Varicose veins

The service treats varicose veins with conservative therapies that can be done in an outpatient setting, i.e., without being admitted to the hospital, and using local or regional anaesthesia: CHIVA techniques, localized phlebotomy, foam, and endoluminal techniques such as radiofrequency (RF).

Congestive pelvic syndrome

It is a type of varicose vein that appears in the female genital area, usually after at least one pregnancy, causing discomfort or pain in the lower abdomen, especially during periods, among other symptoms. It is treated without the patient having to be admitted to the hospital by means of endovascular techniques with a type of catheter, in collaboration with the hospital's interventional angioradiology professionals.

To treat chronic kidney failure with hemodialysis, it may be necessary to create a connection between an artery and a vein, i.e., a surgical fistula to make it easy to insert needles and allow a blood flow to leave the hemodialysis machine.

Critical extremity ischaemia endovascular surgery

Through catheters and guides, lower extremity arteries that are obstructed or stenosed (i.e., have become narrower) are recanalised or dilated. These obstructions can cause various degrees of ischaemia (loss of irrigation and, therefore, oxygen)

• Invalidating intermittent claudication: muscle pain when walking in the buttocks or calves
• Rest pain
• Up to loss of tissue integrity and gangrene

Recanalisation or dilation, which can include placing a type of small tubes called stents, is performed with local or locoregional anaesthesia, and when it fails, there is always the possibility of classical surgery, i.e., bypass.

Critical extremity ischaemia open surgery or bypass

Today, this is the alternative when endovascular surgery is not a possibility because it has been tried and has not worked, or because the arterial lesions are very extensive. It is an operation to irrigate areas where arteries are blocked by connecting with arteries with good blood flow. If necessary, it can include a small prosthesis.

Chronic visceral ischaemia surgery

When two or more abdominal arteries become obstructed (obliteration) or narrow (stenosis), they may cause what it is called intestinal angina, i.e., abdominal pain after eating. Renovascular hypertension may also be produced by renal artery stenosis. These problems may be solved by endovascular techniques, which by introducing catheters help dilate the arteries again, which may include placing small tubes called stents. Only in very specific cases, when these endovascular techniques fail, it is necessary to use a bypass, a surgical procedure to irrigate areas of where the arteries are obstructed by connecting with arteries with good blood flow.

Carotid stenosis surgery

Between 60 and 70% of ischaemic stroke (caused by blood clots) originate from the arterial branches above the aorta. The carotid artery goes from the upper part of the trunk to the brain through the neck, and if the point where this artery branches off becomes narrow, clots can originates, causing this type of stroke. If this happens, surgery can be very effective to solve this problem.

Infrarenal abdominal aortic aenurysm repair

An aneurysm is the widening of an artery that makes its walls so thin that they can break. In the case of the aorta, as it runs through the abdomen under the kidneys, the Germans Trias Angiology and Vascular Surgery Service repairs the aneurysm by means of these two types of surgery, depending on its anatomy and the patient's condition.

• Endoprosthesis (EVAR). Through a catheter introduced from the femoral arteries, a prosthesis is placed in the area of the aneurysm. This is the preferred technique for elderly patients who have had previous surgeries or ostomies or who have other diseases that increase the risk of open surgery.
• Open surgery (OS). Usually for low-risk patients or when the anatomy of the aneurysm requires it.

Thoracic aortic aneurysm repair

This pathology is treated by means of thoracic endoprosthesis (TEVAR), which is placed by means of a catheter introduced through the femoral artery. This minimizes the risk of paraplegia.

Thoracic-abdominal aortic aneurysm repair

Treating this disease is a challenge and involves great risk because it is necessary to replace the entire artery by means of what is called inclusion technique (Crafword) or by means of hybrid surgery. The Germans Trias Angiology and Vascular Surgery Service has experience in this type of treatment, despite the risk it entails.

These are cross treatment units in which professionals form different specialities, including Angioradiology, Endocrinology, Orthopaedic Surgery and Traumatology, Rehabilitation and Infectious Diseases, take part. The Angiology and Vascular Surgery Service participates in the following:

• Diabetic foot unit
• Critical extremity ischaemia treatment functional unit
• Multipurpose unit for ambulatory intravenous vassodilators-antiaggregants (prostglandins) treatments in ischaemic patients.