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Der Klinikarzt 2019; 48(05): 186-191
DOI: 10.1055/a-0899-3849
Schwerpunkt
© Georg Thieme Verlag Stuttgart · New York

Interventionelle Therapie von Becken/Bein-pAVK

Vielversprechende Ansätze durch neue Verfahren
Erwin Blessing
1   SRH Klinikum Karlsbad-Langensteinbach, Karlsbad-Langensteinbach
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Publication History

Publication Date:
21 May 2019 (online)

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ZUSAMMENFASSUNG

Die pAVK stellt eine der häufigsten Erkrankungen vor allem in westlichen Industrienationen dar. In den letzten Jahren hat sich der Trend von der offenen chirurgischen zur endovaskulären Revaskularisation weiter fortgesetzt. Aufgrund der hohen Erfolgs- und geringen Komplikationsrate stellen Interventionen in den überwiegenden Fällen die Methode der Wahl dar. Eine Hauptlimitation ist das Auftreten von Restenosen nach Interventionen. Ein deutlicher Fortschritt konnte hierbei durch den Einsatz medikamentenbeschichteter Ballons und Stents erzielt werden. Dadurch konnte vor allem im Bereich der Oberschenkelgefäße die Notwendigkeit für erneute Eingriffe deutlich reduziert werden. Eine aktuelle Metaanalyse ergab allerdings Hinweise auf eine etwaige erhöhte Mortalität nach Verwendung dieser Paclitaxel-beschichteten Ballons und Stents, sodass es die weitere Entwicklung abzuwarten gilt. Zahlreiche neue Verfahren fokussieren sich aktuell auf eine sogenannte Läsionspräparation. Hierbei wird das verengte Gefäß entweder mittels spezieller Ballons behandelt bzw. die Plaque entfernt. Ob sich dadurch tatsächlich eine höhere Offenheitsraten erzielen lässt, muss allerdings noch durch entsprechende Studien bestätigt werden.

 

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