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Chirurgische Behandlungsverfahren des diabetischen Fußsyndroms

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Klinische Angiologie

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Zusammenfassung

Das fortgeschrittene diabetische Fußsyndrom ist durch ein hohes Amputationsrisiko aufgrund der ausgeprägten Makroangiopathie und der Kombination mit einer Neuropathie gekennzeichnet. Sehr häufig findet sich der periphere Verschlusstyp mit bevorzugtem Befall der Unterschenkelarterien und relativer Aussparung der pedalen Arterien. Zur Therapieplanung ist eine exakte angiographische Darstellung der Becken-Beingefäße und besonders der cruralen und pedalen Gefäße unverzichtbar. Zentrale Gefäßläsionen können mit hoher Erfolgswahrscheinlichkeit endovaskulär behandelt werden. Wichtig ist eine Rekonstruktion der Femoralisbifurkation. Der distale autologe Venenbypass in Kombination mit endovaskulären Techniken ist durch eine hohe Erfolgsrate mit gutem langfristigen Beinerhalt gekennzeichnet. Die Verwendung von kleinlumigen Gefäßprothesen ist möglich, allerdings mit schlechterer Bypassoffenheit und einer niedrigeren Beinerhaltungsrate. Lokale Amputationen und plastische chirurgische Maßnahmen am Fuß ergänzen das Spektrum der gefäßchirurgischen Möglichkeiten.

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Authors and Affiliations

  1. Klinik und Poliklinik für Herz- und Gefäßchirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland

    Achim Neufang

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  1. Achim Neufang
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Correspondence to Achim Neufang .

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Editors and Affiliations

  1. Gefäßzentrum-Angiologie, Klinikum Innenstadt der LMU, München, Bayern, Deutschland

    Ulrich Hoffmann

  2. Medizinische Klinik und Poliklink III, Universitätsklinikum, TU Dresden, Dresden, Sachsen, Deutschland

    Norbert Weiss

  3. Med Poliklinik, Abteilung Angiologie, Klinikum der LMU, Campus Innenstadt, München, Bayern, Deutschland

    Michael Czihal

  4. Angiologie, Gefäßzentrum Ostbayern, Universitätsklinikum Regensburg, Regensburg, Bayern, Deutschland

    Birgit Linnemann

  5. Klinik für Kardiologie I, Uniklinikum Münster, Münster, Nordrhein-Westfalen, Deutschland

    Eva Freisinger

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Neufang, A. (2023). Chirurgische Behandlungsverfahren des diabetischen Fußsyndroms. In: Hoffmann, U., Weiss, N., Czihal, M., Linnemann, B., Freisinger, E. (eds) Klinische Angiologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-61379-5_79-1

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  • DOI: https://doi.org/10.1007/978-3-662-61379-5_79-1

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