Aktuelle Therapieoptionen der Varikose der unteren Extremität

Die Varikosis der unteren Extremität stellt eine häufige Erkrankung dar, die zu Ödemen, trophischen Störungen und Ulzerationen der Haut führen kann. In den letzten 15 Jahren haben sich neben dem klassischen operativen Verfahren der Krossektomie mit Stripping der Stammvene zunehmend minimalinvasive endoluminale Behandlungsverfahren etabliert, sodass dem modernen Phlebologen nun ein bunter Strauß an Prozeduren zur Verfügung steht. Es gilt, daraus für jeden Patienten die individuell optimale Behandlungsoption zu wählen.

Modern Treatment Procedures of Varicosis of the Leg

The varicosis of the leg is one of the most frequent diseases of western countries causing oedema, trophic disturbances and ulcer of the skin. Patients’ quality of life is significantly reduced. Conservative treatment options e. g. compression, special medication and physical measures are still effective, but are only resolutely and sufficiently used in the minority of patients. The standard operative treatment is the crossectomy and stripping technique. In recent years competing minimal-invasive operative techniques have been developed that offer comparable long-term results with less invasiveness. Basically, these procedures are the radiofrequency ablation, the endovenous laser ablation and the sclerotherapy. Therefore, nowadays it is necessary to choose the optimal treatment procedure for every individual patient.

Kernaussagen

• In den vergangenen 15 Jahren haben sich verschiedene endoluminale Techniken in der Behandlung der Varikosis der unteren Extremität entwickelt und etabliert. Hierzu zählen im Wesentlichen

  • die Radiofrequenzobliteration (RFO),

  • die endovenöse Lasertherapie (EVLT) und

  • die Schaumsklerosierung.

• Diese Techniken können zu Langezeitergebnissen führen, die denen des konventionellen Strippings mit Krossektomie vergleichbar sind.

• Sie bringen den Vorteil der meist besseren Kosmetik und schnelleren Rekonvaleszenz, sind aber kostenintensiv und werden nicht von allen Krankenkassen übernommen.

• Die Behandlung der Beinvenenvarikosis sollte aufgrund der dargestellten Vielzahl moderner Verfahren in spezialisierten Zentren erfolgen, in denen die dargestellten Techniken beherrscht werden.

Schlüsselwörter

Varikose - untere Extremität - Gefäßchirurgie - Venerologie - Phlebologie - Varize - Krampfader

Keywords

varicosis of the leg - crossectomy and stripping - radiofrequency and endovenous laser ablation - sclerotherapy

^* Birgit Kahle und Andreas Bayer haben den Beitrag zu gleichen Teilen verfasst.

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