Venous Malformation — Venous Embolization: treatment in the Best Hospitals in the World
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Department of Interventional Neuroradiology
The Department of Interventional Neuroradiology offers the full range of services in the areas of its specialization. The medical facility provides imaging diagnostics and low-traumatic image-guided interventional treatment of nervous system diseases. The department's specialists have rich experience and exceptional professional skills in the field of interventional procedures for acute and chronic vascular diseases, such as ischemic strokes, brain hemorrhages, cerebral artery stenosis, brain aneurysms, and vascular malformations. The department's neuroradiologists cooperate closely with neurologists and neurosurgeons so that each patient receives an optimal treatment regimen based on the expert opinions of the specialists. The department's medical team has state-of-the-art computed tomography (CT), magnetic resonance imaging (MRI), and MR angiography systems that are actively used for diagnosing patients and therapeutic procedures. Medical care is provided in compliance with current clinical protocols. The department also offers many outpatient medical services, which is an advantage for many patients.
Department of Diagnostic and Interventional Radiology
The Department of Diagnostic and Interventional Radiology offers all modern diagnostic tests using ionizing radiation, imaging-guided tissue sampling procedures (biopsy) and minimally invasive therapeutic procedures. The patients can receive medical care both on an inpatient and outpatient basis. To achieve the optimal results, the department cooperates closely with specialists in the field of radiation therapy, oncology, neurology, neurosurgery and neuro-oncology, as well as urology, orthopedics, pain therapy and palliative care. Such collaboration helps to establish an accurate diagnosis and provide the most effective therapy.
Department of Diagnostic and Interventional Radiology, Nuclear Medicine
The Department of Diagnostic and Interventional Radiology, Nuclear Medicine offers the full range of diagnostic and therapeutic procedures in the areas of its specialization. The department has high-tech equipment for all types of modern imaging tests, image-guided therapeutic procedures, as well as radioisotope examinations and treatment of thyroid diseases using radioiodine therapy. The patients are provided with both inpatient and outpatient medical care. However, hospitalization is usually required only in the case of complex therapeutic interventions. The patients' health is in the good hands of the highly qualified doctors. The specialists regularly undergo advanced training courses, attend medical congresses and symposia, where they find out about innovations in the area of their specialization and share their experience with colleagues. To provide maximum safety for patients, the department strictly adheres to radiation protection standards.
Department of Interventional Radiology
The Department of Interventional Radiology offers the full range of imaging examinations, as well as innovative image-guided minimally invasive techniques for the treatment of tumors, vascular diseases and internal pathologies (for example, CT, MRI, PET-CT, SPECT). The department's doctors have deep knowledge and colossal experience in the field of interventional radiological methods of treatment, which represent an excellent alternative to open surgical interventions. Despite the high level of technical equipment and the presence of advanced computerized systems, the focus is always on the person with his individual needs. Compliance with current clinical protocols and high professionalism of the department's specialists contribute to the successful clinical practice, as well as the reputability of the department among the best medical facilities of this kind in Germany.
Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology
The Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology offers the full range of modern radiological diagnostics and minimally invasive treatment both on an inpatient and outpatient basis. It has advanced equipment for conducting radiological studies in adults and children, as well as minimally invasive procedures under the guidance of imaging systems. There is maintained close cooperation with many departments of the hospital, which provides an interdisciplinary approach to treatment and comprehensive medical care.
Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology
The Department of Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology is one of the best institutions of its kind in Germany and offers patients the full range of radiological studies and imaging-guided minimally invasive therapy. The department’s scope of tasks also includes imaging diagnostics in children of all age groups, detection and invasive treatment of cerebral vascular pathology (neuroradiology). Patient care is provided both on an inpatient and outpatient basis.
Department of Neuroradiology
The Department of Neuroradiology provides the full range of diagnostic and therapeutic services in the areas of its specialization. The team of the department's doctors deals with the diagnostics and treatment of brain and spinal cord pathologies. The department has at its disposal state-of-the-art medical equipment, including systems for CT, MRI and myelography, thanks to which specialists can comprehensively assess the state of the nervous system, detect pathological processes at the initial stages and provide effective treatment. Among the department's therapeutic options, a special focus is on the interventional treatment of acute stroke – thrombectomy. Another important focus of the specialists' work is the treatment of cerebral vascular malformations, stenosis of the arteries of the brain and spinal cord, and cerebral aneurysms. In addition, the department provides CT-guided interventional pain management to relieve chronic back pain. The department's neuroradiologists cooperate closely with doctors from the related medical specialties: neurologists, neurosurgeons, ophthalmologists, otolaryngologists and radiation therapists. The specialists strive to provide each patient with high quality medical care meeting his needs and wishes.
