Vascular Surgery Department

A narrowing of the carotid artery is caused by changes and deposits on the vessel wall. The reason for this is the aging process. This can be accelerated by certain risk factors such as smoking, high cholesterol, diabetes and high blood pressure. A severe narrowing, or even an occlusion, of the artery leading to the brain can lead to a circulatory disorder in the brain and – in the worst case – to a stroke with permanent damage.

Frequently, a narrowing of the carotid arteries is also discovered during an ultrasound examination without any symptoms having been noticed so far. Under these circumstances, you should seek advice from a specialist, to check which treatment options make sense in your individual case. The diagnostics and the indication are made individually for each patient within the vascular team and in close cooperation with the neurologist.

In the case of advanced narrowing of the carotid artery without symptoms, an operation can be considered as a primary prophylaxis. In the case of a narrowing of the carotid artery with warning symptoms that have already occurred or a stroke, you should be hospitalized immediately and – where possible and sensible – have a treatment promptly.

The intervention is usually performed under local anaesthesia. Through a puncture in the groin area, catheter-supported probing of the target vessel is carried out. A protective shield is placed in the vessel above the lesion. A stent is then implanted in the area of the lesion in order to restore the patency of the vessel.

The operation is performed under general anaesthesia. The affected carotid artery is exposed via a small incision and the calcification is peeled out. A small (“patch”) is then sewn in. The blood flow to the brain is guaranteed continuously. At the end of the operation, the success of the intervention is checked and confirmed using imaging methods.

The inpatient stay is usually only a few days. In this phase, the results are checked again. We recommend performing an ultrasound check three months after the operation. The supportive drug treatment should be continued permanently. Blood pressure, diabetes and cholesterol should be checked regularly and optimally adjusted.

An aortic aneurysm is an enlargement of the main artery, most commonly found in the abdomen. Under the constant pressure of the bloodstream, the diameter often increases continuously. As the diameter increases, so does the risk that the aneurysm will burst, resulting in bleeding. Furthermore, clots can form in the aneurysm, which can lead to acute vascular occlusions in the affected organs or extremities.

The diagnosis is made primarily by ultrasound, possibly also by tomography (MRI/CT). Treatment depends on the size or increase in size and the location of the aneurysm and possible symptoms. Smaller aneurysms that do not yet require treatment should be monitored with ultrasound at regular intervals.

If necessary, treatment is then either open surgery or minimally invasive. In open surgery, the aneurysm is eliminated via an abdominal or flank incision by inserting a vascular prosthesis made of synthetic fibres into the diseased area. In the minimally invasive procedure, the dilatation of the artery is switched off by implantation of stent grafts via small punctures in the groin. All therapy options are discussed in an interdisciplinary manner in order to be able to offer an individualized and optimal treatment for each individual patient.

Our therapy options also include other pathological changes in the main artery in the chest and abdomen (Dissection, Stenoses).

In the case of peripheral arterial occlusive disease (PAOD), or “intermittent claudication”, constrictions or even blockages in the arteries lead to circulatory disorders in the affected extremity with varying degrees of symptoms.

Risk factors for the development of PAOD are diabetes mellitus, elevated blood pressure, elevated blood lipids, chronic kidney disease, smoking and lack of exercise. Most often, the circulatory disorder affects the lower extremities, in very rare cases the arms are affected. It usually manifests itself as muscle pain in the calves, thighs or buttocks after walking a certain distance. In the later course of the disease, the pain also occurs at night and during periods of rest. With increasing circulatory disorders, tissue dies off in the final stages of the disease, usually first on the toes and feet.

In our department, all common surgical, interventional and conservative therapy methods are used to treat patients with circulatory disorders. Diseased arteries are treated using classic surgical procedures (bypass surgery, desobliteration surgery) or minimally invasive procedures (balloon dilatation or stent application) or combined interventions (so-called hybrid surgeries).

Patients who require dialysis need access via which they can be connected to the artificial kidney. These accesses can be placed in our department. Furthermore, we carry out any kind of corrective interventions.

The kidneys are responsible for blood detoxification, among other things. In principle, two forms of therapy are possible in the event of loss of kidney function: kidney transplantation or kidney replacement procedures. In kidney replacement procedures, a distinction is made between washing the blood (haemodialysis) and washing the peritoneum (peritoneal dialysis). Secure access is required for both.

In haemodialysis, the access required is achieved via a connection between the artery and vein. This connection is made either by a direct connection between artery and vein, or by a bridge between the vessels, a prosthesis. After the fistula vein has sufficiently “matured” or the prosthesis has healed, it can be used for haemodialysis. For this reason, the installation of a corresponding access for haemodialysis should ideally take place well before the actual start of dialysis.

Some vascular accesses require a service operation or a corrective operation in the course. In our clinic, both the initial installation of vascular access for dialysis and complex service and corrective operations are carried out.

In peritoneal dialysis, the peritoneum is used as a membrane for detoxification. Surgically, usually using the keyhole method, a flexible plastic tube is placed in the small pelvis and drained through the lateral abdominal wall. A special liquid for detoxification is fed into the body at regular intervals and drained again after a few hours. This protects the heart and circulation and the remaining kidney functions are preserved.

Patients who require dialysis need access via which they can be connected to the artificial kidney. These accesses can be placed in our department. Furthermore, we carry out any kind of corrective interventions.

The kidneys are responsible for blood detoxification, among other things. In principle, two forms of therapy are possible in the event of loss of kidney function: kidney transplantation or kidney replacement procedures. In kidney replacement procedures, a distinction is made between washing the blood (haemodialysis) and washing the peritoneum (peritoneal dialysis). Secure access is required for both.

In haemodialysis, the access required is achieved via a connection between the artery and vein. This connection is made either by a direct connection between artery and vein, or by a bridge between the vessels, a prosthesis. After the fistula vein has sufficiently “matured” or the prosthesis has healed, it can be used for haemodialysis. For this reason, the installation of a corresponding access for haemodialysis should ideally take place well before the actual start of dialysis.

Some vascular accesses require a service operation or a corrective operation in the course. In our clinic, both the initial installation of vascular access for dialysis and complex service and corrective operations are carried out.

In peritoneal dialysis, the peritoneum is used as a membrane for detoxification. Surgically, usually using the keyhole method, a flexible plastic tube is placed in the small pelvis and drained through the lateral abdominal wall. A special liquid for detoxification is fed into the body at regular intervals and drained again after a few hours. This protects the heart and circulation and the remaining kidney functions are preserved.