Atherosclerosis of the lower extremities is a disease in which plaques appear inside the arteries supplying the extremities, interfering with the free circulation of blood. They create blockage of blood vessels, narrowing the lumen, resulting in tissue necrosis.
After diagnosis, surgery for atherosclerosis of the lower extremities is often used. Mild stages can be treated with medications. In case of complications of the disease, surgical intervention is required. Surgeons use plastic surgery and bypass surgery, and in particularly severe situations, surgery to excise damaged tissue.
A bloodless operation, actively used in modern surgery, angioplasty, helps to eliminate blockage of arteries. A balloon coated with a special medicine enters the artery through a catheter, where the medicine is absorbed into the walls of the vessels. The substances reduce inflammation and normalize the diameter of blood vessels, allowing blood to flow freely to all parts of the lower extremities.
In order to diagnose the need for angioplasty, surgeons perform angiography of the extremities.
Necessary conditions for the procedure:
Next, the angiography procedure is carried out step by step:
Angioplasty involves the use of a guidewire, as in contrast diagnostics. It has a small deflated balloon at the end (1-2 mm diameter). A catheter with a balloon is inserted to the site of narrowing of the artery, and the process is monitored by an angiograph.
The surgeon must ensure that the balloon is in the problem area requiring intervention. Fluoroscopy observations help to adjust the surgical site. Next, air is supplied through the catheter, causing the balloon to inflate. It enlarges and impacts the plaque, causing it to flatten. Thus, the blockage of the vessel is eliminated.
Surgeons speak positively about such operations and actively use angioplasty as a method of surgical treatment for blockage of blood vessels. If there are reasons for such an operation, the intervention effectively eliminates the causes of the disease.
This method has its advantages, pushing the doctor and patient to choose angioplasty:
According to statistics, 80% of patients after balloon angioplasty for 3 years had no problems with blockage of blood vessels or decreased blood flow. To do this, you should take into account the recommendations of doctors and engage in special walking.
It is necessary to undergo regular examinations:
Based on them, the doctor assesses the condition of the arteries and, if necessary, decides to take additional measures to improve their condition. If the operation does not bring results, the option of vascular bypass is considered.
By installing intravascular prostheses (shunts), possible consequences of atherosclerosis and the presence of plaques in the form of tissue necrosis and the development of gangrene are prevented.
Surgical treatment of atherosclerosis of the lower extremities is carried out by a specialist in the field of angiosurgery; the operation requires knowledge, skills and experience in performing this type of operation. Therefore, bypass surgery is carried out in specialized clinics, having previously made a complete diagnosis of the patient to ensure a positive result of the operation.
Modern surgical methods make it possible to perform surgery without general anesthesia. In this case, the shunt is inserted without any particular damage to the skin tissue, which promotes rapid healing and recovery after shunting.
The essence of the operation is to ensure normal blood flow in the lower extremities using bypasses (prosthesis). Damaged areas of the artery (less commonly, veins), due to which blockage occurs, are thus excluded from the circulatory system and replaced with an implant.
The surgeon makes an incision in the upper thigh to reach the part of the healthy aorta, not susceptible to atherosclerosis, located above the site of injury. An artificial vessel is attached to this area, made from materials that have good characteristics that prevent rejection by the body. The other end of the prosthesis is attached below the affected area, to the healthy part of the vessel.
Two types of vascular prostheses can be used for the operation:
The first type of implant is the tissue of the patient’s body. Such shunts are characterized by high strength, but can only be used in small areas of the damaged vessel. In surgery, a part of the saphenous femoral vein most often becomes a natural prosthesis.
If blockage and obstruction of the blood flow process is observed in a significant area of the artery, surgeons make multi-storey shunts, which allow alternating healthy areas with prostheses.
Bypass surgery helps restore blood flow, prevents the development of complications such as gangrene, and reduces the risk of blood clots.
Replacing a damaged area of blood vessels with prostheses is a difficult operation that requires the precision and professionalism of a surgeon.
