The doctor is a cardiovascular surgeon that treats. Who is an angiosurgeon

Great amount people today are suffering from various problems with vessels. Such problems can be caused by the most various factors, but they require a mandatory proper treatment supervised qualified specialist. To date, there are several doctors who are able to help patients with vascular diseases. Just such doctors are an angiosurgeon and a phlebologist, 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 the surgical and sometimes conservative treatment of vascular ailments - both arteries and veins.

Basically, such doctors use the methods of minimally invasive interventions in their activities. 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 disease itself different type both congenital and acquired. This also applies to tumor formations that are located near the veins and arteries and provoke various Negative consequences – cosmetic defects, soreness, impaired functioning of organs and systems, as well as the formation of trophic ulcers, etc.

In addition, angiosurgeons are also involved in microsurgery. This category includes surgical treatment, which is used for injured surfaces that are not amenable to successful healing for a long time. The profile of their activity is also replantology - sewing on severed limbs with the maximum possible recovery their functions.

most common cause of calls to an angiosurgeon today is considered atherosclerosis, in which there is a deposition cholesterol plaques in the lumen of blood vessels. As a result of such a 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 also includes the removal of congenital forms some pathological formations in which vascular damage is observed. Examples include hemangiomas and arteriovenous malformations.

Also, an 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, coronary artery disease, angiopathy, arteriovenous marlrmation, disculatory encephalopathy and many other conditions. The main task of such a specialist is to treat circulatory and lymphatic vessels, while therapy can be both conservative and operational.

An angiosurgeon should be consulted 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 for redness and tightness in the legs, with the appearance of a loss of sensitivity or movement. An angiosurgeon helps patients with necrosis and blackening of the foot and fingers, with long-term non-healing ulcerative lesions and gangrene. His consultation may be needed for sudden swaying, loss of consciousness and falls. It is also worth making an appointment with him for headaches, noises in the head and dizziness.

And the doctor phlebologist - what does he treat?

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

As practice shows, most often ailments of the veins concern the legs, since it is the lower limbs that endure especially heavy load. Most often, a phlebologist is contacted with the development varicose veins veins, but in addition to the profile of his activity also include the therapy of thrombophlebitis, phlebitis and phlebothrombosis. This specialist also treats post-thrombotic disorders, venous insufficiency and bleeding from varicose veins. They also turn to him if necessary in the treatment of trophic disorders.

For a consultation with a phlebologist, you need to come with a predisposition to the development of these diseases, as well as during pregnancy, during work related to permanent seat, at sedentary manner and strongly active way life. Also, this doctor can be useful for excessive body weight and unhealthy way life.

Of course, one 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 soreness along the surface lower extremities, heaviness in the legs, cramps, swelling of the legs and protrusion of the veins.

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

So, having considered the activities of such doctors as an angiosurgeon and a 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 vessels, and the second one treats only vein ailments.

An angiosurgeon is a doctor who specializes in diseases of the vascular and lymphatic systems. System blood vessels It is made up 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. 20th century vascular surgery belonged to the activities of surgeons general practice. However, over the next 10 years, innovators from the UK, Australia and the US successfully developed and launched a training program for narrow-profile surgeons - angiosurgeons.

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

What diseases does an angiosurgeon treat?

Most often, an angiosurgeon has to deal with conditions such as aneurysm 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 injuries. vascular system when it is necessary to redirect blood flow from damaged vessels to healthy veins and arteries in order to improve blood circulation in patients with diabetes and disease peripheral vessels.

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

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

Quite often, if there are no indications for urgent surgical intervention, angiosurgeons prescribe medication. For example, diseases such as intermittent claudication are treated with pills. A small abdominal aneurysms or narrowing cervical arteries medium degree can be treated in a non-contact way. And even in cases where intervention is required, available innovative technologies to avoid abdominal surgery. Manipulations performed inside the arteries using special balls and catheters can restore blood circulation or the integrity of the walls of the vessel without the need to open the vessel. Since angiosurgeons have the knowledge to perform different kind treatment from medication to abdominal surgery, they always suggest that the patient start with the type of treatment in which he will be exposed to minimum risk complications.

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

An angiosurgeon should be contacted if you are concerned about fatigue and heaviness in the legs, swelling, appearance on the legs vascular networks 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 disease;
thrombophlebitis;
post-thrombotic disease;
telangiectasia;
varicose veins in the lower extremities;
diabetic angiopathy;
aortoarteritis;
obliterating endarteritis;
lymphostasis;
trophic ulcer.

What is included in 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 treatment of diseases can be conservative and operative (with surgical intervention).

An angiosurgeon studies and researches:

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

What organs does an angiosurgeon deal with?

Veins, vessels, arteries, heart, legs.

