Surgery & Intervention

Aorta and large branches of the aorta

Aneurysms and constrictions of the aorta and its branches
Vascular constrictions and occlusions of the aorta and iliac arteries: What you should know
Treatment

Obliterative changes (constrictions – stenoses – and occlusions) of the arteries can be successfully treated with catheter methods, surgical procedures or a combination (hybrid interventions), depending on the localisation and severity. In the case of constrictions, balloon dilation with or without a stent is often used; alternatively, surgical treatment with bypass methods may also be necessary, in which the damaged section of the vessel is replaced or bypassed.

Narrowing (stenosis) and occlusion of the aorta and pelvic arteries are primarily caused by progressive vascular calcification (atherosclerosis). These constrictions or blockages can significantly reduce blood flow, leading to serious circulatory disorders in the legs and organs. 

Causes 

  • Atherosclerosis – Deposits of fat, cholesterol, and calcium in the arterial walls (the most common cause).
  • Thrombosis – Blood clots that can suddenly block blood vessels.
  • Embolism – Vessel blockages caused by dislodged clots, fat particles, or air bubbles.
  • Vascular inflammation (vasculitis) – Autoimmune processes that damage the blood vessel walls.
  • Connective tissue disorders (e.g., Marfan syndrome, Ehlers-Danlos syndrome) – Can weaken vascular structures.
  • Traumatic injuries – Vascular damage from accidents or medical procedures.
  • Radiation or chemotherapy – Can lead to long-term vascular changes.

Risk Factors 

Lifestyle Factors: 

  • Smoking (drastically increases the risk of atherosclerosis) 
  • Lack of physical activity 
  • Unhealthy diet (high in fat and salt) 
  • Obesity 

Medical Factors: 

  • High blood pressure 
  • Diabetes mellitus 
  • High blood lipids (LDL cholesterol) 
  • Chronic kidney disease 
  • Genetic predisposition 

Hormonal Influences: 

  • Hormonal contraceptives (increase the risk of thrombosis) 
  • Pregnancy (increases blood clotting tendency) 

Narrowing and occlusion of these vessels can have severe consequences, including claudication (intermittent limping), critical limb ischemia, leading to amputation, or organ failure. Early diagnosis and treatment are crucial.

Constrictions and occlusions of the abdominal and iliac arteries lead to reduced blood flow in the legs, which can occur under stress (intermittent claudication with walking distances of several hundred metres to a few steps) or, in the worst case, is so pronounced that there is an insufficient supply of oxygen to the tissue, which leads to non-healing wounds and tissue destruction.

Healthy lifestyle habits such as a balanced diet, regular exercise, no smoking and blood pressure control help to reduce the risk of the development and progression of vasoconstriction. Regular check-ups are particularly important if you have diagnosed or treated diseases in the area of other arteries.

My services for you:

  • PTA (balloon dilation) with stent for aortoiliac constrictions

  • CERAB (Covered Enddovascular reconstruction of the Aortic Bifurcation) for complex aortoiliac occlusions

  • Hybrid procedure with surgical reconstruction and catheter therapy in combination

  • Open aortic replacement for aneurysms and occlusion processes with or without reconstruction of visceral arteries

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