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Femoropoplitealer Gefäßabschnitt

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Operative und interventionelle Gefäßmedizin

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Zusammenfassung

Verschlussprozesse der Arteria femoralis superficialis (AFS) und der Arteria poplitea (AP) werden häufig zusammengefasst, obwohl bei der AP indikatorische und therapeutische Besonderheiten bestehen. Die AFS ist ein 4– 6 mm durchmessendes, im Wesentlichen gerade verlaufendes reines Leitungsgefäß mit einer Länge zwischen 25 und 35 cm. Das Gefäß entspringt im Bereich der Profundagabel und führt ohne Abgabe wesentlicher Äste bis zum femoropoplitealen Übergang distal des Adduktorenkanals (► Kap. 2, ◘ Abb. 2.22). Das Anschlussgefäß, die AP, geht weiter distal in den als Trifurkation angelegten Truncus tibiofibularis und die nachfolgenden drei Unterschenkelgefäße A. tibialis anterior, A. tibialis posterior und A. fibularis über. Somit ist die AFS sowohl proximal als auch distal von Gefäßgabelungen begrenzt – eine Konstellation, die wegen der vermehrt auftretenden Flussturbulenzen mit einem erhöhten Atheroskleroserisiko einhergeht. Die proximale Bifurkation stellt zudem eine konkurrierende Flusssituation dar, in der der Blutfluss in der AFS wegen des Abflusses in die A. profunda femoris (APF) reduziert und somit das Arterioskleroserisiko weiter erhöht wird. Wie bei allen die Muskulatur versorgenden Gefäßen ist der periphere Widerstand in der AFS, zusätzlich durch die Verzweigung in die drei Unterschenkelgefäße, hoch [15]. ◘ Abb. 32.1 zeigt den Verschluss der AFS im 128-Zeilen-CT-Angiogramm.

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  1. Klinik und Poliklinik für Gefäßmedizin, Universitäres Herzzentrum GmbH, Universitätsklinikum Hamburg-Eppendorf, Hamburg

    Univ.-Prof. Dr. med. E. Sebastian Debus

  2. GefäßCentrum Hamburg (GCH), ASKLEPIOS KLINIK Harburg, Hamburg

    Prof. Dr. med. Walter Gross-Fengels

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    E. Sebastian Debus

  2. GefäßCentrum Hamburg (GCH), ASKLEPIOS KLINIK Harburg, Hamburg

    Walter Gross-Fengels

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Debus, E., Gross-Fengels, W. (2012). Femoropoplitealer Gefäßabschnitt. In: Debus, E., Gross-Fengels, W. (eds) Operative und interventionelle Gefäßmedizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-01709-4_32

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