Zusammenfassung
Die Varikose ist eine lebenslange, jedoch keine lebensentscheidende Erkrankung, gleichwohl ist sie gekennzeichnet durch die drohende Entwicklung einer Vielzahl an z. T. eingreifenden und belastenden Möglichkeiten von Komplikationen, von der oberflächlichen Venenthrombose und dem Bezug zur TVT sowie verschieden Formen der Phlebitis auf der einen Seite und den Begleitumständen der anhaltenden chronisch venösen Insuffizienz mit peripheren Ödemen und sekundären Umbauvorgängen in den abhängigen Gewebepartien bis hin zum Ulcus cruris auf der anderen Seite.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Literatur
Abdel-Naby DN, Duran WN, Lal BK, Padberg FT, Pappas P (2017) Pathogenesis of varicose veins and cellular pathophysiology of chronic venous insuffiziency. In: Gloviczki P (Hrsg) Handbook of venous and lymphatic disorders, 4. Aufl. CRC Press; Boca Raton, London, New York
Alikhan R, Cohen AT, Combe S (2004) Risk factors for venous thromboembolism in hospitalized patients with acute medical illness: analysis of the MEDENOX – Study. Arch Intern Med 164:963–968
Ampazoni G, Preiss U, Hatch GM, Zech WD, Bolliger S, Thali MJ, Ruder TD (2011) Leg Med 13:87–90
Aquila I, Sacco MA, Gratteri S, Di Nunzio C, Ricci P (2017) Sudden death by rupture of a varicose vein: Case report and review of literature. Med Leg J 85:47–50
Ascher E, Hingorani A (2001) Superficial thrombophlebitis; Handbook of venous disorders, 2. Aufl., Bd 17, S 179–182
Augustin M, Montero EC, Zander N, Baade K, Herberger K, Debus S, Diener H, Neubert T, Blome C (2017) Validity and feasibility of the wound QoL questionaire on health-related quality of life in chronic wounds. Wound Rep Reg 25:852–857
Baker CC, Peterso SR, Sheldon GF (1979) Septic phlebitis a neglected disease. Am J Surg 138:97–103
Becker M, Schilling T, von Beckerath O, Kröger K (2015) Sonography of subcutaneous tissue cannot determine causes of lower limb edema. Vasa 44:122–128
Beidler SK, Gouillet CD, Berndt DF, Keagy BA, Rich PB, Marston WA (2009) Inflammatory cytokine level in chronic venous insufficiency ulcer tissue before and after compression therapy. J Vasc Surg 49:1013–1020
Belcaro G, Nicolaides AN, Errichi EM et al (1999) Acute superficial venous thrombophlebitis: does emergency surgery have a role? Int Angiol 21:93–95
Beyer-Westendorf J, Schellong SM, Gerlach, Rabe HE, Weitz JI, Jersemann K, Sahin K, Bauersachs R (2017) Prevention of thromboembolic complications in patients with superficial-vein thrombosis given rivaroxaban or fondaparinux: the open-label, randomised, non-inferiority SURPRISE phase 3b trial Lancet. Hematology 4(3):e105–e113
Blome C, Baade K, Debus S, Price P, Augustin M (2014) The „Wound-QoL“: A short questionaire measuring quality of life in patients with chronic wounds based on three established disease-specific instruments. Wound Rep Reg 22:504–514
Blumenberg RM, Barton E, Gelfand ML, Skudder P, Brennan J (1998) Occult deep vein thrombosis complicating superficial thrombophlebitis. J Vasc Surg 27:338–343
Bounameaux H, Reber-Wasem MA (1997) Superficial thrombophlebitis and deep vein thrombosis. A controversial association. Arch Intern Med 157:1822–1843
Caggiati A, Lattimer C, Kalodiki E, Oberto S, Bergamo G, Kontothanassis D (2018) Underwater compression group. Underwater sonography of leg veins. EJVES Short Rep 41:13–15
Carradice D, Mazari FAK, Samuel N, Allgar V, Hatfield J, Chetter IC (2011) Modelling the effect of venous disease on quality of life. Br J Surg 98:1089–1098
Colderidge Smith PD (2017) Drug treatment of varikose veins, venous edema, and ulcers. In: Gloviczki P (Hrsg) Handbook of venous and lymphatic disorders, 4. Aufl. CRC Press; Boca Raton, London, New York
Coleridge Smith PD, Thomas P, Scurr JH, Dormandy JA (1988) Causes of venous ulceration. A new hypothesis. Br Med J 296:1726–1727
