Angiology and Vascular Surgery
- Presentation
- Healthcare services
- Team
- About diseases or procedures
- Research
- Teaching
- Contact
Codi servei:
Recerca:
The Angiology and Vascular Surgery Service is part of several international registers of endoprosthesis and endovascular material (ILICO, VSX-Trial Gore Registry, PRIZER...).
It has recently ended a clinical trial, in collaboration with Bellvitge Hospital and other international centers, to prevent surgical infections (VAS-INF).
Presentation:
The Angiology and Vascular and Endovascular Surgery service is responsible for the diagnosis, medical and surgical treatment and monitoring of diseases related to the body's blood vessels, that is, blood, venous and lymphatic pathologies.
Among the functions that are developed in the service, the following stand out:
- Aneurysmatic pathology.
- Pathology of supra-aortic trunks.
- Peripheral arterial disease.
- Venous accesses.
- Vascular complementary explorations.
- Other procedures such as: minor amputations, ostectomies, major amputations, debrides, preparation of vessels and optimization prior to performing a kidney transplant.
To make this possible, it has multidisciplinary cross-sectional intra-hospital teams. Specifically:
- It is part of the multidisciplinary team of the Diabetic Foot Unit, in collaboration with the Hospital's Endocrinology and Nutrition service, through weekly sessions (committees) and daily care activity, including emergency care.
- Collaborates with the Cardiovascular Surgery service in carrying out complete aortic arch surgeries.
- It is present in different committees: complex care, kidney transplantation, vascular neurology of vascular access and consultation of vascular access and vascular malformations.
In addition, it has a strong relationship with the internal medicine service of the Hospital, for the medical treatment of complex hospitalized patients, for the optimization of patients and for the prevention of cardiovascular diseases.
Likewise, it also collaborates with other centers, such as the Hospital l'Esperit Sant Foundation and the Badalona Municipal Hospital where it carries out assistance activities for better care for patients.
Tipus Servei: 2
Correu: cirurgiavascular.germanstrias@gencat.cat
Docència:
Pregraded teaching
The service gives classes of its specialty at the Faculty of Medicine of the UAB at the Can Ruti Campus.
Postgraduate teaching
Classes are taught on the UAB Master's Degree in Diabetic Foot and the master's intra-hospital internships are carried out.
The team also teaches classes in the Master's Degree in Surgical Nursing at the Autonomous University of Barcelona at the Hospital de Sant Pau.
Information for residents
Teaching guide.
The professionals of the service are authors and co-authors of book chapters of the specialty and give presentations and presentations at multiple national and international conferences.
Medical team
Pere Altés Mas
Head of Service
Carlos Esteban Gracia
Section Head
Manuela Rodríguez Dominguez
Medical specialist
Clàudia Riera Hernàndez
Medical specialist
Lucia Martínez Carnovale
Medical specialist
Montserrat Esturrica Duch
Medical specialist
Joan Sancho Llorens
Medical specialist
Gonzalo Bueno Casanovas
Medical specialist
Marc Masana Llimona
Medical specialist
Miquel Gil Olaria
Medical specialist
Ivan Sanchez Peña
Resident doctor
Candela Otero Martinez
Resident doctor
Víctor Martínez Valiente
Resident doctor
Paula Casellas De Miguel
Resident doctor
Mireia Cabot Paredes
Resident doctor
Nursing team
Anna Julven Segovia
Surgery Nursing Team
Ariadna Corral Calero
Surgery Nursing Team
Laura Narejo Mejia
Surgery Nursing Team
Xavier Hernandez Beardo
Surgery Nursing Team
Diana Gomez Muñoz
Surgery Nursing Team
Administrative team
Anna Homs Casals
Secretary of the Service
The Angiology and Vascular and Endovascular Surgery service is responsible for the diagnosis, medical and surgical treatment and monitoring of diseases related to the body's blood vessels, that is, blood, venous and lymphatic pathologies.
Among the functions that are developed in the service, the following stand out:
- Aneurysmatic pathology.
- Pathology of supra-aortic trunks.
- Peripheral arterial disease.
- Venous accesses.
- Vascular complementary explorations.
- Other procedures such as: minor amputations, ostectomies, major amputations, debrides, preparation of vessels and optimization prior to performing a kidney transplant.
To make this possible, it has multidisciplinary cross-sectional intra-hospital teams. Specifically:
- It is part of the multidisciplinary team of the Diabetic Foot Unit, in collaboration with the Hospital's Endocrinology and Nutrition service, through weekly sessions (committees) and daily care activity, including emergency care.
- Collaborates with the Cardiovascular Surgery service in carrying out complete aortic arch surgeries.
- It is present in different committees: complex care, kidney transplantation, vascular neurology of vascular access and consultation of vascular access and vascular malformations.
In addition, it has a strong relationship with the internal medicine service of the Hospital, for the medical treatment of complex hospitalized patients, for the optimization of patients and for the prevention of cardiovascular diseases.
Likewise, it also collaborates with other centers, such as the Hospital l'Esperit Sant Foundation and the Badalona Municipal Hospital where it carries out assistance activities for better care for patients.
Varicose veins
The service treats varicose veins with conservative therapies that can be done in an outpatient setting, i.e., without being admitted to the hospital, and using local or regional anaesthesia: CHIVA techniques, localized phlebotomy, foam, and endoluminal techniques such as radiofrequency (RF).
