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Gefässchirurgie

, Volume 24, Issue 1, pp 75–85 | Cite as

Gefäßerkrankungen bei Triathleten

  • S. RegusEmail author
CME
  • 44 Downloads

Zusammenfassung

Die überwiegende Mehrzahl der Triathleten weist keinerlei kardiovaskuläre Risikofaktoren auf. Dennoch gibt es bei diesem für uns Gefäßchirurgen untypischen Patientenklientel zunehmend Berichte über arterielle Komplikationen. In der Literatur werden 3 Krankheitsbilder als ursächlich benannt: die iliakale Endofibrose, das Adduktorkanalsyndrom sowie das popliteale Entrapment-Syndrom. Die exogene, kompressionsbedingte Gefäßwandschädigung ist allen 3 Krankheitsentitäten gemeinsam. Die richtige Diagnosestellung erfolgt nicht selten mit einer Latenz von mehreren Jahren. Dies ist erklärbar durch die meist unspezifische Beschwerdesymptomatik, gut tastbare Fußpulse sowie unauffällige Verschlussdrücke in Ruhe. Wegweisend ist ein Abfall des Knöchel-Arm-Index („ankle-brachial index“, ABI) nach Belastung. Die Magnetresonanzangiographie (MRA) wird bei den weiterführenden Schnittbildverfahren der computertomographischen Angiographie (CTA) zur Verringerung der Strahlenbelastung oft vorgezogen. Die digitale Subtraktionsangiographie (DSA) sollte erst nach vorheriger Schnittbilduntersuchung und nur in Kombination mit interventionellen Therapiemaßnahmen verwendet werden. Nur durch die operative Korrektur kann die exogene Gefäßwandaffektion beseitigt werden, weshalb die chirurgische Therapie die besten Langzeitergebnisse aufweist.

Schlüsselwörter

Ausdauersportler Endofibrose Adduktorkanalsyndrom Popliteales Entrapment-Syndrom Sportassoziierte Gefäßerkrankungen 

Vascular diseases in triathletes

Abstract

The vast majority of triathletes do not have any cardiovascular risk factors; however, there are increasing numbers of reports of arterial complications in these unusual patients for vascular surgeons. In the literature three types of complications have been reported: iliac artery endofibrosis, femoral adductor canal syndrome and popliteal artery entrapment syndrome. All three disease entities have in common an exogenic compression-related vascular wall damage. The correct diagnosis is not uncommonly made after a delay of several years. This can be explained by the mostly unspecific symptoms, easily palpable foot pulses and a resting ankle-brachial index (ABI) within normal ranges. The most important diagnostic tool is a reduction of the ABI after maximum effort. Magnetic resonance angiography (MRA) is often preferred to computed tomography angiography (CTA) to reduce radiation exposure. Digital subtraction angiography (DSA) should first be used following cross-sectional imaging methods and only in combination with interventional treatment measures. The exogenic vascular affection can only be eliminated by operative repair, which is why surgical treatment shows the best long-term results.

Keywords

Endurance athletes Endofibrosis Adductor canal syndrome Popliteal artery entrapment syndrome Sports-related diseases 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

S. Regus gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Gefäßchirurgische AbteilungUniversitätsklinikum ErlangenErlangenDeutschland

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