Le Coz CJ, Scrivener Y, Santinelli F, Heid E (1998) Contact sensitization in leg ulcers. Ann Dermatol Venerol 125:694–699
Cullum N, Nelson EA, Fletscher AW, Sheldon TA (2004) Compression for venous leg ulcers. Cochrane Database Syst Rev (2):CD000265
Decousus H et al (2010) Fondaparinux for the treatment of superficial-vein thrombosis in legs. NEJM 363:1222–1232
Decousus H, Epinat M, Guillot K, Quenet S, Boissier C, Tardy B (2003) Superficial vein thrombosis:risk factors, diagnosis, and treatment. Curr Opin Pulm Med 5:393–397
Decousus H, Leizorovicz A (2005) Superficial thrombophlebitis of the legs: still a lot to learn. J Thromb Haemost 3:1149–1151
Denzel C, Lang W (2000) Die Diagnostik und Therapie der progressiven Thrombophlebitis epifaszialer Beinvenen. Zbl Chir 126:374–378
Deutsche Gesellschaft für Wundheilung und Wundbehandlung e. V., DGfW (2012) S3-Leitlinie Lokaltherapie chronischer Wunden bei Patienten mit den Risiken periphere arterielle Verschlusskrankheit, Diabetes mellitus, chronische venöse Insuffizienz. http://www.awmf-online.de/
Di Nisio M et al (2013). Treatment for superficial thrombophlebitis of the leg. Cochrane Database Syst Rev 2013; 30; 4: CD004982
Di Minno G, Mannucci PM, Tufano A, Palareti G, Moia M, Baccaglini U, Rudelli G, Giuducu CA on behalf of the FAST Study Group (2005) The first ambulatory screening on thromboembolism: a multicentre, cross-sectional, observational study on risk factors for venous thromboembolism. J Thromb Haemost 3:1459–1466
Diehm C (2014) Phlebitis migrans sive saltans. In: Nüllen H, Noppeney T, Diehm C (Hrsg) VTE – Venöse Thromboembilie. Springer, Heidelberg
Dissemond J (2017) Differntialdiagnose des chronischen Ulcus cruris. Gefässchirurgie 22:505–514
Dissemond J, Körber A, Grabbe S (2006) Differential diagnosis of leg ulcers. JDDG 4:627–634
Du Toid DF, Knott-Craig C, Laker L (1985) Bleeding from varicose vein – still potentially fatal. A case report. S Afr Med JU 23:303
Encke A, Haas S, Krauspe R, Riess H (2003) Stationäre und ambulante Thromboembolieprophylaxe in der Chirurgie und präoperativen Medizin. Interdisziplinäre Leitlinie. Phlebologie 32:164–169
Evans CJ, Fowkes FGR, Ruckley CV, Lee AJ (1999) Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study. J Epidem Comm Health 53:149–153
Finlayson K, Edwards H, Courtney M (2010) The impact of psychosozial factors on adherence to compression therapy to prevent recurrence of venous leg ulcers. J Clinic Nursing 19:1289–1297
Gamble JL (1960) Chemical anatomy, physiology and pathology of the extracellular fluid. Havard University Press, Cambridge
Geerts WH, Berquist D, Pineo GF, Heit JA, Samama CM, Lassen MR, Colwell CW (2008) Prevention of venous thromboembolism. 8th ACCP guidelines. Chest 133:381S-453S
Gelfand JM, Hoffstad O, Margolis DJ (2002) Surrugate endpoints of treatment of venous leg ulcers. J Invest Dermatol 119:1420–1425
Gethin G, Cowman S, Kolbach DN (2015) Debridement for venous leg ulcers. Cochrane Database Sys Rev issue 9, Art.N0:CD008599. DOI: https://doi.org/10.1002/14651858.CD0085599,pub2
Gilbert JD, Byard RW (2017) Ruptured varicose veins and fatal hemorrhage. Forensic Sci Med Pathol. https://doi.org/10.1007/s12024-017-9897-y
Gohel MS, Heatley F, Liu X, Bradbury A et al (2018) A randomized trial of early endovenous ablation in venous ulceration. N Engl J Med 378:2105–2114
Grotewohl JH (1996) Der phlebologische Notfall. Notfallmedizin 22:444–449
Gräni N, Buset C, Dziunycz P, Frauchinger AL, Kaufmann F et al (2014) Wundschmerz. Phlebologie 43:317–320
Haas S (2003) Venous thromboembolism in medical patients- the scope of the problem. Sem Thromb Hemostasis 29:17–21
Haas S (2005) Modelle zur Risikoabschätzung. In: Hass S (Hrsg) Prävention von Thrombosen und Embolien in der Inneren Medizin. Springer, Berlin
