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Operative und interventionelle Gefäßmedizin pp 1–8Cite as

Erkrankungen und Behandlung der A. subclavia

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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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Authors and Affiliations

  1. Klinik und Poliklinik für Gefäßmedizin, Universitäres Herzzentrum Hamburg, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    Christian-Alexander Behrendt, Axel Larena-Avellaneda, Tilo Kölbel & Eike Sebastian Debus

Authors
  1. Christian-Alexander Behrendt
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  2. Axel Larena-Avellaneda
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  3. Tilo Kölbel
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  4. Eike Sebastian Debus
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Corresponding author

Correspondence to Christian-Alexander Behrendt .

Editor information

Editors and Affiliations

  1. Klinik und Poliklinik für Gefäßmedizin, Universitäres Herzzentrum GmbH, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany

    Eike Sebastian Debus

  2. Radiologie, Allgemeines Krankenhaus Harburg Abt. Diagnostische und Interventionelle, Hamburg, Germany

    Walter Gross-Fengels

Section Editor information

  1. Klinik und Poliklinik für Gefäßmedizin, Universitäres Herzzentrum GmbH, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    Eike Sebastian Debus

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

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Behrendt, CA., Larena-Avellaneda, A., Kölbel, T., Debus, E.S. (2019). Erkrankungen und Behandlung der A. subclavia. In: Debus, E., Gross-Fengels, W. (eds) Operative und interventionelle Gefäßmedizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45856-3_54-1

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  • DOI: https://doi.org/10.1007/978-3-662-45856-3_54-1

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  • Print ISBN: 978-3-662-45856-3

  • Online ISBN: 978-3-662-45856-3

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