Range of Services

• vascular diagnostics
• vascular surgery
• surgery of the veins
• main artery expansion (aortic aneurysm)
• endovascular elimination of aortic aneurysms
• vascular renal dysfunction
• circulation disorders in the legs

• vascular diagnostics
• vascular surgery
  • surgery of the veins
    
  • main artery expansion (aortic aneurysm)
    
  • endovascular elimination of aortic aneurysms
    
  • endoscopic minimally invasive aortic surgery
    
  • endovascular aortic surgery
  • laser surgery of the veins
  • PTA

• arterial diseases
• vascular renal dysfunction
• vascular tumors and vascular malformations
• circulation disorders in the legs
• atherosclerosis of brain arteries
• hardening of the arteries

Treatment options include all intervention in the arterial and venous system, which are not bound to an extracorporeal circuit (heart-lung machine). We focus on supra-aortic interventions, mainly the catchment area of the A. carotis, vertebralis and subclavia. Interventions at the aorta are carried out openly and interventionally. Of special interest is minimally invasive, endoscopic surgery.

The surgical area is equipped with the latest generation of devices that serve the safety and comfort of our patients. The cell-saver systems for instance, significantly reduced the consumption of homologous blood. With the retractor and lighting control systems our surgeons are enabled to making even smaller, more gentle approaches to the surgical field. In  case of venous ulcus diseases and in aortic surgery, endoscopic instruments are used. With digital X-ray C-arm technique even during surgery an intraoperative angiographic control can be made. Angioplasties using balloon catheters, as well as stent implantation are also possible in combination with open surgery. A special feature here is the elimination of aortic aneurysm by so-called endografts, so that open surgery can be avoided in the abdominal area.

The latest laser technology is available for vein therapy and minimally invasive surgeries.

Varicose veins are a common problem for patients. The formation of large varicose veins (known as Stammvarikosis) is best treated by surgical removal (stripping). However, other methods that constitute the smallest interference (CHIVA method) can be carried out in this department.
Serious cases that involve venous leg ulcers, are treated with endoscopic surgery. We attach particular importance to cosmetically correct and optimal wound healing. The necessary skin incisions are kept as small as possible. The scarring is usually not visible.

The extension of the main artery in the chest and the abdomen usually develops in older patients. It always bears the risk of a possible life-threatening rupture of the vessel with a large hemorrhage. The surgical approach includes the elimination of the extended vascular segment and the replacement of the aorta by a plastic vessel.

The elimination of the endovascular aortic aneurysm has become possible. Only about one quarter of all expansions can, however, been treated with this method. A three-dimensional CT with precise measurement is necessary to  determine whether a patient is suitable and to determine the nature and fit the endovascular prosthesis (so-called stent-graft prosthesis).

endoscopic minimally invasive aortic surgery

This minimally invasive approach is used for large aortic operations with access through so-called trocars. These are approaches that have about 1 cm in diameter and instruments can be intduced through the abdominal cavity. Large abdominal incisions are avoided and the stress of surgery is minimized.

endovascular aortic surgery

Access to the aorta is given via the groin artery, where a catheter systems is introduced and a stent-graft can be inserted to eliminate an aneurysm in the aorta. A stent graft consists of a vascular prosthesis that is supported by a metal grid. This construction will be anchored in the vessels above and below the aortic aneurysms.

laser surgery of the veins

There are two areas where we use laser surgery as therapy. The first area is the common venous insufficiency in varicose vein disease. A laser probe is introduced in the saphenous veins. About this probe a defined energy is then given with which the vein is brought to contraction and scarring. The vein does not need to be pulled anymore.
The second type of application is a therapy for spider veins, where the spider veins are treated with the laser from outside.

PTA

The percutaneous transluminal angioplasty (PTA) is a standard procedure for the treatment of arterial stenoses or occlusions. Using PTA we can eliminate both narrowing (stenosis) or occlusions (occlusion) in various blood vessels or vascular systems.

PTA is used in

• pelvic and leg arteries
• renal arteries
• arm arteries
• main artery (aorta)
• carotid artery

A catheter with a balloon at the tip is inserted into the artery, where the bottleneck or the vascular occlusion in the vessel will be recanalized, and subsequently expanded by inflating the balloon. The procedure is performed under local anesthesia and takes approximately 30 - 60 minutes.
With the simultaneous introduction of a so-called "stent" the success rate over time can be further improved compared to the result of an isolated balloon angioplasty.

A slowly progressive renal dysfunction results in younger patients by the narrowing of the main renal artery. This often leads to high blood pressure. If the narrowing develops into a closure, the loss of the kidney is unavoidable. By vascular surgery or through a balloon angioplasty the high blood pressure can be eliminated and loss of the organ can be avoided. In case the narrowing cannot be eliminated, chronic - in rare cases renal failure - can occur. This condition also arises from a number of other causes (inflammation, cysts, drug abuse) and requires constant dialysis.

To perform this life-sustaining treatment the patient requires an arterio-venous circuit connection. This is preferably applied on the forearm and under local anaesthesia during an outpatient or inpatient surgery by vascular surgeons. Other arterio-venous connections require the implantation of plastic prostheses, which are manufactured specifically for the lasting impact of puncture.

Patients who come to us with circulation disorders in the legs will be operated under certain indications - from the open and minimally invasive aortic surgery to the surgery of leg arteries. Apart from surgical procedures we offer a wide range of conservative and semi-invasive therapies, such as

• PTA (balloon dilatation of blood vessels)
• various kinds of lysis
• combined therapies, etc.