Congestive pelvic syndrome
It is a type of varicose vein that appears in the female genital area, usually after at least one pregnancy, causing discomfort or pain in the lower abdomen, especially during periods, among other symptoms. It is treated without the patient having to be admitted to the hospital by means of endovascular techniques with a type of catheter, in collaboration with the hospital's interventional angioradiology professionals.
To treat chronic kidney failure with hemodialysis, it may be necessary to create a connection between an artery and a vein, i.e., a surgical fistula to make it easy to insert needles and allow a blood flow to leave the hemodialysis machine.
Critical extremity ischaemia endovascular surgery
Through catheters and guides, lower extremity arteries that are obstructed or stenosed (i.e., have become narrower) are recanalised or dilated. These obstructions can cause various degrees of ischaemia (loss of irrigation and, therefore, oxygen)
- Invalidating intermittent claudication: muscle pain when walking in the buttocks or calves
- Rest pain
- Up to loss of tissue integrity and gangrene
Recanalisation or dilation, which can include placing a type of small tubes called stents, is performed with local or locoregional anaesthesia, and when it fails, there is always the possibility of classical surgery, i.e., bypass.
Critical extremity ischaemia open surgery or bypass
Today, this is the alternative when endovascular surgery is not a possibility because it has been tried and has not worked, or because the arterial lesions are very extensive. It is an operation to irrigate areas where arteries are blocked by connecting with arteries with good blood flow. If necessary, it can include a small prosthesis.
Chronic visceral ischaemia surgery
When two or more abdominal arteries become obstructed (obliteration) or narrow (stenosis), they may cause what it is called intestinal angina, i.e., abdominal pain after eating. Renovascular hypertension may also be produced by renal artery stenosis. These problems may be solved by endovascular techniques, which by introducing catheters help dilate the arteries again, which may include placing small tubes called stents. Only in very specific cases, when these endovascular techniques fail, it is necessary to use a bypass, a surgical procedure to irrigate areas of where the arteries are obstructed by connecting with arteries with good blood flow.
Carotid stenosis surgery
Between 60 and 70% of ischaemic stroke (caused by blood clots) originate from the arterial branches above the aorta. The carotid artery goes from the upper part of the trunk to the brain through the neck, and if the point where this artery branches off becomes narrow, clots can originates, causing this type of stroke. If this happens, surgery can be very effective to solve this problem.
Infrarenal abdominal aortic aenurysm repair
An aneurysm is the widening of an artery that makes its walls so thin that they can break. In the case of the aorta, as it runs through the abdomen under the kidneys, the Germans Trias Angiology and Vascular Surgery Service repairs the aneurysm by means of these two types of surgery, depending on its anatomy and the patient's condition.
- Endoprosthesis (EVAR). Through a catheter introduced from the femoral arteries, a prosthesis is placed in the area of the aneurysm. This is the preferred technique for elderly patients who have had previous surgeries or ostomies or who have other diseases that increase the risk of open surgery.
- Open surgery (OS). Usually for low-risk patients or when the anatomy of the aneurysm requires it.
Thoracic aortic aneurysm repair
This pathology is treated by means of thoracic endoprosthesis (TEVAR), which is placed by means of a catheter introduced through the femoral artery. This minimizes the risk of paraplegia.
Thoracic-abdominal aortic aneurysm repair
Treating this disease is a challenge and involves great risk because it is necessary to replace the entire artery by means of what is called inclusion technique (Crafword) or by means of hybrid surgery. The Germans Trias Angiology and Vascular Surgery Service has experience in this type of treatment, despite the risk it entails.
These are cross treatment units in which professionals form different specialities, including Angioradiology, Endocrinology, Orthopaedic Surgery and Traumatology, Rehabilitation and Infectious Diseases, take part. The Angiology and Vascular Surgery Service participates in the following:
- Diabetic foot unit
- Critical extremity ischaemia treatment functional unit
- Multipurpose unit for ambulatory intravenous vassodilators-antiaggregants (prostglandins) treatments in ischaemic patients.
Peripheral artery disease (chronic lower extremity ischaemia)
This is a disease that causes leg pain when walking, or depending on the condition and degree of arterial obstruction, may cause sores or rest pain. Risk factors for developing this disease are smoking, high blood pressure, diabetes and dyslipidemia. Treatment consist, mostly, of controlling the risk factors and antiaggregant therapy. There are also several endoluminal revascularisation techniques (minimally invasive) or open surgery ( bypass). In very advanced cases of the disease or failure of surgical techniques, it could cause limb loss.
Aneurysmatic disease
An aneurysm is a disease caused by destruction of structural arterial wall tissue, specially in the aorta, causing progressive dilation. Timely diagnosis by means of ultrasound or other imaging diagnostic techniques makes it possible to prevent an artery from breaking.
The Angiology and Vascular Surgery Service is part of several international registers of endoprosthesis and endovascular material (ILICO, VSX-Trial Gore Registry, PRIZER...).
It has recently ended a clinical trial, in collaboration with Bellvitge Hospital and other international centers, to prevent surgical infections (VAS-INF).
Pregraded teaching
The service gives classes of its specialty at the Faculty of Medicine of the UAB at the Can Ruti Campus.
Postgraduate teaching
Classes are taught on the UAB Master's Degree in Diabetic Foot and the master's intra-hospital internships are carried out.
The team also teaches classes in the Master's Degree in Surgical Nursing at the Autonomous University of Barcelona at the Hospital de Sant Pau.
Information for residents
Teaching guide.
The professionals of the service are authors and co-authors of book chapters of the specialty and give presentations and presentations at multiple national and international conferences.
Contacte: cirurgiavascular.germanstrias@gencat.cat