Only after a course of conservative drug treatment, which did not bring the desired effect, do doctors, in order to avoid amputation, consider the option of vascular bypass surgery. To do this, they carefully study the patient’s health condition.
Indications for the operation are:
To make a decision about bypass surgery, it is also necessary to exclude cases where this type of operation is contraindicated for the patient.
It is not carried out:
After making a decision to perform vascular bypass surgery of the lower extremities, the angiosurgeon conducts a survey of the patient in advance to determine the symptoms and location of the pain, find out the presence of other diseases, and general well-being. Diagnostic procedures are also mandatory to compile a general clinical picture of atherosclerosis.
Diagnostic methods determine in which part of the vessels the plaques that narrow the lumen of the arteries are located:
Based on the research results, if bypass surgery is necessary, the doctor sets a date for the operation.
A few days before the procedure, you should undergo additional procedures:
7 days before surgery, the patient must take blood thinning medications, as well as antibiotics and anti-inflammatory drugs. They reduce the risk of blood clots during surgery. It is recommended to eat and drink less the day before.
Based on the scale of damaged areas of blood vessels, the surgeon chooses one of the intervention options:
The choice of anesthesia for surgery depends on the degree of complexity of the disease and the general condition of the patient. Based on diagnostic studies, the doctor administers local anesthesia or general anesthesia.
Where does bypass surgery begin? First, the patient is given anesthesia. Then the manipulations are carried out one by one - the stages of the operation.
Patients who have undergone vascular bypass surgery of the lower extremities require inpatient monitoring. Bed rest is prescribed for 2 days, then the patient can and should walk. Diagnostic examinations are also carried out.
To relieve pain after surgery, the following procedures are performed in the hospital:
If no complications arise, the sutures are removed after a week, after 10-14 days the patient goes home for rehabilitation.
For a quick recovery after surgery, it is recommended to follow the rules and follow the recommendations of doctors:
According to reviews, most people who had lower limb bypass surgery felt better after being discharged from the hospital. Signs of atherosclerosis, pain, numbness when following the doctor’s recommendations and active rehabilitation disappeared 2 months after the operation.
Some patients complain of complications after surgery; in some cases, symptoms of atherosclerosis resumed after a certain period due to damage to neighboring vessels. Negative patient reviews indicate the high cost of the operation.
You can find out how much the operation costs from the price lists of medical clinics. The cost depends on the qualifications of the surgeon, the location of the clinic and the amenities provided, and the equipment used during bypass surgery. In public medical institutions the price is slightly lower than in private ones. The average cost is 100-150 thousand rubles, depending on the type of operation, localization, and complexity of bypass surgery.
It is important to remember: bypass surgery removes the consequences of atherosclerosis, but for the disease to recur, it is necessary to exclude the causes of its occurrence. Changing the patient’s lifestyle will become an obstacle to the further development of atherosclerosis and problems in the future.
Cholesterol can be deposited in any vessel, but most often thrombosis affects the arteries and veins of the lower extremities. The development of vascular atherosclerosis causes pain, lameness and even amputation of the legs. Pathology therapy is aimed at stimulating cardiac activity, improving blood supply and cleansing arteries and veins. Along with conservative methods, treatment with folk remedies is used for atherosclerosis of the vessels of the lower extremities. It begins with organizing a balanced diet and is aimed at lowering the concentration of cholesterol in the blood plasma and getting rid of excess weight.
Nutritional “treatment” of atherosclerosis is based on conscious food choices. Refined products (semolina, high-quality flour, refined rice, pasta) are not recommended in the presence of atherosclerotic plaques. To clean veins and arteries use:
It is recommended to include 300 g of vegetables and at least 200 g of fruit in the daily menu of a patient with atherosclerosis of the legs. The diet should be varied. When combining vegetables and fruits with biologically active substances, the expected effect is enhanced. When creating a menu, you can use a color hint. Every day you need to eat foods of certain shades:
When using “dietary” therapy for atherosclerosis and thrombosis, it is important not to overeat. The positive effect of products can be completely destroyed by their large one-time consumption. With atherosclerosis, diet should become a way of life. The ideal dietary option is No. 10. Garlic and onions are used as medicine in different variations. Patients 40 years of age and older are recommended to drink freshly squeezed potato, cucumber, and beet juice.
