Angiosurgeon (vascular surgeon). An angiosurgeon is a vascular surgeon. What does an angiosurgeon treat and when to contact him

A clinical medicine specialist who deals with the diagnosis, treatment and prevention of the progression of vascular diseases of the arteries and veins.
You should contact an angiosurgeon if you are concerned about fatigue and heaviness in the legs, swelling, the appearance of spider veins or spider veins on the legs, increased venous pattern, pain, cramps in the calves, the appearance of varicose veins, inflammation of the vein, the presence of a trophic ulcer.
An angiosurgeon provides prevention and treatment of diseases such as:

Reticular varicose veins;
- Telangiectasia;
- Phlebeurysm lower limbs;
- Varicose veins;
- Thrombophlebitis;
- Postthrombotic disease;
- Trophic ulcer;
- Thrombangiitis;
- Obliterating endarteritis;
- Aortoarteritis;
- Obliterating atherosclerosis;
- Lymphostasis;
- Diabetic angiopathy.

(see also Vascular surgeon)

What is the competence of an Angiosurgeon?

Studies blood and lymphatic vessels, their structure and functioning, their diseases and pathological conditions, methods of diagnosis, prevention and treatment of these diseases, both conservative and surgical (surgical).

What diseases does the Angiosurgeon deal with?

- Angiopathy;
- Arteriovenous malformation;
- Arteriovenous fistula;
- Atherosclerosis;
- Phlebeurysm;
- Varicocele;
- Gas embolism;
- Diabetic angiopathy;
- Encephalopathy;
- Stroke;
- Heart attack;
- Ischemic disease hearts;
- Ischemic stroke;
- Marbling of the skin;
- Acute myocardial infarction myocardium;
- Heart failure;
- Goodpasture's syndrome;
- Marfan syndrome;
- Wright's syndrome;
- Stenosis of the carotid arteries;
- Subarachnoid hemorrhage;
- Transposition of the great vessels;
- Thrombosis;
- Thrombophlebitis;
- Phlebitis;
- Scurvy.

What organs does the Angiosurgeon deal with?

Veins, blood vessels, arteries, heart, legs.

When should you contact an Angiosurgeon?

- Pain in the legs;
- Edema;
- Cramps, burning, tingling;
- Redness and thickening;
- Blackening and necrosis of fingers, feet, long-term non-healing ulcers, gangrene;
- Headache;
- Sudden swaying, falling and loss of consciousness;
- Noise in the head, dizziness, “flickering of midges”;
- Loss of sensation and movement.

When and what tests should be done

- Clinical blood test;
- Biochemical analysis blood;
- Lipid spectrum(total cholesterol, HDL, LDL, VLDL, triglycerides, atherogenic index);
- Hydroxybutyrate degylrogenase (1st and 2nd fractions of LDH);
- Creatine kinase MB;
- D-dimer;
- Homocysteine;
- Potassium/sodium/chlorides;
- C-reactive protein;
- Adrenaline, norepinephrine;
- Hemostasiogram (prothrombin time, prothrombin index, fibrinogen);
- General urine analysis;
- Serological blood test for infections (if indicated).

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

- Vascular Doppler (ultrasound);
- Magnetic resonance imaging;
- X-ray angiography;
- Positron emission tomography;
- Endoscopic studies;
- ECG;
- Echocardiography;
- Daily allowance ECG monitoring(according to indications);
- Daily blood pressure monitoring (according to indications);
- Ultrasound of the kidneys and adrenal glands. Thyroid gland. (ultrasound of other organs according to indications);
- Duplex sonography of the main arteries of the head;
- Duplex sonography of the vessels of the extremities (according to indications);
- Anthropometry with calculation of body mass index. To keep your heart healthy for many years, you must follow several important rules:

1. Don't smoke.
2. Eat healthy and varied (meat, fish, vegetables, fruits, cereals, bread from whole grain, vegetable oils, less fat and sweets) and monitor your weight.
3. Move more, especially on fresh air: for example, walk at a brisk pace at least 3, and preferably 5 km per day.
4. Monitor your blood pressure. If there is a stable increase or frequent changes, be sure to undergo an examination.
5. After 40 years, regularly check your cholesterol and blood sugar levels.
6. Drink a glass of red wine with dinner two or three times a week.

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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 the delivery 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 have appeared, 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 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 arteries in order to improve blood circulation in patients with diabetes and peripheral vascular disease.

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

For patients with diseases lymphatic system, for example, lymphedema, may also require the help of an angiosurgeon. In lymphedema, fluids transport blood components from vessels to cells. Patients suffering from scleroderma (an autoimmune disease that causes tissue thickening) or Raynaud's syndrome (a disease of the extremities in which spasm of blood vessels occurs and blood circulation is impaired) also turn to the angiosurgeon.

Quite often, if they are not available for urgent surgery, angiosurgeons prescribe treatment. For example, diseases such as intermittent claudication are treated. And small abdominal aneurysms or narrowing of the cervical arteries medium degree can be treated in a non-contact manner. And even in cases where intervention is required, available innovative technologies to avoid surgery. Manipulations carried out inside the arteries using special 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 types of treatment from medication to abdominal surgery, they always suggest that the patient begin with the type of treatment in which he will be at minimal risk of complications.

