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Erschienen in: CardioVasc 6/2021

14.12.2021 | Periphere arterielle Verschlusskrankheit | Zertifizierte Fortbildung

Behandlung der verschiedenen Segmente

Interventionelle Therapie der PAVK - "How I do it"

verfasst von: Prof. Dr. Peter Huppert

Erschienen in: CardioVasc | Ausgabe 6/2021

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Die demografische Entwicklung bedingt eine Zunahme der peripheren arteriellen Verschlusskrankheit (PAVK). Der Stellenwert der katheterbasierten interventionellen Behandlungsverfahren bei PAVK-Patienten nimmt stetig zu. In diesem Beitrag sollen die Therapieziele sowie die methodischen Gemeinsamkeiten und Unterschiede interventioneller Behandlungen im aortoiliakalen, femoropoplitealen und kruropedalen Segment beschrieben, an Fallbeispielen dargestellt und bezüglich ihrer Ergebnisse zusammengefasst werden. …
Literatur
1.
Zurück zum Zitat Malyar N, Fürstenberg T, Wellmann J et al. Recent trends in morbidity and in-hospital outcomes of in-patients with peripheral arterial disease: a nationwide population-based analysis. Eur Heart J. 2013;34:2706-14 Malyar N, Fürstenberg T, Wellmann J et al. Recent trends in morbidity and in-hospital outcomes of in-patients with peripheral arterial disease: a nationwide population-based analysis. Eur Heart J. 2013;34:2706-14
2.
Zurück zum Zitat S3 Leitlinie PAVK. AWMF Register Nr. 065/003. Deutsche Gesellschaft für Angiologie Gesellschaft für Gefäßmedizin. http://www.awmf-online.de Stand 30.9.2015 (derzeit unter Aktualisierung) S3 Leitlinie PAVK. AWMF Register Nr. 065/003. Deutsche Gesellschaft für Angiologie Gesellschaft für Gefäßmedizin. http://​www.​awmf-online.​de Stand 30.9.2015 (derzeit unter Aktualisierung)
3.
Zurück zum Zitat Lane R, Ellis B, Watsou L et al. Exercise for intermittend claudication. Cochrane Database Sys Rev. 2014;7:CD000990 Lane R, Ellis B, Watsou L et al. Exercise for intermittend claudication. Cochrane Database Sys Rev. 2014;7:CD000990
4.
Zurück zum Zitat Fokkenrood HJ, Bendermacher BL, Laurent GJ et al. Supervised exercise therapy versus non-supervised exercise therapy for intermittend claudication. Cochrane Database Sys Rev. 2013;8:CD005263 Fokkenrood HJ, Bendermacher BL, Laurent GJ et al. Supervised exercise therapy versus non-supervised exercise therapy for intermittend claudication. Cochrane Database Sys Rev. 2013;8:CD005263
5.
Zurück zum Zitat McDermott MM, Spring B, Tian L et al. Effect of low-intensity vs high-intensity home-based walking exercise on walk distance in patients with peripheral artery disease - The LITE randomized trial. JAMA. 2021;325;13:1266-76 McDermott MM, Spring B, Tian L et al. Effect of low-intensity vs high-intensity home-based walking exercise on walk distance in patients with peripheral artery disease - The LITE randomized trial. JAMA. 2021;325;13:1266-76
6.
Zurück zum Zitat Alexandrescu V, Vincent G, Azdad K et al. A reliable approach to diabetic neuroischemic foot wounds: below-the-knee-angiosome-oriented angioplasty. J Endovasc Ther. 2011;18:376-87 Alexandrescu V, Vincent G, Azdad K et al. A reliable approach to diabetic neuroischemic foot wounds: below-the-knee-angiosome-oriented angioplasty. J Endovasc Ther. 2011;18:376-87
7.
Zurück zum Zitat Fossaceca R, Guzzardi G, Cerini P et al. Endovascular treatment of diabetic foot in a selected population of patients with below-the-knee disease: Is the angiosome model effective? Cardiovasc Intervent Radiol. 2013;36:637-44 Fossaceca R, Guzzardi G, Cerini P et al. Endovascular treatment of diabetic foot in a selected population of patients with below-the-knee disease: Is the angiosome model effective? Cardiovasc Intervent Radiol. 2013;36:637-44
8.
