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Dtsch Med Wochenschr 2019; 144(10): 683-689
DOI: 10.1055/a-0826-2868
Review
© Georg Thieme Verlag KG Stuttgart · New York

Antithrombotische Therapie der peripheren arteriellen Verschlusskrankheit – ein Überblick über aktuelle Evidenz, Praxis und Ausblick

Anti-Thrombotic Therapy of Peripheral Arterial Disease – A Review of Current Evidence, Practice and Outlook
Rupert Bauersachs
1   Klinikum Darmstadt
,
Christine Espinola-Klein
2   Universitätsmedizin Mainz
,
Holger Lawall
3   Gemeinschaftspraxis Lawall/Diehm Ettlingen
,
Martin Storck
4   Städt. Klinikum Karlsruhe
,
Thomas Zeller
5   Universitäts-Herzzentrum Bad Krozingen
,
Sebastian Debus
6   Universitätsklinikum Hamburg
› Author Affiliations
Further Information

Publication History

Publication Date:
13 May 2019 (online)

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Updated by:

Antithrombotische Therapie der peripheren arteriellen VerschlusskrankheitGeriatrie up2date 2021; 3(03): 195-205
DOI: 10.1055/a-1483-3356

Zusammenfassung

Die periphere arterielle Verschlusskrankheit ist eine häufige, chronische Störung der arteriellen Durchblutung v. a. der unteren Extremitäten, wobei fibröse Plaques der Gefäßwand zu Stenosen und Thrombenbildung führen. Bei betroffenen Patienten besteht ein hohes Risiko für kardiovaskuläre Komplikationen im gesamten arteriellen Gefäßsystem, auch nach dortigen Eingriffen. Daher besteht Optimierungsbedarf bei der antithrombotischen Therapie. Zur Mehrfach-Thrombozytenaggregationshemmung durch neue Arzneimittelklassen werden in den nächsten Jahren Studiendaten erwartet. Aktuelle Studien zeigten bei Hemmung der Gerinnungskaskade durch direkte orale Antikoagulanzien klinische Vorteile bei vertretbarem Sicherheitsprofil. Grundlage medikamentöser Therapie bleibt das Management von Risikofaktoren wie Übergewicht und Nikotin sowie die Korrektur metabolischer Störungen. Diese Aspekte sollten den behandelnden Ärzten bekannt sein, um eine optimale Versorgung und Motivation der Patienten zu erreichen.

Abstract

Peripheral arterial occlusive disease is a frequent and chronic vascular disorder mostly affecting the lower limbs and caused by fibrous plaques in arteries that can result in stenoses and thrombi. Patients suffering from this condition show a high risk for cardiovascular complications of the complete arterial vascular system, especially post-procedural. Thus, there is a need to optimize anti-thrombotic therapy. Data on multiple antiplatelet aggregation therapy including new drug classes are expected in the coming years. In addition, recent studies showed that direct oral anticoagulation provided clinical advantages combined with a reasonable safety profile. Management of risk factors such as overweight and nicotine and correction of metabolic disorders are not to be ignored and the background to further therapy. All treating physicians should be aware of these aspects to guarantee an optimal care and motivation of their patients.

Schlüsselwörter

PAVK - Atherosklerose - Risikomanagement - Thrombozytenaggregationshemmer - Antikoagulanzien

Key words

PAD - arteriosclerosis - risk management - antiplatelet therapy - anticoagulation
 

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