Skip to main content
Erschienen in: Gefässchirurgie 6/2017

29.09.2017 | Periphere arterielle Verschlusskrankheit | CME

Endovaskuläre First-line-Behandlung der peripheren arteriellen Verschlusskrankheit

verfasst von: Dr. Y. Bausback, S. Steiner, A. Schmidt, D. Scheinert

Erschienen in: Gefässchirurgie | Ausgabe 6/2017

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die Gefäßmedizin und mit ihr die Behandlung der symptomatischen arteriellen Verschlusskrankheit (pAVK) haben im letzten Jahrzehnt einen starken Wandel hin zur endovaskulären Therapie erfahren. Attraktiv v. a. durch die geringe Invasivität der Behandlung, können nun auch komplexe Gefäßpathologien technisch endovaskulär gelöst werden. Für die Beckenarterien haben Stents vergleichbare Ergebnisse zur aortofemoralen Bypasschirurgie gebracht. Femoropopliteal erzielten medikamentenbeschichtete Stents und Ballonkatheter verbesserte Langzeitergebnisse nach endovaskulärer Intervention. Im kruralen Stromgebiet haben die wenig invasiven Rekanalisationstechniken der endovaskulären Therapie zum Durchbruch verholfen. Seit dem Jahr 2000 wurden fachgesellschaftsübergreifend internationale Behandlungsempfehlungen (TASC[Trans-Atlantic Inter-Society Consensus] I + II) herausgegeben, die letztmals 2015 für das krurale Gefäßgebiet ergänzt wurden. Für Deutschland wurden 2016 interdisziplinär neue Leitlinien zur Behandlung der pAVK publiziert, die der endovaskulären Therapie erstmals einen so hohen Stellenwert einräumen, dass sie in der täglichen Praxis zunehmend „first line“ eingesetzt werden kann.
Literatur
1.
Zurück zum Zitat Jaff MR, White CJ, Hiatt WR et al (2015) An Update on Methods for Revascularization and Expansion of the TASC Lesion Classification to Include Below-the-Knee Arteries: A Supplement to the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). TASC Steering Committee. J Endovasc Ther 22:663–677CrossRefPubMed Jaff MR, White CJ, Hiatt WR et al (2015) An Update on Methods for Revascularization and Expansion of the TASC Lesion Classification to Include Below-the-Knee Arteries: A Supplement to the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). TASC Steering Committee. J Endovasc Ther 22:663–677CrossRefPubMed
2.
Zurück zum Zitat Lawall H, Huppert P (2017) German guideline on the diagnosis and treatment of peripheral artery disease – a comprehensive update 2016. Espinola-Klein et al, Bd. 46., S 79–86 Lawall H, Huppert P (2017) German guideline on the diagnosis and treatment of peripheral artery disease – a comprehensive update 2016. Espinola-Klein et al, Bd. 46., S 79–86
3.
Zurück zum Zitat Mwipatayi BP, Thomas S, Wong J et al (2011) A comparison of covered vs bare expandable stents for the treatment of aortoiliac occlusive disease. J Vasc Surg 54:1561–1570CrossRefPubMed Mwipatayi BP, Thomas S, Wong J et al (2011) A comparison of covered vs bare expandable stents for the treatment of aortoiliac occlusive disease. J Vasc Surg 54:1561–1570CrossRefPubMed
4.
Zurück zum Zitat Dohi T, Iida O, Okamoto S et al (2013) Mid-term clinical outcome following endovascular therapy in patients with chronic aortic occlusion. Cardiovasc Intervention and Therapeutics 28(4):327–332CrossRef Dohi T, Iida O, Okamoto S et al (2013) Mid-term clinical outcome following endovascular therapy in patients with chronic aortic occlusion. Cardiovasc Intervention and Therapeutics 28(4):327–332CrossRef
5.