When should you contact an angiosurgeon?

with convulsions, burning, tingling;
with pain in the legs;
with edema;
with redness and compaction in the legs;
with loss of sensation and movement;
with necrosis and blackening of the foot with fingers;
with long-term non-healing ulcers, gangrene;
with sudden swaying, falling and loss of consciousness;
with headache;
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 (as indicated);
hemostasiogram (prothrombin time, prothrombin index, fibrinogen);
epinephrine, norepinephrine;
creatine kinase;
C-reactive protein;
D-dimer;
potassium/sodium/chloride;
homocysteine.

What are the main types of diagnostics usually carried out by an angiosurgeon?

Doppler of vessels (ultrasound);
Magnetic resonance imaging;
X-ray angiography;
Positron emission tomography;
Endoscopic studies;
echocardiography;
24-hour ECG monitoring (according to indications);
Daily monitoring of blood pressure (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 the for a long time everyone needs to follow a number of necessary rules:

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

Upon reaching the age of 40, blood sugar and cholesterol levels should be checked;
More movement, better on fresh air(at least 3 or 5 km a day to walk at a fast 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 extensive. In this regard, the help of an angiosurgeon is indispensable.

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Patients with serious illnesses vascular nature know who is it 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 at the angiosurgeon

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

diagnosis of any pathologies associated with blood vessels and lymphatic system the human body;
restoration of the integrity of damaged traumatically veins and arteries;
fight with oncological diseases, damaging vessels sprouting 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 in case of traumatic amputation of limbs or parts thereof;
conducting conservative therapy with 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 a 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 specializes in the following pathologies:

In addition to the listed diseases, an 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?

An angiosurgeon is often referred to by other specialists, in particular a general practitioner. Also preventive examination at this doctor should be periodically taken by all people, and especially diabetics.

A person should go to an angiosurgeon if they are concerned about the following symptoms:

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

Basic diagnostic methods

At the appointment with an angiosurgeon, a thorough examination of the patient is carried out. The doctor collects an 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 need to do tests:

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

Instrumental techniques can be as follows:

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

Research will depend on what the specialist is treating. Sometimes additional consultation with related specialists who conduct their own diagnostics is required. The diagnosis is approached very carefully, since the health and even the 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 disease. How serious is this and is it possible to help in already running cases?

Unfortunately, we are often approached by patients with diabetes and already in 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 frequency of critical ischemia is about 5 times higher than in the rest of the population. Trophic disorders develop in 10% of elderly patients with diabetes mellitus. About 40-50% of lower limb amputations for peripheral arterial insufficiency performed in diabetic patients. Major amputations are 11 times more common in diabetics than in other patients, with amputations being required in younger people.

What diseases are treated by vascular surgeons?

Vascular surgeons are doctors involved in the diagnosis, prevention and treatment of diseases that affect the 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, allowing blood to flow to human organs without difficulty. With pathology, the inner wall of the arteries becomes uneven, due to the deposits of cholesterol and other lipids, it thickens. This pathological process called atherosclerosis, or hardening of the artery wall. With the progression of the atherosclerotic process, 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 arteries by atherosclerosis causes "vascular catastrophes" in human body: stroke, heart attack, gangrene of the lower extremities. The task of vascular surgeons is to prevent formidable, disabling complications of atherosclerosis using modern possibilities medicine.

What are the first signs of atherosclerosis of the arteries of the lower extremities? What should be done when they appear?

Unfortunately, often the first symptoms of atherosclerosis are detected when there is already a pronounced lesion of the arteries. Even with a significant narrowing or blockage of the arteries, the disease is often asymptomatic. A significant decrease in the flow of blood to the lower extremities in atherosclerosis is manifested by discomfort, cramps, and causes pain in the hips and legs when walking. Pain in the muscles of the thighs or lower 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 muscles of the legs 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 resting pain is aggravated by raising the legs while lying in bed and at night. Patients find relief from pain when they lower their foot from the bed. Gangrene or "tissue death" can occur when the nutrition needed for normal growth and tissue repair, cannot be ensured due to severe arterial narrowing or total block of the arteries of the lower extremities. If you or your friends have these signs of atherosclerosis of the arteries of the lower extremities, you should urgently contact a vascular surgeon. Timely assistance can save the limb and prevent the development of gangrene.

Tell us about new directions in the treatment of such a formidable 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 it receives oxygenated blood. Further, 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 an aneurysm. An aneurysm of the aorta and other arteries is a sac in some part of an artery resulting from 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, life can end at any moment as a result of a rupture of the aneurysm sack.

On the basis of our center there is a program for the treatment of patients with aneurysms of the abdominal aorta using endovascular prosthesis. This became possible thanks to our cooperation with vascular surgeons from the United States, who have repeatedly performed demonstrative operations in the Department of Vascular Surgery for diseases of the aorta and peripheral arteries. Endoprosthesis replacement of aneurysm of the abdominal aorta can significantly expand the contingent of operated patients due to the low-invasiveness of the technique, which in many cases allows performing the intervention under local anesthesia.

Please tell us about your Center.

