Vascular Surgery

Aneurysms of the thoracic aorta, suprarenal and infrarenal abdominal aorta, thoracoabdominal aorta, iliac arteries, and visceral arteries (splenic, superior mesenteric, renal); aortic coarctation; and aortic dissections.

• Traditional surgery of the supra-aortic trunks: carotid, subclavian, and vertebral arteries.
• Conventional surgery for chronic and acute arterial diseases of the lower limbs.
• Endovascular Surgery for Aortic Aneurysms: Placement of endografts for thoracic aortic aneurysms, infrarenal abdominal aortic aneurysms, iliac artery aneurysms, endovascular repair of aortic dissections, and treatment of traumatic thoracic aortic ruptures.
• Endovascular Surgery of the Supra-Aortic Trunks: Angioplasty and stenting for carotid, subclavian, and vertebral artery stenoses.
• Endovascular Treatment of Peripheral Artery Disease: Angioplasty and stenting of stenoses and occlusions in the iliac, femoral, popliteal, and tibial arteries.
• Sympathetic Nervous System Interventions: Lumbar and thoracic ganglionectomy.
• Surgery for Chronic Venous Diseases of the Lower Limbs: Treatment of varicose veins, varicothrombophlebitis, post-thrombotic syndrome, and venous stasis ulcers.
• Lymphatic Surgery: Management of primary and secondary lymphedema.
• Hemodialysis Access: Complex arteriovenous fistulas and central venous catheter placements.

TEVAR (Thoracic Endovascular Aortic Repair)

Endovascular repair of thoracic aortic aneurysms.

This technique, based on the same principles as EVAR (Endovascular Aneurysm Repair), is utilized for the treatment of aneurysms located in the thoracic aorta. It is particularly effective for thoracoabdominal aortic dissections using endografts.

Collaboration with the Complex Cardiac Surgery Unit (COU) ensures a comprehensive approach to treating conditions involving all segments of the thoracic aorta through a coordinated Aortic Team strategy.

An endovascular approach for managing stenotic disease at the carotid bifurcation using a minimally invasive inguinal or brachial access. A balloon and a stent—often tailored to the patient’s specific needs due to the broad availability of devices—are used to restore a functional lumen in the internal carotid artery. This procedure requires the administration of contrast agents and exposure to ionizing radiation. Post-procedure, patients must adhere to dual antiplatelet therapy for at least 30 days.

This gold-standard revascularization technique is used to treat hemodynamically significant carotid stenosis. It involves a lateral cervical incision and the isolation of the diseased carotid bifurcation for surgical intervention.

This endovascular, minimally invasive revascularization technique is used to treat obstructive arterial disease in the lower limbs. It utilizes standard balloons, drug-coated balloons, uncovered or covered stents, or drug-eluting stents to restore a functional lumen in stenotic or occluded arteries. The procedure involves the use of ionizing radiation and contrast agents.

Laser thermoablation is a minimally invasive procedure for treating venous varicosities, targeting the great or small saphenous veins.

The technique involves percutaneous access and vein cannulation. Under local anesthesia, the vein is functionally ablated using heat transmitted through a catheter inserted into the vessel (causing no discomfort to the patient). The procedure is carefully indicated based on the patient’s comorbidities and is frequently performed as a day-service procedure (same-day discharge). Post-treatment, the affected limb requires elastic compression for at least 30 days.

Venous Stripping and Phlebectomy : These are traditional surgical techniques for removing venous varicosities and are applicable to various anatomical regions. The procedures involve surgical incisions, and elastic compression therapy is required for at least 30 days post-surgery.

Monocyte Infusion from Peripheral Blood : This innovative technique addresses critical limb ischemia that cannot be treated surgically or through endovascular methods. Monocytes are extracted from the patient’s peripheral blood using a dedicated kit and are infused into specific areas of the affected limb, mapped in advance. The goal is to stimulate neovascularization and reduce the patient’s pain.

Tecnica tradizionale che prevede la rivascolarizzazione di un’arteria malata ( occlusa, dilatata o lacerata) mediante l’utilizzo di un nuovo dispositivo ( che può essere una vena del paziente prelevata da un altro sito o una protesi biocompatibile). Può applicarsi in caso di interventi programmati o in emergenza ( traumi, aneurisma rotto o fissurato, occlusioni arteriose).

Tecnica mini-invasiva per il trattamento delle varici venose. Applicata sulla vena grande safena e della piccola safena, prevede un accesso mini-invasivo percutanea e l’incanalamento della vena da trattare; previa anestesia locale, la vena è funzionalmente devitalizzata mediante utilizzo di calore trasmesso dal catetere che incanala il vaso ( senza che il paziente avverta disagio). Ha indicazioni stringenti secondo le comorbilità del paziente ed è spesso realizzata in regime di day-service ( ricovero che si svolge nell’arco di una sola giornata). Necessità di elastocompressione di tutto l’arto interessato per almeno 30 giorni.

These are traditional surgical techniques for the removal of varicose veins, applicable to various anatomical regions. The procedures involve surgical incisions, and elastic compression therapy is required for at least 30 days post-surgery.

Tecnica d’avanguardia per il trattamento dell’ischemia critica di arto inferiore non più suscettibile di trattamento chirurgico/ endovascolare. Prevede il recupero, mediante apposito kit, di cellule del sangue del paziente ( monociti) e l’infusione, lungo un decorso che viene previamente mappato sull’arto del paziente, delle stesse. L’obiettivo della tecnica è di favorire la neovascolarizzazione al fine di ridurre il dolore avvertito dal paziente.