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Venenthrombose und Lungenembolie

Aktualisierte S2-Leitlinie zu Diagnostik und Therapie

Venous thrombosis and pulmonary embolism

Updated S2 guidelines on diagnostics and therapy

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An Erratum to this article was published on 05 April 2016

Zusammenfassung

Seit Ende des letzten Jahres liegt die aktualisierte S2k-Leitlinie zu Diagnostik und Therapie von Venenthrombose und Lungenembolie vor. Vor- und Nachteile der zur Verfügung stehenden Untersuchungs- und Behandlungsmethoden, diagnostische Abfolge von Untersuchungen unter verschiedenen klinischen Bedingungen, Invasivität und Dauer der Therapien sowie die potenziellen Besonderheiten „vulnerabler“ Patientenkollektive finden darin Beachtung. Der vorliegende Beitrag stellt eine Zusammenfassung der wichtigsten Aussagen dar.

Abstract

The updated version of the S2k guidelines on diagnostics and therapy of venous thrombosis and pulmonary embolism have been available since the end of last year. The guidelines deal with the advantages and disadvantages of the currently available investigation and treatment methods, the diagnostic sequence of investigations under various clinical conditions, the invasiveness and duration of therapies and the potential special features of vulnerable patient collectives. This article presents a summary of the most important assertions.

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Literatur

  1. Bates SM, Greer IA, Middeldorp S et al (2012) VTE, thrombophilia, antithrombotic therapy, and pregnancy: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141:e691S–e736S

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Chan WS, Rey E, Kent NE et al (2014) Venous thromboembolism and antithrombotic therapy in pregnancy. J Obstet Gynaecol Can 36:527–553

    Article  PubMed  Google Scholar 

  3. Cohen AT, Agnelli G, Anderson FA et al (2007) Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost 98:756–764

    CAS  PubMed  Google Scholar 

  4. Decousus H, Prandoni P, Mismetti P, Bauersachs RM et al (2010) Fondaparinux for the treatment of superficial-vein thrombosis in the legs. N Engl J Med 363:1222–1232

    Article  CAS  PubMed  Google Scholar 

  5. Enden T, Haig Y, Klow NE, Slagsvold CE, Sandvik L et al (2012) Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial. Lancet 379:31–38

    Article  PubMed  Google Scholar 

  6. Erkens PM, Prins MH (2010) Fixed dose subcutaneous low molecular weight heparins versus adjusted dose unfractionated heparin for venous thromboembolism. Cochrane Database Syst Rev 9:CD001100

    PubMed  Google Scholar 

  7. Gary T (2014) Cancer related venous thromboembolism – prophylaxis and therapy. Vasa 43:245–251

    Article  PubMed  Google Scholar 

  8. Geersing GJ, Janssen KJ, Oudega R, Bax L et al (2009) Excluding venous thromboembolism using point of care D-dimer tests in outpatients: a diagnostic meta-analysis. BMJ 339:b2990

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Hao Q, Dong BR, Yue J, Wu T, Liu GJ (2015) Thrombolytic therapy for pulmonary embolism. Cochrane Database Syst Rev 9:CD004437

    PubMed  Google Scholar 

  10. Horlocker TT, Wedel DJ, Rowlingson JC, Enneking FK et al (2010) Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition). Reg Anesth Pain Med 35:64–101

    Article  CAS  PubMed  Google Scholar 

  11. Johnson SA, Stevens SM, Woller SC et al (2010) Risk of deep vein thrombosis following a single negative whole-leg compression ultrasound: a systematic review and meta-analysis. JAMA 303:438–445

    Article  CAS  PubMed  Google Scholar 

  12. Kearon C, Akl EA (2014) Duration of anticoagulant therapy for deep vein thrombosis and pulmonary embolism. Blood 123:1794–1801

    Article  CAS  PubMed  Google Scholar 

  13. Kearon C, Akl EA, Comerota AJ, Prandoni P et al (2012) Antithrombotic therapy for VTE disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141:e419S–e494S

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Kuo WT, Gould MK, Louie JD, Rosenberg JK et al (2009) Catheter-directed therapy for the treatment of massive pulmonary embolism: systematic review and meta-analysis of modern techniques. J Vasc. Interv Radiol 20:1431–1440

