Vascular Specialist Dr Ludwig – Head Physician Vascular Surgery Dresden

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Dr Stefan Ludwig is a specialist in vascular surgery and head physician of the Department of Vascular Surgery, Vascular and Endovascular Surgery, and Phlebology at the Municipal Hospital Dresden.

The Department of Vascular Surgery provides the full range of modern vascular medicine, including all conventional and minimally invasive surgical procedures, for diagnosing and treating arterial and venous diseases. The department is part of the interdisciplinary Vascular Center certified by the German Society for Vascular Surgery.

Dr Ludwig's experienced and dedicated medical team assesses whether purely medical therapy, a catheter procedure, or surgical intervention is necessary for the patient and determines an individual treatment strategy accordingly.

Initially, there is always an evidence-based and guideline-oriented indication for surgery/intervention. Then, to consider all facets, a treatment recommendation is always made after discussing the available findings in the interdisciplinary vascular conference by vascular surgeons, angiologists, radiologists, and, if necessary, other specialist disciplines.

The Interdisciplinary Vascular Center has been continuously certified by the three professional societies since 1996.

As far as possible, surgeries are carried out in the hybrid surgery room, which allows a combination of open surgery and endovascular - minimally invasive - procedures by using high-quality technology for X-ray, vascular imaging, and, if necessary, intraoperative tomography.

Specialist for Aneurysms of the Thoracic and Abdominal Aorta

Aneurysms are defined in medical terminology as the bulging of a section of a vessel as a result of weakness in the connective tissue in the wall layers of the affected vessel. In principle, these can occur in all arterial vessels of the organism. Since such predetermined rupture points can burst when the wall tension of the vessel is high, aneurysms usually carry a high-risk potential. High wall stresses occur due to blood pressure peaks, increased pressure in the abdominal and thoracic cavities, or severe shocks. If the vessel ruptures, life-threatening and difficult-to-control internal bleeding occurs. Due to their wide diameter and high blood flow in the aorta, aortic aneurysms are ticking time bombs that should be surgically relieved promptly upon diagnosis.

Comprehensive Diagnosis and Treatment of Circulatory Disturbances of the Brain-Supplying Arteries

Circulatory disorders of the brain-supplying arteries are particularly critical. These paired vessels enter the skull at the front as the common carotid artery through the cervical fascia and at the back as the vertebral artery through a bony canal in the spinal column.

If stenoses (constrictions) occur in its course, such as atherosclerotic calcifications, an adequate blood supply to all brain areas can no longer be ensured. Classic symptoms of such stenosis are dizziness, ringing in the ears, or even fainting episodes. During a catheter intervention, such constrictions can be widened using small balloons, and a so-called stent (vascular support) can be used to prevent the constriction from closing again.

A High Level of Expertise in the Field of Arterial Circulatory Disorders (Pelvic and Leg Vessels, Neck and Arm Vessels, Internal Arteries)

In the case of vascular stenosis, the supply area of the affected pathway is insufficiently supplied with oxygen and nutrients. As a result, carbon dioxide and other metabolic waste products accumulate in the area with insufficient blood supply. Depending on the vessel affected, a wide variety of symptoms become noticeable. In particular, oxygen-dependent tissues such as the brain, heart muscle, or working skeletal muscles quickly fail to function when there is a lack of oxygen.

A common disease in industrialized countries is a peripheral arterial occlusive disease, also known as window-shopping disease. This popular name comes from the fact that those affected can only walk short distances, i.e., from one shop window to the next, without pain, before giving the undersupplied muscles a break.

The causing vascular occlusions of the pelvic and leg arteries can also be dilated in a catheter intervention using balloon dilatation and kept open by stent implantation. In severe cases, the vessel must be surgically exposed and opened to remove the plaque with an adherent blood clot (thromboendarterectomy). In the case of the highest degree of occlusion, the occlusion can be bridged by a surgically created vascular bypass.

State-of-the-Art Diagnostics & Therapy for Carotid Artery Stenosis

Thanks to Doppler sonography and computer tomographic imaging, carotid stenosis can be reliably diagnosed today. Doppler or duplex sonography is a non-invasive procedure based on ultrasound technology that allows precise blood flow calculation in the carotid arteries. Subsequently, for optimal therapy planning, the three-dimensional extent of the constriction can be visualized by computer tomography, if necessary, with a contrast agent.

While the progression of the disease can be prevented by early diagnosis through avoidance of all risk factors, such as tobacco consumption and lack of exercise, and medication to control high blood pressure, blood sugar, and blood lipid levels, dilatation and stent implantation using a catheter procedure can be considered for medium grade stenoses. However, the plaque must be peeled out for high-grade stenosis in an open surgical procedure.

Varicose Vein Treatment at the Municipal Hospital Dresden

Varicose veins occur predominantly in the lower extremities. They express a predisposed weakness of the vein wall, which can be further aggravated by permanent congestion of the bloodstream in the legs, for example, due to long periods of standing at work. As a result, the blood no longer flows appropriately towards the heart but instead accumulates in the veins, e.g., in the calf, where it leads to unsightly bulges. In addition, the slowed blood flow favors the development of venous thrombosis. If conservative measures, such as wearing compression stockings, do not show any significant improvement, the varices can be sclerosed by injecting a saline solution. However, this is likely to damage the inner layer of the vessel wall, causing the vessel to contract and be displaced by a blood clot before being transformed into a bloodless connective tissue strand. If this attempt of sclerotherapy is unsuccessful, the surgical extraction of the varicose vein via two small skin incisions remains a therapy option (varicose vein stripping).

Placement of Shunts (Dialysis Shunt Surgery)

If permanent dialysis therapy is required to treat chronic renal insufficiency, the patient can be relieved of suffering if extensive vascular access can be created without any problems. This is made possible by a so-called dialysis shunt, a short-circuit connection of arteries and veins, usually in the forearm. This large-lumen vessel can be pierced with a needle as painlessly as possible, usually in the first attempt, and dialysis treatment can be administered through it. Dr Ludwig and his team have already created numerous dialysis shunts, making the complex treatment easier for many dialysis patients.

For more information, please visit the website of the Department for Vascular Surgery.