Vascular Surgery

When should you consult a vascular surgeon?

Vascular surgery is a specialty of surgery in which diseases of the vascular system are managed by medical therapy. A vascular surgeon should be consulted with problems involving the veins and arteries as well as the lymphatic system. Persons at risk of cardiovascular disease, are highly encouraged to have screening examinations, as prevention.

It is a well-known fact that the leading cause of death in Hungary is cardiovascular disease. It is not as well known, however, that arterial disease is a disease of the system, meaning that, if one artery is involved, all arteries of the system are involve, in some measure or other, making screening examinations for prevention and early treatment, especially important.

Even when no symptoms or complaints are present, screening examinations followed by timely treatment and regular care, when needed, are especially recommended in cases of high risk such as diabetes, high blood pressure, elevated blood fats, when vascular disease is prevalent in the family, certain blood-forming (hematopoietic) diseases and smoking.

Varicosity, found in various forms and degrees of gravity and also considered a national disease in Hungary, affecting 40% of the population and the sometimes resulting ulcers affect 2-4% of the population over 60 years of age could easily be prevented with treatment begun, in time, before symptoms appear. Preventive screening examination is of special importance when venous diseases are rampant in a family. Some varicosities, such spider veins do not cause complaints but are aesthetically troubling especially to women. Their removal helps to regain self-confidence.

Diseases and treatment

Arterial diseases

The symptoms caused by arterial diseases vary according to the artery involved and whether it is a dilatation, narrowing or occlusion. Dilatations on the aorta may grow in the abdomen and the chest without provoking any symptoms with the risk that, should a tear occur, a life threatening situation would result. Thus, should you feel a significant throbbing in your abdomen that you had not felt before, a vascular surgeon should be consulted.

Narrowing of the carotid artery may also remain symptom free for a long time with the first symptom possibly being paralysis of one side of the body. This, one of the most dangerous of vascular diseases, can often be diagnosed, by a trained ear, simply with a stethoscope. Lower extremity vascular narrowing, or vasoconstriction, on the other hand, causes early symptoms such as difficulty in walking. Pain in the calf presenting while walking and disappearing with a few minutes of rest, may be a signal of beginning vascular narrowing. People often mistake these symptoms as rheumatic in origin.

Screening for arterial diseases, diagnosis, treatment and care

The patient's medical history is first taken followed by a physical examination. The blood circulation of the peripheral arteries is then checked with an instrument to determine whether further examinations are necessary or whether the disease may be kept in check with medication. Should the patient's condition so require, we will take the responsibility for arranging a complete physical examination and vascular surgery in the proper hospital. Regular checkups and treatments will be required following surgery.

Varicose veins

The dilated veins are, at times, mainly unsightly and may not causing problems for a some time; however, if untreated, they will before long cause complaints and perhaps also complications. The complaints may be varied and may include heavy feet syndrome, leg cramping, numbness, tired legs and localized burning pain, to mention but a few.

Varicose veins may be caused by the veins dilating, or when the vein valves are not functioning properly cause the blood to pool and thicken causing surface thrombosis and significant pain. There is increased danger of deep vein thrombosis which could lead to pulmonary embolism. There are instances where the main veins are normal but the feeder veins are dilated, unsightly and painful. The treatment is determined by the type of vein involved.

Conservative treatment

The therapy is set up according to the individual's needs which might include bandages, short or long, elastic stockings of varying degrees of compression, medication for the vein walls, swollen feet and inflammation, and, if recommended, special venous exercises.

Injection therapy (sclerotherapy)

The vein to be treated is injected with a solution that immediately causes the vein to shrink. Compression bandaging or stocking must be worn afterwards for two weeks. This treatment is principally used for eliminating larger spider veins and smaller varicose veins. Larger veins may require the removal of pooled blood which is performed with a syringe, in this case, the bandaging or elastic stocking is worn for a longer period of time. The number of treatments necessary will depend on the type and magnitude of the varicosities.

Surgery

Surgery is necessary when the size of the varicose vein, in itself, is of significant risk (i.e., when there is increased danger of thrombosis before greater surgery, orthopedic or gynecological surgery). Besides the esthetical reasons, the surgical removal of dilated veins is recommended for the prevention of problems and surface or deep vein inflammation. Spinal block anaesthesia is used. The main trunk is removed through two small incisions, the feeder veins, through ?3 mm punctures.

Ulceration treatment

Ulcers developed as a result of varicosities, are not only painful but are very prone to infection. These are treated partly locally and partly with the conservative treatment described above. Once healing occurred, surgery quickly follows to remove the vein insufficiency causing the ulcer.

Varicosity during pregnancy

Varicosity is more prone to develop during pregnancy. The already present venous dilations dilate further causing complaints. This is due partly to the hormone changes and partly to increased body weight and increased pelvic pressure. Although, it has not been unequivocally shown that the venous medications are damaging to the fetus, they are not recommended. Surgery is also not recommended not only because of the pregnancy, but also due to the fact that some dilated veins shrink following delivery. The pregnant woman should prepare herself ahead of time in order to know what to do during her pregnancy, birth and while nursing.

Why choose the Buda Health Center?

The Patient-Doctor relationship is based on trust, the determining factor in a treatment's success or failure. We feel that our doctors have earned this trust through their professionalism, knowledge, experience and know-how. The level of care is further guaranteed since many of our leading physicians have gained renown and are respected in their field of specialty.