    Article  PubMed  Google Scholar 

  15. Le Gal G, Righini M, Roy PM, Sanchez O et al (2006) Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Ann Intern Med 144:165–171

    Article  PubMed  Google Scholar 

  16. Lee AYY, Kamphusien PW, Meyer G, Bauersachs R et al (2015) Tinzaparin vs warfarin for treatment of acute venous thromboembolism in patients with active cancer: a randomized clinical trial. JAMA 314:677–686

    Article  CAS  PubMed  Google Scholar 

  17. Marik PE, Plante LA (2008) Venous thromboembolic disease and pregnancy. N Engl J Med 359:2025–2033

    Article  CAS  PubMed  Google Scholar 

  18. Marti C, John G, Konstantinides S, Combescure C et al (2015) Systemic thrombolytic therapy for acute pulmonary embolism: a systematic review and meta-analysis. Eur Heart J 36:605–614

    Article  PubMed  PubMed Central  Google Scholar 

  19. Mathis G, Blank W, Reissig A, Lechleitner P et al (2005) Thoracic ultrasound for diagnosing pulmonary embolism: a prospective multicenter study of 352 patients. Chest 128:1531–1538

    Article  PubMed  Google Scholar 

  20. Meinel FG, Nance JW, Schoepf UJ, Hoffmann VS et al (2015) Predictive value of computed tomography in acute pulmonary embolism: systematic review and metaanalysis. Am J Med 128:747–759

    Article  PubMed  Google Scholar 

  21. Meyer G, Vicaut E, Danays T, Agnelli G et al (2014) Fibrinolysis for patients with intermediate-risk pulmonary embolism. N Engl J Med 370:1402–1411

    Article  CAS  PubMed  Google Scholar 

  22. Righini M, Jobic C, Boehlen F, Broussaud J et al (2013) Predicting deep venous thrombosis in pregnancy: external validation of the LEFT clinical prediction rule. Haematologica 98:545–548

    Article  PubMed  PubMed Central  Google Scholar 

  23. Righini M, Van EJ, Den Exter PL et al (2014) Age-adjusted D-dimer cutoff levels to rule out pulmonary embolism: the ADJUST-PE study. JAMA 311:1117–1124

    Article  CAS  PubMed  Google Scholar 

  24. Sanchez O, Trinquart L, Colombet I et al (2008) Prognostic value of right ventricular dysfunction in patients with haemodynamically stable pulmonary embolism: a systematic review. Eur Heart J 29:1569–1577

    Article  PubMed  Google Scholar 

  25. Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein DA et al (2012) International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 38:577–559

    Article  PubMed  Google Scholar 

  26. Waurick K, Riess H, Van Aken H et al (2014) S1-Leitlinie: Rückenmarksnahe Regionalanästhesien und Thrombembolieprophylaxe/antithrombotische Medikation. Anästh Intensivmed 55:464–492

    Google Scholar 

  27. Wells PS, Ginsberg JS, Anderson DR, Kearon C et al (1998) Use of a clinical model for safe management of patients with suspected pulmonary embolism. Ann Intern Med 129:997–1005

    Article  CAS  PubMed  Google Scholar 

  28. Wells PS, Anderson DR, Rodger M et al (2003) Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. N Engl J Med 349:1227–1235

    Article  CAS  PubMed  Google Scholar 

  29. Wilkens H, Lang I, Blankenburg T, Grohe C et al (2014) Chronic thromboembolic pulmonary hypertension – a position paper. Dtsch Med Wochenschr 139(Suppl 4):S155–S165

    PubMed  Google Scholar 

  30. Zondag W, Kooiman J, Klok FA, Dekkers OM et al (2013) Outpatient versus inpatient treatment in patients with pulmonary embolism: a meta-analysis. Eur Respir J 42:134–144

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes, Gebäude 57, 66421, Homburg, Deutschland

    T. Volk

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T. Volk gibt an, Beraterhonorare und Unterstützung für Forschungsprojekte von folgenden Firmen erhalten zu haben: CSL Behring, Boehringer Ingelheim, Bayer, Mitsubishi.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren. Ethische Richtlinie, sofern zutreffend, sind sämtlich eingehalten.

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Volk, T. Venenthrombose und Lungenembolie. Anaesthesist 65, 212–220 (2016). https://doi.org/10.1007/s00101-016-0135-x

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  • DOI: https://doi.org/10.1007/s00101-016-0135-x

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