Therapy for atherosclerosis is more effective if the liver is cleansed beforehand. To restore it, in particular, cold compresses are used. They are applied in the morning and evening in the area of the right hypochondrium for two weeks.
Herbal infusions and decoctions are used not only for prevention purposes. But with progressive atherosclerosis of the lower extremities, folk remedies, even as additional treatment methods, should be used after consultation with a doctor.
The principle of action of herbal decoctions and infusions is aimed at lowering blood sugar levels, thinning it and cleansing it of lipid compounds.
Atherosclerosis is a pathology in which plaques form on the walls of blood vessels, interfering with blood circulation. The disease affects blood vessels throughout the body, but there are cases of local damage.
Atherosclerosis of the abdominal aorta is characterized by the concentration of plaques in the epigastrium, but this does not make the disease dangerous when compared with generalized atherosclerosis. The abdominal aorta provides blood supply to no less important organs than the thoracic aorta. If it is damaged, significant organs will malfunction, not receiving nutrition and oxygen, or will fail.
It will not be possible to independently identify the pathology in the early symptoms, since its signs appear already at a stage when serious help is required. However, it is still possible to identify impaired vascular patency if you monitor your health and undergo regular examinations.
Typically, atherosclerosis of the abdominal aorta is detected in people whose blood vessel walls become thinner under the influence of various factors. At risk are people who are overweight, smokers, and those whose activities involve staying in a static position for a long time.
Atherosclerosis of the abdominal vessels is an age-related disease that is detected in men from the age of 40, and in women from the age of 55.
The main provoking factors causing narrowing of the aortic vessels in the peritoneum are:
Often, atherosclerosis of the abdominal aorta occurs due to disruptions in lipid metabolism, when low-density lipoproteins begin to predominate in the blood instead of high-density lipoproteins. This provokes the formation of plaques inside the vessels, and the narrowing of the lumen leads to poor blood supply to the organs, a deficiency of oxygen and nutrients.
Doctors distinguish 4 periods of development of pathology, which differ in the presence of symptoms, prognosis and treatment:
If atherosclerosis of the abdominal aorta appears, what it is can be understood in the final stages, when the vessels are severely damaged. Considering that the abdominal aorta is responsible for feeding the organs in the peritoneum and legs, the signs will be appropriate:
Often, atherosclerosis of the abdominal aorta develops for a long time without any special signs, and is detected only as a result of ischemia.
With atherosclerosis of the abdominal region, there will be many symptoms in the epigastric zone; weight loss is associated with disruptions in the digestive tract. If the accumulation of plaques is localized in the area where the aorta divides into 2 channels, then the symptoms are more often localized in the legs - swelling and pain appear. If treatment is not started in time, necrotic lesions arise with the ensuing consequences.
To establish a diagnosis, a number of studies are prescribed:
The listed research methods reveal the extent to which the abdominal organs receive nutrition from the blood. The doctor examines the patient, collects anamnesis and gives a referral for a blood test. The results show elevated cholesterol.
If the initial stage of atherosclerosis is suspected, diagnostic procedures are prescribed: electrokymogram, sphygmogram, ballistocardiogram.
After an accurate diagnosis is made, complex treatment is required, including the need to adjust the diet so that it contains less animal fat. Products that affect the heart and blood vessels are prohibited.
The therapeutic diet reduces cholesterol levels in the blood and stops the progression of the pathology.
For overweight patients, a diet is not only recommended, it is a prerequisite for therapy. The same can be said about bad habits - it's time to quit smoking and give up excessive libation. Sports activity, on the contrary, needs to be increased regularly.
Treatment is aimed not only at atherosclerosis, but also related diseases - hypertension, diabetes. Medicines from different groups are prescribed:
Ascorbic acid is prescribed as an antioxidant. The listed drugs normalize fat metabolism, dilate blood vessels, and liquefy formed plaques.
