Vascular Specialist Offenbach (Hesse): PD Dr Dr habil. Schmandra

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PD Dr Dr habil. Thomas Schmandra specializes in vascular surgery and medicine. He is the head physician of the vascular surgery clinic and spokesperson for the vascular center at Sana Klinikum Offenbach (a maximum care hospital).

As a vascular center recognized by the German Society for Vascular Surgery and Vascular Medicine (DGG), the team around PD Dr Dr Schmandra diagnoses and treats all arterial and venous vascular diseases. The clinic's high treatment standards and proven expertise in open surgical, endovascular, and hybrid procedures have been confirmed by its recognition as an aortic center.

Specialist in Arterial and Venous Vascular Diseases

The Offenbacher Klinik for vascular surgery under the direction of Dr. Dr. Schmandra offers the entire treatment spectrum of arterial and venous vascular diseases. In doing so, the most suitable treatment concept is determined for each patient. Coordinated conservative therapy methods are used, as well as sophisticated interventional and surgical procedures. Experienced specialists and surgeons perform these at the highest level.

One of the clinic's main areas of focus is the implementation of special surgeries using minimally invasive techniques that are as gentle as possible. In particular, the surgeons carry out stent implantations very precisely and routinely to avoid risky open surgery on the aorta or carotid artery. During these procedures, aneurysms are treated with specialized techniques, as are significant narrowing of the vessels (stenoses), which can lead to downstream reduced blood flow. The clinic has excellent instrumental equipment and a state-of-the-art hybrid operating room for treatment.

Other key areas of treatment include, in addition to the treatment of peripheral arterial disease (PAD = intermittent claudication), the treatment of inflammatory and chronic vascular diseases, mainly as a result of diabetes, invasive stroke prophylaxis, the creation of dialysis access and the treatment of varicose veins. The clinic is one of only about a hundred clinics in Germany that have been certified as a recognized vascular center. This title is subject to high demands in logistics and infrastructure and proves a high standard of treatment. Proven vascular surgical and vascular medical care is offered around the clock, seven days a week, in Offenbach.

Special vascular consultation hours are used to provide detailed medical history, diagnostics, and care for patients at the highest medical level. In doing so, modern procedures ensure long-term treatment success and consistently validated results. The team always places a high value on the individual involvement of the patient as well as the closest interdisciplinary cooperation with other specialties to ensure the best possible therapeutic success.

Long-Standing Experience in the Treatment of Aortic Aneurysms

A bulging of the aorta is called an aortic aneurysm and most often occurs in the abdominal aorta. It can be caused by increasing vascular calcification but can also be genetic. With an aortic aneurysm, there is a risk of vascular rupture as the aneurysm grows, i.e., the bulging of the vessel can burst, resulting in internal bleeding and death.

Therefore, such an absolute emergency must be treated surgically in the shortest possible time. Indications of such a rupture can be severe back pain and abdominal pain with nausea and vomiting, as well as incipient circulatory failure. The aortic center of the Offenbacher Vascular Surgery offers open surgical and endovascular procedures for the emergency treatment of aortic aneurysms. The doctors operate routinely and precisely while keeping their heads in an emergency. An experienced team is available 24 hours a day, seven days a week.

Aneurysms are usually discovered by chance during an imaging examination since the disease often occurs without symptoms, even in the case of large vascular bulges. However, more significant bulges can also cause back or abdominal pain, which must be considered a forerunner of an impending rupture of the aneurysm.

During the specific consultation hours, experienced vascular specialists explain the disease and the associated risks to the patient. Depending on the size of the aneurysm, conservative therapy can be used, or a surgical intervention can be recommended. In the case of a wait-and-see approach, the size is regularly checked by ultrasound. Surgical treatment should be carried out if the aneurysm reaches a diameter of about five centimeters or more. This can be done by open surgery or minimally invasive surgery.

In the conventional open procedure, the abdominal wall is opened vertically from the sternum to the pubic bone by the vascular surgeons in Offenbach. The aneurysm is exposed and clamped, and a vascular prosthesis is surgically implanted to replace the vessel wall.

