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Ultraschall in der Gefäßchirurgie

Ultrasound in vascular surgery

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Zusammenfassung

Die Ultraschalldiagnostik ist für Gefäßchirurgen von großer Bedeutung. Sie steht im Diagnosepfad bei den meisten Gefäßerkrankungen an erster Stelle der apparativen Techniken. Diese Arbeit beschreibt neuere Erkenntnisse auf vier Gebieten der Diagnostik: der Karotisstenose, den peripheren Durchblutungsstörungen einschließlich Nachkontrollen, den Venenerkrankungen und dem abdominellen Aortenaneurysma.

Die Quantifizierung einer Karotisstenose ist zuverlässig, das Plaque-Imaging noch aufwändig. Die Ultraschalluntersuchung sollte der invasiven Diagnostik bei peripheren Durchblutungsstörungen vorangestellt werden. Die routinemäßige Nachkontrolle nach infrainguinalem Bypass hat keine evidenzbasierte Begründung. Bei Erkrankungen des Venensystems (Thrombose oder Insuffizienz) sind die Ultraschallverfahren zur Standardtechnik geworden. Die Diagnostik des abdominellen Aortenaneurysmas ist zuverlässig, Therapieplanung und Nachkontrolle endoluminaler Verfahren aber sehr eingeschränkt.

Abstract

Diagnosing vascular diseases by ultrasound is of major interest to vascular surgeons and now regarded as the primary noninvasive technique. This paper presents developments in four different fields: stenoses of the carotid arteries, peripheral artery occlusive diseases (PAOD) including surveillance programs, diseases of the veins, and abdominal aortic aneurysm. Calculating the extent of a carotid artery stenosis is now accurate, but plaque imaging remains complex. Examination by ultrasound should precede any invasive techniques in PAOD. Duplex surveillance on a routine basis is no longer recommended after infrainguinal bypass. In future vascular diseases will be diagnosed primarily by ultrasound. Diagnosis of abdominal aneurysm is now absolutely reliable, whereas planning and follow-up of endoluminal techniques are quite restricted.

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Literatur

  1. Arning C, Hammer E, Kortmann H et al. (2003) Quantifizierung von A. carotis interna-Stenosen: Welche Ultraschallkriterien sind geeignet? Ultraschall Med 24: 233–238

    Article  PubMed  Google Scholar 

  2. Arnold JA, Modaresi KB, Thomas N et al. (1999) Carotid plaque characterization by duplex scanning: observer error may undermine current clinical trials. Stroke 30: 61–65

    PubMed  Google Scholar 

  3. Biasi GM, Froio A, Diethrich EB et al. (2004) Carotid plaque echolucency increases the risk of stroke in carotid stenting: the Imaging in Carotid Angioplasty and Risk of Stroke (ICAROS) study. Circulation 110: 756–762

    Article  PubMed  Google Scholar 

  4. Chahwan S, Miller MT, Pigott JP et al. (2007) Carotid artery velocity characteristics after carotid artery angioplasty and stenting. J Vasc Surg (in press)

  5. Coleridge-Smith P, Labropoulos N, Partsch H et al. (2006) Duplex ultrasound investigation of the veins in chronic venous disease of the lower limbs–UIP consensus document. Part I. Basic principles. Eur J Vasc Endovasc Surg 31: 83–92

    Article  PubMed  Google Scholar 

  6. Davies AH, Hawdon AJ, Sydes MR, Thompson SG (2005) Is duplex surveillance of value after leg vein bypass grafting? Principal results of the Vein Graft Surveillance Randomised Trial (VGST). Circulation 112: 1985–1991

    Article  PubMed  Google Scholar 

  7. Denzel C, Balzer K, Muller KM et al. (2003) Relative value of normalized sonographic in vitro analysis of arteriosclerotic plaques of internal carotid artery. Stroke 34: 1901–1906

    Article  PubMed  Google Scholar 

  8. Eiberg JP, Madycki G, Hansen MA et al. (2002) Ultrasound imaging of infrainguinal arterial disease has a high interobserver agreement. Eur J Vasc Endovasc Surg 24: 293–299

    Article  PubMed  Google Scholar 

  9. Grant EG, Benson CB, Moneta GL et al. (2003) Carotid Artery Stenosis: Gray-Scale and Doppler US Diagnosis–Society of Radiologists in Ultrasound Consensus Conference. Radiology 229: 340–346

