Vascular surgery services at Acıbadem cover the diagnosis and treatment of occlusions, stenoses and dysfunctions affecting peripheral arteries, veins and lymphatic vessels throughout the body (excluding intracranial vessels, intrathoracic structures and the coronary arteries that supply the heart). Our multidisciplinary vascular surgeons provide medical management, open surgical repair and minimally invasive endovascular procedures — including balloon angioplasty and stent placement — tailored to each patient’s condition and risk profile.
Below are common vascular diseases and conditions managed by the cardiovascular and vascular surgery teams at Acıbadem Healthcare Group, with typical diagnostic approaches and treatment pathways.
Occlusions and Stenoses Secondary to Atherosclerosis
Atherosclerotic narrowing of peripheral arteries can cause symptoms from intermittent claudication to rest pain and critical limb ischemia. Diagnosis typically begins with clinical assessment and noninvasive testing (Doppler duplex ultrasound, ankle–brachial index), progressing to CT or MR angiography when anatomical detail is needed. Treatment is staged: conservative care (risk-factor control, supervised walking programs, medical therapy) → minimally invasive endovascular procedures (angioplasty with balloon dilatation and, where indicated, stenting) → open surgical repair when necessary (bypass grafting or endarterectomy). Choice of procedure depends on lesion location, extent, patient comorbidities and overall surgical risk; multidisciplinary teams at the hospital individualize plans to restore blood flow and preserve limb function.
Buerger’s Disease (Thromboangiitis Obliterans)
Buerger’s disease is a nonatherosclerotic inflammatory syndrome that typically affects small- and medium-sized arteries and veins of the hands and feet and most commonly occurs in young smokers. Diagnosis is based on clinical features supported by imaging (duplex ultrasound and, when needed, CT or MR angiography or conventional angiography to map distal vessel involvement). Primary treatment is smoking cessation and avoidance of local trauma; pharmacologic options (vasodilators, antiplatelet therapy) may relieve symptoms. In select cases with severe ischemic pain or tissue loss, surgical options (revascularization when feasible) or sympathetic blockade (e.g., chemical sympathectomy) can be considered to improve blood flow and reduce pain. Early referral to a vascular surgeon is recommended for assessment and to coordinate smoking-cessation resources and limb-preserving care.
Sudden-Onset Vascular Occlusions (Embolism, Thrombosis)
Acute arterial occlusion is a time-sensitive emergency caused by embolism or in-situ thrombosis that abruptly interrupts blood flow to a limb or organ. Typical presentation includes the five P’s—pain, pallor, pulselessness, paresthesia and paralysis—and immediate assessment with bedside Doppler and urgent vascular imaging (CT angiography or conventional angiography) is required to determine the occlusion site and plan treatment.
Acute management aims to restore blood flow as quickly as possible to minimize ischemic injury. Initial steps include anticoagulation and urgent consultation with vascular surgery. Reperfusion options depend on ischemia severity, timing and lesion anatomy and may include catheter-directed thrombolysis, percutaneous thrombectomy or surgical embolectomy/thrombectomy. If an underlying severe stenosis or chronic lesion is identified or revascularization fails, definitive repair—such as bypass grafting or targeted artery repair—may be required to restore durable flow.
Clinical decision-making follows a clear algorithm: assess limb viability and symptom duration, stabilize the patient, obtain imaging, then proceed with the least invasive effective procedure (endovascular thrombectomy/angioplasty with or without stenting when feasible) or open surgery when necessary. Time to revascularization strongly influences limb salvage rates; delayed treatment increases the risk of tissue loss and amputation. If you or someone has sudden severe limb pain, numbness or loss of pulse, seek emergency care immediately and request vascular surgery evaluation to optimize outcomes.
Diabetic Foot
Diabetic foot problems arise from a combination of neuropathy, impaired immunity and poor wound healing; infection and tissue breakdown are common complications. When atherosclerotic vascular occlusions are present and ulcers or gangrene develop, the primary issue is often peripheral artery disease associated with diabetes rather than neuropathic ulceration alone, and treatment must address both foot care and limb perfusion.
Assessment should include careful wound evaluation and vascular testing — ankle–brachial index (ABI), toe pressures or transcutaneous oxygen (tcPO2), duplex ultrasound and, when planning intervention, CT or MR angiography to map arterial disease. A multidisciplinary team approach (vascular surgeons, podiatry, infectious disease, endocrinology and wound care) guides management.
Treatment principles combine optimized diabetes control and infection management with limb-revascularization when ischemia contributes to nonhealing wounds. Revascularization options include minimally invasive endovascular techniques — angioplasty with balloon dilatation and stenting when indicated — and open surgical repair such as bypass grafting for extensive disease. Selection depends on anatomical findings, the patient’s surgical risk and goals of care; restoring adequate blood flow improves healing rates and reduces the risk of amputation.
If you have a diabetic foot ulcer, increasing pain, swelling, or signs of infection, request urgent vascular assessment — early evaluation by a vascular surgeon can identify peripheral artery disease, prioritize revascularization when needed, and coordinate wound-preserving care.
Carotid Artery Diseases (Stenoses or Occlusions of Carotid Artery)
Carotid artery disease — narrowing or blockage of the carotid arteries — increases the risk of transient ischemic attack (TIA) and stroke by reducing blood flow to the brain. Patients may present with focal neurologic symptoms (weakness, speech changes, transient visual loss) or be asymptomatic and identified on screening. Initial noninvasive evaluation usually begins with duplex Doppler sonography; CT angiography or MR angiography provide detailed anatomic mapping when intervention is being considered, and conventional digital subtraction angiography is reserved for selected diagnostic or therapeutic planning.