In addition to drug treatment, there are also surgical options that are indicated in difficult situations. The operations are performed openly, during the process the sections of the blood vessel that are damaged and affected by plaques are removed. Special prostheses allow you to restore the blood supply network. The operation is prescribed only in extreme cases, when there is a risk of blockage of the vessel and death.
Medicinal plants can help treat atherosclerosis, but only as adjunctive therapy. You cannot choose prescriptions on your own, only under the supervision of a doctor. The recommendations are as follows:
proper diet, give up bad habits, exercise
Recommendations to help reduce the risk of complications are simple and clear. They are common to all forms of atherosclerosis. The first step is to move more so that blood actively circulates through the vessels and prevents them from deteriorating as a result of deposits.
You should give up bad habits, including food addictions to junk food. Even older people should do a simple exercise routine and eat right. It is necessary to undergo preventive examinations and promptly treat diseases that can provoke atherosclerosis.
Exclude fatty foods, sweets, and baked goods from your diet. Vegetable fats are used instead of animal fats. If you are overweight, reduce the amount of fats and carbohydrates, learn to cook tasty and healthy meals.
Damage to the abdominal aorta by atherosclerosis leads over time to the death of intestinal loops, resulting in peritonitis. Thrombosis will accelerate inflammation and tissue necrosis. One common complication is kidney failure. At different stages of the disease, new complications are revealed:
The prognosis for atherosclerosis is difficult; the state of health depends both on the patient’s behavior and on the characteristics of the body. The severity of the disease affects the ability to work. Diagnostics, complex therapy and compliance with the recommendations of the attending physician can reduce the risk of deaths.
Elevated cholesterol levels and lipid imbalance in most patients lead to the development of obliterating atherosclerosis of the lower extremities. You will have to be persistent and patient to stop the disease, but everyone can do it.
Before treating atherosclerosis of the vessels of the lower extremities, it is worth understanding the features of the drugs that doctors use.
What groups of drugs are usually prescribed by doctors for the drug treatment of atherosclerosis of the lower extremity vessels and how do they affect the disease?
This is “basic therapy” that eliminates the cause of the disease. They are not able to free the arteries from existing plaques , but do not allow them to increase and close the lumens of the vessels.
Aspirin copes with these tasks . Clopidogrel provides support for the patency of arterial shunts.
Treatment of atherosclerosis of the arteries of the lower extremities with anticholesterol drugs is the use of statins and fibrates to prevent the growth of cholesterol plaque in the vessels of the legs and worsening symptoms.
Available in the form of tablets of 10, 20 and 40 mg. Prescribed, depending on the cholesterol level, from 10 to 80 mg . Single appointment.
Contraindicated , like all other statins, in severe liver damage, individual intolerance, pregnancy and lactation.
Statins are used with caution in cases of alcoholism, certain genetic diseases, and endocrine disorders. You need to warn your doctor about taking other drugs , since simvastatin is not compatible with amiodarone, gemfibrosin, cyclosporine, fenofibrate, verapamil, diltiazem and high doses of nicotinic acid.
The drug belongs to the middle price category. Domestic analogues (Aterostat, Ovencor, Simvastatin) and foreign ones (Simvor, Simlo, Sincard) are more accessible . European simvastatin is more expensive. The most famous are Simgal, Simvastol and Simvakol.
This lipid-lowering substance can block the production of cholesterol in the early stages. The drug is better absorbed with food, so it should not be taken on an empty stomach.
Tablets of 20 or 40 mg are taken twice a day , with breakfast and dinner. If necessary, the dose is increased to a maximum of 80 mg per day. Contraindications are the same as for simvastatin. Caution should be exercised in patients with kidney disease who are taking antibiotics and antifungals.
Lovastatin is included in the middle price category. In Russia you can purchase a domestic analogue with the trade name Cardiostatin, Lovastatin from a Belarusian manufacturer and Slovenian Holetar .