Zurück zum Zitat Varela C, Acin F, Haro J et al. The role of foot collateral vessels on ulcer healing and limb salvage after successful endovascular and surgical distal procedures according to an angiosome model. Vas Endovasc Surg. 2010;44:654-60 Varela C, Acin F, Haro J et al. The role of foot collateral vessels on ulcer healing and limb salvage after successful endovascular and surgical distal procedures according to an angiosome model. Vas Endovasc Surg. 2010;44:654-60
9.
Zurück zum Zitat Ye W, Lin CW, Ricco JB et al. Early and late outcomes of percutaneous treatment of TransAtlantic Inter-Society Consensus class C and D oarto-iliac lesions. J Vasc Surg. 2011;53:1728-37 Ye W, Lin CW, Ricco JB et al. Early and late outcomes of percutaneous treatment of TransAtlantic Inter-Society Consensus class C and D oarto-iliac lesions. J Vasc Surg. 2011;53:1728-37
10.
Zurück zum Zitat Jongkind V, Akkersdijk GJ, Yeung KK et al. A systematic review of endovascular treatment of extensive aorto-iliac occlusive disease. J Vasc Surg. 2010;52:1376-83 Jongkind V, Akkersdijk GJ, Yeung KK et al. A systematic review of endovascular treatment of extensive aorto-iliac occlusive disease. J Vasc Surg. 2010;52:1376-83
11.
Zurück zum Zitat Bausback Y, Botsios S, Flux J et al. Outback catheter for femoropopliteal occlusions: immediate and long-term results. J Endovasc Ther. 2011;18:13-21 Bausback Y, Botsios S, Flux J et al. Outback catheter for femoropopliteal occlusions: immediate and long-term results. J Endovasc Ther. 2011;18:13-21
12.
Zurück zum Zitat Bolia A, Sayers RD, Thompson MM et al. Subintimal and intraluminal recanalisation of occluded crural arteries by percutaneous balloon angioplasty. Eur J Vasc Surg. 1994;8:214-19 Bolia A, Sayers RD, Thompson MM et al. Subintimal and intraluminal recanalisation of occluded crural arteries by percutaneous balloon angioplasty. Eur J Vasc Surg. 1994;8:214-19
13.
Zurück zum Zitat Met R, van Lienden KP, Koelemay MJN et al. Subintimal angioplasty for peripheral arterial occlusive disease: a systematic review. Cardiovasc Intervent Radiol. 2008;31:687-97 Met R, van Lienden KP, Koelemay MJN et al. Subintimal angioplasty for peripheral arterial occlusive disease: a systematic review. Cardiovasc Intervent Radiol. 2008;31:687-97
14.
Zurück zum Zitat Schmidt A, Bausback Y, Piorkowski M et al. Retrograde recanalization technique for use after failed antegrade angioplasty in chronic femoral artery occlusions. J Endovasc Ther. 2012;19:23-29 Schmidt A, Bausback Y, Piorkowski M et al. Retrograde recanalization technique for use after failed antegrade angioplasty in chronic femoral artery occlusions. J Endovasc Ther. 2012;19:23-29
15.
Zurück zum Zitat Surmely JF, Tsuchikane E, Katho O et al. New concept for CTO recanalization using controlled antegrade and retrograde subintimal tracking: the CART technique. J Invasive Cardiol. 2006;18:334-38 Surmely JF, Tsuchikane E, Katho O et al. New concept for CTO recanalization using controlled antegrade and retrograde subintimal tracking: the CART technique. J Invasive Cardiol. 2006;18:334-38
16.
Zurück zum Zitat Montero-Baker M, Schmidt A, Bräunlich S et al. Retrograde approach for complex popliteal and tibioperoneal occlusions. J Endovasc Ther. 2008;15:594-604 Montero-Baker M, Schmidt A, Bräunlich S et al. Retrograde approach for complex popliteal and tibioperoneal occlusions. J Endovasc Ther. 2008;15:594-604
17.
