Blood vessels run throughout the body in order to supply tissues with blood, oxygen and nutrients and to transport blood back to the heart. Larger vessels are frequently protected by muscles and bones or cross other deep structures, such as nerves or tendons.
External structures may cause narrowing or even complete occlusion of blood vessels for a variety of reasons, known as vascular compression syndrome (mechanical vasoconstriction).
Vascular compression syndromes differ not only in terms of the site of anatomical involvement but also in terms of symptoms. Both arteries and veins may be involved, in principle. Involvement of veins usually leads to disturbance of flow with swelling in the affected region, while arterial involvement results in a circulatory disorder, which often manifests with pain.
Identification and diagnosis of vascular compression syndromes requires a wide body of experience. Imaging techniques, such as ultrasound, CT and MRI are supplemented with special functional tests in order to visualize blood flow in a variety of situations
Patients with vascular compression syndrome require treatment when symptomatic, at the very latest.. Treatment may be necessary even in the absence of symptoms. Prolonged narrowing of a vessel may lead to injuries and changes in the vessel wall with dire consequences. The choice of therapy usually depends on the type and localization of the structure causing the narrowing.
Arterial decompression is usually necessary, whereby constricting structures, e.g., muscle, tendons or bone, are either slit or divided during an operation. Internal splinting with a stent frequently suffices for venous occlusion. The stent is usually placed by minimally invasive surgery in the narrow segment via the femoral vessels.
A number of investigations are often required to precisely determine the site of involvement before deciding on the type of therapy.. We will discuss all available options with advantages and disadvantages with you thereafter and counsel you in detail. Therapy, the procedure and duration of hospitalization depend entirely on the affected site. The patient may be discharged even after two to three days after stent placement. Hospitalization is usually somewhat longer – about six to seven days – after operations for management of the surgical wound.
No rehabilitation is generally required thereafter. Outpatient physiotherapy mostly suffices in the vast majority of cases. Our Center has proven expertise in the management of vascular compression syndromes , although these are rare entities.
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University Hospital Zurich
Clinic for Vascular Surgery