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Die chirurgische Behandlung der arteriellen Verschlusskrankheit

Operationsmethoden und Ergebnisse

Surgical management of peripheral arterial disease

Operative methods and results

  • Arterielle Verschlusskrankheiten
  • Published:
Der Radiologe Aims and scope Submit manuscript

Zusammenfassung

Zur invasiven Therapie der arteriellen Verschlusskrankheit (AVK) stehen verschiedene operative und interventionelle Behandlungsformen zur Verfügung. Die Auswahl der geeigneten Methode richtet sich nach dem Allgemeinzustand des Patienten, der Morphologie des arteriellen Verschlusses, dem Komplikationsrisiko und der Erfolgswahrscheinlichkeit der jeweiligen Behandlung im Langzeitverlauf. Hierbei konkurrieren die verschiedenen Verfahren nur oberflächlich betrachtet miteinander, sie ergänzen sich in ihren jeweiligen technischen Möglichkeiten und dem Risikoprofil. Die Kombination chirurgischer und interventioneller Methoden bietet neue Behandlungsoptionen. Im Rahmen dieses Artikels werden die verschiedenen Operationsverfahren und deren Ergebnisse dargestellt.

Abstract

Various operative and interventional methods are available to treat patients with peripheral arterial disease (PAD).

The selection of the appropriate therapy should be made after a careful review of the patient’s general condition, the morphology of the arterial occlusion, the risk of possible complications, and the likelihood of long-term success for each type of treatment.

The different procedures complement one another in their technical possibilities and their risk profile The combination of surgical and interventional methods offers new therapeutic possibilities. The different surgical procedures and their long-term outcome are presented in this publication.

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Literatur

  1. Abbott WM, Green RM, Matsumoto T et al. (1997) Prosthetic above-knee femoropopliteal bypass grafting: results of a multicenter randomized prospective trail. J Vasc Surg 25: 19–28

    Article  PubMed  Google Scholar 

  2. Aburahma AF, Robinson PA, Cook CC, Hopkins ES (2001) Selecting patients for combined femoro-femoral bypass grafting and iliac ballon angioplasty and stenting for bilateral iliac disease. J Vasc Surg 33: S93–99

    Article  PubMed  Google Scholar 

  3. Albers M, Battistella VM, Romiti M et al. (2003) Meta-analysis of polytretafluoroethylene bypass grafts to infrapopliteal arteries. J Vasc Surg 37(6): 1263–1269

    Article  PubMed  Google Scholar 

  4. Albers M, Romiti M, Peirera CA et al. (2004) Meta-analysis of allograft bypass grafting to infrapopliteal arteries. Eur J Vasc Endovasc Surg 28(5): 462–472

    Article  PubMed  Google Scholar 

  5. Albers M, Romiti M, Brochado-Neto FC et al. (2006) Meta-analysis of popliteal-to-distal vein bypass grafts for critical ischemia. J Vasc Surg 43(3): 498–503

    Article  PubMed  Google Scholar 

  6. Audet P, Therasse E, Oliva VL et al. (1998) Infrarenal aortic stenosis: long-term clinical and hemodynamic results of percutaneous transluminal angioplasty. Radiology 209: 357–363

    PubMed  Google Scholar 

  7. Bergaminin TM, George SM, Massey HT et al. (1994) Pedal or peroneal bypass:which is better when both are patent? J Vasc Surg 20: 347–356

    PubMed  Google Scholar 

  8. Blum U, Gabelmann A, Redecker M et al. (1993) Percutaneus recanalisation of iliac artery occlusions: results of a prospective study. Radiology 189: 536–540

    PubMed  Google Scholar 

  9. Brewster DC (1997) Current controversies in the management of aortoiliac occlusive disease. J Vasc Surg 25: 365–379

    Article  PubMed  Google Scholar 

  10. Criqui MH, Langer RD, Fronek A et al. (1992) Mortality over a period of 10 years in patients with peripheral arterial disease. N Engl J Med 326: 381–386

    PubMed  Google Scholar 

  11. Davidovic L, Vasic D, Maksimovic R et al. (2004) Aortobifemoral grafting: factors influencing long-term results. Vascular 12: 171–178

    PubMed  Google Scholar 

  12. Diehm N, Savolainen H, Mahler F et al. (2004) Does deep femoral artery revascularization as an isolated procedure play a role in chronic critical limb ischemia? J Endovasc Ther 11(2): 119–124

    Article  PubMed  Google Scholar 

  13. Elkouri S, Hudon G, Demers P et al. (1999) Early and long-term results of percutaneous transluminal angioplasty of the lower abdominal aorta. J Vasc Surg 30(4): 679–692

