Endovascular Surgery

The measurements show the difference. Access is gained with a puncture of 2 to 8 millimetres instead of an incision of 15 to 30 centimetres of open surgery. Most procedures are performed under τοπική αναισθησία and the patient is usually mobilised within 24 hours.

Endovascular access is gained with a simple puncture of the vessel, typically 2 to 8 millimetres, χωρίς χειρουργική τομή. Γι’ αυτό οι περισσότερες ενδαγγειακές επεμβάσεις πραγματοποιούνται με τοπική αναισθησία and the patient is mobilised on the same or the next day.

Endovascular surgery is based on the use of specialised instruments that are inserted directly into the blood vessels through a small incision in the skin. Using thin catheters, the vascular surgeon can reach the exact location of the vascular problem and, with the assistance of advanced imaging systems, restore normal blood flow.

Several techniques are used in endovascular surgery.

Angioplasty

Angioplasty involves the use of a small balloon catheter that is inflated at the site of a narrowed artery. This expands the vessel lumen and restores proper blood circulation.

Stent Placement

In many cases, after angioplasty, a stent is inserted. A stent is a small metal scaffold that remains inside the artery to keep it open and prevent the vessel from narrowing again.

Stent Grafts (Endoprostheses)

For the treatment of aneurysms, a stent graft is used. This device combines a metal framework with a synthetic graft covering and is placed inside the artery to create a new internal channel for blood flow, reducing the risk of aneurysm rupture.

Endovenous Techniques for Veins

For venous diseases such as chronic venous insufficiency, endovenous techniques using laser or radiofrequency energy are applied. These methods heat and seal diseased veins, providing effective and safe treatment.

All these procedures are performed under continuous imaging guidance, allowing the surgeon to navigate instruments precisely and significantly reduce the risks compared with traditional open surgery.

The latest developments in the field, such as robotic vascular surgery, were presented at the LINC 2025 in Leipzig.

Endovascular surgery offers several important advantages compared with conventional open surgical procedures. Because large incisions are not required and only small access points are used, the procedure is less traumatic for the body. As a result, patients typically experience faster recovery, less postoperative pain, shorter hospital stays, and quicker return to normal daily activities. Additionally, the risk of complications is generally lower, making this approach a safe and reliable treatment option for appropriately selected patients.

The method has a long history. The vessel puncture technique still used today was described in 1953 by the Swedish radiologist Sven Seldinger, while the first endovascular repair of an aortic aneurysm was performed in 1991. In less than 40 years the endovascular approach became the first choice in a large part of vascular conditions.

Endovascular techniques are used to treat a wide range of vascular diseases, often replacing procedures that previously required major surgery.

Aortic Aneurysm: placement of a stent graft (EVAR) protects against aneurysm rupture without the need for open surgical repair

Carotid Artery Disease: endovascular carotid stenting can help prevent ischaemic stroke in patients with significant carotid artery narrowing

Peripheral Arterial Disease: through angioplasty and stent placement, blood flow to the lower limbs can be restored, reducing symptoms of claudication and preventing limb-threatening complications such as amputation

Chronic Venous Insufficiency and Varicose Veins: endovenous techniques using laser or radiofrequency energy eliminate diseased veins while improving both function and cosmetic appearance

Diabetic Foot: endovascular procedures can restore blood circulation in the limbs, reducing the risk of chronic ulcers and limb amputation

Before any endovascular procedure, a comprehensive preoperative evaluation is performed. This includes blood tests, ultrasound examinations, or CT angiography in order to accurately assess the condition of the blood vessels and plan the treatment. The patient is informed in detail about the procedure, its benefits, and potential risks.

Vascular access is usually obtained through a small incision in the groin or wrist. The procedure is typically performed under local or regional anaesthesia, allowing most patients to avoid general anaesthesia. The duration of the intervention depends on the complexity of the condition, with simple procedures usually taking 30–60 minutes and more complex procedures taking 2–3 hours.

After the procedure, the patient remains in the hospital for observation. In most cases, hospitalisation lasts one to two days. Mobilization begins only a few hours after the intervention, and in straightforward cases the patient may return home the following day.

Dr. Theodosios Bisdas has many years of experience in vascular surgery and specializes in endovascular techniques. As Director of the 3rd Vascular Surgery Department at Athens Medical Center, he applies the most advanced methods daily for the treatment of complex vascular diseases.

His expertise in the hybrid operating room environment enables the safe performance of highly complex procedures. A key component of this approach is the collaboration of a specialised medical team consisting of vascular surgeons, interventional radiologists, and highly trained nursing staff.

This multidisciplinary teamwork ensures comprehensive and safe patient care, with every patient evaluated individually in order to select the most appropriate treatment and improve quality of life.