Treatment of lower limbs atherosclerosis (stage 4) by thromboendarterectomy in University Hospital of Ludwig Maximilian University of Munich

About the department

The Department of Vascular Surgery at the University Hospital of Ludwig Maximilian University of Munich offers the full range of diagnostic services and surgical interventions for patients with diseases of the arteries, veins, and lymphatic vessels. The department's doctors have excellent skills and deep knowledge in the field of vascular surgery, ranging from complex interventions on the aorta to advanced endovascular methods for treating varicose veins using ultrasound. In close cooperation with the specialists from the Center for Vascular Diseases, the department's doctors provide an individual and interdisciplinary therapy for patients with severe vascular and concomitant diseases. The department has prestigious quality certificates from the German Society of Vascular Surgery (DGG) and a certificate from the Institute for Quality and Patient Safety (BQS). The health of patients is in the safe hands of highly qualified specialists, for whom it is important that a patient receives the most sparing and effective treatment in a pleasant atmosphere. The Head Physician of the department is Prof. Dr. med. Nikolaos Tsilimparis.

The department's doctors always devote enough time to examining a patient to make an accurate diagnosis, which largely determines the success of the upcoming treatment. The medical facility has well-equipped diagnostic rooms with the possibility of performing B-mode sonography, Doppler ultrasonography, duplex sonography, oscillography, photoplethysmography, digital subtraction angiography and many other tests.

One of the primary focuses of the department's clinical practice is carotid artery stenosis treatment. As a rule, the pathology is detected incidentally during the diagnostic examination for other complaints, since carotid stenosis does not cause any symptoms at its early stages. However, the pathology is quite dangerous, as it often provokes the development of a stroke, which in turn may cause partial or complete paralysis, impaired speech, memory, or even death. The main and most effective method of eliminating carotid artery stenosis is stent implantation. The essence of the technique is to implant a stent (a special metal frame) in the lumen of the narrowed section of the artery. Doctors can also perform an endarterectomy, an operation to remove atherosclerotic plaques from the carotid artery. A physician chooses the optimal type of surgical intervention based on a patient's particular clinical case.

The department's surgeons often treat aortic aneurysms, which are characterized by the dilation of a certain part of the aorta due to stretching or thinning of its walls. A patient is usually unaware of the presence of this disease, since it causes practically no symptoms. When the aneurysm reaches a large size, the risk of its tear increases significantly, and if the patient does not receive any qualified emergency care, in many cases, a fatal outcome occurs. The department's team of doctors offers both minimally invasive interventions and open surgery. Stent implantation is preferred whenever possible. In particularly complex clinical cases, vascular surgeons perform an open operation (interventions for thoracic aortic aneurysms are performed in cooperation with cardiac surgeons).

The department's specialists also successfully perform the surgical treatment of varicose veins. The desired result can often be achieved using conservative methods (drug therapy, the use of ointments and gels, or compression therapy) and minimally invasive interventions (endovenous laser coagulation, foam sclerotherapy, radiofrequency, and laser obliteration). Advanced stages of the disease require more serious treatment, namely surgery. The team of surgeons at the medical facility successfully performs a phlebectomy, during which varicose veins are removed. Flap plastic surgery may be performed after the operation to achieve a good aesthetic result, if required.

The department's diagnostic options include:

• Diagnostics of arterial diseases
  • Dopplerography
  • B-mode sonography
  • Duplex sonography
  • Color duplex sonography
  • Percutaneous microcirculation assessment
• Diagnostics of venous diseases
  • Arterial oscillography
  • Light reflection rheography
  • Photoplethysmography
  • Phlebotonometry
• Intraoperative diagnostics
  • Blood flow velocity Doppler measurement
  • Digital subtraction angiography
  • Intraoperative neuromonitoring with a continuous recording of sensorimotor evoked potentials
  • Intraoperative neuromonitoring using transcranial dopplerography
• Other diagnostic examinations

The department's surgical services include the following options:

• Diagnostics and surgical treatment of aortic aneurysm
  • Minimally invasive interventions with stent implantation 
  • Open interventions on the thoracic aorta (in collaboration with the Department of Cardiac Surgery)
• Diagnostics and surgical treatment of occlusive peripheral arterial disease
  • Balloon dilatation (including for the smallest blood vessels)
  • Operations (for example, elimination of calcification and bypass surgery) on the blood vessels with implanted port systems
• Diagnostics and surgical treatment of carotid stenosis
  • Preventive drug therapy
  • Stent implantation
  • Endarterectomy
• Diagnostics and surgical treatment of varicose veins
  • Stripping (removal of large varicose veins)
  • Minimally invasive techniques (for example, sclerotherapy)
  • Radiofrequency ablation
  • Laser ablation
  • Phlebectomy
• Dialysis access formation
• Other medical services