Activities

Narrowing of the carotid artery     

It has been known for a long time that arteriosclerotic narrowing (stenosis) of the carotid artery plays an important role in the pathogenesis of stroke. Surgery for these stenoses is intended to prevent stroke and associated problems.

Symptoms of carotid artery stenosis and of imminent stroke are mostly temporary episodes which appear harmless, and during which an arm or a leg is paralyzed for a short time, or vision of one eye is impaired. The so-called Doppler sonography is a simple tool to examine and diagnose the carotid artery. This method is based on ultrasound technology and may be performed rapidly with little effort. Subsequently, arteriosclerotic changes can be further assured by X-ray pictures (angiography).

Carotid artery stenosis has to undergo surgery if there is a high degree of stenosis or if the above symptoms have already occurred.

Surgery starts with a short  skin incision at the affected cervical side. During the procedures, one opens up the carotid artery and removes the stenosis. If surgery proceeds as scheduled, hospital length of stay will be about one week.

Surgery for varicosis     

Varicose veins at the legs mostly result from an insufficiency of venous valves. One differentiates between several types of varicosis.

Primary varicosis

In such cases superficial veins at the leg are dilated. This type of varicosis is usually caused by an insufficiency of so-called perforating veins. Insufficient closing of valves in these perforating veins increases pressure in the superficial veins, thereby dilating them and resulting in varicosis.

Often patients with varicose veins complain about swelling of legs and a feeling of heaviness following longer walks or standing.

Secundary varicosis

Thrombosis of deep leg veins also leads to a destruction of venous valves leading to a so-called chronic venous insufficiency.

Legs of these patients are significantly prone to swell causing serious complaints. Commonly, this chronic stasis already alters appearance of the skin markedly. Often these patients are also troubled due to poor wound healing in this area (crural ulcer). Furthermore, these patients frequently present with varicose veins which are then called secondary varicose veins.

In principle, surgery is only indicated with primary varicosis. Therefore, one has always to proof patency of deep leg veins before performing surgery for varicosis. Proof can either be furnished by an ultra sound examination or by contrast imaging of deep leg veins, by a so-called phlebography.

Surgery for varicosis commonly includes removal of the large saphenous vein, if its valves are no longer functioning. To do so, a small cut in the groin is necessary. The other varicose veins are removed individually through several small cuts. During this procedure it is important to search for the perforating veins mentioned above and to close them.

After this type of surgery hospital length of stay usually amounts to one to two days.

Contact

	0049-(0)89-7276-224
	0049-(0)89-7276-233
	chirurgie.muenchen@martha-maria.de
	Krankenhaus Martha-Maria München Chirurgische Klinik Wolfratshauser Straße 109 D-81479 München Germany