Haas S (2006) Venöse Thromboembolien in der Inneren Medizin. In: Haas S (Hrsg) Niedermolekulare Heparine. Springer, Berlin
Hach-Wunderle V, Kopp I, Gerlach H, Konstantinides S, Noppeney T, Riess H, Schellong S, Wildberger J (2016) Diagnostik und Therapie der Venenthrombose und Lungenembolie. Vasa 45 90:6–48
Hach and Hach-Wunderle, , 2013. Hach W, Mumme A, Hach-Wunderle V (2013) VenenChirurgie, 3. Aufl. Schattauer, Stuttgart
Hamahata A, Yamaki T, Osada A, Fujisawa D, Sakurai H (2011) Schaumsklerotherapie bei blutenden varikösen. Venen vasomed 23:199–200
Herpetz U (1999a) Ödeme – Pathogenese, Differentialdiagnose und Therapie (Teil 1). Vasomed 11:208–215
Herpetz U (1999b) Ödeme – Pathogenese, Differentialdiagnose und Therapie (Teil 2). Vasomed 11:254–260
Herpetz U (2001) Die häufigsten Beinödeme. Phlebologie 30:48–52
Heyer K, Protz K, Glaeske G, Augustin M (2016) Epidemiology and the use of compression treatment in venous leg ulcers: nationwide claims data analysis in Germany. Int Wound J 14:228–343
Heyer K, Augustin M (2014) Barmer GEK Heil- und Hilfsmittelreport 2014. http://presse.barmergek.de/barmer/web/Portale/Presseportal/Subportal/Presseinformationen/Archiv/2014/140916-Heil-und-Hilfsmittelreport/PDF-Heil-und-Hilfsmittelreport-2014,property=Data.pdf
Heyer K (2016) Versorgungsepidemiologie des Ulcus cruris in Deutschland. Erkrankungshäufigkeit, Versorgungsqualität und Prädiktoren der Wundheilung. Springer, Wiesbaden
Hill J, Treasure T (2007) Reducing the risk of venous thromboembolism in patients having surgery: summery of NICE guidance. BMJ 334:1053–1054
Hopman WM, Buchanan M, VanDenKerhof EG, Harrison MB (2013) Pain and health-related quality of life in people with chronic leg ulcers. Chronic Dis Injuries Can 33:167–174
Huerta C, Johansson S, Wallander MA, Garcia Rodriguez LA (2007) Risk factors and short-term mortality of venous thromboembolism diagnosed in the primary care setting in the United Kingdom. Arch Intern Med 167:935–943
Jacobs B, Coleman DM (2017) Superficial thrombophlebitis. In: Gloviczki P (Hrsg) Handbook of venous and lymphatic diaorders, 4. Aufl. CRC Press
Knighton (1990) Amputation prevention in an independently reviewed at-risk diabetic population using a comprehensive wound care protocol. Am J Surg 160 466 471
Komai H, Kawago M, Juri M (2006) Massive spouting bleeding from chronic stasis ulceration caused by arteriovenous communication of trhe lower extremity. J Vasc Surg 44:658–659
Kroeger K (2007) Risikofaktoren für eine venöse Thromboembolie. DÄ 107:2544–2550
Kurz X, Lamping LD, Kahn SR, Baccaglini U, Zuccarelli F, Spreafico G, Abenhaim L (2001) Do varicose veins affect quality of life? Results of an international population-based study. J Vasc Surg 34:641–648
Körber A, Klode J, Al-Benna S, Wax C, Schadendorf D, Steinstraesser L, Dissemond J (2011) Genese des chronischen Ulcus cruris bei 31 619 Patienten im Rahmen einer Expertenbefragung in Deutschland. J Dtsch Dermatol Ges 9(2):116–122
Labas P, Cambal M (2007) Profus bleeding in patients with chronic venous insufficiency. Int Angiol 26:64–66
Labas P, Vrtik L (1997) Management of profus bleeding from varicose veins. Int Angiol 16(1):81
Leon L, Giannoukas AD, Dodd D, Chan P, Labropoulos N (2005) Clinical significance of superficial vein thrombosis. Eur J Vasc Endovasc Surg 29:10–17
Leu HJ (1999) Pathologische Morphologie und Histopathologie der Venenwand. In: Rieger H, Schoop W (Hrsg) Klinische Angiologie. Springer, Berlin
Leu HJ (1998) Pathologische Morphologie und Histopathologie der Venenwand. In: Rieger H, Schoop W (Hrsg) Klinische Angiologie. Springer, Heidelberg
Lutz L, Haas S, Hach-Wunderle V, Betzl G, Jarmatz H (2002) Venöse Thromboembolie in der Inneren Medizin: Risikoeinschätzung und medikamentöse Prophylaxe. Med Welt 53:231–234
