Treatment of bilateral carotid artery stenosis by thromboendarterectomy in Hospital zum Heiligen Geist Frankfurt am Main

About the department

The Department of Vascular Surgery at the Hospital zum Heiligen Geist Frankfurt am Main offers the full range of medical services in the area of its ​​specialization. It provides modern treatment of diseases of the arteries, veins and lymphatic vessels. The department's team of doctors has in its arsenal both classical open surgical techniques and image-guided interventional catheter-based techniques. The specialists of the medical facility are deservedly proud of their rich and successful experience in the treatment of peripheral arterial occlusive disease, carotid stenosis, aortic aneurysms and varicose veins. In addition, the department's vascular surgeons successfully deal with the treatment of diabetic foot syndrome and Charcot foot. The patients with lymphedema can also get medical care here. Each clinical case is considered on an individual basis, which contributes to the development of the most effective treatment regimen. The department's operating rooms are equipped with the very latest technology, which, combined with the high professionalism of surgeons, makes it possible to restore the health of patients even in the most complex clinical cases. The Head Physician of the department is Dr. med. Jens Hahner.

One of the most common diagnoses in the department's practice is occlusive peripheral arterial disease. Pathology is a stenosis or thrombosis of the arteries of the lower extremities (sometimes – of the upper extremities) due atherosclerosis, which leads to circulatory disorders. The department has all diagnostic examinations to detect pathology: dopplerography, angiography, computed tomography, magnetic resonance imaging, blood pressure measurement, laboratory tests. If the patient has occlusive peripheral arterial disease, the specialists also determine the stage of the pathological process. In the early stages, it is possible to avoid surgical intervention and carry out conservative treatment by giving up a sedentary lifestyle and smoking, as well as prescribing a course of drug therapy to compensate for diabetes mellitus, normalize blood pressure, etc. In more complex cases, surgical treatment may be required. The advantage for the department's patients is the widespread use of low traumatic endovascular interventions. Open surgery is used as a last-line therapy for the treatment of particularly complex forms of occlusive peripheral arterial disease. The department's vascular surgeons have vast experience in such endovascular interventions as thromboendarterectomy, balloon dilatation and stent implantation. With appropriate clinical indications, more radical operations can also be performed: bypass surgery with transplantation of an autologous vein or implantation of an artificial vascular prosthesis (Dacron, PTFE).

The department also provides comprehensive medical care to patients with carotid artery stenosis, which can lead to the development of a stroke, if untreated. Carotid artery stenosis does not cause any complaints, so many people with this diagnosis are not even aware of the presence of pathology. To assess the patency of the carotid arteries, the department's specialists use Doppler ultrasound scanning. In some cases, computed tomography (CT) or magnetic resonance imaging (MRI) may be required. To eliminate the obstruction of the carotid arteries, the department's doctors resort to modern endovascular procedures: eversion carotid endarterectomy, thromboendarterectomy followed by patch plastic surgery and stent implantation.

Another focus of work of the department's specialists is the diagnostics and treatment of abdominal aortic aneurysm – an increase in its diameter by more than 50% compared to the norm or a local protrusion of its wall. The ultrasound scan is performed to make the diagnosis, after which the CT scan may be required. After studying the diagnostic data obtained, the attending physician determines further actions: regular check-ups to control the aneurysm or surgical intervention. Should surgery be required, the possibility of abdominal aortic prosthetic repair is considered.

The department's therapeutic options are complemented by the treatment of varicose veins. During the diagnostic examination, clinical tests and color Doppler imaging are performed. The diagnostic protocol also includes venous occlusion plethysmography and light reflection rheography. The choice of treatment tactics depends on the stage of varicose veins – the pathology has four stages. In the early stages, conservative methods are often enough: wearing compression stockings and giving up a sedentary lifestyle. In the advanced stages, the only effective treatment is surgery. The department's vascular surgeons perform such operations as crossectomy, Venefit procedure and foam sclerotherapy.

The department's range of medical services includes:

• Diagnostics and treatment of occlusive peripheral arterial disease
• Diagnostics and treatment of carotid artery stenosis
• Diagnostics and treatment of abdominal aortic aneurysm
• Diagnostics and treatment of varicose veins
• Diagnostics and treatment of diabetic foot syndrome and Charcot syndrome
• Diagnostics and treatment of lymphedema
• Diagnostics and treatment of other vascular pathologies

The department specializes in the following surgical interventions:

• Thrombendarterectomy
• Balloon dilatation
• Stent implantation
• Bypass by transplanting an autologous vein or implanting an artificial vascular prosthesis (Dacron, PTFE)
• Eversion carotid endarterectomy
• Abdominal aortic prosthetic repair
• Crossectomy
• Venefit procedure
• Foam sclerotherapy
• Surgical treatment of non-healing wounds
• Other operations