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Erschienen in: Der Nervenarzt 10/2015

01.10.2015 | Leitthema

Periinterventionelles Management der akuten endovaskulären Schlaganfallbehandlung

verfasst von: Dr. S. Schönenberger, J. Bösel

Erschienen in: Der Nervenarzt | Ausgabe 10/2015

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Zusammenfassung

Mit der beeindruckend konsistenten Evidenz, die die Wirkung der endovaskulären Schlaganfalltherapie (EST) belegt, werden sich in den kommenden Jahren viele Akutkliniken und Schlaganfallzentren darauf einstellen müssen, diese Therapie in optimaler Weise vorhalten zu können. Nicht nur die Intervention selbst, sondern auch die Vorbereitung des Patienten darauf, seine Stabilisierung und Monitoring während der Prozedur und die Nachbehandlung stellen erhebliche Herausforderungen dar und sind zum Teil kaum in Studien untersucht worden. Unter diesen Aspekten hat die Frage des optimalen Sedierungs- und Atemwegsmanagements bisher noch die größte Beachtung gefunden. Basierend auf retrospektiven Studien scheint es schon heute gerechtfertigt, die Intervention unter Beachtung bestimmter Kriterien im nichtintubierten, leicht sedierten („conscious sedation“, CS) Zustand dem der Intubationsnarkose („general anesthesia“, GA) vorzuziehen, und nur im Notfall auf letztere zu wechseln, bis diese Frage durch prospektive Studien geklärt ist. Dieser und andere Aspekte des periinterventionellen Managements wie Logistik, Monitoring, Blutdruck, Beatmungseinstellung, postprozedurale Maßnahmen auf Station und Bildgebungskontrollen werden in dieser Übersicht behandelt. Nicht Teil dieser Übersicht sind die klinische und radiologische Selektion des Patienten, also die Entscheidung zur Intervention oder technische Aspekte der Intervention selbst.
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Metadaten
Titel
Periinterventionelles Management der akuten endovaskulären Schlaganfallbehandlung
verfasst von
Dr. S. Schönenberger
J. Bösel
Publikationsdatum
01.10.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Der Nervenarzt / Ausgabe 10/2015
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI
https://doi.org/10.1007/s00115-015-4269-x

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