Die Relevanz des Angiosomen-Konzepts in der Behandlung der chronisch kritischen Extremitätenischämie

The relevance of the “angiosome” concept for treatment of chronic limb-threatening ischemia

Zusammenfassung

Hintergrund

Das Angiosomen-Konzept als eine Entscheidungsgrundlage zur Revaskularisation bei Patienten mit chronisch kritischer Extremitätenischämie und notwendiger Unterschenkelrevaskularisation wird in der Literatur kontrovers diskutiert.

Methoden

Es wurde eine narrative Literatursuche auf PubMed (US National Library of Medicine) durchgeführt.

Ergebnisse und Schlussfolgerung

Es liegen zahlreiche retrospektiven Studien vor, die eine unterschiedliche Relevanz dieses Konzeptes in Abhängigkeit des gewählten Therapieverfahrens (offen-chirurgisch vs. endovaskulär) zeigen. Ebenso haben Nebenerkrankungen einen Einfluss auf dessen Relevanz.

Dieser Artikel gibt eine Übersicht über die derzeitige Studienlage zur angiosomenorientierten Revaskularisation in Abhängigkeit vom gewählten Therapieverfahren sowie eventuell vorliegender Nebenerkrankungen.

Abstract

Background

The angiosome concept as a role model for decision making on revascularization in patients with chronic limb-threatening ischemia and the necessary lower leg revascularization has recently been the subject of controversial discussion in the literature.

Methods

A narrative literature search was conducted in PubMed (US National Library of Medicine).

Results and conclusion

There are a large number of retrospective studies showing the different relevance of this concept depending on the selected treatment procedure (open surgery vs. endovascular). Comorbidities also have an influence on the relevance. This article summarizes the current literature on the angiosome-oriented revascularization based on the selected treatment procedure and possible pre-existing comorbidities.

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Correspondence to PD Dr. U. Rother.

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Interessenkonflikt

U. Rother, J. Günther, A. Meyer, W. Lang, C. Behrendt, H. Görtz, G. Rümenapf und C. Uhl geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Rother, U., Günther, J., Meyer, A. et al. Die Relevanz des Angiosomen-Konzepts in der Behandlung der chronisch kritischen Extremitätenischämie. Gefässchirurgie 26, 97–101 (2021). https://doi.org/10.1007/s00772-020-00737-x

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Schlüsselwörter

  • Gefäßchirurgie
  • Entscheidungsfindung
  • Unterschenkelrevaskularisation
  • AVK
  • Beinerhalt

Keywords

  • Vascular surgery
  • Decision making
  • Lower leg revascularization
  • PAD
  • Limb salvage