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A to Z of vascular medicine

 

What can I find in this section?

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Unfortunately, specialist terminology cannot always be avoided, especially when it comes to such a complex subject as medicine. For this reason, our A to Z of vascular medicine provides you with a short description of an array of terms, sorted in alphabetical order.

 

 A  B  C  D  E  F  G  H  I  L  M  N  O  P  R  S  U  V 


Angiology

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Angiology is a branch of internal medicine which deals with vascular diseases (arteries, veins, lymphatic vessels). Angiology deals with the formation, epidemiology, diagnosis and the various forms of therapy (including rehabilitation and prevention) of vascular medicine.

 

Aneurysm

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Dilation of the vessel wall, generally in the abdomen. An aneurysm occurs when the abdominal aorta dilates in excess of 3 cm. Aneurysms are rarely innate, and are generally caused by arteriosclerosis in middle age. There is a certain familial aggregation. Since aneurysms generally don’t cause any symptoms, preventive check-ups are recommended from the age of 50.

 

Apoplexy

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Known in the vernacular as a stroke, which can result in impaired vision, paraesthesia or signs of paralysis in the arms and legs and in the face and is caused by a circulatory disorder to the brain arteries.

 

Arteries

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The arteries transport the oxygen-rich blood from the heart to the various regions of the body.

 

Atherectomy

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The atherectomy is a method whereby plaques (deposits in the arteries) can be removed with the aid of a special catheter.

 

Atherosclerosis

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Deposits in the vessels which calcify over time and, as so-called plaques, can constrict the vessels, restricting the flow of blood. Larger plaques can break away and, depending on the localisation, can result in life-threatening situations (blocked vessel in the leg, heart attack, stroke).

The cause of the calcifications are the vascular risk factors of smoking, increased blood fat values, increased blood pressure, diabetes mellitus.

 

Balloon dilation

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Constrictions of the vessels can be dilated with the aid of an inflatable balloon. This reinstates the flow of blood. Should, following a balloon dilation, constrictions still need to be treated, small stents are generally used.

 

Calf muscle pump

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The calf muscle pump is the natural pump mechanism of the legs, which transports both the venous blood and the lymph from the leg back to the heart.

 

Cholesterol embolism

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With cholesterol embolisms, small pieces are washed from the plaques and then deposited via the blood stream in the smallest vessels, usually in the toes, which results in an acute circulatory disorder of these parts of the body. Cholesterol embolisms are caused by frequent pronounced plaque formation in the abdominal artery (particularly in the case of an abdominal aorta aneurysm) and in the pelvic arteries.

 

Chronic venous insufficiency

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Chronic venous insufficiency is frequently characterised by swelling in the legs and changes to the skin. Chronic venous insufficiency can be caused by weaknesses in the vein valves in the superficial vein system (see varicosis) or in the deep vein system. In the event of progressive venous weakness, in addition to changes to the skin, non-healing ulcers (“ulcus cruris”) can appear on the legs.

 

Computer tomography angiography (CTA)

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The computer tomography angiography is a non-invasive examination in order to, with the aid of contrast agent and an associated “tube examination”, visualise the vessels. The computer tomography is used mainly to visualise the vessels in the abdomen, and has a high degree of accuracy in the evaluation of changes to the vascular wall in regions which it is hard to examine sonographically.

 

Corona phlebectatica

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Corona phlebectatica is the presence of spider veins which occur on the ankle and which can frequently indicate a vascular weakness.

 

Crosse

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Termination point of the large superficial skin veins (groin or the hollow of the knee) in the deep guide veins.

 

Crosse insufficiency

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Pathological return of blood from the deep vein system via the crosse into one of the superficial main veins (great saphenous vein = vena saphena magna or small saphenous vein = vena saphena parva).

 

Compression stockings

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Compression stockings are available in various materials and lengths (lower leg compression stockings and thigh compression stockings). They exert consistent pressure on the tissue, and can thereby result in an improvement to the calf muscle pump which transports the venous blood back from the leg to the heart.

 

Compression therapy

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Depending on the degree of severity of the congestion, compression stockings or bandaging which is easier to dose is used as the treatment. Padding using foam pads or pelottes is frequently used for bandaging a lymphoedema.

 

Digital subtraction angiography (DSA)

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The digital subtraction angiography (DSA) is one of the most precise methods for evaluating vascular changes as part of catheter interventions. With the aid of the DSA, the results are presented following catheter interventions.

 

Diabetes mellitus

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“Sugar” is a common metabolic disorder whereby the blood sugar level is pathologically raised. The increased blood sugar level and the resulting metabolic changes result in arteriosclerosis, which frequently affects the arteries in the lower leg.

