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Erkrankungen und Behandlung der A. subclavia

  • Christian-Alexander BehrendtEmail author
  • Axel Larena-Avellaneda
  • Tilo Kölbel
  • Eike Sebastian Debus
Living reference work entry
Part of the Springer Reference Medizin book series (SRM)

Zusammenfassung

Unter den insgesamt seltenen Erkrankungen der A. subclavia (AS) zählen atherosklerotische Einengungen und Verschlussprozesse des proximalen Abschnitts zu den häufigsten Ursachen für eine gefäßmedizinische Therapie. Deutlich seltener sind dagegen traumatische Verletzungen des Schultergürtels oder maligne Erkrankungen mit Gefäßbeteiligung, iatrogene Verletzungen der A. subclavia (ZVK- oder ECMO-Anlage), strahlenbedingte Gefäßläsionen, Kompressionssyndrome der oberen Thoraxapertur (arterielles Thoracic-Outlet-Syndrom, TOS), Halsrippensyndrom, entzündliche Gefäßerkrankungen (z. B. Takayasu Arteriitis, Riesenzellarteriitis), fibromuskuläre Dysplasie, Dissektionen, aneurysmatische Erkrankungen oder Eingriffe im Rahmen von endovaskulären Behandlungen der thorakalen Aorta (TEVAR). Zur letztgenannten Gruppe gehören sogenannte Debranching-Operationen: Transpositionen der AS auf die A. carotis (ST) und Karotis-Subclavia-Bypässe (CSB). Die klinische Symptomatik von hämodynamisch relevanten Läsionen der AS ist, sofern vorhanden, äußerst heterogen und reicht von belastungsabhängigen Ischämieschmerzen der oberen Extremitäten und dem sogenannten Subclavian-Steal-Syndrom mit passageren vertebro-basilären Defiziten (z. B. Schwindel, Sehstörungen) bis hin zu manifesten Hirninfarkten. Nach koronaren Bypassoperationen mit der A. thoracica interna als Spendergefäß oder nach Anlage von Dialyseshunts können Verschlussprozesse an der AS auch durch ein Coronary-Steal-Syndrom oder eine verschlechterte Dialyseshuntfunktion symptomatisch werden.

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Copyright information

© Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature 2019

Authors and Affiliations

  • Christian-Alexander Behrendt
    • 1
    Email author
  • Axel Larena-Avellaneda
    • 1
  • Tilo Kölbel
    • 1
  • Eike Sebastian Debus
    • 1
  1. 1.Klinik und Poliklinik für GefäßmedizinUniversitäres Herzzentrum Hamburg, Universitätsklinikum Hamburg-EppendorfHamburgDeutschland

Section editors and affiliations

  • Eike Sebastian Debus
    • 1
  1. 1.Klinik und Poliklinik für GefäßmedizinUniversitäres Herzzentrum GmbH, Universitätsklinikum Hamburg-EppendorfHamburgDeutschland

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