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Die Intimahyperplasie—Bedeutung für den Gefäßchirurgen und therapeutische Möglichkeiten

Intimal hyperplasia—significance for the vascular surgeon and therapeutic options

  • Intimahyperplasie
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Zusammenfassung

Bei der Intimahyperplasie (IH) handelt es sich die um die Reaktion eines Gefäßes auf ein beliebiges Trauma. Klinische Relevanz besteht vor allem bei Re-Stenosen oder Verschlüssen nach Angioplastie oder Operation. Die zeitlichen Abläufe bei der Ausbildung der IH sind gut erforscht und spielen sich immer nach demselben Muster ab. Als entscheidender Mechanismus ist die Proliferation und Migration von glatten Muskelzellen aus der Media in die Intima, zusammen mit der Produktion von extrazellulärer Matrix, anerkannt.

Für den Chirurgen ist die IH insbesondere nach Rekonstruktion schmallumiger Gefäße am Unterschenkel oder am Herzen relevant, aber auch Stenosen nach Karotisrekontruktion oder Dialyseshunt sind häufig hierdurch bedingt. In dieser Übersichtsarbeit werden die verschiedenen Strategien zur Beeinflussung der IH diskutiert.

Abstract

Intimal hyperplasia (IH) evolves from the reaction of the vessel to a trauma. Restenosis or occlusion after angioplasty or operation may be the consequence. The pathophysiology and time course have been described. The proliferation and migration of smooth muscle cells from the media into the intima, together with the production of extracellular matrix, have been pointed out to be crucially important for the formation of IH.

For the surgeon, IH is the main reason not only for unsuccessful recontructions in crural or coronary surgery, but also in carotid or dialysis shunt surgery. In this review, different therapeutic options to reduce IH are discussed.

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  1. Abteilung für Gefäßchirurgie, Endovaskuläre Chirurgie, Chirurgische Klinik und Poliklinik, Universitätsklinik Würzburg

    A. Larena-Avellaneda & S. Franke

  2. Abteilung für Gefäßchirurgie, Endovaskuläre Chirurgie, Chirurgische Klinik und Poliklinik, Universitätsklinik Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg

    A. Larena-Avellaneda

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Larena-Avellaneda, A., Franke, S. Die Intimahyperplasie—Bedeutung für den Gefäßchirurgen und therapeutische Möglichkeiten. Gefässchirurgie 9, 89–95 (2004). https://doi.org/10.1007/s00772-004-0339-2

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