Marchiori A, Verlato F, Sabbion P et al (2002) High versus low doses of unfractionated heparin for the treatment of superficial thrombophlebitis of the leg. A prospective, controlled, randomized study. Haematologica 87:523–527
Mondor H (1939) Tronculite sous-cutanée subaiqure de la paroi thoracique antero-laterale. Mem Acad Chir 1939, S. 1271
Nelzen O (2000) Leg ulcers: Economic aspects. Phlebology 15:110–114
Noppeney T, Noppeney J, Winkler M et al (2006) Strategien zur Antikoagulation und Operation bei akuter Thrombophlebitis. Zentralbl. Chirurgie 31:51–56
Nüllen H (1996) Ist die Krampfadererkrankung ein Risikofaktor für das Auftreten einer tiefen Beinvenenthrombose und ergibt sich daraus ggf. eine Indikation zur prophylaktischen Operation der Krampfadererkrankung? Gefäßchirurgie 1:116–118
Nüllen H, Noppeney T (2007) Ödeme. Gefäßchirurgie 12:134–138
Nüllen H (2014) Septische Thrombose. In: Nüllen H, Noppeney T, Diehm C (Hrsg) VTE – Venöse Thromboembolie. Springer, Heidelberg
Oger E, Leroyer C, Le Moigne E et al (1997) The value of risk factor analysisin clinically suspected deep venous thrombosis. Respiration 64:362–430
Pannier F, Noppeney T, Alm J, Breu FX, Bruning G, Flessenkämper I, Gerlach H, Hartmann K, Kahle B, Kluess H, Mendozza E, Mühlberger D, Mumme A, Nüllen H et al. (2019) S2k-Leitlinie Diagnostik und Therapie der Varikose. AWMF, www. leitlinien-online.de
Pappas PJ, DeFouw DO, Venezio LM et al (1997) Morphometric assessment of the dermal microcirculation in patients with chronic venous insufficiency. J Vasc Surg 26:784–795
Partsch H, Clark M, Mosti G et al (2008) Classification of compression bandages: practical aspects. Dermatol Surg 34:600–609
Partsch H, Mortimer P (2015) Compression for leg wounds. Br J Dermatol 173:359–369
Partsch H, Rabe E, Stemmer R (1999) Kompressionstherapie der Extremitäten. Editions Phlebologiques Francaises, Paris (ISBN 2.85480.770.7)
Pitre JJ Jr, Koziol LB, Kruger GH, Vollmer A, Ophir J, Ammann JJ, Weitzel WF, Bull JL (2016) Design and testing of a single-element ultrasound viscoelastography system for point-of-care edema quantification. Ultrasound Med Biol 42(9):2209–2219
Protz K, Heyer K (2016) Praktische Aspekte der Kompressionstherapie – Update 2016. Phlebologie 45:224–228
Protz K (2014) Moderne Wundversorgung. Praxiswissen, Standards und Dokumentation, 7. Aufl. Urban und Fischer, München
Rabe E, Pannier-Fischer F, Schuldt K, Stang A et al (2003) Bonner Venenstudien der Deutschen Gesellschaft für Phlebologie zur Frage der Häufigkeit und Ausprägung von chronischen Venenerkrankungen in der städtischen und ländlichen Wohnbevölkerung. Phlebologie 32:1–14
Reich-Schupke S, Kreuter A, Altmeyer P, Stücker M (2009) Wrong diagnosis erysipelas: hypodermitis – case series and review of literature. J Dtsch Dermatol Ges 7(3):222–225
Renner R, Gebhardt C, Simon JC, Seikowski K (2009) Changes in quality of life for patients with chronic venous insufficiency, present or healed leg ulcers. JDDG 7:953–960
Rettenbacher T, Tzankov A, Hollerweger A (2006) Sonographische Erscheinungsbilder von Ödemen der Subkutis und Kutis – Korrelation mit der Histologie. Ultraschall in Medizin 27:240–244
Rieger H et al (1998) Chronisch venöse Insuffizienz. In: Rieger H, Schoop W (Hrsg) Klinische Angiologie. Springer, Heidelberg
Rieger H (1998) Varizen. In: Rieger H, Schoop W (Hrsg) Klinische Angiologie. Springer, Heidelberg
Rieger H (1998) Entzündliche Venenerkrankungen. In: Rieger H, Schoop W (Hrsg) Klinische Angiologie. Springer, Heidelberg
Ruckley CV (1997) Sozioeconomic impact of chronic venous insufficiency and leg ulcers. Angiology 48:67–69
Ruckley CV, Evans CJ, Allan PL, Lee AJ, Fowkes FG (2002) Chronic venous insufficiency: clinical and duplex correlations. The Edinburgh vein study of venous disorders in the general population. J Vasc Surg 36:520–525
