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Akute Gefäßverschlüsse — interdisziplinäres Therapiespektrum

  • Conference paper
Qualitätssicherung durch Zusammenarbeit in der Chirurgie

Part of the book series: Langenbecks Archiv für Chirurgie ((KONGRESSBAND,volume 1995))

  • 35 Accesses

Summary

In order to improve the therapeutic results of the ischemic syndrome of the lower limb, we carried out a retrospective follow-up of 344 patients. Acute arterial occlusion was due to an embolic event in 46.4% and to acute thrombosis in 32.7%; in 20.9% the cause could not be defined. In 29% of the embolic and in 41% of the thrombotic occlusions, efficient therapy was started more than 12 h after the acute onset of symptoms. In 67% an indirect transfemoral thrombembolectomy was performed. This result could be further improved by using modern therapeutic methods (thrombolytic treatment, combined medical and surgical treatment).

Zusammenfassung

Unter dem speziellen Gesichtspunkt der Verbesserung der Behandlungsergebnisse des akuten Ischämie-Syndroms der unteren Extremitäten erfolgte eine retrospektive Analyse von 344 Patienten. Eine arterielle Embolie lag in 46,4%, eine akute Thrombose in 32,7%, den akuten Verschlüssen zugrunde. In 20,9% war eine eindeutige Zuordnung der Verschlußursache nicht möglich. Das Zeitintervall zwischen Symptom und Beginn der Therapie betrug bei den Embolien in 29% und bei den Thrombosen in 41% mehr als zwölf Stunden. In 67% wurde eine transfemorale indirekte Thrombembolektomie durchgeführt. Durch den Einsatz neuerer risikoarmer Behandlungsmethoden (Aspirationsembolektomie, Lyse und PTA etc.) läßt sich das Ergebnis weiter verbessern.

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Literatur

  1. Berguer R, Feldmann Al (1982) Infected Groin Aneurysms from Heroin Addiction. In: Bergan JJ, Yao JST (Eds) Aneurysms Diagnosis and Treatment Grune & Stratton

    Google Scholar 

  2. Patel KR, Semel L, Clauss RH (1988) Routine revascularization with resection of infected femoral pseudoaneurysms from substance abuse. Journal of Vascular Surgery, Volume 8, No 3: 321–328

    PubMed  CAS  Google Scholar 

  3. Reddy DJ, Smith RF, Elliot JP, Haddad GK, Wanek EA (1986) Infected femoral artery false aneurysms in drug addicts: Evolution of selective vascular reconstruction. Journal of Vascular Surgery, Volume 3, No 5: 718–724

    PubMed  CAS  Google Scholar 

  4. Zühlke HV, Harnoss B-M, Lorenz EPM (1994) Septische Gefäßchirurgie, Blackwell Wissenschaftsverlag, 128–129

    Google Scholar 

  5. Amiral J, Bridey F, Dreyfuss M, Vissac AM, Fressinaud E, Wolf M, Meyer D (1992) Platelet Factor 4 complexed to heparin is the target for antibodies generated in heparin-induced thrombocytopenia. Thromb Haemost 68: 95–96

    PubMed  CAS  Google Scholar 

  6. Arzneimittelkommission der deutschen Ärzteschaft (1994) Unerwünschte Arzneimittelwirkungen durch fraktionierte and unfraktionierte Heparine. Dt Ärzteblatt 24: B1293 — B1294

    Google Scholar 

  7. Collins R, Scrimgeour A, Yusuf S, Peto R (1988) Reduction in fatal pulmonary embolism and venous thrombosis by perioperative administration of subcutaneous heparin. N Engl J Med 318: 1162–1173

    Article  PubMed  CAS  Google Scholar 

  8. Greinacher A, Mueller-Eckhardt C (1991) Diagnostik der Heparin-assoziierten Thrombozytopenie. DMW 116: 1479–1482

    Article  CAS  Google Scholar 

  9. Greinacher A, Pötzsch B, Amiral J, Dummel V, Eichner A, Mueller-Eckhardt C (1994) Heparin-associated thrombocytopenia: isolation of the antibody and characterization of a multimolecular PF4-heparin complex as the major antigen. Thromb Haemost 71: 247–251

    PubMed  CAS  Google Scholar 

  10. Greinacher A, Liebenhoff U, Kiefel V, Presek P, Mueller-Eckhardt C (1994) Heparin-associated thrombocytopenia. The effects of various intravenous IgG preparations on antibody mediated platelet activation — a possible new indication for high dose i.v. IgG. Thromb Haemost 71: 641–645

    PubMed  CAS  Google Scholar 

  11. Koster T, Rosendaal FR, de Ronde H, Briet E, Vandenbroucke JP, Bertina RM (1993) Venous thrombosis due to poor anticoagulant response to activated protein C: Leiden Thrombophilia Study. Lancet 342: 1500–1506