In the minimally invasive endovascular variant, vascular specialists slide a stent graft over the femoral artery into the aorta to shut down the area of the aneurysm from the inside. There is no need to open the abdomen. This is much less stressful for the patient, and the recovery time from the procedure is significantly shorter. However, such a minimally invasive procedure is not possible for all patients.

The patient is thoroughly informed about the possible procedures and all treatment steps. During the consultation, sufficient time is taken to address the fears and questions of patients before such an intervention. PD Dr Dr Schmandra's team also emphasizes a clearly structured aftercare plan to ensure the best possible surgical outcome.

State-of-the-Art Medical Treatment of Intermittent Claudication

The so-called "window-shopping disease" is a circulatory disorder of the legs caused by the narrowing of the leg arteries due to vascular wall deposits (arteriosclerosis). In most cases, the development of these chronic vascular occlusion processes is caused by specific risk factors such as smoking, arterial hypertension, hypercholesterolemia, and diabetes, in addition to a congenital tendency.

These patients complain about pain when walking and climbing stairs, which forces them to stop. In the advanced stages, pain can occur in the legs even at rest, and tissue damage with open wounds can occur. Due to poor blood circulation in the legs, these wounds show no tendency to heal and continue to worsen. In such cases, there is a risk of the affected limbs being lost. The experienced vascular surgery specialist at Sana Klinikum in Offenbach is committed to preventing such a severe progression of the disease, which could result in amputation. For this reason, all existing therapeutic approaches are used to the full for those affected.

Conservative measures include physiotherapy, walking training, and optimized medication. In addition, the team discusses with the patient any necessary lifestyle changes to optimize the above-mentioned risk factors.

There are various invasive options for treating the narrowed vessels. A balloon catheter can expand the constriction in the artery and thus eliminate it. In some cases, a surgeon must insert a stent to prevent the vessel from closing up again.

If a minimally invasive catheter procedure is unsuccessful, the standard surgical procedure of clearing or completely bypassing the narrow point is used. In Offenbach, all bypass procedures are carried out with great expertise to preserve the extremity. The more advantageous method depends on the extent of the disease. Therefore, the treatment concept in Offenbach is individually tailored to each patient.

Carotid Artery Stenosis: The Greatest Expertise in Diagnosis & Surgery

Arteriosclerosis can also affect the carotid artery that supplies the brain with blood. For this reason, a narrowing of the carotid artery can have dangerous consequences for patients. A sudden occlusion of the carotid artery or a displaced blood clot can lead to an acute stroke, which can be potentially fatal or result in severe disability. Visual and speech disorders and paralysis can accompany this cerebral infarction and must be treated immediately as an emergency.

Transient deficits can be an early warning sign of an impending stroke in patients with a narrowed carotid artery and should always be taken very seriously. At the Offenbach Vascular Surgery clinic, a detailed medical history and diagnosis are carried out under the direction of Dr Dr Schmandra, using an ultrasound examination of the carotid arteries to enable a timely and precise diagnosis.

In case of a significant narrowing of the carotid artery, invasive treatment is strongly recommended to prevent a stroke. The experienced vascular surgeons will explain the possible options. All treatment steps are described in detail, and comprehensibly, and questions are answered in detail.

During the procedure, the constriction is either treated with a minimally invasive stent or removed by open surgery. In the latter case, Dr Dr Schmandra's team exposes the carotid artery through a small incision and removes the constriction from the opened vessel. During the procedure, blood flow to the brain is continuously monitored and checked. After the procedure, the doctors check the result with a vascular imaging examination. Patients usually only need to stay in the hospital for a few days after the procedure.

Dialysis Access: Modern Shunt Surgery at the Vascular Center of the Klinikum Offenbach

A properly functioning dialysis access is crucial for smooth dialysis treatment and keeping the burden on patients as low as possible during hemodialysis. The vascular surgery team in Offenbach provides modern and safe shunt placement; general anesthesia is not usually necessary.

First, the vascular surgeons thoroughly examine the patient's vascular system to determine the correct location for the dialysis shunt. Then, the surgical procedure is carried out routinely and precisely, ensuring that nothing stands in the way of trouble-free dialysis therapy.

Please Visit the Clinic for Vascular Surgery and Vascular Center's Website for more Information.