Angiosurgeon (vascular surgeon)

A vascular surgeon or angiosurgeon is a physician who diagnoses and treats diseases of the vascular system.

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Who is an angiosurgeon?

Who is a vascular surgeon? This question may be asked by those patients who are referred to a specialist for consultation regarding progressive pathological processes in the lower extremities, cardiopathology, diabetic angiopathy, erectile dysfunction, renal failure and many other problems. The specialization was named after the separation of the Greek words - ἀγγεῖον, which means vessels and χειρουργική - action with hands.

Angiosurgery as a separate direction appeared relatively recently, in the middle of the last century, together with pulmonology and proctology, but as a science it developed over several centuries. Such famous doctors as Pirogov, Yasinovsky, Sabaneev made an invaluable contribution to vascular surgery. The multivariate differentiation of surgery as a medical field is associated with the desire of doctors for organ-preserving medicine, for such that is capable of not only excising (removing), but, if possible, preserving and restoring damaged organs and systems.

An angiosurgeon is a vascular surgeon, phlebologist, a doctor who, in addition to receiving a basic higher medical education, completed an internship, received a specialization in surgery, and also chose a specific direction for his activities in the field of diagnostics, treatment and prevention of pathologies of the vascular system - arteries, veins, as well as all diseases that have a vascular etiology.

When should you see a vascular surgeon?

The ideal regime for contacting a vascular surgeon is an annual preventive examination and diagnostics, but not everyone understands the importance of such a medical examination. The list of symptoms that helps determine when to contact a vascular surgeon summarizes the multivariate manifestations of vascular pathologies:

• Swelling of the legs and arms.
• Recurrent or chronic cramps, including at night.
• A feeling of tingling and numbness in the limbs.
• A burning sensation in the feet or calves of the legs.
• Redness of the extremities (feet, toes).
• Lumps in the lower limbs.
• Headache that has no objective cause (acute respiratory disease, flu).
• Atypical skin tone of the lower extremities (blackening of the fingers).
• Chronic, non-healing wounds, ulcers.
• Dizziness, ataxia - loss of coordination.
• Sudden fainting, loss of consciousness.
• Ophthalmological manifestations - "flies" before the eyes.
• Tinnitus.
• Feeling of loss of sensitivity in fingers and toes.

What tests should be taken when visiting a vascular surgeon?

To determine the properties of blood flow and the state of the vascular system, clinical and ultrasound, contrast studies are necessary. What tests should be taken when visiting a surgeon to determine the biochemical composition of the blood and the functionality of the blood flow?

1. OAC is a general clinical blood test that allows you to specify the condition of the vessel walls, determine the level of hemoglobin, leukocytes, erythrocytes, the volume and index of platelets, ESR.
2. A biochemical blood test that shows the functional parameters of the internal systems and organs. The analysis is needed to determine homocysteine, creatine kinase MB, two fractions of lactate dehydrogenase (LDH), fibrin breakdown products (D-dimer), potassium, chlorides, sodium, C-reactive protein, adrenaline and noradrenaline levels.

An important marker in biochemical analysis is the cholesterol level:

• total cholesterol level.
• high-density lipoprotein (HDL) index.
• Low-density lipoprotein (LDL) index.
• triglyceride index - fats.
• atherogenic coefficient – an indicator of the risk of developing atherosclerosis (the ratio of HDL to total cholesterol).

3. Hemostasis, coagulogram, helps to determine the prothrombin index, time, fibrinogen level
4. General urine analysis.
5. According to indications – determination of antibodies (antigens) in the blood serum – serological test.
6. You can find out what tests you need to take when visiting a vascular surgeon during your initial consultation with the doctor.

What diagnostic methods does a vascular surgeon use?

The diagnostic complex may include research using the following methods and techniques:

• MRI angiography is a method that helps to obtain a two-dimensional image of blood vessels.
• Dopplerography of blood vessels is a method that can assess blood flow functions (velocity), the condition of the vessel walls and the presence of atherosclerotic deposits (plaques).
• Angiography using X-rays.
• Endoscopy.
• PET – positron emission tomography, radionuclide imaging.
• Electrocardiogram (dynamic – daily study).
• Echocardiogram.
• Blood pressure monitoring.
• Sonography (echography) of the main vessels of the head.
• Ultrasound of internal organs, with mandatory examination of organs responsible for hormone production (kidneys, thyroid gland, adrenal glands).
• Sonography (echography) of the vessels of the lower extremities.
• Consulting with specialized professionals.
• Anthropometry – calculation of the ratio of body mass index and other indicators.