What is the danger of cerebral atherosclerosis and how does it manifest itself? Find out by clicking here.
Read about medications for cerebral atherosclerosis in another material - here.
It is distinguished from other statins by its ability to restore the balance between “useful” and “harmful” blood lipoproteins .
For ease of administration, it is available in tablets of 10, 20, 30 and 40 mg. Starting from 10 mg, the dose is gradually increased to 80 mg per day.
Contraindicated in case of exacerbation of liver diseases and allergies to the drug. The medicine does not affect kidney function.
A popular drug from the fibrate group. The active ingredient is fenofibrate . Contraindicated for liver damage.
Tablets of 145 and 160 mg are taken once a day , regardless of meals. After the initial course of 3 months, the result is assessed by analysis and a decision is made to cancel or continue taking it.
The Russian plant produces an analogue - Fenofibrate canon , and the French one - Lipantil .
Ramipril has been proven in studies to be effective and safe for patients with obliterating atherosclerosis . Therefore, doctors prefer it to other ACE inhibitors.
Tablets of 2.5 mg, 5 mg and 10 mg are taken at any time. Treatment is continuous . Contraindicated in case of intolerance, increased aldosterone production and renal failure.
There are a number of new promising drugs that are at the stage of clinical trials and have not yet been used for the treatment of obliterating atherosclerosis of the lower extremities with medication. Hopes are pinned on iloprost and alprostadil .
Learn more about how to treat the disease from this video:
Atherosclerosis of the lower extremities is a severe progressive disease . But, thanks to proper nutrition, lifestyle changes and the use of modern medications, it is possible to avoid surgical intervention and stop the progression of the disease.
Bypass surgery of the arteries of the lower extremities is a reconstructive operation that involves creating a shunt to bypass a narrowed section of a blood vessel.
With atherosclerosis, atherosclerotic plaques are deposited on the intima of the arteries of the lower extremities.
Over time, they narrow the lumen of the arteries and impair blood circulation in the lower extremities.
With complete obliteration (narrowing) of the artery, necrosis develops.
Indications for surgery
Arterial bypass is indicated for obliterating atherosclerosis, endarteritis, aneurysms of peripheral arteries, in cases where stenting and angioplasty are contraindicated for the patient.
Surgical intervention is performed in patients with threat of gangrene of the limb, with constant pain and ineffectiveness of conservative treatment.
Before surgery, the patient undergoes general clinical examinations, duplex ultrasound scanning, magnetic resonance angiography, and angiography.
Arterial bypass surgery is performed under general or local anesthesia. The saphenous vein of the thigh is taken as a shunt.
The veins of the lower extremities are not affected by atherosclerosis; they are large and long enough to be taken, therefore they are most suitable as shunts. Synthetic materials or other veins may also be used.
The surgeon makes a skin incision in the area of the affected vessel, the artery is isolated, and incisions are made in the places where the shunt is supposed to be sutured. The next stage of the operation: suturing the shunt to the affected vessel.
After surgery, duplex ultrasound scanning and angiography are repeated to monitor the successful operation. In the postoperative period, to prevent infectious complications, a course of antibiotic therapy is prescribed at the Asuta clinic.
The patient is in the hospital after the operation for 2-7 days.
Bypass surgery of lower extremity vessels in Israeli clinics is performed in combination with endarterectomy of the affected artery.
After bypass surgery of the lower extremities, the patient should follow medical recommendations, because the progression of atherosclerosis continues, and atherosclerotic plaques may reappear.
Weight loss, smoking cessation, physical activity, limiting foods containing large amounts of saturated fat and calories, dynamic monitoring with laboratory testing, and constant use of statins and anticoagulants are recommended.
Age-related diseases are dangerous because they accumulate gradually, starting from a young age. Feeling great in our youth, we pay little attention to our health, although proper nutrition, the absence of bad habits, and sports are already important at this time. Treatment of cerebral atherosclerosis with folk remedies becomes relevant after 40-50 years, when this disease makes itself felt with serious disorders.