Department of Adult and Pediatric Diagnostic, Interventional Radiology
The Department of Adult and Pediatric Diagnostic, Interventional Radiology offers the full range of services in these medical fields. To ensure the accurate diagnostics and effective treatment, the department has state-of-the-art medical equipment, particularly 64-slice CT scanner, two 1.5 Tesla high-performance MRI devices, modern equipment for digital subtraction angiography (DSA), pulsed fluoroscopy and many other devices. All medical services are carried out in strict accordance with the protocols of professional societies.
Department of Adult and Pediatric Diagnostic, Interventional Radiology
The Department of Adult and Pediatric Diagnostic, Interventional Radiology offers the full range of medical services in these fields. In order to ensure the most accurate and reliable diagnostics, the department has state-of-the-art systems for CT, MRI, PET, ultrasound and X-ray examinations, as well as PET-CT and SPECT-CT hybrid examinations. The department specializes in interventional radiology, namely, imaging-guided therapy. It performs all vascular (for example, vascular recanalization) and non-vascular imaging-guided interventions (for example, tumor ablation). The department is one of the largest and leading medical facilities of this kind in Europe.
Department of Clinical and Interventional Neuroradiology
The Department of Clinical and Interventional Neuroradiology offers the full range of services in the relevant medical fields. It provides high-precision diagnosis and effective treatment of diseases of the central nervous system, that is, the brain and spinal cord, meninges and vessels that supply these organs.
Department of Interventional Radiology
The Department of Interventional Radiology conducts high-precision imaging diagnostics of all the organs and anatomical structures of the body, and also offers many interventional image-guided therapeutic procedures. Particular attention is paid to angiography to assess the state of the vascular system and patency of the blood vessels, skeletal X-ray scanning and comprehensive diagnostics of oncological diseases. The department cooperates with the specialists from all medical fields of the hospital, providing them with its technical resources for examining their patients. The department's doctors also specialize in image-guided interventional minimally invasive procedures for the treatment of certain diseases, such as vascular pathologies. The doctors of the medical facility work on state-of-the-art equipment, which guarantees a high safety of manipulations and a compliance with radiation protection standards. The department's patients most often undergo their diagnostic examinations and treatment on an outpatient basis, which is an indisputable advantage.
Department of Adult and Pediatric Interventional Radiology, Neuroradiology
The Department of Adult and Pediatric Interventional Radiology, Neuroradiology specializes in modern imaging examinations and minimally traumatic image-guided interventional procedures. Of particular interest to the department's experienced medical team is individualized minimally invasive therapy for cancer and the treatment of pain syndromes and vascular pathologies. The medical facility has state-of-the-art equipment for X-ray scanning, angiography, ultrasound scanning, CT, MRI, and PET/MRI. The diagnostic devices are adapted for children, including newborns. During examinations and treatment, the department's specialists strictly meet radiation protection standards. As for treatment, special attention in clinical practice is paid to interventional procedures for vascular diseases and malignant tumors. These procedures are performed using catheter-based techniques under CT, MRI, or angiography guidance. Despite the low trauma rate of interventional manipulations, their effectiveness is comparable to full-fledged surgery. The medical facility cooperates closely with other departments at the hospital, thus providing comprehensive medical care at the highest level of university medicine. The department's successful clinical practice has been recognized by prestigious quality certificates, including the ClarZert certificate and certificates from the German Cancer Society (DKG) and the German Radiological Society (DRG).
