Well, it will be very easy for me to write this section. After all, 26 years have been devoted to vascular surgery, of which the last 12 were spent in one of the best vascular centers in Germany – the Nuremberg clinic.

Vascular Diseases: The Disease of the Century

Today, vascular diseases can simply be called the „disease of the century.“ Vascular surgery today deals with diseases of the arteries and veins in all parts of the human body from the brain to the foot. The success of vascular surgery is practically associated with two pioneering discoveries: the development of angiography (contrast examination of blood vessels) and the creation of vascular synthetic substitutes.

Diagnosis of Vascular Diseases in Germany

According to the World Health Organization, the main causes of death among the population are strokes and „heart attacks“. What is it? It is nothing more than a disease of the blood vessels of the brain or heart. Narrowing of the blood vessels leads to a decrease in blood circulation in one or another organ, causing its dysfunction. It is like a car that you forgot to fill up with gasoline. Not a single organ of the human body can function without blood circulation.

It is clear that prevention and early diagnostics of vascular diseases allow for the application of certain treatment methods to prevent severe consequences of the disease. In this section we will not dwell on the damage of the heart vessels and will describe this in a separate article „Cardiology in Germany“. Now we are talking only about what vascular surgery can do.

Methods for Diagnosing Vascular Diseases

With the advent of ultrasound and contrast vascular examination methods, it became possible to detect vascular narrowing at the earliest stages of arterial disease, determine its degree, extent, and, as we say, its significance. The ultrasound diagnostic method today allows us to establish vascular lesions completely “painlessly”. Only in some cases is so-called angiography required. This technique is based on the fact that a special, ultra-thin catheter is brought to the area of vascular narrowing, through which a contrast agent is injected and an X-ray “photograph” is taken. Then the doctors have a special X-ray image in their hands, allowing them to see the lumen of the vessel.

Advances in Vascular Surgery and Treatment Techniques

But vascular surgery and radiology have gone further. Today, it is possible to insert special balloons into the narrowing area and expand it, and to prevent it from forming again, a special spiral or stent is inserted into the lumen! The entire procedure takes no more than an hour and the patient can safely go home. The treatment is complete. The patient only needs to periodically visit the doctor for monitoring and further prevention of vascular diseases.

Surgical Treatment of Aortic Aneurysms

A special place is occupied by surgical treatment of aortic aneurysms. Aortic aneurysms are the expansion of the „main“ vessel in the form of a „sac“, which can lead to thinning of its wall and rupture. And this is already life-threatening and then the operation is done according to emergency indications and urgently.

Aortic Endoprosthetics: A New Technique in Vascular Surgery

Modern technologies over the past 10-15 years have made it possible to create and give vascular surgeons a completely new technique – the so-called „Aortic endoprosthetics“. Previously, we had to cut out this expanded section of the aorta and replace it with a synthetic prosthesis. Now technologies allow us to insert a vascular prosthesis into the lumen of the aorta through a special catheter and prevent further expansion of the wall and reduce the risk of rupture several times. If earlier the operation lasted 2-3 hours, today, using this method, the entire treatment takes about an hour. The patient after the „classical operation“ had to stay in the clinic for 10-14 days, and today he can be discharged home in 3-4 days. It is true that it is not possible to use such new technologies in all cases, although manufacturers of medical equipment are also not standing still and more and more patients can now receive treatment using this new method.

Treatment of Vascular Diseases in Germany

Above we have already briefly touched upon angiography and stenting of vessels as a method of treating vascular diseases. But the treatment of vascular diseases is not always possible with such simple and gentle methods. Then my friends and colleagues – vascular surgeons – take up the matter. Various methods can be used to restore blood flow. This is mainly vascular bypass, when a parallel artificial vessel is created to bypass the closed section of the artery.

Conclusion

In Germany, vascular surgeons work in close contact with radiologists, cardiologists, and manufacturers of medical equipment. The department of vascular surgery, where I had the honor of working for 12 years, performed about 4,000 operations on arteries per year, and I am glad that I was also involved in this.