Center for Vascular Surgery. T. Topper was created on the basis of a multidisciplinary hospital of one of 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 medical equipment, comfortable conditions hospital stays allow for high level conduct high-quality examination and treatment of patients with vascular diseases.

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

Center for Vascular Surgery modern level according to the latest methods, conservative and surgical treatment of diseases of the carotid, vertebral subclavian arteries, aorta, iliac arteries, arteries of the lower extremities (atherosclerosis, aorto-arteritis, thromboangiitis, diabetic angiopathy, aneurysms); diseases venous system(varicose disease, post-thrombophlebitic disease). Center specialists provide round-the-clock emergency assistance patients with acute vascular disease ( arterial thrombosis and embolism, deep vein thrombosis, thrombophlebitis, vascular injury). 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 death and disability both in our country and abroad. In Russia, stroke develops annually in 450 thousand people, a third of them die in acute period diseases, 80% of survivors have movement and speech disorders

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

Indeed, in most cases, a stroke or acute disorder cerebral circulation develops with severe atherosclerosis arteries supplying the brain. The carotid arteries are the main blood supply to the brain. Atherosclerotic narrowing or blockage of the carotid arteries leads to temporary or permanent damage to the brain by cutting off part of the brain from the blood supply. The risk of developing a stroke increases with the progression of atherosclerosis, the growth of an atherosclerotic plaque and the formation of its "instability", that is, a state when there is a risk of ulcer formation, destruction of the inner lining of the artery and on the surface of the altered vessel, the risk of developing thrombosis increases significantly. When a blood clot or part of an atherosclerotic plaque breaks off, with the blood flow through the carotid arteries, they enter the brain and block 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).

The classic signs of a cerebrovascular accident are: loss of vision in one eye, impaired (difficulty) speech, numbness, weakness or paralysis of one side of the body or face, problems with balance or coordination. If you have these symptoms of damage to the vessels of the brain, 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 with ultrasonic methods(primarily duplex scanning) allows you to answer the question of what measures should be taken to prevent a stroke or its recurrence.

With severe atherosclerotic narrowing of the carotid arteries, the main measure for preventing stroke is to eliminate atherosclerotic plaques interfering with the normal blood circulation of the brain, which can only be achieved surgically. In this case, such an operation, known for more than 50 years, is performed, such as carotid endarterectomy. This operation, first performed in 1953 by the eminent American vascular surgeon Michael DeBakey, has been well established in leading vascular clinics peace, ensures a long positive result, and bears 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 after 7-14 days.

As an alternative surgical treatment an intravascular (endovascular) technique is used, which is a 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 along with angiography under local anesthesia through a puncture in the groin. The essence of the procedure is the intravascular supply to the site of narrowing of the carotid artery with a special catheter with a balloon. When the balloon is inflated in the lumen of the carotid artery, the narrowed area is expanded. To consolidate the effect, stenting of the dilated carotid artery is performed by installing an internal stent (framework) 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) Vessels of the Lower Extremities. The main complaints in peripheral arterial disease are pain in the legs when walking or during exercise. Due to the narrowing of the arteries, the muscles receive less blood, which leads to pain or cramps. This is called intermittent claudication. After you stop and the blood flow to the muscles becomes adequate, the pain will gradually subside.

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

Feeling of chilliness, numbness, "tingling", cramps in the legs;
Feeling tired, pain in the legs or thighs when walking, forcing the patient to stop and rest (intermittent claudication);
With the progression of the disease, the pains are permanent, they deprive them of sleep (rest pains). May form trophic ulcers and necrosis.

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

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

If you smoke, then you need to quit, as smoking is the main cause of BPS. Approximately 97% of people with ABP have been smoking for over 20 years. It is 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. Feeling the pain, try not to stop as long as possible, this will not hurt 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 be, of course, complex, often combining conservative and surgical methods. The most frequent surgical intervention is bypass surgery using one's 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 - vascular) is a type of intervention in which therapeutic effect carried out from within 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 expanded with a balloon catheter inserted into its lumen. A balloon catheter is placed at the narrowing of the artery and inflated to restore the normal diameter of the vessel. This technique is used for diseases various vessels, however, it is most often used for lesions of the coronary (heart), renal and iliac arteries. In the vast majority of cases, angioplasty of the vessel ends with its 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 the re-narrowing of the vessel in this place. Stenting allows you to fix the effect of angioplasty on long time. The main advantage that makes endovascular techniques so attractive is the low risk for the patient and a shorter hospital stay compared to open ones. surgical interventions. Open interventions, in turn, show high efficiency in remote period. Therefore, the approach to choosing the type medical procedure at vascular diseases should be based on individual characteristics patient.

Specialists of the Center for Vascular Surgery clinical hospital No. 122 im. L.G. Sokolova, the method of simultaneous combination of endovascular treatment and direct vascular operations, which improves outcomes, reduces the number of complications and significantly reduces the time of hospitalization.