Chief of the department: Tsyplyashchuk Alexandra Vladimirovna, M.D., Ph.D., surgeon of the highest category, cardiovascular surgeon, assistant professor of surgery with courses of traumatology, orthopedics and surgical endocrinology.
The Consultative and Diagnostic Center “Arbatsky” and the Phlebological Center, created on the basis of the surgical department No. 2, are located in the heart of Moscow, in one of the alleys of the Old Arbat. The prices for examination and treatment in our center are traditionally lower than in other state medical centers in Moscow.
The department assists with the following diseases:
- Varicose disease;
- Postthrombotic disease;
- Trophic ulcers;
- Congenital diseases of veins;
- Venous malformations;
- Thrombophlebitis of subcutaneous veins;
- Deep vein thrombosis.
Methods of diagnosis and treatment
Laboratory diagnostics — all kinds, including genetic analysis on thrombophilia (hereditary propensity to thrombosis).
Ultrasonic angioscanning of veins (triplex and duplex ultrasound), dopplerography.
Modern methods of treatment of diseases of the venous system, used in the Pirogov Center
The method of sclerotherapy, first of all, is used to treat varicose veins for the purpose of “cosmetic” removal of dilated veins.
However, this method can be used instead of traditional surgical interventions. In the competent hands of a competent phlebologist, under ultrasound control this method can treat any form of chronic diseases of the veins.
Endovasal laser obliteration (EVLO) and radiofrequency obliteration (RFO)
These are two interchangeable methods, they are used for radical treatment of patients with varicose veins of the lower limbs, and hospitalization in the hospital is not required. No cuts are made. The procedure takes from 15 minutes, after which the patient can immediately lead a normal life for him. The method was created specifically for people who must be at work on a daily basis and can not leave it even for a couple of days.
Unfortunately, sometimes one has to deal with such neglected forms of the disease that no modern minimally invasive methods can be applied. In such cases, modern modifications of traditional operations are used.
The Center uses almost all types of conservative treatment of venous pathology:
- Appointment and selection of compression knitwear and / or training in the rules and techniques of applying a compression bandage of elastic bandages;
- Appointment and control of phlebotrophic drugs;
- Selection of a dose of indirect anticoagulants (warfarin) in venous thromboses and control (including laboratory) for their application;
- Complex conservative treatment of lymphedema;
- Other conservative methods.
On the elimination of intradermal varicosity, vascular reticulums, asterisks, very little objective information. Vascular asterisks, or telangiectasia — this is not the first stage of varicose veins. This is an exclusively cosmetic defect, which manifests itself as a vascular pattern of blue or red hue, reminiscent of “stars”, “spiders” or “mesh”. For their elimination in most European countries, as in our Center, the methods of microsclerotherapy and percutaneous laser coagulation are applied, which give a good cosmetic effect.
A new approach to managing patients with diseases of the venous system
With any medical technology, it is impossible to guarantee a 100% positive result. Vein dilatation is not an appendicitis, in which, by removing an appendix, it can be guaranteed to the patient that this illness will not return to him. Vein diseases occur against a background of genetic predisposition, which can not be eliminated at the present stage of the development of medicine. Therefore, our Center has developed and implemented a new approach to managing patients with venous pathology. Its essence lies in the fact that patients become “attached” to our Center as a family doctor, i.e. throughout the life of a person is observed by the same doctor. “Once I did the operation, and the veins got out anyway, it makes no sense to get used again,” said patients with relapses almost in one voice. A new approach allows us to determine whether the varicose vein will “come out” again or not, at a stage when the patient does not yet know about it. And prevent the occurrence of relapse. The Center reorganized its approach to the treatment of patients with veins — from the impersonal system “operated and forgot” to the system of lifelong observation, treatment and prevention of complications, as with any other chronic disease.
Advice to patients
General recommendations for endovenous laser obliteration and RFO
- In the morning on the day of the operation, you must have breakfast! If the intervention is scheduled for the afternoon, it is advisable to have lunch two hours before the intervention.
- Take with you:
- Compression jersey (necessarily stockings, not pantyhose);
- Cotton T-shirt, bathrobe (or tights), slippers, change of underwear.
- Shave legs.
Physical activity after surgery
Walking is possible immediately after the intervention — the patient can leave the clinic and get to the house himself. Before you get behind the wheel (or in the subway), you need to walk for 40 minutes. In the first day, a “protective” regime is desirable, in which excessively active movements (running, lifting weights and doing sports, etc.) are not recommended,
Normal physical activity is possible only
Wearing compression knitwear
Until the time of the first dressing, it is necessary to wear a compressive knitwear of the 2nd class of compression around the clock (do not take off stockings in the first day).
After dressing (performed the next day, or a day after the procedure), the knitwear is worn only in the afternoon. The duration of wearing is chosen by the doctor individually and depends on the amount of intervention and the severity of the pathological process. On average, the wearing of jersey lasts 2 weeks, in day mode (ie at night the stockings are removed).
If you have any questions, please contact your doctor!
The list of studies before EVLO and RCHO (the tests are valid for 14 days):
- General blood test + ESR;
- Blood Sugar;
- Coagulogram (INR, APTT,
- Blood test for HIV, Hepatitis B, Hepatitis C, syphilis.
Address: Moscow, Gagarinsky lane, 37 (metro station Smolenskaya of the Arbatsko-Pokrovskaya line or metro station Kropotkinskaya)