In conversations you can hear the word “sclerosis”, which is usually used as a synonym for memory impairment. This is partly true, because. atherosclerosis is indeed associated with disorders of brain functions, including memory.
In fact, pathology covers a much larger area, which includes everything that is controlled by the brain:
Depending on which area is affected by the disease, one or another system in the body begins to malfunction.
Atherosclerosis is a chronic process. For a number of reasons, blood vessels lose their elasticity, become dense, rigid, and their walls become fragile.
This leads to the formation of fatty deposits inside the artery, which over time become covered with tissue and turn into plaque.
The formations become so large that they block the lumen - the vessel stops passing blood to one or another organ, in the case of sclerosis these are different parts of the brain.
Atherosclerotic plaques are dangerous: they can come off the walls of the vessel, move inside, and accumulate. The resulting plug leads to thrombosis of an artery or vein - a cerebral infarction or ischemic stroke occurs. This phenomenon is critical for the disease and entails irreversible consequences. The most common is paralysis, general or partial.
Dementia or dementia occurs at an advanced stage. This stage is characterized by the loss of simple self-care skills and loss of contact with loved ones. Therefore, atherosclerosis needs to be treated as early as possible.
The vessel consists of tissue that easily undergoes changes - depending on how a person eats and what kind of lifestyle he leads. Atherosclerosis occurs due to:
Diseases that can cause the development of cerebral sclerosis:
Atherosclerosis of the vessels of the head has its own symptoms, which are sometimes quite pronounced:
Atherosclerosis can sometimes be confused with migraine, because... here, too, crises periodically occur in the form of severe headaches. A distinctive feature is severe weakness in the limbs only on the right or left. This is due to the fact that the head vessel affected by plaques is usually located on the opposite side.
Symptoms may be:
Atherosclerosis can be diagnosed - for this, professional tools and methods are used:
In order to rehabilitate the brain, a specialist can prescribe herbs:
The most effective way to treat a diseased vessel is to combine traditional and medical methods in a complex.
You can make an appointment by leaving a request on the website.
Each patient is examined according to an individual plan. Only proven folk methods are prescribed and recommended.
Our specialists combine them with modern medications and unique, unparalleled physiotherapeutic approaches.
Thanks to this, at the Tinnitus Neuro restorative neurology clinic, we provide effective treatment for all causes of tinnitus, including such severe ones as atherosclerosis and its consequences.
There are a huge number of types of surgical interventions performed on blood vessels, as well as indications for their implementation. In this article we will tell you about modern surgical techniques used to treat vascular pathologies of the brain, heart and lower extremities.
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I’m not used to trusting any information, but I decided to check and ordered a package. I noticed changes within a week: the constant pain in my heart, heaviness, and pressure surges that had tormented me before receded, and after 2 weeks they disappeared completely. Try it too, and if anyone is interested, below is the link to the article.
Let's start with the pathology of cerebral vessels. If this pathology is present, the indication for surgery is:
Not only operations on the vessels of the head are performed, but also operations on the vessels of the neck. Which is quite logical, because blood to the brain initially flows through the vessels of the neck, and only then enters directly into the vessels of the head.
What operations are performed if there are appropriate indications?
Let us consider the possible types of operations, according to each of the above indications. If there is an intact aneurysm, perform:
Performing a clipping operation requires providing direct access to the aneurysm, that is, it implies the need for trephination.
The endovascular and stereotactic method, as well as the method of artificial thrombosis, are mini-invasive surgical techniques that do not require trepanation, but have a number of limitations.
If there is a ruptured aneurysm, perform:
Such patients are treated conservatively, as in the case of stroke of the hemorrhagic type, but in the presence of a formed hematoma, it is necessary to resort to one of the above-mentioned surgical techniques.
If pathological tortuosity of the artery carrying blood to the brain is detected, the following is performed:
Both methods are minimally invasive and do not require wide surgical incisions.
All patients with pathological tortuosity of any of the neck vessels are advised to undergo surgery as the only possible option for effective treatment.