Treatment aims to prevent stroke and is individualized based on symptoms, stenosis severity and overall patient risk. Medical management includes antiplatelet therapy and aggressive risk-factor control. For symptomatic high-grade stenosis (commonly >70%) and certain moderate lesions, carotid endarterectomy (open surgical repair) remains the standard of care for many patients; carotid artery stenting (a minimally invasive endovascular procedure) is an alternative for select patients at high surgical risk or with challenging anatomy. A multidisciplinary vascular surgery and neurovascular team evaluates each case to choose the safest procedure — endarterectomy or carotid stenting — to restore blood flow and reduce stroke risk.
If you experience sudden neurological symptoms such as weakness, numbness, slurred speech or sudden vision loss, seek urgent medical attention; rapid assessment and vascular surgeon input can be critical for stroke prevention. For patients with known carotid disease, regular follow-up imaging and timely discussion of surgical versus endovascular procedures help optimize long-term cerebral perfusion and reduce the risk of stroke.
Aneurysms (Dilatation and Balloon Formation in Blood Vessels)
Aneurysms are localized dilatations of arteries that may occur in the aorta (including abdominal aortic aneurysm), peripheral arteries or other vessels. Small aneurysms are usually managed with surveillance using ultrasound or CTA/MRA at intervals determined by size and growth rate (commonly every 6–12 months for small abdominal aortic aneurysms), while sudden enlargement or symptoms prompt expedited imaging and intervention planning.
When repair is indicated—based on aneurysm diameter, growth rate, symptoms or rupture risk—both open surgery (graft repair) and minimally invasive endovascular aneurysm repair (EVAR) with stent-graft placement are treatment options. Choice of technique depends on aneurysm anatomy, patient comorbidities and long-term considerations; endovascular repair offers shorter recovery for suitable anatomy, while open surgery may be preferred for certain aortic or complex peripheral aneurysms to achieve durable repair.
Surveillance and timely decision-making by experienced vascular surgeons reduce the risk of rupture and optimize outcomes. If you have been diagnosed with an aortic aneurysm or have risk factors (family history, smoking, hypertension), ask about enrollment in an aneurysm surveillance program and a consultation to discuss repair options — including endovascular aneurysm repair — appropriate for your anatomy and overall health.
Chronic Venous Failure and Varicose Veins
Chronic venous insufficiency and varicose veins result from faulty valves or obstruction in the leg veins that impair normal blood return, causing symptoms such as leg heaviness, swelling, aching, skin changes and, in advanced cases, venous ulcers. Diagnosis is based on clinical exam and duplex color Doppler ultrasound with full venous mapping to identify reflux, obstruction and the specific veins involved.
Management follows a stepped approach: conservative measures (compression stockings, leg elevation, exercise and weight optimization) are first-line for symptom control and prevention. When intervention is indicated, minimally invasive endovenous techniques such as radiofrequency ablation or endovenous laser treatment target refluxing truncal veins and generally offer quicker recovery than open surgery. Sclerotherapy treats smaller tributary veins and spider veins, while surgical vein stripping or phlebectomy remains an option for select patients or complex anatomy.
Each procedure has specific benefits and expectations—endovenous thermal ablation typically allows rapid return to activities, sclerotherapy is useful for cosmetic and symptomatic tributaries, and surgery can provide durable results in some cases. Your vascular surgeon will recommend the most appropriate technique based on duplex findings, symptoms and treatment goals. For personalized evaluation and treatment planning, consider booking a venous clinic appointment to discuss options for varicose veins and chronic venous disease.
Deep Vein Thrombosis and Pulmonary Embolism
Deep vein thrombosis (DVT) and pulmonary embolism (PE) are related conditions in which blood clots form in the deep veins—usually of the legs—and may travel to the lungs, where they can cause life‑threatening obstruction. Common symptoms of DVT include leg swelling, pain, warmth and redness; PE may present with sudden shortness of breath, chest pain, rapid heart rate or fainting. Prompt evaluation is essential: leg vein mapping with duplex Doppler ultrasound is the first‑line test for suspected DVT, while computed tomography pulmonary angiography (CTPA) is the standard imaging study to confirm PE.
Initial treatment focuses on anticoagulation to stop clot propagation and reduce embolic risk. In selected acute, limb‑threatening DVT or massive/submassive PE with hemodynamic compromise, interventional procedures—catheter‑directed thrombolysis, percutaneous thrombectomy or mechanical clot removal—may be offered to rapidly restore blood flow and limit long‑term complications. These endovascular procedures are most effective when performed early (typically within days to a few weeks of symptom onset, depending on clot chronicity and clinical context), and the decision to proceed is made by a multidisciplinary team including vascular surgeons and interventional specialists.
Noninterventional care remains central for most patients: therapeutic anticoagulation, graduated compression stockings for selected cases, risk‑factor modification and monitoring for post‑thrombotic syndrome. In specific situations where anticoagulation is contraindicated, an inferior vena cava (IVC) filter may be considered. Follow‑up includes assessment of clot resolution, anticoagulation duration planning and rehabilitation to preserve limb function.
If you experience sudden leg swelling, severe unexplained breathlessness, chest pain, or fainting, seek emergency care immediately—early diagnosis and timely vascular surgery or interventional consultation can be lifesaving. Acıbadem’s vascular teams coordinate hospital‑level care and follow‑up to manage acute DVT/PE, plan procedures when appropriate, and reduce long‑term complications through comprehensive medical and procedural strategies.