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Make an appointment with an Angiologist

Who is an angiologist?

Angiologist is a doctor whose responsibilities include identifying diseases of the vascular system and developing a treatment plan. This specialist also deals with the prevention of vascular diseases. To make it easier to understand the scope professional activity this doctor, you should familiarize yourself with the structure of the vascular system ( networks) and the functions it performs.

The vascular network in the human body consists of two subsections - the circulatory and lymphatic systems. The circulatory network is formed by the heart and the vessels through which blood circulates.

Exist the following types vessels through which blood circulates:

• Arteries. These vessels transport blood away from the heart. Arterial blood saturated with oxygen and has a bright red color.
• Vienna. These vessels transport blood to the heart. Deoxygenated blood contains little oxygen, but is saturated with carbon dioxide. The blood in the veins has a more viscous consistency and a darker color.

• Capillaries. These vessels are distinguished by their small diameter, and their role is to communicate between the arterial and venous systems.

Main functions circulatory system is the transport of oxygen, carbon dioxide and nutrients. The vessels also ensure the delivery of decay products to the organs of the excretory system.
The lymphatic system consists of capillaries through which lymph flows ( colorless liquid) And lymph nodes. The main task of the lymphatic system is to produce special substances ( lymphocytes), which protect the body from foreign agents ( for example, infections).

Angiology deals with the study of how the circulatory and lymphatic network is built and functions. Accordingly, an angiologist must have knowledge in such areas as the symptoms of vascular diseases and methods for diagnosing them. And also this specialist must know the existing methods of treatment ( conservative, surgical and combined) and prevention of violations of both systems.

When is a consultation with an angiologist necessary?

Vascular disorders rarely manifest themselves with any pronounced and characteristic symptoms. Therefore, patients often get an appointment with an angiologist not on their own initiative, but through the referral of other doctors.

In the fight against disorders of the vascular system, it is important to identify the problem in time and begin treatment. Therefore, you should know the signs of vascular disorders, and if you identify one or more of them, consult a doctor. Of course, each disease has symptoms unique to it, but there are also general signs disorders of the vascular system.

The following conditions require consultation with an angiologist:

• not passing long time feeling of heaviness in the legs;
• swelling of the lower extremities after exercise ( appears in the evening);
• pronounced venous pattern ( veins become darker and more prominent) on foot;
• the appearance of compactions, trophic ulcers on the legs;
• pinpoint hemorrhages, spider veins on the body;
• leg cramps, burning, pain in the calves and/or feet that appear during exercise or at rest;
• change in hue ( blueness, redness, paleness) skin;
• tingling/numbness in fingers, feet, or other areas of the body;
• decreased or loss of skin sensitivity on the arms or legs;
• non-healing for a long time cuts, abrasions, bruises;
• pain in the lumbar region, which can spread to the groin, abdomen, buttocks, and lower extremities;
• “dots” before the eyes, tinnitus, dizziness, migraine;
• sudden loss of consciousness, loss of clarity of movements, swaying, falling.

What does an angiologist treat?

The angiologist treats all disorders of the vascular system, which may act as primary ( arises independently), and secondary ( develops against the background of another pathology) diseases.

There are the following vascular disorders that an angiologist treats:

• vascular atherosclerosis;
• vascular aneurysm;
• systemic vasculitis;

• angiopathy;
• embolism;
• lymphangioma;
• lymphostasis;

Vascular atherosclerosis

Atherosclerosis is the formation of cholesterol plaque on inner surface vessels, which causes a decrease in their diameter and impaired blood circulation. Atherosclerosis affects arteries of large and medium diameter such as vital important organs like the brain, heart. Cholesterol plaques can also form in the vessels of the lower extremities, abdominal cavity, kidneys Atherosclerosis is a frequently identified pathology characteristic of men aged 45–50 years.

The following common forms of vascular atherosclerosis are distinguished:

• Atherosclerosis of the brain. Damage to the cerebral vessels is manifested by increased fatigue, headaches, sleep disturbances, and dizziness with a sudden change in body position. In advanced stages, there is a deterioration in memory, attentiveness, and ability to concentrate. Depending on the type of vessels affected, the patient's vision, speech, or hearing may be affected. Atherosclerosis of cerebral vessels often initiates acute strokes, in which sharp violation blood supply, and the brain does not receive oxygen for a certain time. The consequence of a stroke can be paralysis, loss of life important functions (speech, vision, motor function), death.
• Atherosclerosis of heart vessels. Deposition of cholesterol in the heart vessels is manifested by pain in the heart, cold hands and feet, and pale skin. The working capacity of such patients decreases, apathy, irritability, and nervousness develop. Atherosclerosis of the heart vessels is a common cause of myocardial infarction ( death of heart muscle cells), cardiosclerosis ( condition in which normal muscle fibers hearts are replaced by dense scar tissue).
• Atherosclerosis of abdominal vessels. The pathology is manifested by pain in the navel area, the intensity of which increases after eating. Patients also complain of stool disorders ( constipation, diarrhea, bloating), causeless weight loss. Since atherosclerosis deteriorates the circulatory system as a whole, this disease also manifests itself as pain in the legs, lameness, redness of the skin and/or the appearance of ulcers on the legs.
• Atherosclerosis of the kidneys. The first symptom is an increase in blood pressure and protein in the urine ( determined by analysis). After this, the patient begins to experience pain in the abdominal cavity and/or lower back, which can radiate to the groin. Some patients suffer from periodic vomiting and low body temperature. In severe cases, atherosclerosis of the renal vessels causes renal failure.
• Atherosclerosis of the extremities. This pathology can affect the vessels of both the upper and lower extremities. With this form of atherosclerosis, the patient’s hands and/or feet feel cold, “goosebumps” are often disturbing, and the skin turns pale. In later stages, severe pain in the limbs, lameness, swelling, and redness of the skin appear.