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When blood vessels carrying blood to the brain are blocked by blood clots, one of the following interventions is indicated:
Of all the listed interventions, only carotid endarterectomy requires a surgical incision and implies direct removal of the blood clot. But today, stenting or selective thrombolysis are more often used, due to their less traumatic nature.
Selective thrombolysis involves the introduction of a substance with thrombolytic activity directly into the area of thrombosis (through a special catheter).
In the presence of an atherosclerotic plaque causing hemodynamic failure, the following is indicated:
Endarterectomy involves the direct removal of plaque from the vessel. When performing balloon angioplasty, the patency of the bed is restored by inflating the balloon, and when performing stenting, by installing a stent.
Many of our readers actively use the well-known method based on Amaranth seeds and juice, discovered by Elena Malysheva, to CLEAN VESSELS and reduce the level of CHOLESTEROL in the body. We recommend that you familiarize yourself with this technique.
In case of traumatic damage to any part of the bloodstream of the brain, open surgery is indicated in all cases.
When the damage is localized at the level of the neck, a layer-by-layer dissection of the soft tissue is performed, the source is searched and the bleeding is stopped. And when the damage is localized at the level of the head, trepanation is performed, followed by searching for the source and stopping the bleeding. During such interventions, special vascular sutures are applied.
The main indication for surgery on the heart vessels is coronary artery disease (ischemic heart disease). But not all patients suffering from this disease are indicated for surgery, because many patients can be successfully managed conservatively. Surgical treatment is indicated in cases where:
That is, surgery is indicated in the presence of life-threatening conditions that cannot be eliminated by any other method other than surgery.
Currently, three main methods of treating cardiac vascular pathology are used in cardiac surgery:
Balloon angioplasty and angiostenting have already been discussed above. The only difference is that the intervention is carried out in the coronary arteries.
Coronary artery bypass grafting is an open operation performed under conditions of a cardiopulmonary bypass machine (CAB), as well as in conditions of cardioplegia. The operation is long and quite complex, but nowadays all cardiac surgeons are fluent in it.
The essence of the intervention is that a shunt is placed to bypass the affected segment of the coronary bed of the heart, ensuring the passage of blood in the distal direction. The patient's veins are usually used to create a shunt.
All vascular diseases of the lower extremities can be divided into two groups: diseases affecting the arteries of the legs, as well as diseases affecting the veins of the legs. Accordingly, we distinguish two main groups of indications for the operation:
According to these groups of indications, various options for surgical interventions are distinguished, which are fundamentally different from each other.
If there is an indication of the first group (obstruction in the arterial bed), it is possible to perform:
Plastic surgery using a balloon or stent is performed when the arteries of the lower extremities of medium and small caliber are affected.
If large-caliber leg arteries are damaged, one of the following bypass options is performed:
All of these are reconstructive operations on blood vessels, because when they are performed, a certain segment of the bloodstream of the legs is restored (reconstructed). The application of a shunt involves the creation of a bypass path at the location of a hemodynamically significant obstruction.
Angioprosthetics is also an option. This is another reconstructive operation, during which the diseased segment of the vessel is removed and replaced with an implant. For replacement purposes, special tissue implants are used; in some cases, it is possible to use one’s own blood vessels.
Now we will consider the options for interventions performed in the presence of indications of the second group (deterioration of venous function). For varicose veins in the legs, the following is carried out:
Phlebectomy is a classic solution to the problem, removing the vessels of the legs affected by varicose veins.
Mini-phlebectomy involves performing the same actions, but through tiny incisions (1-2 mm). The last three of the above techniques are minimally invasive and eliminate the diseased leg veins through sclerosis, coagulation and ablation, respectively.
Modern angiosurgery has a considerable number of effective methods and techniques of intervention. There is a strong trend towards the preferential use of minimally invasive techniques that are minimally traumatic for the patient and give excellent results. Treatment of the vessels of the lower extremities, heart, and brain can be relatively easy and quick if the issue of surgery is decided in a timely manner.