    Article  Google Scholar 

  12. Laster J, Cikrit D, Walker N, Silver D (1987) The heparin-induced thrombocytopenia syndrome: An update. Surgery 102: 763–770

    PubMed  CAS  Google Scholar 

  13. Leyvraz P, Bachmann F, Bohnet J, Breyer HG, Estoppey D, Haas S, Hochreiter J, Jabujek H, Mair J, Sorensen R (1992) Thromboembolic prophylaxis in total hip replacement: a comparison between the low molecular weight heparinoid Lomoparan and heparin-dihydroergotamine. Br J Surg 79: 911–914

    Article  PubMed  CAS  Google Scholar 

  14. Matsuo T, Kario K, Chikahira Y, Nakao K, Yamada T (1992) Treatment of heparin-induced thrombocytopenia by use of argotroban, a synthetic thrombin inhibitor. Br J Haematol 82: 627–629

    Article  PubMed  CAS  Google Scholar 

  15. Streicher H-J, Kußmann J, Koppenhagen K, Häring R, Theiss W, Adolf J, Haas S, Reilmann H, Tscherne H, Siewert JR (1988) Thromboembolie-Prophylaxe in der Chirurgie — heute obligat? Langenbecks Arch Chir 373: 136–140

    Article  PubMed  CAS  Google Scholar 

  16. Warkentin TE, Hayward CPM, Boshkov LK, Santos AV, Sheppard JAI, Bode AP, Kelton JG (1994) Sera from patients with heparin-induced thrombocytopenia generate platelet-derived microparticles with procoagulant activity: an explanation for the thrombotic complications of heparin-induced thrombocytopenia. Blood 84:3691 —3699

    Google Scholar 

  17. Warkentin TE, Levine MN, Hirsh J, Horsewood P, Roberts RS, Gent M, Kelton JG (1994) A prospective study of heparin-induced thrombocytopenia: unfractionated heparin compared with low-molecular-weight heparin. Blood 84: 188a

    Google Scholar 

  18. Allenberg JR, Lehnert T (1993) Die asymptomatische Karotisstenose: Besteht eine Indikation zur Operation? Chirurg 64: 252

    PubMed  CAS  Google Scholar 

  19. Chambers BR, Norris JW (1986) Outcome in patients with asymptomatic carotid bruits. N Engl J Med 315: 860

    Article  PubMed  CAS  Google Scholar 

  20. Hohlbach G, Meffert R (1995) Nutzen-Risiko-Abwägung der operativen Behandlung asymptomatischer Karotisstenosen. Zentrbl Chir (im Druck)

    Google Scholar 

  21. Norris JW, Zhu CZ, Bornstein NM, Chambers BR (1991) Vascular risk of asymptomatic carotid stenosis. Stroke 22: 1485

    Article  PubMed  CAS  Google Scholar 

  22. Street DL, O’Brien MS, Ricotta JJ, Ekholm SE, Ouriel K, Green RM, DeWeese JA (1988) Observation on cerebral computed tomography in patients having carotid endarterectomy. J Vasc Surg 7: 798

    PubMed  CAS  Google Scholar 

  23. Winslow CM, Solomon DH, Chassin MR, Koscoff J, Merrick NJ, Brook RH (1988) The appropriateness of carotid endarterectomy. N Engl J Med 318: 721–727

    Article  PubMed  CAS  Google Scholar 

  24. Warlow C: MRC European Carotid Surgery Trial; interim results for symptomatic patients with severe (70–99%) or with mild (0–29%) carotid stenosis. The Lancet 337: 1235–1243

    Google Scholar 

  25. Taylor DW, Barnett HJM: Beneficial Effect of Carotid Endarterectomy in Symptomatic Patients with High-Grade Carotid Stenosis. New Engl J Med 325: 445–453

    Google Scholar 

  26. Hobson RW, Weiss DG, Fields WS et al.: Efficacy of Carotid Endarterectomy for Asymptomatic Carotid Stenosis. New Engl J Med 328: 221–227

    Google Scholar 

  27. Cragg AH, DeJong S, Barnhart W, Landers SK, Smith TP (1993) Nitinol intravascular stent: results of preclinical evaluation. Radiology 189: 775–778

    PubMed  CAS  Google Scholar 

  28. Steckmeier B, Küffer G, Schmölder A, Huber R, Reininger C, Spengel FA (1991) Adjuvante Angioplastie bei simultaner gefäßchirurgischer Rekonstruktion. Angio 13: 77–88

    Google Scholar 

  29. Allenberg J-R, Maeder N, Meybier H (1989) Chronisch arterielle Verschlußkrankheit im FemoralisPoplitea-Bereich. Chirurg 60: 322–329