The cause of atherosclerosis is increased levels of cholesterol in the blood. Hormonal imbalances, disorders fat metabolism, hereditary predisposition– all these factors significantly increase the risk of developing atherosclerosis. Experts also note that triggers ( contributing factors) this pathology may be excess weight, the predominance of fatty foods in the diet, long-term consumption of tobacco or alcohol products.

Vascular aneurysm

An aneurysm is an increase in the diameter of the vessel by more than 2 times, which appears due to a defect in the vascular wall. The most common locations of aneurysms are the arteries of the heart muscle, brain, testicles, and kidneys. The shape, structure and size of the aneurysm may vary.

This pathology is assessed by doctors as a dangerous condition and is often called a time bomb. The danger lies in the rupture of an aneurysm, which leads to acute circulatory disorders and irreversible deformations of the structure of the organ where it is located. The situation is complicated by the fact that often this pathology is detected only in late stages due to the absence of obvious symptoms. Since heredity increases the likelihood of developing an aneurysm, people whose relatives suffer from this disease should undergo regular examinations by an angiologist. Aneurysm also often occurs as a complication of atherosclerosis, chronic infectious diseases, congenital vascular defects. Head injuries play an important role in the development of cerebral aneurysms. Predisposing factors for this pathology include diabetes mellitus, smoking, and heavy physical labor.

Obliterating endarteritis

With this vascular disorder, the arteries and capillaries of the legs are affected, as a result of which the vessels “stick together” and an acute circulatory disorder occurs. Receiving insufficient nutrition, cells begin to die, which in the absence of competent medical care leads to gangrene ( tissue rotting). Obliterating endarteritis is a disease characteristic of young and middle-aged male patients. If left untreated, this pathology may require amputation of one or both feet.

The disease develops due to failures immune system, in which the body begins to fight against its own cells. The exact reason for this “behavior” of the body has not been established, but the triggering mechanisms have been well studied obliterating endarteritis. Patients with a long history of smoking, as well as those who wear uncomfortable shoes that cause calluses and corns, are more susceptible to pathology. Triggers of the disease include frequent hypothermia or leg injuries, the predominance of fatty foods in the diet, and some chronic infections.

A characteristic symptom of endarteritis is acute, sudden pain in the calves, due to which the patient begins to limp. In addition, there is sweating of the feet, constant goosebumps, and heaviness in the legs. The feet become colder to the touch, and the skin becomes bluish-pale.

Systemic vasculitis

Systemic vasculitis is the name of a large group of diseases that are manifested by inflammation of blood vessels with their subsequent destruction. Factors that trigger the inflammatory process are viral or bacterial infections, some medications, hereditary predisposition. Symptoms depend on the type of vasculitis, but the common signs for the entire group of these diseases are worsening general condition, loss of appetite followed by weight loss.

There are the following types of systemic vasculitis:

• Takayasu arteritis. This form of vasculitis occurs predominantly in women and is manifested by inflammation large arteries. Symptoms include frequent headaches, chilliness and hard-to-palpable pulse in the legs, and vision problems.
• Behçet's disease. With this disease, small and medium-sized arteries and veins become inflamed. The disease is most often diagnosed among young men and manifests itself as ulcers that first affect the oral mucosa and then appear on the genitals and other parts of the body.
• Buerger's disease. With this pathology, small blood clots form in the vessels of the legs. Patients ( most often men aged 20 to 40 years) complain of numbness and chilliness of the toes, pain in the feet, lameness. Lack of timely treatment measures can lead to gangrene with subsequent amputation of the limb.
• Wegener's granulomatosis. This disease is manifested by an inflammatory process that involves the vessels of the upper respiratory tract (nose, throat), eyes and kidneys. Primary symptoms are runny nose, nosebleeds. Some patients have a cough, discomfort or chest pain.
• Horton's disease. This type of vasculitis is common in older patients, of whom 65 percent are women. With this pathology, the arteries become inflamed ( most often temporal and cranial) large and medium size. Signs of Horton's disease are sharp pain in the masticatory muscles when eating or talking, high fever, and numbness of the face.
• Microscopic polyangiitis. This type of vasculitis affects small vessels, located in the skin, kidneys and lungs. Small ulcers appear on the patient's skin, and fever is possible. The consequence of this pathology can be kidney failure.
• Hemorrhagic vasculitis. This disease most often affects children aged 3 to 7 years or adolescents 14 to 15 years old. With this form of vasculitis, an inflammatory process develops in the vessels of the skin, joints, and organs. gastrointestinal tract. A characteristic symptom of the disease is small hemorrhages that look like a rash. In addition, there may be blisters or ulcerative lesions on the skin.