Zurück zum Zitat Laird JR, Katzen BT, Scheinert D et al. Nitinol stent implantation vs. balloon angioplasty for lesions in the superficial femoral and proximal popliteal arteries of patients with claudication; Three-year follow-up from the RESILIENT randomized trial. J Endovasc Ther. 2012;19:1-9 Laird JR, Katzen BT, Scheinert D et al. Nitinol stent implantation vs. balloon angioplasty for lesions in the superficial femoral and proximal popliteal arteries of patients with claudication; Three-year follow-up from the RESILIENT randomized trial. J Endovasc Ther. 2012;19:1-9
18.
Zurück zum Zitat Dick P, Wallner H, Sabeti S et al. Balloon angioplasty versus stenting with nitinol stents in intermediate length superficial femoral artery lesions. Cath Cardiovasc Interv. 2009;74:1090-1095 Dick P, Wallner H, Sabeti S et al. Balloon angioplasty versus stenting with nitinol stents in intermediate length superficial femoral artery lesions. Cath Cardiovasc Interv. 2009;74:1090-1095
19.
Zurück zum Zitat Matsumura JS, Yamanouchi D, Goldstein JA et al. The United States study for evaluating endovascular treatments of lesions in the superficial femoral artery and proximal popliteal by using the Protege Everflex Nitinol Stent System II (DURABILITY II). J Vasc Surg. 2013;58:73-83 Matsumura JS, Yamanouchi D, Goldstein JA et al. The United States study for evaluating endovascular treatments of lesions in the superficial femoral artery and proximal popliteal by using the Protege Everflex Nitinol Stent System II (DURABILITY II). J Vasc Surg. 2013;58:73-83
20.
Zurück zum Zitat Bosiers M, Torsello G, Gissler HM et al. Nitinol stent implantation in long superficial femoral artery lesions: 12-month results of the DURABILITY I study. J Endovasc Ther. 2009;16:261-69 Bosiers M, Torsello G, Gissler HM et al. Nitinol stent implantation in long superficial femoral artery lesions: 12-month results of the DURABILITY I study. J Endovasc Ther. 2009;16:261-69
21.
Zurück zum Zitat Lammer J, Zeller T, Hausegger KA et al. Heparin-bonded covered stents versus bare-metal stents for complex femoropopliteal artery lesions: The randomized VIASTAR trial (Viabahn endoprosthesis with PROPTEN bioactive surface (VIA) versus bare nitinol stent in the treatment of long lesions in superficial femoral artery occlusive disease). J Am Coll Cardiol. 2013;62:1320-27 Lammer J, Zeller T, Hausegger KA et al. Heparin-bonded covered stents versus bare-metal stents for complex femoropopliteal artery lesions: The randomized VIASTAR trial (Viabahn endoprosthesis with PROPTEN bioactive surface (VIA) versus bare nitinol stent in the treatment of long lesions in superficial femoral artery occlusive disease). J Am Coll Cardiol. 2013;62:1320-27
22.
Zurück zum Zitat Klumb C, Lehmann T, Aschenbach R et al. Benefit and risk from Paclitaxel-coated balloon angioplasty for treatment of femoropopliteal artery disease: A systematic review and meta-analysis of randomised controlled trials. E Clin Med (Lancet). 2019;16:42-50 Klumb C, Lehmann T, Aschenbach R et al. Benefit and risk from Paclitaxel-coated balloon angioplasty for treatment of femoropopliteal artery disease: A systematic review and meta-analysis of randomised controlled trials. E Clin Med (Lancet). 2019;16:42-50
23.
Zurück zum Zitat Dake MD, Ansel GM, Jaff MR et al. Paclitaxel-eluting stents show superiority to balloon angioplasty and bare metal stents in femoropopliteal disease: Twelve-month Zilver PTX randomized study results. Circulation. Cardiovasc Interv. 2011;4:495-505 Dake MD, Ansel GM, Jaff MR et al. Paclitaxel-eluting stents show superiority to balloon angioplasty and bare metal stents in femoropopliteal disease: Twelve-month Zilver PTX randomized study results. Circulation. Cardiovasc Interv. 2011;4:495-505
24.