 

Duplex sonography

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This is a special ultrasound method whereby a standard ultrasound image is combined with a colour-coded blood flow measurement analysis (Doppler examination). The computer-aided analysis of the Doppler flow can determine the volume and the speed of the blood flow. The duplex sonography is the most frequently used method for the non-evasive evaluation of the vessels.

 

Embolism

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An embolism is a travelling blood clot that can arise in the vein system (usually in the legs) and in the artery system (usually in the heart). A pulmonary embolism can arise when the blood clot moves in the vein system (characterised by pain breathing in, shortness of breath and coughing up blood). A stroke can arise when the blood clot moves in the arterial system (suddenly occurring paraesthesia, paralysis and impaired vision) or an acute vascular occlusion arises in the leg (suddenly occurring pain in the leg, suddenly occurring severe pain in the calf when walking).

 

Erysipelas

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Inflammation of the lymphatic breaks in the skin, typically caused by bacteria.

 

Exercise therapy

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Exercise therapy is necessary to sustain the treatment success of manual lymph drainage and instrument-based compression. Generally, a suitable exercise programme is drawn up by the lymph therapy which should be performed on a daily basis.

 

Flat-knit stocking

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The flat-knit stocking is a non-elastic compression – similar to a bandage – which is used especially for the treatment of lymph oedemas and advanced chronic venous insufficiency/post-thrombotic syndrome.

 

Foam sclerotherapy

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For the foam sclerotherapy treatment, as a rule Aethoxysklerol is mixed with a small amount of air, which significantly increases the surface of the substance. The Aethoxysklerol results in an artificial inflammation of the vein wall followed by the adhesion and the breakdown of the vein. Following foam sclerotherapy, increased pigment deposit in the region of the occluded vein disappears following resorption of the vein by the body (frequently only completely resorbed after six months).

 

Gait training

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Gait training can promote the formation of side veins / collaterals in the case of blockages in the legs. This results in longer pain-free stretches on foot. Along with the determination of the vascular risk factors, gait training forms the basis for the treatment of the peripheral arterial disease.

 

Guide veins

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The veins which make up the deep vein system are known as guide veins. In the event of a dysfunction of the guide veins, swollen veins with nutritional disturbances of the superficial layers of skin can arise, which can result in an ulcus cruris (ulcer of the leg).

 

Heparin

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Medication used for the short-term prevention of the blood clot. Heparins are administered either 1-2 times per day by means of injections in the skin (on an out-patient basis) or by means of steady infusions (during the course of a hospital stay). Heparins are used mainly on bed-ridden patients and as part of operations in order to prevent vein thromboses from occurring.

 

High blood pressure

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High blood pressure is when the upper value (systole) exceeds 140 mmHg or the lower value (diastole) exceeds 90 mmHg. High blood pressure doesn’t, as a rule, cause any symptoms, but can cause serious damage to the vital organs, such as the heart, kidney and even the eyes.

 

Hyperlipidemia

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With hyperlipidemia, we distinguish between elevated “bad” cholesterol (LDL cholesterol) and elevated neutral fats (triglycerides). Healthy people that don’t have further vascular risk factors have a normal value of up to 160 mg/dl LDL cholesterol, and triglycerides should not exceed 200 mg/dl (in fasting serum). In the event of arthrosclerosis with constrictions, the LDL cholesterol should be reduced to values less than 100 mg/dl (sometimes even less than 70 mg/dl).

In addition to the elevated LDL cholesterol, further, rarer lipid protein particles (such as lipoprotein(a)) can result in arteriosclerosis.

 

Imaging methods

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The most frequently used imaging method for vascular diseases is the duplex sonography. In special circumstances, an MR angiography, computer tomography angiography and a digital subtraction angiography (DSA) are also used.

 

Instrument-based drainage

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In addition to general measures, a mechanical drainage therapy using a pressure wave device can be helpful. The cuffs attached to the extremities are filled with pressure waves, transporting the tissue fluid towards the abdomen or the chest. The instrument-based compression is frequently complemented by manual lymph drainage. The success of the drainage treatment must be sustained by means of a well-fitting compression stocking or bandage.

 

Laser

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The laser is the parallel concentrated light of one wavelength. Laser is used in many fields of medicine. In the field of angiology, laser can be used to treat spider veins or for treating the superficial main veins in a minimally invasive fashion.

 

Light reflection rheography

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Light reflection rheography is a painless, non-invasive screening method using infrared light for assessing the venous flow in the superficial skin layers. The evaluation of the venous flow in the superficial layers of skin enables information to be gleaned about the quality of the calf muscle pump and the function of the vein valves.

 

Lipedema

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The lipoedema is a genetically caused excessive increase of the subcutaneous fatty tissue which frequently occurs in women. The increase of the fatty tissue results in an accumulation of tissue fluid with associated symptoms caused by congestion (pressure pain, feeling of heaviness in the legs, swelling of the legs).