Embolism

Embolism is vascular disorder, in which particles are present in the blood ( emboli), which should not normally exist. If left untreated, emboli cause blockage of blood vessels. Embolism is classified according to the type of pathological substances present in the bloodstream.

The following forms of embolism are distinguished:

• Cholesterol. In this case, there are fragments of atherosclerotic plaques in the blood, which are torn off from the walls of the vessel by a wave of blood.
• Air. This form of embolism develops during operations or open injuries, as a result of which air enters the blood. There is also a gas embolism, which occurs when there is a sharp change in atmospheric pressure (for example, when a person emerges to the surface from great depth and takes a sharp breath).
• Fat. With this form, particles of fatty tissue enter the bloodstream. Fat embolism develops during operations or severe injuries in patients with large accumulations of fat deposits.
• Bacterial. In this case, there is in the blood a large number of pathogenic microorganisms and their waste products.
• Amniotic fluid embolism. This form of embolism develops upon penetration amniotic fluid into the bloodstream and is a consequence of difficult labor ( with multiple pregnancies, with too early placental abruption, with polyhydramnios).

Angiopathy

Angiopathy is a pathological change in the tone of the vascular wall, which causes the vessels to become more fragile and vulnerable. Depending on the type of vessels that are affected, macroangiopathy is distinguished ( large vessels are damaged) and microangiopathy ( pathological changes occur in small blood vessels). Angiopathy is also classified according to the type of disease, against the background of which a change in the tone of the vascular walls develops.

There is the following classification of angiopathy:

• hypertensive (develops in patients characterized by high blood pressure);
• hypotonic (typical for people suffering from low blood pressure);
• cerebral amyloid (develops against the background of severe brain pathologies, mainly in elderly patients, for example, with Alzheimer's disease);
• diabetic (is a consequence of diabetes mellitus);
• traumatic (appears as a result of previous injuries).

The diabetic form of angiopathy is divided into several subtypes, depending on the organ in which the blood vessels are affected. If the blood vessels located in the kidneys are damaged, the patient is diagnosed with nephropathy. If, as a result of diabetes, the blood vessels in the retina of the eye are affected in a patient, this condition is called retinopathy.

Hemangioma

Hemangioma is a benign tumor that is formed due to the proliferation of vascular tissue. This pathology is typical for newborns and children several months old. Most often, hemangioma forms in the vessels of the skin, mucous membranes, liver or kidneys. Quite often, proliferation of vascular tissue in the spine is diagnosed.

When the tumor is located superficially on the skin, there is a smooth or lumpy elevation of red or bluish color. If hemangioma affects internal organs, then for a long time this condition is asymptomatic. Being benign, up to a certain point, hemangiomas do not provoke any disorders, but, like any other tumors, they are prone to growth. With a strong increase in size, neoplasms begin to negatively affect the functions of the organ in which they are located. So, if the hemangioma is in the ear, it can cause deterioration or complete loss hearing

Lymphangioma

Lymphangioma is a benign tumor that forms when tissue grows lymphatic vessels. The risk group includes children under one year of age. The formation can affect lymphatic vessels of any size. The most common tumors are in the form of a cyst ( occur in 60 percent of cases), which are located in the area of ​​the lymph nodes on the neck and chin. The danger of such lymphangiomas is that as they grow, they begin to put pressure on the larynx, which disrupts the respiratory process.

Lymphostasis

Lymphostasis is a violation of lymph circulation that develops as a result of various diseases. internal organs (kidneys, hearts). The cause of this pathology may also be obstruction of the lymphatic vessels resulting from injuries ( for example, during operations) or when blood vessels are compressed by tumors or inflamed tissues.

The disease develops in 3 stages and is more common in women. At the initial stage, lymphostasis is manifested by swelling of the extremities, which can go away on its own. At the second stage, the swelling is accompanied by the proliferation of connective tissue and hardening of the skin. When the skin is pulled, the patient experiences pain. The third stage of lymphostasis is characterized by a symptom such as elephantiasis, in which the limb greatly increases in size, becomes deformed and loses ( partially or completely) its functions. Complications of the final stage may include blood poisoning, muscle atrophy, tissue necrosis. Often, grade 3 lymphostasis causes the patient’s disability.

Raynaud's disease

Raynaud's disease is a blood supply disorder in which, under the influence of various factors ( most often cold or stress) vasospasm occurs. Women are more susceptible to this pathology than men. An attack of the disease is manifested by a sharp pallor and coldness of certain areas of the skin ( usually on the arms or legs, but the tip of the nose, earlobes, and chin may also be affected). Also, the affected areas are characterized by decreased sensitivity, numbness or pain. These symptoms can persist from several minutes to one hour, after which all manifestations of Raynaud's disease disappear.

