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Gefäßprotheseninfektionen

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Operative und interventionelle Gefäßmedizin

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Zusammenfassung

Die Infektionen, insbesondere aber der Protheseninfekt, stellen in der rekonstruktiven Gefäßchirurgie eine der am meisten gefürchteten Komplikationen dar. Am häufigsten ist die Leistenregion von einer solchen Infektion betroffen. Da alloplastische Implantate normalerweise keine Infektresistenz aufweisen, sind Infektionen in diesem Fall als weitaus bedenklicher einzustufen als bei Verwendung von autologen Venentransplantaten. Die Diagnostik erfolgt primär klinisch unterstützt durch bildmorphologische Korrelate und mikrobiologische Untersuchungen. Der Erregernachweis ist dabei erschwert, häufig finden sich nur unzureichende Ergebnisse. Therapeutisch sollte eine Komplettentfernung der infizierten Gefäßprothesen stets angetrebt werden. In Situ Rekonstruktionen mit autologen und allogenen Transplantaten sind zu bevorzugen. Silberbeschichtete und antibiotikagetränkte Kunststoffprothesen bieten Alternativen mit eingeschränktem Outcome. Die Rekonstruktion mit extraantomischen Bypässen ist ausgewählten Indikationen vorgehalten. Eine Antibiotikatherapie ist für mindestens 4 Wochen bis 6 Monate nach erfolgreicher Operation fortzuführen.

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Authors and Affiliations

  1. Klinik und Poliklinik für Gefäßmedizin, Universitäres Herz- und Gefäßzentrum GmbH, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    Holger Diener, Eike Sebastian Debus & Axel Larena-Avellaneda

  2. Universitätsklinik für Krankenhaushygiene und Infektionskontrolle, Medizinische Universität Wien, Wien, Österreich

    Ojan Assadian

  3. Klinik für Thorax- und Gefäßchirurgie, Krankenhaus Nordwest, Frankfurt am Main, Deutschland

    Max Zegelman

  4. Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Deutschland

    Markus Steinbauer

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  1. Holger Diener
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  3. Max Zegelman
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  4. Markus Steinbauer
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  5. Eike Sebastian Debus
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  6. Axel Larena-Avellaneda
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Correspondence to Holger Diener .

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  1. Klinik und Poliklinik für Gefäßmedizin Gefäßchirurgie – Angiologie – endovaskuläre Therapie, Universitätsklinikum Hamburg-Eppendorf Universitäres Herz- und Gefäßzentrum, Hamburg, Germany

    Eike Sebastian Debus

  2. Abteilung für Diagnostische und Interventionelle Radiologie, Asklepios Klinikum Harburg, Hamburg, Germany

    Walter Gross-Fengels

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Diener, H., Assadian, O., Zegelman, M., Steinbauer, M., Debus, E.S., Larena-Avellaneda, A. (2020). Gefäßprotheseninfektionen. In: Debus, E., Gross-Fengels, W. (eds) Operative und interventionelle Gefäßmedizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53380-2_114

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