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Gefässchirurgie

Erschienen in:

01.05.2015 | Leitthema

Indikationen und Ergebnisse der Bypasschirurgie bei kritischer Extremitätenischämie (CLI)

verfasst von: PD Dr. A. Neufang

Erschienen in: Gefässchirurgie | Ausgabe 3/2015

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Zusammenfassung

Hintergrund

Die fortgeschrittene amputationsbedrohende Durchblutungsstörung stellt angesichts der demografischen Entwicklung mit steigendem Anteil alter und sehr alter Menschen, sowie der Zunahme des Diabetes mellitus eines der zentralen Probleme der modernen Gefäßmedizin dar.

Fragestellung

Die vorliegende Arbeit analysiert die derzeit zur Verfügung stehenden peripheren Bypassverfahren in Hinsicht auf die Indikation zur ihrer Anwendung, den technischen Möglichkeiten und den zu erwartenden Ergebnissen bezüglich Bypassfunktion und Erhalt der betroffenen Gliedmaße. Diese werden anhand der relevanten Literatur zusammenfassend dargestellt.

Ergebnisse

Die periphere Bypasschirurgie bietet vielfältige auf den individuellen Fall anwendbare Revaskularisationstechniken. Grundsätzlich sollte immer eine vollständige autologe Rekonstruktion mit körpereigener Vene angestrebt werden. Hierzu zählt auch der routinemäßige Einsatz von sog. alternativen Venen, wie z. B. der Armvenen. Im Falle der unzureichenden Verfügbarkeit der autologen Vene kann auch auf kleinkalibrige synthetische oder biologische Gefäßprothesen zurückgegriffen werden. Hier sind allerdings schlechtere Ergebnisse in Hinsicht auf Funktion und Beinerhalt zu erwarten.

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Titel: Indikationen und Ergebnisse der Bypasschirurgie bei kritischer Extremitätenischämie (CLI)
verfasst von: PD Dr. A. Neufang
Publikationsdatum: 01.05.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Gefässchirurgie / Ausgabe 3/2015
Print ISSN: 0948-7034
Elektronische ISSN: 1434-3932
DOI: https://doi.org/10.1007/s00772-015-0024-7

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