The cause of the pathology can be various disorders nervous system, blood diseases or certain medications. An interesting fact is that, according to statistics, pianists and typists are more susceptible to this disease.

Phlebologist-angiologist

Phlebologist-angiologist is a specialty that combines such disciplines as angiology ( vascular science) and phlebology ( branch of medicine about pathologies to which veins are exposed). This means that this doctor specializes in identifying and treating pathologies of the vascular system, but he deals more deeply with venous diseases.

There are the following vein diseases, which are dealt with by a phlebologist-angiologist:

• phlebitis;

• phlebothrombosis;
• thrombophilia;
• venous insufficiency.

Phlebeurysm

Varicose veins ( varicose veins) is the swelling and enlargement of veins, which impairs blood circulation and causes blood stagnation. Over time, the structure of blood vessels changes ( they get tortuous), venous nodes are formed.

There are the following parts of the body that are most susceptible to varicose veins:

• Legs. Today every 4 inhabitants of the planet suffer from this problem. Triggers ( reasons) pathologies are hormonal imbalances and uncomfortable shoes, so most often varicose veins on the legs are diagnosed in women. Sedentary work can also provoke this disease ( Doctors call this phenomenon computer varicose veins.), heredity ( in children whose parents suffered from this pathology, the risk of varicose veins increases by 70 percent). Symptoms of the disease include pain, swelling, and a feeling of heaviness in the legs. The skin of the legs takes on a bluish tint, and dilated veins are visible underneath.
• Hands. Varicose veins on the arms are a less common form and are more common in people who, due to their profession or lifestyle, often lift heavy objects. Veins in the upper extremities may also become enlarged from long-term use medications containing hormones, or during menopause ( both men and women).
• Small pelvis. Varicose veins of the small pelvis are a common pathology among women, the trigger for which is often pregnancy. A sign is pain in the lower abdomen, which intensifies with physical or emotional fatigue, at the end of the menstrual cycle, during intimate contacts. In the perineal area and on the buttocks, compactions may appear due to the formation of venous nodules.

Phlebitis

Phlebitis is an inflammatory lesion of the venous walls, which can be both acute and chronic nature. Inflammatory process may affect both the outer walls of the vein ( periphlebitis), and the inner walls of the veins ( endophlebitis). Also, inflammation can be combined and affect both the internal and external walls of blood vessels ( panphlebitis).

In the vast majority of cases, the cause of phlebitis is varicose veins. Quite often, pathology develops against the background of previous infectious diseases. Mechanical damage blood vessels due to injections or injuries can also provoke inflammation of the veins.

At acute form the patient's illness is bothered by severe pain in the area of ​​the affected veins ( most often in the legs). Chronic phlebitis for a long period may not provoke any complaints.

Phlebothrombosis

With this disease internal walls blood clots form in the veins ( blood clots). The cause of phlebothrombosis may be increased blood clotting and a violation of the integrity of the vessel. Trigger this disorder is often caused by hormonal drugs, overweight, previous surgeries.

Blood clots tend to grow, and as their mass increases, a rupture occurs at the site of fixation of the clot to the wall of the vessel, as a result of which the vein becomes clogged and an acute circulatory disorder occurs. Most often, phlebothrombosis affects the lower extremities, manifesting itself as pain in the legs, swelling, and a bluish discoloration of the skin.

Vascular thrombophlebitis

Thrombophlebitis is a combined form of the above phlebitis ( vein inflammation) and phlebothrombosis ( blood clot formation). That is, with this pathology, the vessels of the venous system become inflamed due to the fact that the lumen of the veins is blocked by a blood clot. Both deep and superficial veins can become inflamed.

With thrombophlebitis, a reddened appearance appears on the surface of the skin along the vein. painful lump, whose temperature is higher than other parts of the body. When walking, abruptly changing the position of the legs or physical activity, the pain intensifies and becomes nagging in nature. If deep-lying veins become inflamed, thrombophlebitis may occur without significant symptoms. Factors that increase the likelihood of developing this pathology are a sedentary lifestyle, vascular injuries, and some blood diseases.

Thrombophilia

Thrombophilia is the body's predisposition to form blood clots in the veins. High risk of vein blockage blood clots caused by blood diseases that a person may have from birth or acquire during life. Thrombophilia belongs to the category of common pathologies and occurs in approximately 40 percent of the entire adult population.

Venous insufficiency

Venous insufficiency is an acute or chronic disorder the process of blood outflow in the veins. This problem can be diagnosed in different parts body ( kidneys, liver, brain), but most often it is detected in the lower extremities.

Acute venous insufficiency is a consequence of sudden occlusion of deep veins, which can be caused by a blood clot or injury. This condition manifests itself as severe swelling, which develops immediately after the lumen of the vein is blocked. The skin becomes bluish, and a venous pattern is clearly visible on its surface ( hallmark of acute venous insufficiency).

In chronic venous insufficiency, a violation of the outflow of blood occurs in the superficial veins. The cause of the disease may be clothing squeezing the skin, prolonged static loads on the legs, weak physical activity, overweight. Initially, pigment spots appear in the area of ​​impaired blood circulation, which, if left untreated, noticeably increase in size. Patients complain of swelling, leg cramps, a feeling of fullness and heaviness. With the progression of venous insufficiency, ulcers appear on the skin, which can become the initiator of blood poisoning and other dangerous diseases.