Department Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology
The Department Adult and Pediatric Diagnostic, Interventional Radiology, Neuroradiology offers the full range of services in the areas of its specialization. The department has state-of-the-art equipment, thanks to which doctors successfully carry out imaging diagnostics allowing them to determine the diagnosis as accurately as possible and develop the most effective treatment regimen. The department performs X-ray studies, ultrasound scanning, computed tomography (CT), magnetic resonance imaging (MRI), angiography, mammography and a combined method of computed tomography with positron emission tomography (PET-CT). Cardiac CT and MRI are also carried out in cooperation with the Department of Cardiology. The department is one of the few medical facilities of this kind in Germany specializing in the imaging diagnostics in children. The range of the department's services is complemented by minimally invasive image-guided therapeutic procedures. In the field of interventional radiology, the focus is on the treatment of pain syndromes, vascular diseases, benign and malignant tumors, as well as metastases. The department's radiologists strictly adhere to the radiation protection standards, so all diagnostic and therapeutic procedures are absolutely safe for patients.
Department of Diagnostic and Interventional Radiology
The Department of Diagnostic and Interventional Radiology offers the full range of image-guided diagnostic and interventional therapeutic procedures at the highest level of modern medicine. Medical care can be provided both on an inpatient and outpatient basis. The department's specialists annually perform more than 70,000 diagnostic tests, and therefore they have tremendous experience and guarantee an accurate diagnosis, which determines the success of follow-up treatment. Radiologists have state-of-the-art systems for digital radiography, digital fluoroscopy, sonography, mammography, computed tomography, magnetic resonance imaging, angiography and other examinations. The doctors use in their work a modern picture archiving and communication system, thanks to which the specialists from various departments of the hospital have access to the results of patient's diagnostic examination at any time. The radiation protection standards are strictly observed in the department's clinical practice.
Department of Adult and Pediatric Diagnostic, Interventional Radiology
The Department of Adult and Pediatric Diagnostic, Interventional Radiology offers the full range of imaging diagnostic tests and image-guided interventional therapeutic procedures. Medical care is provided on an inpatient and outpatient basis. The team of the department's doctors provides its services to both adults and young patients. The department has at its disposal high-tech equipment, which allows the doctors to detect the slightest impairments in the anatomical structures of the human body. The diagnostic results are considered at regular boards with the participation of all necessary specialists in related fields. In addition, the department uses an innovative system for storing and managing diagnostic data, allowing doctors in all departments to have unhindered access to the patient's imaging results at any time. The department's radiologists strictly adhere to the current radiation protection standards, and therefore the radiation has a minimal effect on the human body.
Department of Adult and Pediatric Interventional Radiology, Neuroradiology
The Department of Adult and Pediatric Interventional Radiology, Neuroradiology provides the full range of imaging diagnostics and image-guided minimally invasive treatment. The medical facility admits patients of all age groups, including children and adolescents. In the field of interventional radiology, special attention is paid to the treatment of vascular diseases and cancers, and pain management for chronic pain. An integral part of the department's clinical practice is the interventional treatment of neurological disorders, including stroke, carotid stenosis, and cerebral aneurysms. Medical care is provided both on an inpatient and outpatient basis. The department is one of the largest medical facilities of this kind in Germany and has been awarded a prestigious certificate from the German Society for Interventional Radiology and Minimally Invasive Therapy (DeGIR).
The problem of treatment of patients with venous malformations is one of the challenging tasks of clinical practice. Its significance is determined by the danger of developing extremely severe complications, i.e. trophic disorders, ulcers, bleeding from angiomatous tissues, progression of venous insufficiency, etc.
Overview
Venous malformations arise against the background of abnormal veins development. The venous malformation is one of the most common vascular malformations. The venous malformation is characterized by abnormal development and pathological enlargement of superficial or deep veins. Usually, the venous malformation has abnormalities in the structure of a vein. Blood from organs and tissues flows through the veins. Veins with congenital structural anomalies cannot cope with this function. A venous malformation looks like a plexus of bluish vessels that are visible under the skin, and sometimes like varicose veins.
Venous malformations vary in size and location. They can be superficial, deep, or isolated, and affect different parts of the body. They can be confined to one specific area or spread out. Venous malformations usually cause discoloration. Their color depends on the depth and volume of the affected vessels. The closer the affected vessels are to the skin surface, the more intense the color is (from dark blue or burgundy red to bluish).