    Article  PubMed  Google Scholar 

  10. Habscheid W (2006) Sonographie der Beinvenenthrombose. Ultraschall Med 27: 512–532

    Article  PubMed  Google Scholar 

  11. Henao EA, Hodge MD, Felkai DD et al. (2006) Contrast-enhanced Duplex surveillance after endovascular abdominal aortic aneurysm repair: improved efficacy using a continuous infusion technique. J Vasc Surg 43: 259–264; discussion 264

    Article  PubMed  Google Scholar 

  12. Hofmann WJ, Walter J, Ugurluoglu A et al. (2004) Preoperative high-frequency duplex scanning of potential pedal target vessels. J Vasc Surg 39: 169–175

    Article  PubMed  Google Scholar 

  13. Jung EM, Kubale R, Clevert DA et al. (2007) B-flow and B-flow with 3D and SRI postprocessing before intervention and monitoring after stenting of the internal carotid artery. Clin Hemorheol Microcirc 36: 35–46

    PubMed  Google Scholar 

  14. Jung EM, Kubale R, Ritter G et al. (2007) Diagnostics and characterisation of preocclusive stenoses and occlusions of the internal carotid artery with B-flow. Eur Radiol 17: 439–447

    Article  PubMed  Google Scholar 

  15. Lal BK, Hobson RW 2nd, Goldstein J et al. (2004) Carotid artery stenting: is there a need to revise ultrasound velocity criteria? J Vasc Surg 39: 58–66

    Article  PubMed  Google Scholar 

  16. Lal BK, Hobson RW 2nd, Hameed M et al. (2006) Noninvasive identification of the unstable carotid plaque. Ann Vasc Surg 20: 167–174

    Article  PubMed  Google Scholar 

  17. Lang W (2002) Arterielle Gefäßdiagnostik beim diabetischen Fußsyndrom. Gefässchirurgie 7: 122–127

    Article  Google Scholar 

  18. Lewis SC, Wardlaw JM (2002) Which Doppler velocity is best for assessing suitability for carotid endarterectomy? Eur J Ultrasound 15: 9–20

    Article  PubMed  Google Scholar 

  19. Makris SA, Karkos CD, Awad S, London NJ (2006) An „all-comers“ venous duplex scan policy for patients with lower limb varicose veins attending a one-stop vascular clinic: is it justified? Eur J Vasc Endovasc Surg 32: 718–724

    Article  PubMed  Google Scholar 

  20. Mathiesen EB, Bonaa KH, Joakimsen O (2001) Echolucent plaques are associated with high risk of ischemic cerebrovascular events in carotid stenosis: the tromso study. Circulation 103: 2171–2175

    PubMed  Google Scholar 

  21. Norgren L, Hiatt WR, Dormandy JA et al. (2007) Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). Eur J Vasc Endovasc Surg 33: S1–S75

    Article  PubMed  Google Scholar 

  22. Ota H, Takase K, Rikimaru H et al. (2005) Quantitative vascular measurements in arterial occlusive disease. Radiographics 25: 1141–1158

    Article  PubMed  Google Scholar 

  23. Reiter M, Horvat R, Puchner S et al. (2007) Plaque imaging of the internal carotid artery – correlation of B-flow imaging with histopathology. AJNR Am J Neuroradiol 28: 122–126

    PubMed  Google Scholar 

  24. Turton EP, Scott DJ, Richards SP et al. (1999) Duplex-derived evidence of reflux after varicose vein surgery: neoreflux or neovascularisation? Eur J Vasc Endovasc Surg 17: 230–233

    Article  PubMed  Google Scholar 

  25. Wong JK, Duncan JL, Nichols DM (2003) Whole-leg duplex mapping for varicose veins: observations on patterns of reflux in recurrent and primary legs, with clinical correlation. Eur J Vasc Endovasc Surg 25: 267–275

    Article  PubMed  Google Scholar 

  26. Yurdakul M, Tola M, Cumhur T (2006) B-flow imaging for assessment of 70% to 99% internal carotid artery stenosis based on residual lumen diameter. J Ultrasound Med 25: 211–215

    PubMed  Google Scholar 

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  1. Schwerpunkt Gefäßchirurgie, Chirurgische Klinik mit Poliklinik der Friedrich-Alexander-Universität, Krankenhausstraße 12, 91054, Erlangen, Deutschland

    W. Lang

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Correspondence to W. Lang.

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Lang, W. Ultraschall in der Gefäßchirurgie. Chirurg 78, 428–434 (2007). https://doi.org/10.1007/s00104-007-1330-8

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