Interventions in Angiology
State-of-the-art and innovative procedures for revascularization of the peripheral arteries are used in two catheter labs and a hybrid operating theatre.
Endovascular revascularization of the peripheral arteries and veins includes the treatment of:
- Extracranial carotids (carotid artery)
- Shoulder and upper arm arteries
- Abdominal aorta (abdominal artery)
- Mesenteric arteries (intestinal/spleen and liver arteries)
- Renal arteries
- Pelvic arteries
- Arteries of the lower extremities
- Elimination of aneurysms of the peripheral arteries
- Deep pelvic vein thromboses
- Shunt veins
In the treatment of peripheral arterial occlusions, the most modern catheter procedures such as atherectomy catheters (“mini cutter”, laser), thrombectomy catheters (suction catheters) and various stent systems are used, adapted to the individual situation; many of these systems were co-developed in our center.
Recanalization of the popliteal artery using a mini cutter (“tunnel drill”)
The overview angiography shows the occlusion of the knee artery at the level of the knee joint. In the 2nd and 3rd DSA* images, we see the interruption of the contrast medium as evidence of the occlusion. A guidewire is then successfully advanced through the occlusion and the lower leg arteries are visualized using the DSA* technique. In this case, it can be seen that the lower leg artery is chronically occluded and 2 vessels are open and perfused.
Next, an umbrella is placed in the popliteal artery as protection so that if the ablated material is carried away, it is caught by the umbrella and does not block the lower leg arteries.
The mini cutter (“the tunnel drill”) is now slowly advanced through the occlusion via the guide wire and the debris is removed and suctioned off.
After several passages, the angiography no longer shows any significant residual deposits in the vessel wall. Now the entire section of the popliteal artery is carefully dilated for 3 minutes using a drug-coated balloon.
The final angiography shows an excellent result with no residual narrowing of the popliteal artery.
*DSA = Digital subtraction angiography is a special technique of vascular imaging with contrast medium under X-ray