The methods used by the vascular surgeon depend on how far the disease has progressed, the patient’s condition, and the capabilities of the medical facility in terms of equipping it with the necessary equipment.

What does a vascular surgeon do?

Angiologists (vascular surgeons) deal with all types of diseases that are somehow related to pathological processes in large main vessels (veins, arteries), as well as in the lymphatic system. The following list, which includes only general areas of the multi-type activity of a vascular surgeon, can answer the question - what does a vascular surgeon do?

• Diagnosis of diseases of the vascular system and pathologies associated with the main vessels.
• Treatment of traumatic injuries to the vascular system caused by mechanical and everyday factors.
• The competence of vascular surgeons includes certain types of oncological diseases, if the tumor is localized near an artery or vein, or grows into large main vessels.
• Prosthetic replacement of vessels damaged by trauma or during surgery.
• Removal of congenital pathological vascular formations – hemangiomas, AVM – arteriovenous malformations.
• Replantology is a microsurgery that makes it possible to “sew” (replant) limbs (hands, limb fragments) that have been amputated as a result of injury.
• The use in practice of all possible and recognized by the world medical community methods of diagnostics, conservative therapy, surgery, and prevention of diseases of the vascular system.

What diseases does a vascular surgeon treat?

Leading the list of diseases that fall within the competence of a vascular surgeon is atherosclerosis, which in recent decades has become a real disaster for many developed countries of the world. It is no coincidence that atherosclerotic pathologies are considered a real epidemic, although the disease does not have a viral pathology. According to statistics, atherosclerosis can be diagnosed in almost 80% of people who have reached the age of 60, of course, provided that they seek help from a vascular surgeon. The deposition of cholesterol organic compounds in the arteries leads to serious consequences, such as:

• Stroke.
• Heart attack.
• Aortic aneurysm.
• Atherosclerosis of the renal vessels (arterial thrombosis).
• IHD – ischemic heart disease.
• Atherosclerosis of the cerebral vessels.
• Obliterating atherosclerosis of the lower extremities.

In addition, the list of diseases treated by a vascular surgeon includes the following pathologies:

• Reticular ("cosmetic") varicose veins.
• Varicose veins.
• Vascular "networks" - telangiectasias.
• Thrombophlebitis – thrombophlebitis.
• Buerger's disease - obliterating thromboangiitis.
• Lymphostasis.
• Obliterating endarteritis.
• Diabetic angiopathies.
• Takayasu syndrome - aortoarteritis.
• Congenital or trauma-induced arteriovenous fistula.
• Varicocele.
• Raynaud's syndrome.
• DE - discirculatory encephalopathy.
• Gas embolism.
• Stenosis of the carotid arteries.
• Lipedema, lymphedema.
• Pulmonary embolism.
• Coraco-pectoral syndrome, Wright syndrome.
• SM - Marfan syndrome.
• Hepatic vein obstruction - Budd-Chiari syndrome.
• SAH - subarachnoid hemorrhage.
• Trophic ulcers.
• Systemic capillary disease - Goodpasture's syndrome.
• TGA – transposition of the great vessels.

Advice from a vascular surgeon

In order to ensure that neither atherosclerosis nor other vascular diseases lead a person to the doctor, or even more so to the operating table, it is necessary to follow the recommendations and advice of a vascular surgeon:

• Follow the rules of a healthy active lifestyle.
• Give up bad habits, especially smoking, which is a direct path to atherosclerosis.
• Follow the rules of reasonable physical activity. Hypodynamia is a factor that provokes diseases of the vascular system.
• Follow the rules of healthy eating (limit foods rich in cholesterol and fat) and ensure that your body weight is within the normal range.
• It is necessary to monitor - regularly measure blood pressure, if necessary, take recommended medications to regulate blood pressure.
• It is necessary to periodically measure blood sugar levels to prevent the development of diabetes.
• Regularly undergo medical examinations and tests, including those by a vascular surgeon to monitor cholesterol levels.

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