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Kavathrombose

Thrombosis of the vena cava

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Zusammenfassung

Thrombotische Verschlussprozesse der oberen und unteren Hohlvene werden selten beobachtet. Die Klinik richtet sich nach Akutheitsgrad und Ausmaß des thrombotischen Prozesses. Die häufigsten Ursachen sind Raumforderungen und venöse Verweilkatheter. Gefürchtete assoziierte Komplikationen sind Lungenembolie und postthrombotisches Syndrom sowie im Akutfall die obere Einflussstauung. Der diagnostische Pfad besteht vorrangig aus Duplexsonographie und kontrastverstärkter Computertomographie/Magnetresonanztomographie-Venographie. Zum Ausschluss eines malignen Prozesses ist eine Umfelddiagnostik obligat. Therapeutisch stehen neben konservativen Verfahren konventionell-offene und endovaskuläre Optionen zur Verfügung. Insbesondere nach chirurgischer oder interventioneller Versorgung ist eine regelmäßige Nachsorge angezeigt.

Abstract

Thrombotic occlusion of the inferior or superior vena cava is rarely seen. Clinical presentation depends on acuteness and extent of the thrombus. Most frequent causes are tumors and intravenous catheters. Pulmonary embolism, post-thrombotic syndrome and the superior vena cava syndrome represent serious complications. The diagnostic work-up mainly consists of duplex ultrasound and computed tomography/magnetic resonance imaging (CT/MRI) venography. An underlying malignancy has to be excluded. Besides conservative therapy, surgical and endovascular repair are valid treatment options. A continuous follow-up is indicated after conventional/interventional procedures.

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Danksagung

Die Autoren danken Frau Katrin Meisenbacher für die kritische Durchsicht des Manuskripts.

Interessenkonflikt

Der korrespondierende Autor gibt für sich und seine Koautoren an, dass kein Interessenkonflikt besteht.

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Authors and Affiliations

  1. Klinik für Gefäßchirurgie und Endovaskuläre Chirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland

    M.S. Bischoff, A.S. Peters & D. Böckler

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  1. M.S. Bischoff
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  2. A.S. Peters
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  3. D. Böckler
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Correspondence to M.S. Bischoff.

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Teile dieses Beitrags stammen aus: Nüllen H, Noppeney T, Diehm C (2013) VTE – Venöse Thromboembolien (ISBN 978-3-642-21495-0, voraussichtlicher Erscheinungstermin: August 2013).

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Bischoff, M., Peters, A. & Böckler, D. Kavathrombose. Gefässchirurgie 18, 67–77 (2013). https://doi.org/10.1007/s00772-012-1112-6

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