ENCalf pain when walking, a narrowed carotid artery on ultrasound, a widened aorta «being watched», or a major operation proposed at home: in Germany such cases go to vascular surgeons, who treat arteries and veins by open surgery or through a puncture. Vascular surgery in Germany starts by asking whether an intervention is needed now and, if so, which suitable option is least invasive.
This page covers conditions, diagnostics, open and endovascular methods (performed from inside the vessel), doctors, hospitals and arrangements. The heart and its own vessels are covered under heart treatment in Germany.
Which conditions vascular surgeons treat
Vascular surgeons treat narrowed and blocked arteries, a widened aorta and vein disease. Plaque narrowing or blocking the leg arteries is peripheral arterial disease, pAVK in German; its sign is intermittent claudication, calf pain that forces a stop while walking and eases with rest. A narrowed carotid artery often goes unnoticed but risks stroke, as plaque fragments can travel to the brain. An aortic aneurysm is a widening of the main artery that can rupture.
Vein conditions include varicose veins, whose valves no longer return blood to the heart; the after-effects of deep vein thrombosis, such as a swollen, heavy leg; and venous ulcers, lower-leg wounds that do not heal.
For a diabetic foot or a non-healing wound, the vascular surgeon restores blood flow where needed, working with the diabetes specialist and a wound centre; diabetes itself is covered under diabetes treatment in Germany.
Diagnostics: finding and assessing the damaged vessel
A damaged vessel is found by examination, blood pressure on the arms and legs, and duplex ultrasound. Lower pressure at the ankle than in the arm signals poor blood flow to the leg; duplex ultrasound shows the vessel wall, flow and plaque without radiation or contrast. The German guideline on peripheral arterial disease bases diagnosis on these three steps.
CT and MR angiography, cross-sectional images with contrast agent, are needed when ultrasound leaves questions open or an intervention is planned; catheter angiography, with contrast injected into the artery, is usually done during the intervention. Surgery is decided on symptoms and imaging together, not one image: a chance finding is treated differently from a narrowing that limits walking or has caused a mini-stroke. Before travelling, send existing imaging on disc.
Treating blood vessels in Germany: endovascular and open surgery
Arteries are treated from inside through a puncture, the endovascular approach, or by open surgery. Via the groin, a catheter reaches the narrowing, which is widened with a balloon and, if needed, held open by a stent, a small mesh tube. For an aortic aneurysm, a stent graft (a fabric tube on a metal frame) seals off the widening without opening the abdomen. The endovascular route suits older and frail patients; long blockages, heavy calcification or an unsuitable aorta may rule it out, and stent grafts need years of imaging checks.
Open operations remove plaque from the carotid artery, bypass a blocked leg artery with the patient’s own vein or a synthetic graft, or replace a widened section of the aorta with a graft. For carotid narrowing, the German-Austrian guideline makes this operation (endarterectomy) the standard when narrowing is severe, or moderate with symptoms, and stenting an alternative. Open surgery is often more durable for long blockages. A hybrid theatre, with an angiography unit over the operating table, combines both approaches. In Germany vascular surgery is a surgical specialty in its own right, with its own professional society, the German Society for Vascular Surgery and Vascular Medicine (DGG).
Varicose veins are often closed from inside by laser or radiofrequency heat; classic removal through small incisions remains an option. Conservative treatment means compression stockings, walking training for narrowed leg arteries, medicines against clots and cholesterol, and stopping smoking; the doctor decides what suits each patient.
Vascular surgeons and hospitals
Prof. (TUMS) Dr. med. Reza Ghotbi is head of vascular surgery and medical director at Helios Klinikum München West and a DGG-certified endovascular specialist, focusing on arterial occlusive disease, aortic aneurysm, carotid narrowing, varicose veins and wound care. Dr. med. Oliver Wolf, director of vascular surgery at ISAR Klinikum in Munich, passed the European Board of Vascular Surgery examination and is a certified endovascular surgeon, working in open and endovascular surgery, especially on leg arteries.
Dr. med. Kai Mehlhase is head of vascular surgery and vascular medicine at Helios Klinik Rottweil and a DGG-certified endovascular surgeon. Vascular surgery departments in other cities include University Hospital Augsburg (vascular and endovascular surgery), Klinikum Stuttgart, the vascular centre of Sana Klinikum Offenbach and University Hospital Düsseldorf.
Frequently asked questions
Does a narrowed artery always need an operation?
No. A narrowing without symptoms is usually monitored and treated with medicines against cholesterol, high blood pressure and clots; with intermittent claudication, walking training is the basis. An intervention is discussed when pain limits daily life, rest pain or wounds appear, or a carotid narrowing is severe or has caused symptoms.
Which is better: a stent or open surgery?
There is no general answer: it depends on where and how extensively the vessel is affected and on the patient’s overall health. A puncture procedure is easier to cope with and recovery is shorter, but it sometimes has to be repeated; open surgery is harder but in some cases lasts longer.
How much does vascular surgery cost in Germany?
The hospital sets the exact amount in its cost estimate once the vascular surgeon has reviewed the records and proposed a method. The price depends on the procedure, the stent or graft, tests before surgery, the days in hospital and check-ups after discharge. The estimate comes before the trip.
How AlenMed arranges vascular treatment
Before the trip, AlenMed translates reports, ultrasound findings and imaging for a vascular surgeon, who judges whether surgery is needed, and which, or whether monitoring is enough. Sudden severe abdominal or back pain with a known aneurysm, a cold pale leg, arm weakness or disturbed speech need an ambulance locally, not a trip.
AlenMed then books appointments, obtains the hospital’s cost estimate, arranges the visa invitation and accommodation, and provides an interpreter. AlenMed’s office is in Munich; see arranging treatment in Germany for every step.
After surgery the patient gets a discharge report in their language, follow-up advice for home and continued contact with the doctor. If carotid surgery followed a stroke, the next step may be rehabilitation after stroke.
This material is for information and is not an offer; the treatment plan is set by the doctor at an in-person appointment.