Zurück zum Zitat Schmidt A, Piorkowski M, Görner H et al. Drug-coated balloons for complex femoropopliteal lesions: 2-year results of a real-world registry. JACC Cardiovasc Interv. 2016;9:715-24 Schmidt A, Piorkowski M, Görner H et al. Drug-coated balloons for complex femoropopliteal lesions: 2-year results of a real-world registry. JACC Cardiovasc Interv. 2016;9:715-24
25.
Zurück zum Zitat Schmidt A, Scheinert D. Behandlungsstrategien bei kritischer Ischämie und chronischen femoropoplitealen Verschlüssen. In: Teichgräber U, Aschenbach R, Scheinert D, Schmidt A (Hrsg.): Periphere arterielle Interventionen. Springer, 2018: S. 301-13 Schmidt A, Scheinert D. Behandlungsstrategien bei kritischer Ischämie und chronischen femoropoplitealen Verschlüssen. In: Teichgräber U, Aschenbach R, Scheinert D, Schmidt A (Hrsg.): Periphere arterielle Interventionen. Springer, 2018: S. 301-13
26.
Zurück zum Zitat Huppert P Perkutane Angioplastie infrapoplitealer Arterien. In: Teichgräber U, Aschenbach R, Scheinert D, Schmidt A (Hrsg.): Periphere arterielle Interventionen. Springer, 2018: S. 315-40 Huppert P Perkutane Angioplastie infrapoplitealer Arterien. In: Teichgräber U, Aschenbach R, Scheinert D, Schmidt A (Hrsg.): Periphere arterielle Interventionen. Springer, 2018: S. 315-40
27.
Zurück zum Zitat Mustapha JA, Finton SM, Diaz-Sandoval LJ et al. Percutaneous transluminal angioplasty in patients with infrapopliteal arterial disease. Systematic review and meta-analysis. Circ Cardiovasc Interv. 2016;9:1-10 Mustapha JA, Finton SM, Diaz-Sandoval LJ et al. Percutaneous transluminal angioplasty in patients with infrapopliteal arterial disease. Systematic review and meta-analysis. Circ Cardiovasc Interv. 2016;9:1-10
28.
Zurück zum Zitat Romiti M, Albers M, Brochado-Neto FC et al. Meta-analysis of infrapopliteal angioplasty for chronic critical limb ischemia J Vasc Surg. 2008;47:975-81 Romiti M, Albers M, Brochado-Neto FC et al. Meta-analysis of infrapopliteal angioplasty for chronic critical limb ischemia J Vasc Surg. 2008;47:975-81
29.
Zurück zum Zitat Peregrin JH, Koznar B, Kovac J et al. PTA of infrapopliteal arteries: Long-term clinical follow-up and analysis of factors influencing clinical outcome. Cardiovasc Intervent Radiol. 2010;33:720-25 Peregrin JH, Koznar B, Kovac J et al. PTA of infrapopliteal arteries: Long-term clinical follow-up and analysis of factors influencing clinical outcome. Cardiovasc Intervent Radiol. 2010;33:720-25
30.
Zurück zum Zitat Darling JD, Mc Callum JC, Soden PA et al. Clinical results of single versus multiple-vessel infrapopliteal intervention. J Vasc Surg. 2016;64:1675-81 Darling JD, Mc Callum JC, Soden PA et al. Clinical results of single versus multiple-vessel infrapopliteal intervention. J Vasc Surg. 2016;64:1675-81
31.
Zurück zum Zitat Nakama T, Watanabe N, Haraguchi T et al. Clinical outcomes of pedal artery angioplasty for patients with ischemic wounds: Results from the multicenter RENDEZVOUS Registry. JACC Cardiovasc Interv. 2017;9:79-90 Nakama T, Watanabe N, Haraguchi T et al. Clinical outcomes of pedal artery angioplasty for patients with ischemic wounds: Results from the multicenter RENDEZVOUS Registry. JACC Cardiovasc Interv. 2017;9:79-90
32.
