Vascular Surgery

The mission of Vascular Surgery Unit of Ospedale San Raffaele is to provide the highest quality services in order to enhance life quality and expectancy of the community of patients with peripheral vascular diseases. What defines distinctiveness and differentiation of the Unit at the European and International level is the ability to develop a customized plan of care based on individualized needs due to efficient integration of diagnostic methods, clinical activity, surgical procedures and innovative interventional treatment. In cooperation with the university of Vita-Salute San Raffaele, the Vascular Surgery Unit is also able to provide support for clinical research, participation and involvement in projects for clinical trials, studies, and more.

Operating at the international level, the medical staff speaks fluently English as well as some French for the strong link of several surgeons of the staff to the French Society for Vascular Surgery. Furthermore several residents and fellows from middle East are also able to speak Arabic. Promoting global network through the coordination of the international conference “Aortic Surgery and Anesthesia: how to do it”, the Unit is able to attract every two years about 1,250 vascular surgeons, cardiac surgeons, thoracic surgeons, anesthesiologists, radiologists and from all over the world in one of the most important and worldwide known cardiovascular meeting for an overview of the state-of-art of vascular surgery and new techniques, projects and innovative ideas.

Main conditions treated

The department staff is able to deal with all peripheral vascular diseases using traditional surgery technique (open) or by endovascular surgery and the treatment and the most effective strategy is being applied as the case. Two operating rooms are full available five days per week, from 8 am to 8 pm, a cath lab dedicated to endovascular procedures, and a room for emergency cases is always available. The main interventions and strengths are:

  • Aneurysm of the aortic arch, of the descending thoracic aorta, of the thoracoabdominal and of the abdominal aorta.
  • Aneurysm of the arteries of lower and upper limbs;
  • Occlusive diseases of the aorta, iliac arteries, arteries of lower and upper limbs;
  • Acute and chronic dissection of the thoracic and thoracoabdominal aorta;
  • Disease of the supra-aortic trunks (aneurysm and stenosis of carotid, vertebral and subclavian arteries, pathology of carotid glomus)
  • Thoracic outlet syndrome
  • Diseases of the visceral arteries (celiac, superior mesenteric artery, renal arteries, arcuate ligament syndrome)
  • Inflammatory disease of great velssels (Takayasu disease)
  • Connective tissues disorders (Marfan syndrome Loeys-Dietz syndrome, Ehler-Danlos syndrome)
  • Superficial and deep venous diseases of the lower limbs
  • Abdominal venous diseases (syndrome of the inferior vena cava, Nutcracker¬†syndrome)
  • Multidisciplinary management of critical ischemia of the lower limbs (medical therapy, endovascular treatment, surgical management, neurostimulation for the treatment of chronic pain) is also performed in our Unit. In particular a neurostimulation outpatient allows to program and control the medullar stimulators that are implanted for the control of patients suffering from chronic pain and that can not be controlled with medicines.

A clinic following periodically the patients suffering from trophic lesions due to arterial, venous, mixed and lymphatic disorders, making available a wide range of medical devices (implants and autograft of skin, tissue engineering, VAC, PICO, and more).

Research

Ward.JPG Our job is based on continual research and study. Hence, our Unit is involved in the training of specialists surgeons, doctors and nurses, by integrating courses held at Vita-Salute San Raffaele University, such as:

  • School of Specialization in Vascular Surgery
  • Master’s Degree in Aortic Surgery
  • Theoretical-practical lessons in integrated courses for the degree course in medicine and surgery
  • Seminar in International degree course in medicine and surgery (MD Program)
  • Theoretical-practical lessons in integrated courses for the degree course in nursing

A vibrant and prolific scientific research is being done as well. At present it is first in line to:

  • study and develop innovative stent for the treatment of abdominal aortic aneurysms and aneurysms and dissections of the thoracic aorta.
  • study innovative methods of protection of renal function in during the aortic surgery with a randomized trial in progress (ClinicalTrials.gov Identifier: NCT02327611)
  • evaluate methods of cerebrospinal fluid drainage with innovative systems focused on the prevention of spinal cord ischemia after open and endovascular repair of thoracic and thoracoabdominal aortic aneurysms and dissections.
  • evaluate methods of intraoperative neurophysiological monitoring to minimize the risk of spinal complications during thoracoabdominal surgery.
  • study stents and drug-eluting balloons for the treatment of peripheral arterial disease.
  • research project focused on the patient safety in Robotic Surgery and on the Intelligent Surgical Robotics in Vascular Surgery.

The research findings are published in several trade journals including Circulation, Surgery, The Journal of Vascular Surgery, The European Journal of Vascular and Endovascular Surgery, The Annals of Cardiovascular Surgery, The Annals of Vascular Surgery, and more.

Technology

Our Unit has got a significant number of surgery operations leading to the development of skills and expertise, in addition it is equipped with the latest devices, technologies and equipments available on the market to date, starting from the diagnosis, the timing-interventional therapy scheduling, till the surgery itself, taking in consideration the hospital post-surgery and post-operative checks. Each stage of the disease journey is performed by a high technological standard.

Three noninvasive vascular diagnostic outpatients equipped with Doppler ultrasound devise most modern design.

Medical offices provided by the most modern technological tools for surgery operations timing and scheduling.

All operating rooms are able to handle any kind of pathology and intervention, each one is equipped with:

  1. angiography unit latest design, which is able to get an optimal view and help the surgery operations
  2. echocolordoppler unit to ensure a prompt evaluation of the results after surgery operations.

A close cooperation with specialist department as well as general surgery, cardiac surgery, general surgery, thoracic surgery, cardiology and urology is the leading philosophy of our Unit in order to guarantee always the best competences to our patients.

Staff

Prof. Roberto Chiesa, Head of Department, Full Professor in Vascular Surgery, Director of Specializing School of Vascular Surgery, Past President of the French Society for Vascular Surgery (SCV), President of the Italian Society for Vascular and Endovascular Surgery (SICVE)

Prof. Germano Melissano, Dr. Renata Castellano, Dr. Efrem Civilini, Dr. Enrico Marone Maria, Dr. Tshomba Yamume, Dr. Laura Dordoni, Dr. Gloria Esposito, Dr. Domenico Astore, Dr. Massimiliano Marrocco Trischitta, Dr. Domenico Baccellieri, Dr. Andrea Kahlberg, Dr. Luca Bertoglio, Dr. Mascia Daniele, Dr. Sara Spelta, Dr. Marco Leopardi, Dr. Luca Apruzzi, Dr. Enrico Rinaldi, Dr. Serena Frezza, Dr. Renato Vitale, Dr. Giuseppe Cilli, Dr. Amed Sallam and Samuel Bossi, nursing coordinator.