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Nicht invasive Messungen der Gewebedurchblutung bei kritischer Extremitätenischämie

Noninvasive measurements of tissue perfusion in critical limb ischemia

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Zusammenfassung

Die kritische Extremitätenischämie stellt aufgrund nicht heilender Wunden nach wie vor eine Herausforderung an ein interdisziplinär behandelndes Team dar. Vor diesem Hintergrund ist es notwendig, suffizient Erfolgskontrollen einer Revaskularisation durchführen zu können. Neben der Beurteilung der Makrozirkulation in Form von Knöchel-Arm- und Zehen-Arm-Index-Messungen wird häufig die Relevanz der Mikrozirkulation unterschätzt. Um allerdings ein Gesamtbild der Durchblutungssituation zu erhalten, sollte diese nicht außer Acht gelassen werden. Dargestellt werden sollen daher aktuelle Methoden der nicht invasiven Perfusionsanalyse. Hierzu zählen die transkutane Sauerstoffpartialdruckmessung, das „Oxygen-to-see“-Verfahren – eine Kombination aus Weißlichtspektrometrie und Laserdopplerflowmetrie – sowie die Fluoreszenzangiographie durch Indocyaningrün. Ein Ausblick auf mögliche zukünftige Verfahren wie die multispektrale optoakustische Tomographie wird ebenso gegeben.

Abstract

Critical limb ischemia (CLI) remains a challenge for an interdisciplinary therapeutic team due to chronic nonhealing wounds. Against this background, there is a necessity of quality control after revascularization. Beside the isolated evaluation of the macrocirculation by Ankle-Brachial or Toe-Brachial Index measurements, the microcirculation as an additional important factor of wound healing often remains underestimated. The following article gives an overview about the current investigation methods for noninvasive perfusion control of the CLI patient. Therefore, transcutaneous oxygen pressure (tcpO2), the “oxygen-to-see” method which is a combination of white light tissue spectrometry and laser-Doppler flowmetry, fluorescence angiography with indocyanine green, and multispectral optoacoustic tomography will be described.

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Authors and Affiliations

  1. Gefäßchirurgische Abteilung, Universitätsklinikum Erlangen, Krankenhausstraße 12, 91056, Erlangen, Deutschland

    U. Rother & W. Lang

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  1. U. Rother
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Correspondence to U. Rother.

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U. Rother und W. Lang geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Rother, U., Lang, W. Nicht invasive Messungen der Gewebedurchblutung bei kritischer Extremitätenischämie. Gefässchirurgie 22, 358–362 (2017). https://doi.org/10.1007/s00772-017-0292-5

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