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Erschienen in: Gefässchirurgie 7/2021

04.10.2021 | AV-Fisteln | Leitthema

Dialysezugangsassoziierte Extremitätenischämie (DAI)

verfasst von: Dr. Volker Mickley

Erschienen in: Gefässchirurgie | Ausgabe 7/2021

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Zusammenfassung

Als Folge des steten Anstiegs des medianen Alters inzidenter und prävalenter Dialysepatienten und der gleichzeitigen Zunahme des Anteils von Diabetikern unter ihnen sehen wir immer häufiger Patienten mit peripheren Ischämien in Assoziation mit ihrem arteriovenösen (AV) Gefäßzugang. Ursächliche arterielle Einstromstenosen können meist interventionell behoben werden. Meist hat die dialysezugangsassoziierte Ischämie (DAI) jedoch ihre Ursache in einem erhöhten peripheren, arteriellen Abstromwiderstand. In diesen Fällen sind dann häufig komplexe gefäßchirurgische Korrektureingriffe erforderlich. Prä- und intraoperative Flussmessungen sind von großem Wert für eine differenzierte und erfolgreiche Therapie mit dem Ziel des Erhalts von Gefäßzugang und Extremität. Abhängig vom präoperativ gemessenen Shuntfluss können den Fluss reduzierende oder umleitende Operationen zur Anwendung kommen. Die einzelnen Verfahren werden dargestellt und bewertet
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Metadaten
Titel
Dialysezugangsassoziierte Extremitätenischämie (DAI)
verfasst von
Dr. Volker Mickley
Publikationsdatum
04.10.2021
Verlag
Springer Medizin
Schlagwort
AV-Fisteln
Erschienen in
Gefässchirurgie / Ausgabe 7/2021
Print ISSN: 0948-7034
Elektronische ISSN: 1434-3932
DOI
https://doi.org/10.1007/s00772-021-00825-6

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Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.