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Management von Komplikationen nach Revaskularisation wegen peripherer arterieller Verschlusskrankheit

Prophylaxe und konsequente adäquate Therapie nach zeitgerechter Diagnostik

Management of complications after revascularization due to peripheral arterial occlusive disease

Prophylaxis and consistent adequate therapy after timely diagnostics

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Zusammenfassung

Hintergrund

Komplikationen gefährden den Erfolg einer Revaskularisation zur Behandlung der peripheren arteriellen Verschlusskrankheit (paVK) und müssen daher primär vermieden oder bei Auftreten effektiv behandelt werden.

Ziel der Arbeit

Es soll eine Übersicht über die möglichen Komplikationen nach Revaskularisation bei paVK und deren Management erfolgen.

Material und Methoden

Eine systematische Literaturrecherche wurde in PubMed und Medline unter besonderer Berücksichtigung von aktuellen Publikationen vorgenommen.

Ergebnisse

Die Revaskularisation zur Therapie der paVK kann prinzipiell offen, endovaskulär oder als Kombination beider Methoden (Hybridoperation) erfolgen. Das Spektrum möglicher Komplikationen unterscheidet sich dementsprechend. Es können Blutungs-, ischämische und systemische oder auch vaskuläre von nichtvaskulären Komplikationen unterschieden werden. Das optimale Komplikationsmanagement beginnt mit der primären Prophylaxe und beinhaltet weiter die zeitgerechte Diagnostik und Therapie von bereits eingetretenen Komplikationen. Die beste Prophylaxe besteht in einer hohen Qualität von Indikation und Durchführung der Revaskularisation.

Diskussion

Für den Erfolg der Revaskularisation zur Behandlung der paVK ist ein optimales Komplikationsmanagement von entscheidender Bedeutung.

Abstract

Background

Complications are a threat to successful revascularization for treatment of perpheral arterial occlusive disease (PAOD) and must, therefore, be either primarily prevented or effectively treated after having occurred.

Objectives

The aim of this article is to give a survey of possible complications after revascularization for treatment of PAOD and their management.

Material and methods

A systematic literature review was performed in PubMed and Medline. The analysis mainly considered recent publications with a higher level of evidence.

Results

Revascularization for treatment of PAOD can basically be performed by an open surgical approach, an endovascular approach or as a combination of both methods (hybrid operation). The spectrum of possible complications varies accordingly. A differentiation can be made between bleeding, ischemic and systemic complications as well as between vascular and non-vascular complications. Optimal management of complications begins with primary prophylaxis and further includes a timely diagnosis and treatment of established complications. The best prophylaxis consists of a high quality of indications and performance of revascularization.

Conclusion

Optimal management of complications is essential and of utmost importance for successful revascularization to treat PAOD.

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Authors and Affiliations

  1. Klinik für Gefäß- und endovaskuläre Chirurgie, Allgemein- und Viszeralchirurgie, Franziskus-Krankenhaus, Akademisches Lehrkrankenhaus, Charité – Universitätsmedizin Berlin, Budapester Str. 15–19, 10787, Berlin, Deutschland

    R.I. Rückert, U. Hanack, S. Aronés-Gomez & S. Yousefi

  2. Radiologische Gemeinschaftspraxis Ihre-Radiologen.de am Franziskus-Krankenhaus, Berlin, Deutschland

    K. Brechtel

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  1. R.I. Rückert
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  2. U. Hanack
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  4. S. Yousefi
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Correspondence to R.I. Rückert.

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R.I. Rückert, U. Hanack, S. Aronés-Gomez, S. Yousefi und K. Brechtel geben an, dass kein Interessenkonflikt besteht.

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Rückert, R., Hanack, U., Aronés-Gomez, S. et al. Management von Komplikationen nach Revaskularisation wegen peripherer arterieller Verschlusskrankheit. Chirurg 86, 641–649 (2015). https://doi.org/10.1007/s00104-015-0042-8

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  • DOI: https://doi.org/10.1007/s00104-015-0042-8

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