ANGIOLOGY AND VASCULAR SURGERY

The vascular surgeon is a specialist who deals with all circulatory problems, arterial and venous, excluding the heart.

It has an extremely wide field of specialization, because cardiovascular diseases are the leading cause of death in the world, yet most of the tumors, and most of this mortality is precisely linked to poor circulation.

The figure of the vascular specialist is often mistakenly attributed competence only for the treatment of venous disease. In fact much of its activity is inherent to serious diseases of the arterial circulatory system.

AREAS OF EXPERTISE

There are four main areas of expertise for the vascular surgeon:

Carotid and vertebral pathology, for stroke prevention and therapy

Aneurysmatic pathology in the broad sense - in other words, not only of thoracic, thoraco-abdominal or abdominal aneurysms, but also of all aneurysms of the other vessels in the body.

Peripheral arterial pathology of the upper and lower limbs , therefore critical ischemia, limb salvation, treatment of the diabetic feet, vascular access and skin lesions with vascular etiology.

Venous pathology , therefore, all problems of acute and chronic venous insufficiency, including varicose veins of the lower limbs.

PROCEDURES

In 2000, Dr. Eduardo Ewald was the surgeon responsible for carrying out pioneering procedures for the city of Blumenau performed at Hospital Santa Catarina, such as the first endovascular treatment of an infrarenal aortic aneurysm with implantation of an arterial endoprosthesis and the first treatment of carotid stenosis with stent placement in the city.

Ewald Clinic has been monitoring endoprostheses used in this type of surgery with vascular ultrasound for over 15 years on site, which makes it possible to detect any changes in these materials, as well as the evolution of vascular disease that may require reinterventions. The medical literature is emphatic in the evolution of this specialty towards less and less invasive procedures. The execution of these procedures is being facilitated to the present day, due to the improvement in the profile and quality of the endoprostheses used.

As an illustration, we highlight examples of treatments that can be performed by a specialist, being the images of endovascular surgeries highlighted to exemplify the less invasive techniques that are available.

The indication of treatments for the diseases described below is part of the routine of a vascular surgeon. More information on these and other circulatory alterations of the specialty can be found on the websites of the Societies in which Dr. Eduardo Ewald participates (*).

ARTERIAL DISEASES

Supra-Aortic Trunk Disease - Carotid

The main preventable cause of ischemic encephalic vascular accident is the atherosclerotic occlusive disease of the extracranial carotid artery. Encephalic vascular accident ("stroke") is the development of a focal neurological deficit caused by the interruption of blood supply to an area of the brain.

Its treatment can be performed only with medications, by conventional surgery and also with angioplasty using a vascular endoprosthesis (Stent).

Carotid Surgery

Stent placement

Aneurysms

The term aneurysm describes the dilation of any blood vessel. Arterial aneurysms occur throughout the body, but are more prevalent in the infrarenal aorta.

The indication of treatment, whether with follow-up, surgical treatment or endovascular intervention will depend on many factors, such as the location of the aneurysm, its size and speed of growth.

Abdominal Aortic Aneurysm

Thoracic Aortic Aneurysm

Lower Limb Ischemia

Patients with peripheral arterial disease of the lower limbs require clinical treatment of risk factors. It is necessary to assess the risk and benefit of conventional surgical treatment or endovascular revascularization.

There are many therapeutic options, such as vessel dilation by inflating a balloon in the narrow part of the artery, correcting stenoses with the placement of one or more endoprostheses or even removing atherosclerotic plaques that are the most common cause of vessel obstruction.

Lower Limbs Ischemia

VENOUS DISEASES

Venous Thrombosis

Venous thrombosis consists of the formation of a thrombus inside a vein, which can occur in the superficial or deep venous circulation. The focus in addressing this disease is in the diagnosis, treatment, prevention of recurrences and complications.

Venous Thrombosis

Varicose veins

They cover a wide spectrum of diseases, with emphasis on telangiectasias (vascular spiders), reticular veins and varicose veins, among others.

Varicose veins appear progressively and without remission, except after pregnancy. During their occurrence, they can produce aesthetic changes or complications that often lead the patient to seek guidance from a specialist.

Varicose Veins

* - For more information on each procedure, access the website of the societies to which Dr. Eduardo Ewald is affiliated:

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV) - www.sbacv.org.br
U.S.A.: Society for Vascular Ultrasound (SVU) - www.svu.org
U.S.A.: Society for Vascular Surgery (SVS) - www.vascular.org
European Society for Vascular Surgery (ESVS) - www.esvs.org
Società Italiana di Chirurgia Vascolare ed Endovascolare (SICVE) - www.sicve.it

Sociedades