Zurück zum Zitat Shiraki T, Iida O, Takahara M et al. Predictors of delayed wound healing after endovascular therapy of isolated infrapopliteal lesions underlying critical limb ischemia in patients with high prevalence of diabetes mellitus and hemodialysis. Eur J Vasc Endovasc Surg. 2015;49:565-73 Shiraki T, Iida O, Takahara M et al. Predictors of delayed wound healing after endovascular therapy of isolated infrapopliteal lesions underlying critical limb ischemia in patients with high prevalence of diabetes mellitus and hemodialysis. Eur J Vasc Endovasc Surg. 2015;49:565-73
33.
Zurück zum Zitat Liistro F, Porto I, Angioli et al. Drug-eluting balloons in peripheral intervention for below the knee angioplasty evaluation (DEBATE-BTK). A randomized trial in diabetic patients with critical limb ischemia. Circulation. 2013;128:615-21 Liistro F, Porto I, Angioli et al. Drug-eluting balloons in peripheral intervention for below the knee angioplasty evaluation (DEBATE-BTK). A randomized trial in diabetic patients with critical limb ischemia. Circulation. 2013;128:615-21
34.
Zurück zum Zitat Zeller T, Baumgartner I, Scheinert D et al. Drug-eluting balloon versus standard balloon angioplasty for infrapopliteal arterial revascularization in critical limb ischemia. 12-month results from the IN.PACT DEEP randomized trial. J Am Coll Cardiol. 2014;54:1558-76 Zeller T, Baumgartner I, Scheinert D et al. Drug-eluting balloon versus standard balloon angioplasty for infrapopliteal arterial revascularization in critical limb ischemia. 12-month results from the IN.PACT DEEP randomized trial. J Am Coll Cardiol. 2014;54:1558-76
35.
Zurück zum Zitat Zeller T, Beschorner U, Pilger E et al. Paclitaxel-coated balloon in infrapopliteal arteries. JACC Cardiovasc Interv. 2015;8:1614-22 Zeller T, Beschorner U, Pilger E et al. Paclitaxel-coated balloon in infrapopliteal arteries. JACC Cardiovasc Interv. 2015;8:1614-22
36.
Zurück zum Zitat Bosiers M, Scheinert D, Peeters P et al. Randomized comparison of everolimus-eluting versus bare-metal stents in patients with critical limb ischemia and infrapopliteal arterial occlusive disease. J Vasc Surg. 2012;55:390-99 Bosiers M, Scheinert D, Peeters P et al. Randomized comparison of everolimus-eluting versus bare-metal stents in patients with critical limb ischemia and infrapopliteal arterial occlusive disease. J Vasc Surg. 2012;55:390-99
37.
Zurück zum Zitat Rastan A, Tepe G, Krankenberg H et al. Sirolimus-eluting stents vs. bare-metal stents for treatment of focal lesions in infrapopliteal arteries: a double-blind multi-centre, randomized clinical trial. Eur Heart J. 2011;32:2274-81 Rastan A, Tepe G, Krankenberg H et al. Sirolimus-eluting stents vs. bare-metal stents for treatment of focal lesions in infrapopliteal arteries: a double-blind multi-centre, randomized clinical trial. Eur Heart J. 2011;32:2274-81
38.
Zurück zum Zitat Rastan A, Brechtel K, Krankenberg H et al. Sirolimus-eluting stents for treatment of infrapopliteal arteries reduce clinical event rate compared to bare-metal stents. J Am Coll Cardiol. 2012;60:587-91 Rastan A, Brechtel K, Krankenberg H et al. Sirolimus-eluting stents for treatment of infrapopliteal arteries reduce clinical event rate compared to bare-metal stents. J Am Coll Cardiol. 2012;60:587-91
39.