 

Lymph

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Lymph (tissue fluid) is located in the entire bodily tissue and is transported away by lymphatic vessels. Lymph contains metabolites (e.g. remnants of dead cells and proteins). The lymphatic vessels have their own muscle cells which can transport the tissue fluid in the direction of the abdomen and the chest (“lymph pump”). Since the muscles in the lymphatic vessel walls cannot perform the draining on their own, it is necessary to activate the pumping system of the lymph by means of the activation and tension of the musculature.

 

Lymphedema

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The lymphoedema is an, initially painless, doughy swelling of the skin which can be reduced in size by raising the arms and legs. Early detection of oedema is possible if, by pressing the skin, it leaves behind an indent.

Primary lymphoedema is typically innate and commences during early adulthood, although it can sometimes occur during childhood with increasing swelling, starting in the hands or feet. Lymphoedema caused by a different underlying illness generally occurs during later adulthood and can be a symptom of a disruption of venous draining in the region of the chest and abdomen.

 

Magnetic resonance angiography

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Using the magnetic resonance angiograph (MRA), the blood flow in the vessels and the condition of the walls of the vessels is represented with the aid of a magnetic field analysis (without X-rays). The magnetic resonance angiography is frequently used to prepare catheter inventions. As a rule, magnetic resonance angiography cannot be performed on patients with heart pacemakers.

 

Main veins

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The main veins are the large superficial veins which flow together with the deep veins in the region of the groin and in the area of the knee joint. They are also known as the great and small saphenous vein or, in Latin, vena saphena magna or vena saphena parva.

 

Manual lymph drainage

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Manual lymph drainage is a special massage technique whereby the congested lymphatic fluid is transported in the direction of the abdomen and chest. Manual lymph drainage is frequently complemented by a compression therapy following congestion, in order to sustain the success of the treatment.

 

Mini-phlebectomy

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The mini-phlebectomy is used on the dilated lateral saphenous branch veins (generally with a diameter of > 3 mm), whereby they are pulled out through a small hole in the skin (1 mm) using a thin hook following local anaesthetic, thereby permanently removing them.

 

Nicotine abuse

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Around half of all patients with a circulatory disorder in the legs are smokers. Nicotine consumption results in free radicals and oxidised LDL cholesterol particles in the blood, causing the formation of arteriosclerosis (calcifications of the vessels).

 

NOAC

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New Oral Anticoagulants: these medications thin the blood and are generally used for the treatment of deep vein thromboses. These medications can also be used in “half doses” as a long-term treatment (as a prophylaxis against new incidents) in patients with leg vein thrombosis without any discernible cause.

 

Oedema

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State of swelling in the tissue caused by congestion of fluid.

 

Overweight

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Anyone with a Body Mass Index (BMI) of between 26 and 30 is classified as overweight. The Body Mass Index is the weight in kilograms: height x height in metres. For instance, for a person weighing 60kg and 168 cm tall, the Body Mass Index 60 kg: 1.68 m x 1.68 m = 21. Obesity equals a Body Mass Index from 30. Being overweight and having a too-high abdominal fat mass (waist measurement above 80 cm in women, above 94 cm in men) increase the risk of developing diabetes, high blood pressure or a cardiovascular disease.

 

Perforating veins

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Perforating veins are communicating veins between the deep and the superficial vein system. If the blood flows from the outside to the inside, the normal transport function is present. If the blood is transported from the inside to the outside, there is a valve weakness present, frequently accompanied with the formation of varicose veins. Perforating veins are frequently very successfully cured by means of foam sclerotherapy.

 

Peripheral arterial disease (PAD, window shopper’s disease)

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Arterial disease is the presence of constrictions in the arteries. The term “window shopper’s disease” is also used to refer to peripheral arterial disease, since patients are frequently forced to stop walking due to exercise-dependent pains in the legs. Patients with a peripheral arterial disease are three times more likely to suffer a heart attack or a stroke. The increased risk applies not only to patients that have symptoms, but also to patients that have asymptomatic constrictions. Basically, peripheral arterial disease reduces life expectancy by around 10 years, with heart attack and stroke being the most frequent causes of death.

 

Phlebitis

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Phlebitis is the painful hardening and reddening of a superficial vein, usually a varicose vein, caused by a superficially located clot (not to be confused with the formation of a blood clot – thrombosis – in the deep vein system).

 

Phlebology

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The study of venous diseases. Phlebology is concerned in particular with the treatment and prevention of varicose veins as well as venous diseases in the deep vein system.

 

Phlebothrombosis

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Phlebothrombosis is the formation of a blood clot in the deep vein system which frequently occurs in the lower leg veins and which, if not treated, is generally associated with the growth of the blood clot. The risk of a pulmonary vein increases with the increased growth of the clot in larger guide veins.