Surgeon-angiologist

An angiologist surgeon is a specialist who has received education in the field of vascular surgery. This branch of medicine deals with the diagnosis and surgical treatment of diseases of the circulatory and lymphatic networks. Accordingly, the angiologist surgeon ( angiosurgeon) specializes in identifying and treating vascular pathologies using minimally invasive methods. Minimally invasive methods mean surgical interventions ( operations), in which the doctor makes small incisions, which reduces the traumatic nature of the manipulation and shortens the rehabilitation period.

A separate area of ​​vascular surgery is microsurgery, the peculiarity of which is the use of special material and equipment, which allows operations on vessels with a diameter of less than 2 millimeters. During this treatment, the angiosurgeon sews together small blood and lymphatic vessels, restoring the integrity of the vascular system, which is important when sewing on amputated limbs, implanting organs and other similar operations.

What diseases does an angiosurgeon treat?

The competence of an angiosurgeon includes all vascular diseases, the treatment of which involves surgical intervention.

There are the following vascular pathologies that an angiosurgeon treats:

• congenital or acquired vascular defects;
• bleeding disorders and other blood pathologies;
• atherosclerosis;
• aneurysm;
• vascular tumors;
• stenosis ( narrowing) vessels;
• angiopathy of various types;
• phlebeurysm;
• embolism of various forms;
• phlebothrombosis, thrombophlebitis;
• strokes of various types;
• venous insufficiency;
• lymphostasis and other disorders of lymph outflow.

The tasks of the angiologist surgeon include diagnosing these pathologies with subsequent surgical treatment.

Types of diagnostic procedures

To identify and assess the severity of vascular diseases, the angiologist surgeon uses special methods diagnostics

The following are distinguished: diagnostic procedures performed by an angiosurgeon:

• ultrasound duplex scanning (allows you to obtain an image of the vascular system and assess the condition, size, patency, and existing deformations of blood vessels);
• angiography (X-ray examination of blood vessels, which helps to detect and evaluate pathologies such as narrowing or blockage of blood vessels);
• cerebral, coronary angiography (X-ray analysis of the blood vessels of the brain and heart);
• plethysmography (study of the tone and movement of blood in small vessels);
• phlebography (examination of veins using x-rays, often prescribed for varicose veins of the lower extremities);
• computed tomography of blood vessels (allows you to identify blood clots and atherosclerotic plaques, defects in the structure of blood vessels, proliferation of vascular tissue).

Types of vascular operations

Most operations on blood vessels are reconstructive in nature, that is, their goal is to restore the functionality of both the vessel and the vascular network as a whole. Sometimes surgery is performed in order to completely remove the damaged vessel, but such cases are rare, since the goal of the angiosurgeon is to preserve partial or complete integrity of the vessel.

The following common types exist vascular operations:

• Balloon angioplasty. The purpose of this operation is to restore the patency of large vessels. The indication for manipulation is narrowing of arteries or veins due to atherosclerosis or arteritis. The principle of the method is that a small balloon is inserted into the affected vessel, which, inflating from the pressure pumped by the doctor, increases the distance between the vascular walls. Sometimes stenting is performed after balloon angioplasty.
• Stenting. During this operation, into the vessel cavity ( which is previously expanded) a hollow tube is inserted ( stent), in order to prevent further narrowing of the vein or artery. Stents are made of polymer or metal and may have a special therapeutic coating. Most often, stenting is performed for coronary artery disease ( vessels located in the heart area) or carotid arteries ( vessels located in the neck and head). Less often, a stent is implanted into the vessel cavity for varicose veins in the legs.
• Embolectomy, thrombectomy. These operations are indicated for patients who are found to have blood clots in their bloodstream ( thrombectomy is performed) or embolus ( embolectomy is prescribed). The angiosurgeon finds a vessel ( using x-rays or other diagnostic methods), which contains pathological contents, and inserts a hollow tube into it, at the outer end of which there is a balloon. Under pressure, the tube “sucks up” the pathological fragments, and then the artery or vein is sutured.
• Shunting. This surgical intervention is performed for atherosclerosis of the heart vessels or for circulatory disorders in the lower extremities ( much less often). The principle of bypass surgery is that an additional path is created on the diseased vessel, which “bypasses” the affected area. The bypass is formed from a hollow plastic tube called a shunt. After bypass surgery, blood begins to circulate along the line created by the angiosurgeon, without encountering any obstacles in the form of narrowed lumens on its way, as a result of which the circulatory system is restored.
• Vascular prosthetics. This operation is performed for obstruction, narrowing or other pathologies of blood or lymphatic vessels. The doctor removes a fragment of the affected vessel, replacing it with an implant made of synthetic material. In some cases, biomaterial is used for prosthetics ( line segment healthy vessel ).
• Endarterectomy. This surgical intervention is performed in cases where the lumen of the vessel is blocked by an atherosclerotic plaque. The peculiarity of the operation is the fact that it is performed using an open method. In the projection area of ​​the affected vessel, the angiosurgeon makes an incision through which he gains access to the artery. The doctor removes the plaque and sutures the vessel. Sometimes a flap may be used ( from synthetic material or a fragment of a healthy vessel), so that the lumen of the vessel does not narrow during stitching.
• Phlebectomy. This operation is prescribed for patients with varicose veins. Classic method is complete removal vessel, for which the angiosurgeon ties the vein in two places and then removes it using a special probe with a hook at the end. A more gentle method is stripping, in which only a fragment of the diseased vein is removed.
• Laser removal of varicose veins. The procedure is performed for varicose deformation of venous vessels and is an alternative to phlebectomy. Through small punctures A laser emitter is introduced into the vein cavity on the skin, under the influence of which the blood is displaced and the walls of the vessel stick together. As a result, blood circulation in the affected vessels stops.
• Implantation of a vena cava filter. A vena cava filter is a special device that is implanted into the lumen of a vessel in order to catch blood clots or emboli. Externally, the device resembles a cylinder woven from mesh. Due to its design features, the vena cava filter does not create obstacles for blood, but retains various pathological particles. The device is installed in the inferior vena cava, where it is inserted through an incision in the thigh. Implantation of a vena cava filter is indicated for patients with various pathologies blood, which increases the likelihood of vein blockage.