    Article  PubMed  Google Scholar 

  14. Eugster T, Stierli P, Dittli U (1999) Beeinflußt der Risikofaktor Diabetes mellitus die Resultate der infrainguinalen arteriellen Rekonstruktion. Gefäßchirurgie 4: 40–45

  15. Fann JI, Harris EJ, Dalman RL (1993) Basic data underlying clinical decision making. Extra-anatomic bypass. Ann Vasc Surg 7: 378–383

    Article  PubMed  Google Scholar 

  16. Hiatt WR (1997) Quality of life assessment in peripheral arterial disease. Atherosclerosis 131 [Suppl 1]: 35–36

  17. Hunink MG, Wong JB, Donaldson MC et al. (1994) Patency results of percutaneous and surgical revascularization for femoropopliteal arterial disease. Med Decis Making 14: 71–81

    PubMed  Google Scholar 

  18. Illuminati G, Calio FG, Mangialardi N (1996) Results of axillofemoral bypasses for aorto-iliac occlusive disease. Langenbecks Arch Chir 381: 212–217

    Article  PubMed  Google Scholar 

  19. Jernigan WR, Fallat ME, Hatfield DR (1983) Hypoplastic aortoiliac syndrome: an entity peculiar to women. Surgery 94: 572–757

    Google Scholar 

  20. Johnston W (1993) Iliac arteries: reanalysis of results of ballon angioplasty. Radiology 186: 207–212

    PubMed  Google Scholar 

  21. Jorgensen B, Skovgaard N, Norgard J et al. (1992) Percutaneous transluminal angioplasty in 226 iliac artery stenoses: role of the superficial femoral artery for clinical success. Vasa 21: 382–386

    PubMed  Google Scholar 

  22. Kalman PG, Johnston KW, Walker PM (1990) The current role of isolated profundaplasty. J Cardiovasc Surg 31: 107–110

    Google Scholar 

  23. Lang W, Schmidt O, Radespiel-Tröger M, Schweiger H (2001) Der supragenuale PTFE-Bypass. Gefäßchirurgie 6: 34–40

  24. Martin D, Katz SG (2000) Axillofemoral bypass for aortoiliac occlusive disease. Am J Surg 180: 100–103

    Article  PubMed  Google Scholar 

  25. McDaniel MD, Cronenwett JL (1989) Basic data related to the natural history of intermittend claudication. Ann Vasc Surg 3: 273–277

    PubMed  Google Scholar 

  26. Mellière D, Blancas AE, Desgranges P, Becquemin J-P (2000) The underestimated advantages of iliofemoral endarterectomy. Ann Vasc Surg 14: 343–349

    Article  PubMed  Google Scholar 

  27. Mingoli A, Sapienza P, Feldhaus RJ et al. (2001) Comparison of femorofemoral and aortofemoral bypass for aortoiliac occlusive disease. J Cardiovasc Surg 42(3): 381–387

    Google Scholar 

  28. Mousa A, Rhee JY, Trocciola et al. (2005) Percutaneous endovascular treatment for chronic limb ischemia. Ann Vasc Surg 19: 186–191

    Article  PubMed  Google Scholar 

  29. Naylor AR, Ah-See AK, Engeset J (1990) Aortoiliac endarterectomy: an 11-year review. Br J Surg 77: 190–193

    PubMed  Google Scholar 

  30. Nguyen LL, Conte MS, Menard MT et al. (2004) Infrainguinal vein bypass graft revision: factors affecting longterm outcome. J Vasc Surg 40(5): 916–923

    Article  PubMed  Google Scholar 

  31. Nitschmann K, Nöldeke S, Hupp T (2006) Kombination offener und endovasculärer Verfahren der A. femoralis. Gefäßchirurgie 11: 76–83

  32. Oertli D, Waibel P (1995) Die Thrombendarteriektomie bei aorto-iliacaler Verschlußkrankheit. Schweiz Med Wochenschr 125: 1075–1081

    PubMed  Google Scholar 

  33. Oertli D, Wigger P, Landmann J et al. (1996) Long-term results after open and semiclosed thrombendarterectomy for aortoiliac occlusive disease. Eur J Vasc Endovasc Surg 11: 432–436

    Article  PubMed  Google Scholar 

  34. Oskam J, van den Dungen J, Boontje AH (1996) Thrombendarterectomy for obstructive disease of common iliac artery. Cardiovasc Surg 4: 360–363

