. Topper was created on the basis of a multidisciplinary hospital of one of the best clinics St. Petersburg Clinical Hospital No. 122 named after L.G. Sokolov. The powerful scientific and practical potential of the clinic, the availability of the latest modern diagnostic and treatment equipment, comfortable conditions hospital stays allow for high level conduct high-quality examination and treatment of patients with vascular diseases.

The center’s specialists are highly qualified vascular surgeons who have completed internships in leading clinics in Russia, Europe and the USA. They are fluent in modern methods of treating vascular diseases. For the diagnosis of vascular diseases we use modern techniques diagnostics: ultrasound duplex and triplex scanning of the main arteries and veins, computed spiral tomography, radiopaque digital angiography.

At the Vascular Surgery Center on modern level conservative and surgical treatment of carotid and vertebral diseases is carried out using the latest methods subclavian arteries, aorta, iliac arteries, arteries of the lower extremities (atherosclerosis, aortoarteritis, thromboangiitis, diabetic angiopathy, aneurysm); diseases venous system(varicose veins, postthrombophlebitic disease). The center's specialists provide 24-hour service emergency assistance patients with acute vascular diseases ( arterial thrombosis and embolism, deep vein thrombosis, thrombophlebitis, vascular trauma). Unique feature CSH is an opportunity in individual, difficult cases or, at the request of patients, consult and invite leading vascular surgeons in Europe and the USA with whom our center cooperates.

Is stroke associated with vascular disease? Tell us about the mechanisms of its development.

Stroke is one of the main causes of mortality and disability both in our country and abroad. In Russia, 450 thousand people develop stroke annually, a third of them die in acute period diseases, 80% of survivors have motor and speech disorders

In the United States, more than 600,000 strokes occur per year and more than 200,000 brachiocephalic artery surgeries are performed to prevent or recur ischemic strokes. In Russia, these statistics are even more depressing - 450,000 strokes and only about 10 thousand operations on the BCA. Mortality from ischemic stroke among men from 35 to 74 years old it is 9 times higher, among women it is 10 times higher than in France.

Indeed, in most cases, a stroke or acute disorder cerebral circulation develops with severe atherosclerosis arteries supplying blood to the brain. The main suppliers of blood to the brain are the carotid arteries. Atherosclerotic narrowing or blockage of the carotid arteries leads to temporary or permanent brain damage by cutting off part of the brain from the blood supply. The risk of developing a stroke increases as atherosclerosis progresses, the atherosclerotic plaque grows and its “instability” forms, that is, a condition when there is a danger of ulcer formation, destruction of the internal lining of the artery and on the surface of the damaged vessel the risk of thrombosis increases significantly. When a blood clot or part of an atherosclerotic plaque breaks off, it travels through the carotid arteries into the brain and blocks the flow of blood to a certain area of the brain. Depending on the size of the particle and where it ultimately ends up, the patient develops a transient (minor stroke or transient ischemic attack) or permanent cerebrovascular accident (stroke).

Classic signs of a cerebrovascular accident include: loss of vision in one eye, difficulty speaking, numbness, weakness or paralysis of one side of the body or face, and problems with balance or coordination. If these symptoms of cerebral vascular damage occur, or you want to undergo a preventive examination, contact our center for a consultation with a vascular surgeon. Thorough examination condition of the carotid arteries using ultrasonic methods(primarily duplex scanning) allows you to answer the question of what measures need to be taken to prevent a stroke or its recurrence.

With severe atherosclerotic narrowing of the carotid arteries, the main measure to prevent stroke is to eliminate atherosclerotic plaques preventing normal blood circulation to the brain, which can only be achieved surgically. In this case, an operation known for more than 50 years is performed, such as carotid endarterectomy. This operation, first performed in 1953 by the outstanding American vascular surgeon Michael DeBakey, has been well practiced in leading vascular clinics peace, ensures long lasting positive result, and carries minimal risk in most patients. The stay in the clinic is usually 24-48 hours. Most patients experience minor discomfort for a short time and are able to return to ordinary life after treatment 7-14 days.