Zurück zum Zitat Scheinert D, Katsanos K, Zeller T et al. A prospective randomized multicenter comparison of balloon angioplasty and infrapopliteal stenting with the Sirolimus-eluting stent in patients with ischemic peripheral arterial disease. 1-year results from the ACHILLES trial. J Am Coll Cardiol. 2012;60:2290-95 Scheinert D, Katsanos K, Zeller T et al. A prospective randomized multicenter comparison of balloon angioplasty and infrapopliteal stenting with the Sirolimus-eluting stent in patients with ischemic peripheral arterial disease. 1-year results from the ACHILLES trial. J Am Coll Cardiol. 2012;60:2290-95
40.
Zurück zum Zitat Committee Caprie steering: A randomised, blinded trial of clopidogrel versus aspirin in patients at risk of ischemic events (CAPRIE). CAPRIE Steering Committee. Lancet. 1996;348(9038):1329-39 Committee Caprie steering: A randomised, blinded trial of clopidogrel versus aspirin in patients at risk of ischemic events (CAPRIE). CAPRIE Steering Committee. Lancet. 1996;348(9038):1329-39
41.
Zurück zum Zitat Writing Committee members, Gerhard-Herman MD, Gornik HL, Barett C et al. 2016 AHA/ACC Guideline on the management of patients with lower extremity peripheral artery disease: Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Circulation. 2017;135(12):e686-e725 Writing Committee members, Gerhard-Herman MD, Gornik HL, Barett C et al. 2016 AHA/ACC Guideline on the management of patients with lower extremity peripheral artery disease: Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Circulation. 2017;135(12):e686-e725
42.
Zurück zum Zitat Savarese G, Reiner MF, Uijl A et al. Antithrombotic therapy and major adverse limb events in patients with chronic lower extremity arterial disease: systematic review and meta-analysis from the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy in Collaboration with the European Society of Cardiology Working Group on Aorta and Peripheral Vascular diseases. Eur Heart J Cardiovasc Pharmacother. 2020;6:86-93 Savarese G, Reiner MF, Uijl A et al. Antithrombotic therapy and major adverse limb events in patients with chronic lower extremity arterial disease: systematic review and meta-analysis from the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy in Collaboration with the European Society of Cardiology Working Group on Aorta and Peripheral Vascular diseases. Eur Heart J Cardiovasc Pharmacother. 2020;6:86-93
43.
Zurück zum Zitat Bonaca MP, Bauersachs RM, Anand SS et al. Rivaroxaban in peripheral artery disease after revascularization. N Engl J Med. 2020;382:1994-2004 Bonaca MP, Bauersachs RM, Anand SS et al. Rivaroxaban in peripheral artery disease after revascularization. N Engl J Med. 2020;382:1994-2004
44.
Zurück zum Zitat Aboyans V, Ricco J-P, Bartelink M-LEL et al. ESC Guidelines on the diagnosis and treatment of peripheral arterial diseasees, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries Endorsed by: the European Stroke Organization (ESO) The Task Force for the Diagnosis and Treatment of Peripheral Arterial Disease of the European Society Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J. 2018;39:763-816 Aboyans V, Ricco J-P, Bartelink M-LEL et al. ESC Guidelines on the diagnosis and treatment of peripheral arterial diseasees, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries Endorsed by: the European Stroke Organization (ESO) The Task Force for the Diagnosis and Treatment of Peripheral Arterial Disease of the European Society Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J. 2018;39:763-816
45.
Zurück zum Zitat Hardung D, Behne A, Boral M et al. Antithrombotische Therapie der peripheren arteriellen Verschlusskrankheit. Dtsch Ärztebl Int. 2021;118:528-35 Hardung D, Behne A, Boral M et al. Antithrombotische Therapie der peripheren arteriellen Verschlusskrankheit. Dtsch Ärztebl Int. 2021;118:528-35
Metadaten
Titel
Behandlung der verschiedenen Segmente
Interventionelle Therapie der PAVK - "How I do it"
verfasst von
Prof. Dr. Peter Huppert
Publikationsdatum
14.12.2021
Verlag
Springer Medizin
Erschienen in
CardioVasc / Ausgabe 6/2021
Print ISSN: 1617-4933
Elektronische ISSN: 1618-3851
DOI
https://doi.org/10.1007/s15027-021-3602-5

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