Saftoiu A, Gilja OH, Sidhu PS et al (2019) The EFSUMB guidelines and recommendations for the clinical practice of elastography in non-hepatic applications: update 2018. Ultraschall in Med 40:425–453
Samama MM (2000) An epidemiologic study of risk factors for deep vein thrombosis in medical outpatients: the SIRIUS-Study. Arch Intern Med 160:3415–3420
Schad H (2009) Gilt die Starling’sche Hypothese noch? LymphForsch 13:71–77
Schmidt Lang (Hrsg) (2007) Physiologie des Menschen. Springer, Heidelberg
Scott HJ, Smith PDC, Scurr JH (1991) Histological study of white blood cells and their association with lipodermatosklerosis and venous ulceration. Br J Surg 78:201–211
Senet P, Combemale P, Debure C et al (2012) Malignancy and chronic leg ulcers. The value of systematic wound biopsies. A prospective, multicenter, cross-sectional study. Arch Dermatol 148:704–708
Siegenthaler Blum (Hrsg) (2006) Klinische Pathophysiologie. Thieme, Stuttgart
Skillman JJ, Kent KC, Porter DH et al (1990) Simultaneous occurrence of superifcial and deep Thrombophlebitis in the lower extremity. J Vasc Surg 11:818–823
Starling EH (1896) Physiological factors involved in the causation of dropsy. Lancet 1896/I:1267–1270
Strößenreuther RHK (2001) Lipödem und Cellilitis. Viavital-Verlag Köln (ISBN 3–934371–26–4)
Stücker M, Dörler M (2014) Schmerzen im Rahmen einer chronischen venösen Insuffizienz (inclusive Claudicatio venosa). Phlebologie 43:287–289
Stücker M, Piljakic A, Dörler M (2016) Diagnostik des Ulcus cruris venosum. Phlebologie 45:85–90
Swoboda SJ, Schumann H, Kiritsi D (2017) A leg ulcer with pulsating varicose veins – from the leg to the heart. Int Wound J 11(2017). Doi: https://doi.org/10.1111/iwj.12834
The Alexander House Group (1992) Consensus paper on venous leg ulcers. Phlebology 7:48–58
The STENOX Study Group (2003) A randomized double-blind comparison of low-molecular weight heparin, a non-steroidal anti-inflammatory agent, and placebo in nthe treatment of superficial-vein thrombosis. Arch Intern Med 163:1657–1663
The VESALIO Investigators Group (2005) High vs. low doses of low-molecular weight heparin for the treatment of superficial vein thrombosis of the legs: a double-blind, randomized trial. J Thromb Haemost 3:1152–1157
Thomas P, Nash GB, Dormandy JA (1988) White cell accumulation in dependent legs of patients with venous hypertension. A possible mechanism for trophic changes in the skin. Br Med J 296:1993–1995
Unno N, Mitsuoka H, Uchiyama T et al (2002) Superficial thromobphlebitis of the lower limbs in patients with varicose veins. Jap J Surg 32:397–401
Vaitkus PT, Leizorovicz A, Cohen AT (2005) Prevent medical thromboprophylaxis study group. Mortality rates and risk factors for asymptomatic deep vein thrombosis in medical patients. Thromb Haemost 93:76–79
Wagner FW (1981) The dysvascular foot: a system for diagnosis and treadment. Foot & Ankle 2:64–122
Wali MA, Eid RA (2002) Intimal changes in varicose veins: an ultrastructural study. J Smooth Muscle Res 38:63–74
Wenner A, Leu HJ, Spycher M, Brunner U (1980) Ultrastructural changes of capillaries in chronic venous insufficiency. Exp Cell Biol 48:1–14
Wienert V (1999) Epidemiology of leg ulcers. Curr Probl Dermatol 27:65–69
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature
About this chapter
Cite this chapter
Nüllen, H. et al. (2022). Komplikationen bei Varikose. In: Noppeney, T., Nüllen, H. (eds) Varikose. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-59117-8_16
Download citation
DOI: https://doi.org/10.1007/978-3-662-59117-8_16
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-59116-1
Online ISBN: 978-3-662-59117-8
eBook Packages: Medicine (German Language)