Stenting der Arteria femoralis aus angiologischer Sicht

Zusammenfassung

Die perkutane transluminale Angioplastie ist eine gut etablierte, wirksame und sichere Behandlungsoption für Stenosen und kurzstreckige Verschlüsse im Bereich der Oberschenkelarterien. Die zusätzliche Einlage von Stents ist allerdings mit einer häufigen und relativ raschen Restenosierung durch Intimaproliferation vergesellschaftet. Aufgrund dieser Problematik ist die Stenteinlage besonderen Situationen vorbehalten, z. B. Auftreten einer PTA-induzierten Dissektion, elastisches Recoil, insbesondere bei exzentrischen Stenosen.

Bei der Platzierung in Bewegungssegmenten im Bereich der Arteria femoralis communis oder der Arteria poplitea kann es zur Desintegration des Stents kommen. Eine Stenteinlage sollte deshalb vermieden werden. Die aktuelle zurückhaltende angiologische Beurteilung des Stentings in der Arteria femoralis könnte durch effektive Maßnahmen zur Eindämmung der intimalen Hyperplasie (z. B. Brachytherapie oder Sirolimusbeschichtete Stents) revidiert werden.

Summary

The percutaneous transluminal angioplasty of stenosis and short occlusions of the femoral artery is a well established, safe and effective treatment option. The additional placement of stents during angioplasty is associated with frequent and rapid restenosis due to intimal hyperplasia.

Therefore, stent placement of the femoral artery is commonly recommended only for special circumstances, including PTA-induced dissection of the vessel wall, elastic recoil, and excentric stenosis.

Placement of stents near joints, e. g. in the common femoral artery or the popliteal artery should be avoided as it may lead to structural damage of the stents. The current angiological statement concerning stent implantation in the femoral artery may be revised if effective measures to inhibit intimal hyperplasia such as brachy therapy or sirolimus coated stents become available.

Schlüsselwörter

Arteria femoralis - Stents

Keywords

Arteria femoralis - Stents

• Literatur

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