Vascular Surgery

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.