The blood in venous malformations circulates very slowly, causing blood clots to form. When venous malformations are filled with blood, and the blood remains in the abnormal veins, it causes swelling. They can expand due to age, injury, puberty, or pregnancy, and they may contain blood clots that makes it difficult for blood to reach the area around the venous malformations.
It is a congenital abnormality, although clinically it can manifest itself in early childhood, adolescence, or even adulthood. Venous malformations can appear on any part of the body, including skin, muscles, bones, and internal organs.
The disease is most common in female patients. The most common localization of the disease is head and neck – 18,2% of cases; upper limbs – 20,9% of cases; lower limbs – 46,4% of cases; trunk – 4,5% of cases; pelvis, external genitalia – 1,8% of cases; mixed localization – 8,2% of cases.
Symptoms
The symptoms of venous malformations can vary. Depending on its size and location, venous malformation can cause the following symptoms:
- Feeling of heaviness in the affected area
- Acute pain, which is a manifestation of thrombophlebitis in the area of venous malformation
- Hardening of the area or soreness when touched
Varicose veins occur in less than half of patients (32,7%), with localization of the process on the lower extremities in 47,1%. This symptom is typical for complex and extensive pathological processes; less often it is detected in local venous-cavernous lesions.
Trophic disorders in venous malformation develop in 33-36,4% of cases, including open trophic ulcers. In 6,4% of cases a history of bleeding is present, the source of which is venous cavities with thinned skin above them.
The venous malformation can be accompanied by dysfunction of the upper or lower limbs, as well as by poor vascularization of bone structures.
Venous hardening (phleboliths) of the affected area is sometimes detected (in case of damage to the upper and lower extremities). Angiomatosis is noted in about 24,5% of patients. The most distinctive sign of this form is the presence of visible venous nodes with a bluish tinge, that are protruding above the skin surface. It is present in about 61,8% of patients.
Complications of venous malformation depend on the depth and extent of the lesion and can manifest as swelling and soreness in the affected area; varicose veins; bleeding disorders; thrombosis and thrombophlebitis development.
Diagnostics
Like with other vascular anomalies, the diagnosis of venous malformation is made based on a carefully collected anamnesis, physical examination, and instrumental diagnostic methods, i.e. ultrasound scanning, CT scan, MRI, and angiography (X-ray of blood vessels). If the gastrointestinal tract is affected, endoscopic diagnostic methods are used.
Ultrasound methods remain the leading ones in the examination of patients with venous malformations due to their simplicity, safety, and the possibility of performing the procedure repeatedly. In the diagnosis of venous malformation ultrasound shows:
- Atypical anatomical structure of the venous system
- Increase in the diameter of deep veins, valvular insufficiency of deep, superficial, and perforating veins in the absence of significant changes in blood flow through vessels
- Increase in volumetric blood flow rate in lesions in the veins of the proximal limb segment and the veins of distal localization
- Presence of thrombotic masses and phleboliths, which indicates the previous thrombosis
Computed tomography in venous malformation diagnostics provides a doctor with a more detailed visual assessment of the extent of the lesion. Dynamic contrast enhancement allows doctors to get a clearer computed tomographic picture by increasing the density gradient of pathological vessels and surrounding tissues. This diagnostic method can differentiate various anatomical structures. Computed tomography is also good in terms of assessing phleboliths, which is a distinctive computed tomographic sign of venous malformation of arteriovenous forms.
In magnetic resonance imaging (MRI), pathological vascular formations look like numerous rounded foci. At the same time, with MRI, a lot of soft tissue nodes with an inhomogeneous bright MR signal are noted. The foci of an increased signal in case of muscle damage look like rounded formations with rather clear contours, which in places merge to form specific structures. These changes correspond to vascular cavities and vessels with a low-velocity characteristic and are a hallmark of venous malformation.
Embolization
Embolization is a minimally invasive endovascular surgery in which veins and arteries are selectively blocked with special medications. Doctors use it to stop bleeding and cut the blood flow to the tumors. The tumor then stops growing and shrinks, until it disappears completely.
