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Marcumar-Therapie bei infrainguinalen Venenbypässen: Pro

Marcumar for infrainguinal vein bypasses: pro

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Zusammenfassung

Die optimale Medikation zur langfristigen Prävention eines Verschlusses nach infrainguinalem Bypass ist seit langem Gegenstand wissenschaftlicher Debatten. In dieser Arbeit werden auf dem Boden einer selektiven Literaturrecherche die relevanten Arbeiten diskutiert. Dabei zeigt sich, dass die Evidenz nicht hinreichend ist, um verbindliche Empfehlungen zu geben. Es scheint jedoch, dass Patienten mit infrainguinalen Venenbypässen trotz höherer Blutungsraten von einer oralen Antikoagulation mit Vitamin-K-Antagonisten profitieren und diejenigen mit infrainguinalen Kunststoffbypässen einen Vorteil von einer Thrombozytenaggregationshemmung haben.

Abstract

The optimal medication for long-term prevention of occlusions following an infrainguinal bypass has been the subject of scientific discussion for a long time. In this article the relevant studies are discussed based on a selective literature search. The results show that the evidence is not sufficient to be able to give strong recommendations; however it seems that patients with an infrainguinal venous bypass benefit from oral anticoagulation with vitamin K antagonists despite higher rates of bleeding episodes, while patients with infrainguinal synthetic bypasses have an advantage from platelet aggregation inhibitors.

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Literatur

  1. Ariesen MJ, Tangelder MJ, Lawson JA et al (2005) rsik of major hemorrhage in patients after infrainguinal venous bypass surgery: therapeutic consequences? The Dutch BOA( Bypass Oral Anticoagulants or Aspirin ) study. Eur J Vasc Endovasc Surg 30:154–159

    Article  CAS  PubMed  Google Scholar 

  2. Becquemin JP et al (1997) Effect of Ticlopindine on the long-term patency of saphenous vein bypass grafts in the legs. N Engl J Med 337:1726–1731

    Article  CAS  PubMed  Google Scholar 

  3. Bedenis R, Lathaby A, Maxwell H, Acosta S, Prins MH (2015) Antiplatelet agents for preventing thrombosis after peripheral arterial bypass surgery. Cochrane Database Syst Rev 19(2):2015

    Google Scholar 

  4. Belch JJF, Dormndy J, Caspar Writing Committee (2010) Results of the randomized, placebo-controlled clopidogrel and acetylsalicylic acid in bypass surgery for peripheral arterial disease (CASPAR) trial. J Vasc Surg 52:825–833

    Article  PubMed  Google Scholar 

  5. BOA-Study Group (2000) Efficacy of oral anticoagulants compared with aspirin after infrainguinal bypass surgery (the Dutch bypass oral anticaogulants or Asprin study): a randomised trial. Lancet 355(9201):346–351

    Article  Google Scholar 

  6. Eikelboom JW, Connolly SJ, Bosch J et al (2017) Rivaroxaban with or without aspirin in stable cardiovascular disease. N Engl J Med 377:1319–1330

    Article  CAS  PubMed  Google Scholar 

  7. Geraghty AJ, Welch K (2011) Antithrombotic agents for preventing thrombosis after infrainguinal arterial bypass surgery. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.cd000536.pub2

    PubMed  Google Scholar 

  8. Johnson WC, Willioford WO et al (2002) Benefits, morbidity and mortality associated with long term administration of oral anticoagulant therapy to patinets with peripheral arterial bypass procedures: a prospective randomized study. J Vasc Surg 35:413–421

    Article  PubMed  Google Scholar 

  9. Kretschmer G, Wenzl E, Wagner O et al (1986) Influence of anticoagulant treatment in preventing graft occlusion following saphenous vein bypass for femoropopliteal occlusive disease. Br J Surg 73:689–692

    Article  CAS  PubMed  Google Scholar 

  10. Kunlin J (1949) Le traitment de arterite obliterante par la greffe venouse. Arch Mal Coeur Vaiss 371

  11. Liang NL, Bani DT, Averginos ED, Leers SA, Makarouri MS, Chaer RA (2017) Comparative effectiveness of anticoagulation on midterm infrainguianl bypass graft patency. J Vasc Surg 66:499–505

    Article  PubMed  Google Scholar 

  12. Monaco M, Di Tommaso L, Pinna GB, Lillo S, Schiavone V, Stassano P (2012) Combination therapy with warfarin plus clopidogrel improves outcomes in femoropopliteal bypass surgery patients. J Vasc Surg 56:96–105

    Article  PubMed  Google Scholar 

  13. S3 Leitlinie Periphere Arterielle Verschlußkrankheit (PAVK). Diagnostik, Therapie und Nachsorge, AWMF 065-0003, Stand 2015. Home der DGG, Leitlinie „Medikamentöse Therapie“ Stand 2016

  14. S2 Leitlinie der Deutschen Gesellschaft für Gefäßchirurgie, Homepage der DGG, Leitlinie „Medikamentöse Therapie“ Stand 2008

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Authors and Affiliations

  1. Klinik für Viszeral- und Gefäßchirurgie, St. Rochus-Krankenhaus, Glückaufstr. 10, 44575, Castrop-Rauxel, Deutschland

    H. Böhner

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  1. H. Böhner
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Correspondence to H. Böhner.

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H. Böhner gibt an, dass kein Interessenkonflikt besteht.

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

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Böhner, H. Marcumar-Therapie bei infrainguinalen Venenbypässen: Pro. Gefässchirurgie 23, 69–72 (2018). https://doi.org/10.1007/s00772-018-0356-1

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  • DOI: https://doi.org/10.1007/s00772-018-0356-1

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