Angiology – structured vascular diagnosis and evidence-based therapy

Angiology deals with diseases of the arteries and veins. Complaints are often non-specific – all the more important is a precise, structured diagnosis to recognize risks for brain, heart, and extremities early and treat them in a targeted manner.

In my practice, vascular diagnosis is carried out in line with guidelines and using modern color duplex and duplex sonography. The goal is a clear classification: What is harmless, what is in need of treatment, and when is further clarification worthwhile?

Typical complaints and disease patterns

A vascular medical clarification is particularly useful in cases of:

• Severe, tired, or swollen legs
• Visible veins, varicose veins, spider veins, venous inflammation
• Suspicion of thrombosis (deep or superficial)
• Load-dependent leg pain ("shop window disease", pAVK) or resting pain
• Cold sensation, paleness, or wound healing disorders on feet/legs
• Narrowing of the carotid arteries (carotid stenosis) / stroke risk assessment
• Suspicion of aneurysm or aortic screening

Modern vascular diagnosis in my practice (duplex & color Doppler)

The examination includes – depending on the question – among other things:

Arterial diagnosis

• Color duplex of the leg arteries (perfusion, stenosis, plaques)
• Carotid duplex (risk assessment, stroke prevention)
• Aortic screening (aneurysm diagnosis)

Venous diagnosis

• Vein duplex (thrombosis exclusion/confirmation)
• Reflux and valve analysis (varicose veins, chronic venous insufficiency)

Edema assessment

• Differentiation of venous and internal causes (heart, kidney, liver, protein deficiency)
• In case of suspected lymphatic causes: Further clarification in specialized structures.

The vascular sonographic diagnosis is carried out in my practice as far as medically sensible and complete. Invasive diagnostics or interventional therapies (e.g. catheter procedures or operations) are carried out in specialized centers with which we have been well networked for years.

Therapy and individual recommendations

Treatment is based on findings, complaints, and overall risk and includes – depending on the indication –:

• Risk factor management (blood pressure, blood sugar, lipids, smoking, weight, exercise)
• Medication therapy (e.g. platelet inhibition/anticoagulation, lipid therapy – indication-based)
• Compression therapy for venous diseases/edema
• Exercise and gait training for pAVK (structured recommendations)
• Follow-up checks for objective therapy control

The goal is a realistic classification and an effective, well-tolerated therapy – without unnecessary diagnostics and without alarmism.

When a timely assessment is recommended

Please have a timely assessment in case of:

• Acute unilateral swollen, painful leg (thrombosis suspicion)
• New onset resting pain or rapid deterioration of walking distance
• Wound healing disorders on feet/legs
• Neurological warning signs (e.g. transient speech/visual disturbances)
• Severely increasing shortness of breath/chest pain (depending on the situation, also an emergency)

Connection to heart and metabolism

Vascular diseases are often part of an overall picture. If necessary, an internal overall assessment is carried out – in the case of primary heart complaints, see also the page Cardiology Baden-Baden – Diagnostics, Therapy & Prevention.