General indications for embolization minimally invasive surgery include:
- Various bleeding
- Uterine fibroids
- Varicocele
- Preparation for myomectomy
- Conditions requiring isolation of a separate section of the bloodstream from the general blood supply
- Growing inoperable tumor
The main contraindications for embolization include:
- Intolerance to contrast medium
- Pregnancy
- Acute inflammatory processes
- Blood clotting disorders
- Poor permeability of the vessels of the small pelvis
- Some types of fibroids
- Malignant neoplasms in the uterus and ovaries
Vein embolization is the procedure for blocking the veins with special substances or materials. The technique belongs to the category of minimally invasive surgical procedures that are carried out under X-ray control.
A vein embolization procedure is a universal method that includes vein embolization of the prostate, liver, uterus, and other organs. Vein embolization is used for the prevention of recurrence of venous malformations and stimulation of tissue growth to replace the lost tissue mass. Vein embolization offers the prevention of benign neoplasms, although there is evidence of good results in the treatment of malignant tumors as well.
How is vein embolization performed?
Before vein embolization, it is necessary to undergo a standard preoperative examination. It is also necessary to consult a cardiovascular surgeon before the procedure. If indicated, other diagnostic methods of research can be prescribed.
Vein embolization is performed in the operating room equipped with the angiography device and other interventional radiological equipment. For visual control, a contrast agent is injected intravenously.
The special catheter is then inserted inside the vein. A doctor moves it along the vessels until the catheter reaches the desired location. After that, the doctor makes an injection of a special drug that blocks the blood flow in the vessel. The blood supply is controlled with the help of angiograms. The veins supplying the healthy part of the organ are not affected. Most often, vein embolization is performed under local anesthesia and takes about 30-60 minutes.
During vein embolization, a special equipment is used for a surgical procedure, with minimal or no anesthesia at all. In some cases, vein embolization is performed under general anesthesia – for example, with portal vein embolization. In vein embolization, special coils or gelatin sponge are used.
The properties of the gelatin sponge allow doctors to perform a temporary vein embolization. The sponge consists of insoluble gelatin. It absorbs the liquid, swells, and clogs the vessel. Polyvinyl alcohol particles are used for permanent embolization – it consists of very small balls that clog the desired vessel. One of the best materials for embolization is acrylic-gelatin microspheres – particles with an ideal spherical surface.
The embolus is pushed into the target area. Then a control X-ray is performed to determine if the procedure was made correctly (for example, in vein embolization of the uterine).
Since vein embolization is a minimally invasive surgery that does not require skin incisions and suturing, the rehabilitation period is minimal. Usually, the patient spends just several days in the hospital under the supervision of doctors. It is necessary to limit the stress on the cardiovascular system for several months after vein embolization.
Where can I undergo vein embolization abroad?
Health tourism is becoming more and more popular these days, as medicine abroad often ensures a much better quality of vein embolization.
The following hospitals show the best success rates in vein embolization:
- University Hospital Saarland Homburg, Germany
- Memorial Bahcelievler Hospital Istanbul, Turkey
- University Hospital Halle, Germany
- University Hospital Muenster, Germany
- University Hospital Oldenburg, Germany
You can find more information about the hospitals on the Booking Health website.
The cost of treatment abroad
The prices in hospitals listed on the Booking Health website are relatively low. With Booking Health, you can undergo vein embolization at an affordable price.
The cost of treatment varies, as the price depends on the hospital, the specifics of the disease, and the complexity of its treatment.
The cost of treatment of vein embolization in Germany is 16,203-33,997 EUR.
The cost of treatment of vein embolization in Turkey is 13,977-14,433 EUR.
You might want to consider the cost of possible additional procedures and follow-up care. Therefore, the ultimate cost of treatment may differ from the initial price.
To make sure that the overall cost of treatment is suitable for you, contact us by leaving the request on the Booking Health website.
How can I undergo vein embolization abroad?
It is not easy to self-organize any treatment abroad. It requires certain knowledge and expertise. Thus, it is safer, easier, and less stressful to use the services of a medical tourism agency.
As the largest and most transparent medical tourism agency in the world, Booking Health has up-to-date information about vein embolization in the best hospitals. We will help you select the right clinic taking into account your wishes for treatment.
We want to help you and take on all the troubles. You can be free of unnecessary stress, while Booking Health takes care of all organizational issues regarding the treatment. Our services are aimed at undergoing vein embolization safely and successfully.
Medical tourism can be easy! All you need to do is to leave a request on the Booking Health website, and our manager will contact you shortly.