IN separate group vascular operations include manipulations performed by an angiologist when identifying vascular tumors ( hemangiomas, lymphangiomas). There are several methods for removing these tumors, and the choice of the optimal method depends on the location of the tumor, the age of the patient and other factors.

If the tumor is in a hard-to-reach place, the doctor may prescribe sclerotherapy. The principle of the method is that a special drug is injected into the tumor area, under the influence of which the vessels that form the tumor-like formation die off.

Tumors that are located above the surface of the skin are eliminated using a laser or electric current. Under the influence of heat, the vessels coagulate ( are sealed), and the overgrown tissue evaporates. Cryotherapy can also be used, in which tumor tissue is treated with nitrogen, causing it to freeze and die.
If the tumor is located deep in the tissues or organs, a cavitary surgery, in which the angiologist surgeon makes an incision ( skin, tissue, vessel) and eliminates neoplasm.

Consultation with an angiologist

A consultation with an angiologist is a visit to this specialist in order to determine the cause of the patient’s existing problem and receive recommendations for eliminating it. An appointment with this doctor includes a questioning and examination of the patient, as well as the appointment of tests.

How does an angiologist examine and interview a patient?

The purpose of interviewing and examining the patient is to compile a medical history so that the angiologist can make a primary assumption about the nature and cause of the patient’s complaints. The doctor asks questions about when and under what circumstances the symptoms that bother the patient appeared, and whether they change under certain factors ( for example, does leg swelling get worse in the evening?), whether there were any reasons for concern before. Many vascular diseases are inherited, so the angiologist asks if there are any vascular pathologies from close relatives of the patient.

During the examination, the doctor conducts a visual assessment of the patient’s skin condition, palpates parts of the body, and checks the condition of the mucous tissues.

What tests does the angiologist prescribe?

Tests are needed so that the angiologist can confirm or exclude the initial diagnosis. The list of required studies depends on the patient’s problem, but there are also general tests, which are prescribed both in the presence of complaints and for preventive purposes.

General blood analysis ( AK) is a mandatory test for all patients, which is prescribed by an angiologist in order to determine the level of blood parameters such as hemoglobin, leukocytes, red blood cells. TO mandatory analyzes This also includes blood biochemistry, which allows one to assess the level of total cholesterol, the risk of developing atherosclerosis, and others important criteria. Also, the angiologist often prescribes a coagulogram ( blood clotting assessment), blood infection test, urine test.

Consultations with other specialists

There are some vascular pathologies that require professional attention not only from an angiologist, but also related specialists. Therefore, the angiologist can write out a referral for consultation or tests from other doctors in order to get a complete picture of the disease. Thus, for diseases associated with lymphatic vessels, the participation of an endocrinologist is often necessary ( doctor dealing with disorders endocrine system ). In case of pathologies of the heart vessels, the assistance of a cardiologist is required ( specialist who treats disorders of the cardiovascular system). Before use, you should consult a specialist.

A huge number of people today suffer from various vascular problems. Such problems can be caused by a variety of 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, disruption of the functioning of organs and systems, as well as the formation of trophic ulcers, etc.

In addition, angiosurgeons also perform microsurgery. This category includes surgery, which 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.

The most common reason for visits to an angiosurgeon today is considered to be atherosclerosis, in which there is a deposition cholesterol plaques in the lumens of blood vessels. As a result of this pathological process There is a narrowing of the lumen of veins and arteries, which leads to disturbances in 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 of certain 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, and therapy can be both conservative and surgical.

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. The angiosurgeon helps patients with necrosis and blackening of the feet and toes, with long-term non-healing ulcers 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 narrowly focused specialist in the field pathological conditions 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 limbs that bear a particularly heavy load. Most often, a phlebologist is consulted when varicose veins develop, but in addition, his profile also includes the treatment 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 developing the listed diseases, as well as during pregnancy, when working in a job that involves constant sitting, when sedentary and a very active lifestyle. This doctor can also be useful if you have excessive body weight and an unhealthy lifestyle.

