Vascular diagnosis in Luisenhospital Aachen

About the department

The Department of Vascular Surgery at the Luisenhospital Aachen offers the full range of medical services in the field of its competence. The department's team of doctors specializes in the surgical treatment of diseases of the arteries, veins, and lymphatic vessels. Since 2003, the department has been the Center for Vascular Diseases, certified by the German Society of Vascular Surgery (DGG). The department's specialists excel in the surgical treatment of carotid artery stenosis, peripheral arterial occlusive disease, abdominal aortic aneurysms, thoracic aortic aneurysms, deep vein thrombosis, varicose veins, and other pathologies. Eight specialized surgeons and highly qualified nursing staff members take care of the patients' health. The work of the specialists is based on an individual approach to each patient. The department's diagnostic rooms are equipped with state-of-the-art devices for computed tomography, magnetic resonance imaging, digital subtraction angiography, etc. Minor vascular surgical procedures are performed on an outpatient basis, while in complex clinical cases, patients require a hospital stay. The department's surgeons widely practice minimally traumatic endovascular and hybrid techniques, so the risks of complications during surgery or in the postoperative period are practically equal to zero, while the effectiveness of treatment is at a high level. The department is headed by Dr. med. Ulrich Radtke.

The department has accumulated impressive experience in the treatment of carotid artery stenosis. Patients with this pathology often have no complaints, so it is detected during check-ups or diagnostics for other reasons. Carotid artery stenosis is a pathological narrowing of the lumen of the blood vessel due to the formation of atherosclerotic plaques. Pathology significantly increases the risk of a stroke, which may provoke paralysis or even death. In cases of moderate stenosis, the department's vascular surgeons prefer watchful waiting with regular check-ups every 6 months or once a year. However, the specialists diagnose severe carotid artery stenosis if more than 70% of the lumen of the blood vessel is blocked by atherosclerotic plaques, and in such cases, surgery is the best option.

During the preparation for surgery, patients undergo comprehensive diagnostics, including blood tests, ECG, chest X-rays, duplex ultrasound scanning of the carotid arteries, CT, MRI, etc. The department's surgeons have at their command various surgical techniques, but in most cases, they perform eversion carotid endarterectomy. The essence of the intervention is as follows: a surgeon makes a small skin incision on the lateral surface of the neck, after which he separates the affected internal carotid artery from the external, turns it inside out, removes atherosclerotic plaques, and restores the integrity of the vascular wall. The duration of the surgical intervention is 1-2 hours. The operation is performed under local or general anesthesia, depending on the particular clinical case. Patients with recurrent carotid artery stenosis are recommended to undergo endovascular stent implantation.

Another important focus for the department's vascular surgeons is the treatment of peripheral arterial occlusive disease. Pathology is quite common and life-threatening. Patients with this disease have thrombosis or narrowing of the arteries in the lower limbs (in rare cases, the upper limbs may be affected as well), leading to impaired blood flow. The main symptoms include intermittent claudication and severe pain, even at rest. Without treatment, patients are at risk of developing gangrene. The department's vascular surgeons often perform balloon angioplasty with subsequent stent implantation. This treatment option is minimally invasive. The procedure is carried out using catheter-based techniques under general anesthesia. In complex cases, the optimal treatment option is thromboendarterectomy, during which the specialists directly remove atherosclerotic plaques from the affected artery. Good results can also be achieved with the help of bypass surgery, which involves the creation of an alternative blood flow pathway using the patient's own arteries or a vascular graft. When performing thromboendarterectomy and bypass surgery, the department's doctors use hybrid surgical techniques combining classical open surgery and endovascular techniques.

The department's team of surgeons regularly treats patients with thoracic and abdominal aortic aneurysms. An aneurysm is the dilation of a segment of an artery due to the stretching and thinning of its walls. Aneurysms are diagnosed when the diameter of the aorta increases by 2 times or more. The most dangerous complication of an aneurysm is its rupture, which may lead to internal bleeding, necessitating urgent medical intervention and potentially leading to death. The only effective treatment for aneurysms is surgery. Up to 80% of operations for thoracic and abdominal aortic aneurysms are performed in the department using endovascular techniques. The surgeon performs a puncture in the area of the inguinal artery, through which a vascular graft is delivered to the pathological focus. The prosthesis strengthens the vascular wall and restores the normal diameter of the artery.

The department's range of surgical services includes:

• Surgery for carotid artery stenosis
  • Eversion carotid endarterectomy
  • Endovascular stent implantation
• Surgery for peripheral arterial occlusive disease
  • Balloon angioplasty with subsequent stent implantation
  • Thromboendarterectomy
  • Bypass surgery
• Surgery for thoracic and abdominal aortic aneurysms
  • Endovascular and classical (using open surgical techniques) prosthetic repair surgery
• Surgery for deep vein thrombosis
  • Venous thrombectomy
• Surgery for varicose veins
  • Babcock's stripping procedure
  • Foam sclerotherapy
  • Endovenous VNUS Closure procedure
  • Mini-phlebectomy
• Minor surgery for dialysis access formation and port system placement
• Other medical services