As an alternative surgical treatment An intravascular (endovascular) technique is used, which is balloon angioplasty with stenting. Currently, international studies are evaluating the effectiveness of this technique for the treatment of carotid artery atherosclerosis. This procedure is performed in conjunction with angiography under local anesthesia through a puncture in the groin. The essence of the procedure is the intravascular placement of a special catheter with a balloon to the site of narrowing of the carotid artery. When the balloon is inflated in the lumen of the carotid artery, the narrowed area is widened. To consolidate the effect, stenting of the dilated carotid artery is performed by installing an internal stent (frame) of the vessel. The recovery period after angioplasty with stenting is also 1-2 days.

What does the term OASNK mean?

This term stands for Obliterating Atherosclerosis(endarteritis) of the vessels of the lower extremities. The main complaint of peripheral arterial disease is pain in the legs when walking or during exercise. Due to narrowing of the arteries, the muscles receive less blood, which leads to pain or cramps. This is called intermittent claudication. Once you stop and there is adequate blood flow to the muscles, the pain will gradually subside.

Thus, the main symptoms of chronic arterial insufficiency may be:

Feeling of chilliness, numbness, tingling, cramps in the legs;
Feeling of fatigue, pain in the legs or hips when walking, forcing the patient to stop and rest (intermittent claudication);
As the disease progresses, the pain is constant and deprives you of sleep (pain at rest). May form trophic ulcers and necrosis.

Only 20% of patients with damage to the arteries of the lower extremities receive adequate treatment, which often ends in amputation.

You need to see a specialist at our Vascular Surgery Center, where we can assess your condition and outline further tactics. Before you see a doctor, it will be useful to follow these instructions:

If you smoke, you need to quit, as smoking is the main cause of BPS. Approximately 97% of people with BPSD have been smoking for more than 20 years. It's never too late to quit smoking, and your doctor will help you with this if possible;
Maintain blood glucose levels and arterial pressure at proper levels, which reduces the risk of developing complications (including BPS) of diseases such as diabetes And arterial hypertension;
Take regular walks, start with 20 minutes and then gradually increase this time. If you feel pain, try not to stop as long as possible; this will not harm your legs, but rather improve their condition.

When you contact the Vascular Surgery Center, our specialists will decide whether you need urgent surgery. Treatment can certainly be complex, often combining conservative and surgical methods. Most common surgical intervention is bypass surgery using your own vein taken from an arm or leg, or an artificial prosthesis.

What is endovascular surgery? Please tell us about endovascular methods used in the treatment of vascular diseases?

Endovascular surgery (endo - inside, vascular) is a type of intervention in which therapeutic effect carried out from inside the vessel. The use of endovascular techniques is modern direction treatment of vascular diseases.

The most commonly used methods of endovascular surgery are angioplasty and arterial stenting. Angioplasty is a procedure in which a narrowed artery is dilated with a balloon catheter inserted into its lumen. A balloon catheter is placed into the narrowed artery and inflated to restore the vessel to its normal diameter. This technique is used for diseases various vessels, however, it is most often used for damage to the coronary (heart), renal and iliac arteries. In the vast majority of cases, angioplasty of a vessel is completed with stenting. A stent is a structure that serves as the internal frame of a vessel. It is installed in the area of the performed angioplasty and prevents re-narrowing of the vessel in this place. Stenting allows you to consolidate the effect of angioplasty on long time. The main advantage that makes endovascular techniques so attractive is the low risk for the patient and shorter hospital stay compared to open ones. surgical interventions. Open interventions in turn show high efficiency V long term. Therefore, the approach to choosing the type medical procedure at vascular diseases should be based on individual characteristics patient.

Specialists from the Center for Vascular Surgery Clinical hospital No. 122 named after. L.G. Sokolova widely uses the technique of a one-stage combination of endovascular treatment and direct vascular operations, which improves results, reduces the number of complications and significantly reduces hospitalization time.