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 are faced with pain along the surface of the lower extremities, heaviness in the legs, cramps, swelling of the legs and bulging veins.

A phlebologist can offer his patients methods of conservative treatment, as well as methods of surgical correction. Therapy is selected exclusively in individually 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.

) is a doctor who diagnoses diseases of the blood and lymphatic vessels. He selects the appropriate treatment method in each specific case and warns about preventive measures.

Treatment of pathologies of arteries and veins can be either conservative or surgical. TO conservative treatment Reception applies medicines, elastic leg bandaging for varicose veins, combating conditions leading to vascular diseases: smoking, obesity, alcohol abuse, diabetes. If treatment cannot be achieved with conservative methods, the doctor prescribes surgical treatment.

Types of operations performed by an angiosurgeon

It is worth noting that vascular uses minimally invasive therapy methods. In practice this means that when surgical intervention Small incisions are made, sometimes microsurgical. This approach makes it possible to reduce the trauma of the operation while maintaining the effectiveness of the procedure. IN microsurgery does not exist simple operations. Each requires utmost attention and several hours of hard work.

Widely used miniphlebectomy- removal of veins affected by varicose veins under local anesthesia. The advantage of the method is that removal occurs not through an incision, which then looks like a scar, but through a puncture. Through such a small hole, the damaged vein is pulled out with a special “hook”. This operation leaves virtually no cosmetic defects.

Recently it has been increasingly used ultrasound treatment - intravascular laser coagulation veins The procedure is done under local anesthesia, without incisions or stitches. Two hours after its completion, the patient can go home independently.

Replantation- another view surgical intervention, which is done by an angiosurgeon. In terms of complexity, it is not inferior to heart surgery, and its essence boils down to the implantation of amputated limbs (or their fragments) with full or partial restoration of their functions. The angiosurgeon performs replantation sitting, using a microscope, using micro-instruments.

Diseases treated by an angiosurgeon

Answering the question: “what does vascular disease treat?” The answer can be simple: vascular diseases. However, in this case, I would like to know which diseases are associated with vascular pathology. Here is their main list:

• atherosclerosis;
• phlebeurysm;
• stroke;
• heart attack;
• aortic aneurysm;
• cardiac ischemia;
• thrombosis, thrombophlebitis;
• arteriovenous fistula;
• varicocele;
• diabetic foot;
• Buerger's disease - thromboangiitis obliterans;
• Wright's syndrome;
• Raynaud's syndrome;
• Takayasu syndrome (aortoarteritis);
• Budd-Chiari syndrome;
• carotid artery stenosis;
• embolism of arteries and veins;
• gas embolism;
• subarachnoid hemorrhage;
• vascular lesion that cuts off the blood supply to the brain;
• lymphostasis;
• scurvy;
• marbling of the skin;
• transposition of great vessels, etc.

When should I go for an appointment?

It would be good to undergo a preventive examination by an angiosurgeon once a year. And if one or more of the following symptoms are present, you should schedule a visit to the doctor as soon as possible. TO alarming symptoms relate:

• swelling of the legs, feeling of heaviness, pain during exercise;
• visible spider veins on the legs;
• periodic seizures calf muscles at night;
• the skin of the legs is changed in color;
• expansion of saphenous veins;
• frequent headaches of unknown etiology;
• “flies” before the eyes;
• noise in ears;
• feeling of tingling, coldness, cramping in the limbs;
• burning, pain in the feet;
• thickening and redness of the legs;
• pulsation in the abdominal area;
• long-term non-healing wounds, ulcers;
• loss of sensation in the lower extremities;
• change in the color of the fingers (blackening, blueness);
• loss of consciousness.

Preparation for the reception and the reception itself

Before visiting a vascular specialist, it is recommended to take a hygienic shower and put on clean linen. If any examinations have been previously carried out, it is important not to forget to take their results. You also need to have referrals from other doctors with you, if you have any.

At the appointment, the angiosurgeon, in a friendly conversation, will find out the symptoms that are troubling the patient, determine the duration and reasons for their occurrence. After which the patient is examined, during which the doctor will find out what additional examinations needs to be assigned. Based on the results obtained, the doctor decides which treatment will be most effective. For varicose veins, in addition to all of the above, compression knitwear is selected.

What additional examinations may be needed?

The examination includes certain tests and special diagnostics:

• Blood tests: clinical and biochemical, hemostasiogram, coagulogram.
• Dopplerography.
• Homocysteine ​​test.
• General urine analysis.
• Magnetic resonance imaging.
• kidneys, adrenal glands, and thyroid gland.
• Duplex scanning of the great vessels, if indicated - scanning of the vessels of the lower extremities.
• ECG, EchoCG.
• Daily monitoring of blood pressure.
• X-ray tomography, as well as positron emission tomography.
• Anthropometry.

After establishing the diagnosis, the angiosurgeon selects the appropriate therapy. In addition to the methods mentioned, the doctor successfully uses magnetic therapy, pneumomassage, cryotherapy, electrical neurostimulation, physical therapy and other techniques.