 

Post-thrombotic syndrome

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Post-thrombotic syndrome is the result of an earlier case of phlebothrombosis, causing a permanent weakness in the deep vein system. The resulting swelling in the legs and changes to the skin are known as post-thrombotic syndrome. In severe cases, it can result in a venous ulcus (leg ulcer).

 

Pulmonary embolism

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Acute obstruction of a pulmonary vessel by a blood clot which has typically developed in the pelvic veins or in the deep leg veins.

 

Radio wave therapy

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Radio wave therapy consists of closing a non-functioning main vein (vena saphena magna or vena saphena parva) by means of applying heat, breaking it down over the long term. This results in the normalisation of the blood flow in the leg, and the symptoms caused by the congestion are regressed.

 

Raynaud’s phenomenon

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Raynaud’s phenomenon was first described in the 19th century by the French doctor Maurice Raynaud. The fingers turn white, which is why the disorder is also known as “white finger”. Around 10% of the population – frequently women – suffer from these symptoms when exposed to the cold. It is generally harmless, although in rare cases the phenomenon is associated with rheumatic diseases.

 

Reticular varices

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Reticular varices are “mini varicose veins” with a diameter of 1-3 mm. Like spider veins, they rarely cause symptoms.

 

Recurrent varicosis

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The appearance of a new varicosis in the area of a varices which has already been treated is referred to as recurrent.

 

Round-knit stocking

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A round-knit stocking is the most frequently used support stocking. It is elastic and is meant to prevent swollen legs, especially in pure venous diseases.

 

Saphenous varicosis

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Saphenous varicosis is a weakness of the great saphenous veins in the superficial vein system of the skin (vena saphena magna or vena saphena parva) frequently accompanied by varicosis of lateral saphenous branches (varicose veins located directly beneath the skin) which have a diameter in excess of 3 mm.

 

Sclerotization

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Sclerotization or sclerotization therapy is the administration of vein-closing substances (usually Aethoxysklerol) by means of an injection in order to treat smaller varicoses. The injection is frequently associated with a slight stinging sensation at the injection site – however, this soon disappears. Due to the slight amount of pain caused, local anaesthetic is not usually used.

 

Smoking

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Around half of all patients with a peripheral arterial disease are smokers. Tobacco smoke contains around 5,000 toxins, resulting in the formation of “free radicals” and, therefore, promoting arteriosclerosis.

 

Starburst varices

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Starburst varices are the extremely thin (generally less than 1 mm thick) superficial, smallest veins located in the skin.

 

Stemmer sign

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If a skin fold above the fingers or toes can no longer be lifted, this is a typical sign of a lymphoedema.

 

Stent

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The stent is a vascular support with a diameter between 3 and 12 mm and which, following the inflation of a balloon, can stabilise a venous occlusion. There are self-expanding stents which, due to a memory effect of the metal or of the mesh, always return to their original form. As a rule, they are inserted in the thigh. In the case of the balloon-mounted stents, the stent is expanded with the aid of a balloon. As a rule, these stents are used in the vessels of the pelvis and the abdomen (e.g. the renal arteries).

 

Stripping

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Stripping is a formerly frequently used method of pulling out the main vein (vena saphena magna or vena saphena parva) which is performed in the region of the groin crosse. The stripping of the main vein is increasingly being replaced by gentle methods (endovascular methods). With these methods, the crosse no longer has to be stripped, no general anaesthetic is necessary, and the operation can easily be performed on an out-patient basis under a local anaesthetic.

 

Stroke

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A stroke is an acute circulatory disorder of the brain arteries connected with temporary or permanent impaired vision, weakness in the arms of legs as well as paralysis in the face and even paraesthesia. If the brain artery is blocked by a blood clot for more than six hours, a stroke occurs, accompanied by the dying-off of brain cell nerves caused by a lack of oxygen.

 

Ulcus cruris

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The ulcus cruris is increased damage to the skin usually caused by a venous weakness which, exposed to tiny injuries, can result in the development of a permanent sore. The danger presented by the ulcus cruris is in its increased size, the associated pain and, over the course of time, infections (erysipelas) which, if not treated correctly, can result in fever, shivering, sepsis and further complications.

 

Varicosis of lateral saphenous branches

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The varicosis of lateral saphenous branches is a varicosis which is located directly beneath the skin and has a diameter of less than 3 mm. It is frequently refluxed by leaky perforating veins and leaky main veins.

 


In an emergency

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Outside of surgery hours,
please call the emergency
medical assistance service on:
Telephone number 116 117.

Promenadeplatz
Vascular Centre

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Promenadeplatz 8 | 80333 Munich
T: +49 (0)89 21 26 90 90
F: +49 (0)89 21 26 90 99
E: info(at)gefaesszentrum-promenadeplatz.de

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Wednesday and Friday:
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