General and Endovascular Surgery

Endovascular surgery is one of the most promising areas in medicine, which makes it possible to correct and treat a number of severe pathologies without a long recovery period. This method is also referred to by other terms — interventional radiology, X-ray surgery, intravascular surgery. The treatment is based on intravascular manipulations carried out with the help of instruments introduced into the vessels through a small puncture.

Features of the method

The procedure is performed after anesthesia and usually local anesthesia is sufficient. A vessel on one of the limbs is punctured with a thin needle, then instruments are inserted through this puncture, the diameter of which does not exceed 3 mm. The instruments under the control of radiography is advanced along the vascular bed to the diseased organ and the planned operation is carried out.

The intervention is performed in the X-ray operating room using an angiography apparatus, and X-ray surgeons are responsible for the operation. Endovascular surgery is used in the treatment of heart diseases, thrombosis, varicose veins and arteriosclerosis obliterans.

X-ray surgery differs from traditional surgical intervention in:

• Low tissue trauma;
• The absence of complications associated with giving general anesthesia;
• Insignificant frequency of undesirable consequences;
• The shortest possible recovery period.
• Intravascular surgery provides an optimal cosmetic effect. After the procedure, there are no wounds and scars, and the punctures heal in a few days.

Peculiarities of radiation access in endovascular intervention

The safety of X-ray surgery and the quality of the procedure depend on the choice of the puncture site. Radial access provides more opportunities in the treatment of patients with multifocal atherosclerosis and allows manipulation on an outpatient basis.

The positive aspects of radial access in comparison with the traditional one, that is, through the femoral artery, during endovascular intervention include:

• Improving the quality of the procedure;
• Minimizing the number of complications to the very minimum;
• Minimal blood loss;
• Early return to normal life activities.
• The procedure with radial access is easier for the patient. The patient can start walking already on the day coronary angiography is carried out. However, catheterization of the subclavian artery, compared with access through the femoral artery, is a more technically complex manipulation. Therefore, only qualified surgeons can perform it without errors.

Types of endovascular surgery

Endovascular interventions currently practiced include:

• Stenting;
• Balloon angioplasty;
• Installation of intravascular filters;
• Embolization;
• Removal of blood clots.

Stenting and angioplasty are aimed at restoring normal vascular patency. These two methods are used in the treatment of acute infarction, coronary artery disease and arteriosclerosis obliterans.

During embolization, an artificial occlusion of blood vessels is created. This approach is necessary in the treatment of patients with fibroids, pelvic varicose veins and portal hypertension. Embolization is often used in the treatment of oncopathologies.

Endovascular techniques are also used in the treatment of pathologies of the prostate, kidneys, and blood diseases. After the operation, activity is almost completely restored within three days. A few weeks later, contrast radiography is performed, which allows you to evaluate the results of intravascular surgery.