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Innere Medizin up2date 2014; 2(03): 179-191
DOI: 10.1055/s-0034-1387248
Herz, Kreislauf und Gefäße
© Georg Thieme Verlag KG Stuttgart · New York

Diagnostik und Therapie der peripheren arteriellen Verschlusskrankheit (PAVK)

Holger Lawall
,
Claas Luedemann
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Publication History

Publication Date:
18 September 2014 (online)

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See also:

Diagnostik und Therapie der peripheren arteriellen Verschlusskrankheit (PAVK)Diabetologie und Stoffwechsel 2011; 6(06): 71-82
DOI: 10.1055/s-0031-1283836

Fazit für die Praxis

Die PAVK ist häufig und steigt mit höherem Lebensalter an. Sie ist die Markererkrankung für erhöhte kardiovaskuläre Morbidität und Mortalität. Sie ist oft unterbehandelt. Die Behandlung richtet sich nach dem klinischen Stadium. Die Basisbehandlung umfasst die Gabe von Thrombozytenfunktionshemmern und Statinen sowie strukturiertes Gefäßtraining. Vasoaktive Substanzen kommen dann gezielt zum Einsatz, wenn die Lebensqualität erheblich eingeschränkt ist und Gefäßtraining nicht oder nur eingeschränkt durchgeführt werden kann. Oberstes Gebot im Stadium der kritischen Extremitätenischämie ist die rasche arterielle Revaskularisation. Dabei sind endovaskuläre und gefäßchirurgische Verfahren keine Konkurrenten, sondern ergänzen sich je nach Indikation. Diese sollte interdisziplinär in Gefäßzentren unter Berücksichtigung des Nutzen- Risiko-Profils und der Verfügbarkeit getroffen werden. Bei geeigneter Indikation ist die endovaskuläre Behandlung vorzuziehen. In der Nachsorge nach Gefäßeingriffen ist die Gabe von Thrombozytenfunktionshemmern obligat.

 

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