    Article  PubMed  Google Scholar 

  35. Passman MA, Taylor LM, Moneta GL (1996) Comparison of axillofemoral and aortofemoral bypass for aortoiliac occlusive disease. J Vasc Surg 23: 263–271

    Article  PubMed  Google Scholar 

  36. Polterauer P, Prager M, Holzenbein T et al. (1992) Dacron versus polytetrafluoroethylene for Y-aortic bifurcation grafts: a six-year prospective randomized trial. Surgery 111: 626–633

    PubMed  Google Scholar 

  37. Poulias GE, Polemis L, Skoutas B et al. (1985) Bilateral aortofemoral bypass in the presence of aorto-iliac occlusive disease and factors determing results. Experience and long term follow up with 500 consecutive cases. J Cardiovasc Surg 26: 527–538

    Google Scholar 

  38. Schedel H, Wissgott C, Rademaker J, Steinkamp HJ (2004) Primary stent placement for infrarenal aortic stenosis: immediate and midterm results. J Vasc Interv Radiol 15: 353–359

    PubMed  Google Scholar 

  39. Schneider RJ, Walsh DB, McDaniel MD et al. (1993) Pedal bypass versus tibial bypass with autogenous vein: a comparison of outcome and hemodynamic results. J Vasc Surg 17: 1029–1038

    Article  PubMed  Google Scholar 

  40. Szilagy DE, Elliot JP, Smith RF et al. (1986) A thirty-year survey of the reconstructive surgical treatment of aortoiliac occlusive disease. J Vasc Surg 3: 421–436

    Article  PubMed  Google Scholar 

  41. Tetteroo E, van der Graaf J, Bosch JL et al. (1998) Randomized comparison of primary stent placement versus primary angioplasty followed by selective stent placement in patients with iliac-artery occlusive disease. Dutch Iliac Stent Trail Study Group. Lancet 351(9110): 1153–1159

    Article  PubMed  Google Scholar 

  42. Timaran CH, Prault TL, Stevens SL et al. (2003) Iliac artery stenting versus surgical reconstruction for TASC (TransAtlantic Inter-Society Consensus) type B and C iliac lesions. J Vasc Surg 38(2): 272–278

    Article  PubMed  Google Scholar 

  43. Transatlantic Intersociety Consensus (TASC) (2000) Management of peripheral arterial disease (PAD). J Vasc Surg 31: 1–296

    Article  PubMed  Google Scholar 

  44. Trocciola SM, Chaer R, Dayal R et al. (2005) Comparison of results in endovascular interventions for infrainguinal lesions: claudication versus critical limb ischemia. Am Surg 71(6): 474–479

    PubMed  Google Scholar 

  45. Urayama H, Ohtake H, Yokoi K et al. (1998) Long-term results of endarterectomy, anatomic bypass and extraanatomic bypass for aortoiliac occlusive disease. Surg Today 28: 151–155

    Article  PubMed  Google Scholar 

  46. Van den Akker PJ, van Schilfgaarde R, Brand R et al. (1992) Long-term results of prosthetic and non.prosthetic reconstruction for obstructive aorto-iliac disease. Eur J Vasc Surg 6: 53–61

    Article  PubMed  Google Scholar 

  47. Verrel F, Streckmeier B, Ruppert V (2006) Intraoperative Kombinationseingriffe bei AVK vom Beckentyp. Gefäßchirurgie 11: 94–99

  48. Vorwerk D, Günther RW, Schürmann K et al. (1995) Primary stent placement for chronic iliac artery occlusions: follow-up results in 103 patients. Radioloy 194: 745-749

    Google Scholar 

  49. Wintzer C, Daum H, Diener H et al. (2006) Kombination von PTA der Spenderarterien und Cross-over Bypass bei bilateraler Beckenarterienstenose. Gefäßchirurgie 11: 84–93

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Authors and Affiliations

  1. Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein – Campus Lübeck, Ratzeburger Allee 160, 23538 , Lübeck, Deutschland

    B. Wulff, T. Jungbluth, H. Esnaashari, C. Franke & H.-P. Bruch

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  1. B. Wulff
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  2. T. Jungbluth
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  3. H. Esnaashari
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  4. C. Franke
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Correspondence to B. Wulff.

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Wulff, B., Jungbluth, T., Esnaashari, H. et al. Die chirurgische Behandlung der arteriellen Verschlusskrankheit. Radiologe 46, 931–940 (2006). https://doi.org/10.1007/s00117-006-1438-8

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  • DOI: https://doi.org/10.1007/s00117-006-1438-8

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