    PubMed  CAS  Google Scholar 

  30. Currie JC, Wakeley CJ, Cole SEA (1994) Femoropopliteal angioplasty for severe limb ischaemia. BrJSurg81: 191–193

    Google Scholar 

  31. Lorentzen JE, Nielsen OM, Roder OC, Schroeder TV (1993) A prospective study of 698 femoro-infrapopliteal in-situ vein and PTFE bypass procedures. VASA Supplement 42: 30–32

    Google Scholar 

  32. Roth F-J, Behrmann C, Grün B, Rieser R, Roth SP, Scheffler A (1992) Fortschritte arterieller Rekonstruktion an Ober-und Unterschenkel — Perkutane transluminale Verfahren. Langenbecks Arch Chir Suppl (Kongreßbericht): 452–458

    Google Scholar 

  33. Stein U, Reichardt M, Wagner E (1994) Prognostische Kriterien für die initiale Erfolgsrate bei PTA und Katheterthrombolyse. VASA 23: 10–14

    PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Gefäßchirurgische Abteilung, Kreiskrankenhaus Erding, Bajuwarenstraße 5, 85435, Deutschland

    J. Dörrler & G. Seip

  2. Luzern, Schweiz

    J. Largiader

  3. Erlangen, Deutschland

    H. Schweiger

  4. Nürnberg, Deutschland

    D. Raithel, P. Breuer & A. Schröder

  5. Abteilung für Allgemein-, Gefäß- und Thoraxchirurgie, Allgemeines Krankenhaus Harburg, Eißendorfer Pferdeweg 52, 21075, Hamburg, Deutschland

    P. Breuer, A. Schröder, L. Scherlitzky, U. Budde & H. Imig

  6. Gefäßchirurgische Klinik, Kreiskrankenhaus Altenburg, Leipziger Straße 5, 04600, Altenburg, Deutschland

    K. Brachmann, D. Bettac, D. Falkenhahn, R. Junghans, R. Schmitz & J. Lorenz

  7. Chirurgische Universitätsklinik, Marienhospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland

    R. Horstmann, R. Meffert, P. Heistermann & G. Hohlbach

  8. Chirurgische Abteilung, Marienhospital Altenessen, 45329, Essen, Deutschland

    G. Omlor, P. Walter, A. Meyer & G. Feifel

  9. Abteilung für Neurologie, Uniklinken des Saarlandes, 66421, Homburg, Deutschland

    M. Müller & K. Schimrigk

  10. Krankenhaus im Friedrichshain, Landsberger Allee 49, 10249, Berlin, Deutschland

    F. Stimmel, J. H. A. Müller, N. Gruner & L. Metz

  11. Chirurgische Klinik und Poliklinik, LMU München, Klinikum Innenstadt, Nußbaumstraße 20, 80336, München, Deutschland

    B. Steckmeier, A. Parzhuber, C. Reininger & L. Schweiberer

  12. Institut für Radiologische Diagnostik, Pettenkoferstraße 8 a, 80336, München, Deutschland

    G. Küffer & U. Szeimies

  13. Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Universität Mainz, Langenbeckstraße 1, 55101, Mainz, Deutschland

    D. Kirsch, T. Boettger & T. Junginger

Authors
  1. J. Dörrler
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  2. G. Seip
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  3. J. Largiader
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  4. H. Schweiger
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  5. D. Raithel
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  6. P. Breuer
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  7. A. Schröder
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  9. U. Budde
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  10. H. Imig
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  11. K. Brachmann
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  12. D. Bettac
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  13. D. Falkenhahn
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  14. R. Junghans
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  15. R. Schmitz
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  16. J. Lorenz
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  17. R. Horstmann
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  18. R. Meffert
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  19. P. Heistermann
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  20. G. Hohlbach
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  21. G. Omlor
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  22. M. Müller
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  23. P. Walter
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  24. A. Meyer
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  25. K. Schimrigk
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  26. G. Feifel
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  27. F. Stimmel
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  28. J. H. A. Müller
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  29. N. Gruner
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  30. L. Metz
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  31. B. Steckmeier
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  32. G. Küffer
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  33. U. Szeimies
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  34. A. Parzhuber
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  35. C. Reininger
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  36. L. Schweiberer
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  37. D. Kirsch
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  38. T. Boettger
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  39. T. Junginger
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Editor information

Editors and Affiliations

  1. Steinhölzle 16, D-89197, Westerstetten-Vorderdenkental, Deutschland

    W. Hartel

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© 1995 Springer-Verlag Berlin Heidelberg

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Dörrler, J. et al. (1995). Akute Gefäßverschlüsse — interdisziplinäres Therapiespektrum. In: Hartel, W. (eds) Qualitätssicherung durch Zusammenarbeit in der Chirurgie. Langenbecks Archiv für Chirurgie, vol 1995. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-85235-0_39

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  • DOI: https://doi.org/10.1007/978-3-642-85235-0_39

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-60425-9

  • Online ISBN: 978-3-642-85235-0

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