Surgical treatment of subclavian artery occlusive disease in University Hospital Ulm

About the department

The Department of Adult and Pediatric Interventional Radiology, Neuroradiology at the University Hospital Ulm 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). The Head Physician of the department is Prof. Dr. med. Meinrad Beer.

The department often performs catheter-based treatment of malignant tumors using transarterial chemoembolization (TACE) and selective internal radiation therapy (SIRT). During the TACE procedure, emboli (microscopic spheres) containing a chemotherapeutic agent are injected into the blood vessels supplying the tumor using a catheter. After transarterial chemoembolization, the tumor is deprived of blood supply and locally exposed to chemotherapeutic agents, which leads to the death of the neoplasm. The essence of selective internal radiation therapy is the administration of tiny radioactive particles into the blood vessels supplying the tumor, which locally irradiate the tumor while practically not damaging the adjacent healthy tissues. The SIRT procedure is also performed using catheter-based techniques through the inguinal artery under imaging guidance. TACE and SIRT techniques are used to treat primary and secondary liver tumors.

The department's specialists also successfully perform radiofrequency ablation, microwave ablation, and cryoablation for the treatment of tumors of various localizations. The above-mentioned procedures are performed under CT guidance, which ensures their high accuracy and safety. The tumor focus is approached using a special probe, after which the tumor tissue is destroyed by extremely high or low temperatures. The ablation procedure is indicated for patients with tumors no larger than 5 cm.

The department's interventional radiologists regularly admit patients with vascular stenosis and obstructions, abdominal and thoracic aortic aneurysms, and vascular malformations. Balloon dilatation, followed by stent implantation, is performed to normalize blood flow in cases of stenosis. During this interventional procedure, specialists direct a balloon dilator, a long catheter with a deflated balloon attached to its distal end, to the narrowed area along the lumen of the blood vessel under angiography guidance. With the help of a special instrument, a liquid is injected into the balloon, creating a certain pressure, due to which it increases to the required diameter and restores the patency of the affected blood vessel. To prevent recurrent stenosis in the narrowed blood vessel, a stent is placed to maintain it in an open state.

The department also offers neuroradiology services. Doctors specializing in this field carry out imaging diagnostics and interventional catheter-based treatment of diseases of the brain and spinal cord. They perform carotid artery stenting for stenosis, intra-arterial lysis therapy for stroke, coiling for brain aneurysms, and endovascular interventions for arteriovenous fistulas in the department's operating rooms. The department also has vast experience in the treatment of chronic back pain using facet joint infiltration and periradicular therapy. The above-mentioned therapeutic procedures are performed under CT or MRI guidance under local anesthesia.

A special offer in the department is imaging diagnostics for children of all age groups, ranging from premature babies and infants to adolescents up to 18 years old. The department has state-of-the-art equipment to perform accurate examinations of children. All devices work in such a way that the child receives the minimum radiation dose and the growing organism is not harmed. Moreover, the rich experience and high professionalism of the department's doctors specializing in diagnostic imaging in children play a crucial role in successful diagnosis.

The department's range of therapeutic services includes the following options:

• Interventional radiology
  • Interventional treatment of malignant tumors
    • Transarterial chemoembolization (TACE)
    • Selective internal radiation therapy (SIRT)
    • Radiofrequency ablation, microwave ablation, and cryoablation
  • Interventional treatment of vascular stenoses and obstructions
    • Balloon dilatation followed by stent implantation
    • Coiling for abdominal and thoracic aortic aneurysms and vascular malformations
    • Percutaneous transhepatic cholangiography followed by drainage and/or stent implantation
    • CT-guided puncture and drainage
• Neuroradiology
  • Interventional treatment of cerebrovascular diseases
    • Carotid artery stenting
    • Intra-arterial lysis therapy
    • Coiling
  • Interventional treatment of chronic back pain
    • Facet joint block
    • Sacroiliac joint block
    • Periradicular therapy
• Other medical services