Heart and vascular diseases are the leading cause of death of people all over the earth. Therefore, doctors and scientists from different countries are looking for new, more effective, and safer methods of diagnosis and treatment of cardiovascular diseases. Vascular conditions can be treated not only through non-surgical methods: surgery is also possible as a more radical cure. These problems and techniques are studied by a separate subspecialty called vascular surgery.
What Is Vascular Surgery?
It is a surgical specialty working with the disorders of all vessels except coronary arteries and cerebral vessels: these are concerns of cardiac surgeons and neurosurgeons respectively.
Symptoms that require vascular surgeon’s attention:
- the leg pain of any nature;
- starburst veins on different body parts;
- swollen legs and leg pain in the evenings;
- burning and tingling sensation in gastrocnemii;
- cramps and heavy legs;
- lingering non-healing wounds without any constant damage;
- numbness in legs or changed skin color.
Cardiovascular diseases are often chronic and progress over time, so the patients need constant medical supervision: most outpatients are observed by a cardiologist. Vascular surgeons are focused on surgeries: they observe the patients right before an operation and for some time after it.
The Most Common Diseases
Atherosclerosis and its vascular complications are the most common problems. In 80% of cases, atherosclerosis is the reason for operative treatment in vascular surgery. The main causes of atherosclerosis are:
- high blood cholesterol;
- diabetes mellitus and a number of other diseases.
Abnormal narrowing in blood vessels (stenosis), thrombosis, aneurysms, and dissection are also widely spread. Many of these diseases require emergency surgery; otherwise, a fatal outcome is possible. A vascular surgeon deals with vascular tumors, hemangiomas, that also require operational treatment. Together with their colleagues of other specialties, these doctors are engaged in the treatment of renal artery stenosis and abdominal aortic stenosis. They also perform operations for varicose veins, deep vein thrombosis, etc. Leg vein diseases are not only an aesthetic problem: a patient also suffers from pain and is not able to be active in exacerbations. The definite diagnosis is based on the case history and results of a full checkup.
The surgery type is selected depending on the affected vessel, the location, and type of affection, as well as on the patient’s age, history, and other factors. The surgeon can recommend:
- endarterectomy or vascular shunting (implies opening the artery);
- percutaneous surgery involving endovascular techniques (angioplasty, stenting, etc.);
- phlebectomy for venous diseases;
- sclerotherapy, etc.
Foreign specialists choose minimally invasive approaches for almost all surgeries: such a technique guarantees faster recovery, good tolerability, and absence of pain. Patients are more willing to undergo such operations; moreover, minimally invasive operations feature a significantly higher success rate.
Surgery is always accompanied by drug therapy, which can be aimed at relieving symptoms (pain, high blood pressure, etc.) or preparing the patient for the operation. Non-surgical treatments include measures to limit risk factors. Giving up smoking, healthy living and a certain diet are strongly recommended for the patients. Blood thinners, antihypertensives, diuretics, and many other medications are prescribed both for prevention and treatment.
Despite a successful operation and teamwork of the medical staff, the patients’ expectations may fail to materialize: their working ability and physical activity remain poor. This is often attributed to the lack of rehabilitation. Few Russian hospitals have convalescence wards or at least any specialists concerned with rehabilitation. The patients usually visit polyclinics, which have no conditions and personnel for rehabilitation treatment.
If after routine vascular surgery, a person fails to pay due attention to their health and make follow-up appointments with a specialist, they may need another surgery in a few years. Many vascular diseases are chronic, so their effective prevention requires close attention to health from the patient.
Postoperative rehabilitation is aimed at:
- preventing recurrent exacerbations and further disease progression;
- preventing disability;
- improving the quality of life;
- maintaining skills and working ability;
- maintaining optimal physical activity;
- engaging the patient’s family and relatives in the rehabilitation;
- bringing the patient back to a full social life.