What are you willing to change to avoid surgery?
Vascular problems can be solved, but they can also be prevented. We spoke to Dr. Jean-Michel Zabot, vascular surgeon at Clinique de Genolier
1 Jul 2021

What preventive treatment at present has the best impact on avoiding vascular conditions?

Atherosclerosis is an ageing disease of the arteries for which the risk factors are known. Some are unchangeable, such as age and gender. The four main risk factors are smoking, high blood pressure, high cholesterol and diabetes mellitus. We should also mention obesity, sedentary lifestyle and stress. Among these, the easiest to correct is smoking, acquired hypercholesterolemia and/or obesity, and physical inactivity. Therefore, it is necessary to stop smoking, eat a balanced diet and practise sport. It is also very important to seek appropriate treatment for blood pressure and diabetes.

With all the information available, why do people continue to consume so much fat knowing the consequences?

This is probably due to the fact that atherosclerosis remains an invisible, asymptomatic and serious disease. Cardiovascular diseases are the leading cause of death and disability in developed countries. We know that the quality of our food is an important factor in good health, so it is really necessary to reduce our intake of fats, especially animal fats, but also sugar.

How has technology contributed lately to improve the surgical procedures treating vascular issues?

Over the last 20 to 30 years, vascular surgery has evolved a great deal. Endovascular procedures have advanced considerably. They can now be performed via the skin. For example, arteries can be recanalized, dilated or stented and endoprosthesis can be performed. This is also the case for varicose veins, where we use endovenous procedures. These are minimally invasive techniques that allow us to operate on elderly or fragile patients.

After vascular surgeries, do patients often revert to their normal routines and carelessness? Or does the delicacy of the intervention sensitize them and cause them to change their lives radically?

Awareness of the seriousness of the disease is very important because it is essential to have a good long-term outcome and to be able to act on the risk factors. However, there are times when patients continue to smoke even though they know it is bad for them and their arteries.

Have you had to postpone surgeries as a result of lack of bed availability due to Covid issues?

During the first confinement period we had to suspend all non-urgent surgery. Since then, the authorities have understood the need to continue treating other patients as well. Clinique de Genolier has implemented a free COVID policy by systematically testing any patient who needs to be hospitalised.

How many vascular surgeries do you perform each week and what is the average duration of each one?

We have signed a public-private partnership agreement for vascular pathologies between Morges Hospital (EHC) and Clinique de Genolier to create the “Centre Vasculaire de la Côte”. In these two establishments we operate on more than 1,000 patients a year. The duration of the surgeries varies, from half an hour for a simple varicose vein operation or an easy angioplasty, to several hours for a difficult bypass operation.

Are young people more or less careful with their diets?

The pandemic has made us aware of the importance of a varied, locally sourced and quality diet. I think that young people are a little more sensitive to this, but we should not forget that overweight or obesity affects 15% to 20% of children and teenagers, and that they spend most of their time in front of their computer or mobile-phone screens. We have to insist on the importance of physical activity.

* Julián Ginzo is the Editorial Coordinator of UN Today.
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