The following content has been provided by the University of Erlangen-Nürnberg.

Welcome everybody. Today we have our guest speaker. It's Dr. Heinz Lieber from the University of Erlangen-Nürnberg.

He's a rascals surgeon and we know each other for 10 years now.

He was in the early days here in Erlangen in the surgery department.

We are still in regular contact and I appreciate it a lot that he accepted my invitation.

In the upcoming 45 minutes he will tell us what he's actually doing and why medical technology and imaging technology is so important, partially for his daily work in the hospital.

At least a little important. Thank you Joachim for the invitation and the nice introduction.

You might wonder why a vascular surgeon is talking about imaging and what we need.

So I don't know what you know about vascular medicine at all. We have some rivers, we could talk about rivers or streets, we have arteries and veins.

It's like a map and you might be aware that if you close a bridge there might come up a traffic jam and the whole traffic could collapse, which is worse in the human body of course if the traffic collapses.

And on the way back even if a river closes it might come to a great flood or whatever.

So the vascular system is pretty much like a map and as I already mentioned we have arteries and veins.

So what we are doing first, people don't come in and show us their images. That's how I look inside.

So we have to think about what's going on there. We have a clinical examination, we have some doubler ultrasound, just the frequency is relevant.

There we get an idea on whether the artery is fully working or not. Then we have duplex sonography, ultrasound.

And there in most cases even if the vessels are pretty close to the surface you have a pretty good view like you see up here.

Whether the artery is open you can be sure, you can measure how fast the blood is flowing in there.

And that's the relevant information we need. There might be a stenosis.

By the way if there are any words I use that are uncommon please don't hesitate to ask. I try to answer them as good as possible.

And if there is a stenosis previous to the examined place then the profile might be different.

Another problem with the vessels of the human body is that they can enlarge. So we call that an aneurysm.

And this is another big point. If you imagine you have a highway four to five lanes each direction and then a car breaks down,

you push him aside of course, then you repair the car and then you try to come back in.

Which might be pretty difficult if there's so much traffic. But finally you might end up and you might be taken with you and then you might fall out again.

This is what happens in aneurysms. I might show you later on.

To give you some more pictures, we do angiograms by puncturing the arteries directly. And then you see what is interesting for us,

either the regular vessel or you have an occlusion like here or you have a stenosis like here.

You see the regular vessel here and then it goes further down.

We do it during the operation since for us we try to reconstruct the blood flow again either with a dilatation,

what's not possible in traffic of course. If two cars park too close you shouldn't squeeze in and push them aside.

But in human body we can do that. I show you some examples later on.

We have a further imaging technology which is a CT scan even with contrast agent or CT angiogram.

But there are certain limitations due to the structure of the plaque and the bone structure might have an overlay.

So we cannot exactly get an idea on how the vessels do.

We can especially to explain the disease to the patients do some nice reconstructions.

As you see here, this is what I mentioned earlier, an aneurysm.

Here the aorta has a big balloon and then it continues and of course we can treat that in different kinds.

But we need exact measurements to get an idea on how to treat this lesion.

Here on the right hand side you see the aneurysm treated with a so-called endograph prosthesis.

Further on we can work with NMR scans which is a brilliant thing for soft tissue contrast.

And even for NMR angiography we can get an idea on how the blood flow is even in the peripheral arteries.

Here you see the main important thing while thinking about a picture on the left hand side.

You see the MR angiogram, see the aorta filled with contrast agent.

And if you have a look at this contrast agent apart from some kind of bellies here, it looks pretty normal.

But if you have this view you realize that there is a certain area filled with contrast agent.

But there is a wide area around where the blood is thrombosed.

You have a thrombosis block like the broken car inside the highway.

And so the blood only runs through the center of this aneurysm.

So as soon as you have the suspicion that the patient has an aneurysm you have to go into further angiograms which is a CT or an MR.

We even can do MR angiograms for the peripheral arteries.