Zurück zum Zitat Stavroulakis K, Usai MV, Torsello G et al (2016) Efficacy and safety of transbrachial access for iliac endovascular interventions. J Endovasc Ther 23:554–560 (Cardiovasc Interv and Ther 28:327–332)CrossRef Stavroulakis K, Usai MV, Torsello G et al (2016) Efficacy and safety of transbrachial access for iliac endovascular interventions. J Endovasc Ther 23:554–560 (Cardiovasc Interv and Ther 28:327–332)CrossRef
6.
Zurück zum Zitat Bath J, Avgerinos E (2016) A pooled analysis of common femoral and profunda femoris endovascular interventions. Vascular 24:404–413CrossRefPubMed Bath J, Avgerinos E (2016) A pooled analysis of common femoral and profunda femoris endovascular interventions. Vascular 24:404–413CrossRefPubMed
7.
Zurück zum Zitat Nasr B, Kaladji A, Vent PA et al (2017) Long term outcomes of common femoral artery stenting. Ann Vasc Surg 40:10–18CrossRefPubMed Nasr B, Kaladji A, Vent PA et al (2017) Long term outcomes of common femoral artery stenting. Ann Vasc Surg 40:10–18CrossRefPubMed
8.
Zurück zum Zitat Gouëffic Y, Schiava DN, Thaveau F et al (2017) Stenting or Surgery for De Novo Common Femoral Artery Stenosis. JACC Cardiovasc Interv 10:1344–1354CrossRefPubMed Gouëffic Y, Schiava DN, Thaveau F et al (2017) Stenting or Surgery for De Novo Common Femoral Artery Stenosis. JACC Cardiovasc Interv 10:1344–1354CrossRefPubMed
9.
Zurück zum Zitat Scheinert D, Scheinert S, Sax J et al (2005) Prevalence and clinical impact of stent fractures after femoropopliteal stenting. J Am Coll Cardiol 45:312–315CrossRefPubMed Scheinert D, Scheinert S, Sax J et al (2005) Prevalence and clinical impact of stent fractures after femoropopliteal stenting. J Am Coll Cardiol 45:312–315CrossRefPubMed
10.
Zurück zum Zitat Zeller T, Peeters P, Bosiers M et al (2014) Heparin-bonded stent-graft for the treatment of TASC II C and D femoropopliteal lesions: the Viabahn-25 cm trial. J Endovasc Ther 21:765–774CrossRefPubMed Zeller T, Peeters P, Bosiers M et al (2014) Heparin-bonded stent-graft for the treatment of TASC II C and D femoropopliteal lesions: the Viabahn-25 cm trial. J Endovasc Ther 21:765–774CrossRefPubMed
11.
Zurück zum Zitat Scheinert D, Werner M, Scheinert S et al (2013) Treatment of complex atherosclerotic popliteal artery disease with a new self-expanding interwoven nitinol stent: 12-month results of the LEIPZIG SUPERA popliteal artery stent registry. JACC Cardiovasc Interv 6:65–71CrossRefPubMed Scheinert D, Werner M, Scheinert S et al (2013) Treatment of complex atherosclerotic popliteal artery disease with a new self-expanding interwoven nitinol stent: 12-month results of the LEIPZIG SUPERA popliteal artery stent registry. JACC Cardiovasc Interv 6:65–71CrossRefPubMed
12.
Zurück zum Zitat Stavroulakis K, Schwindt A, Torsello G et al (2017) Directional atherectomy with antirestenotic therapy vs drug-coated balloon angioplasty alone for isolated popliteal artery lesions. J Endovasc Ther 24:181–188CrossRefPubMed Stavroulakis K, Schwindt A, Torsello G et al (2017) Directional atherectomy with antirestenotic therapy vs drug-coated balloon angioplasty alone for isolated popliteal artery lesions. J Endovasc Ther 24:181–188CrossRefPubMed
13.
Zurück zum Zitat Katsanos K, Spiliopoulos S, Diamantopoulos A, Siablis D, Karnabatidis D, Scheinert D (2016) Wound Healing Outcomes and Health-Related Quality-of-Life Changes in the ACHILLES Trial: 1‑Year Results From a Prospective Randomized Controlled Trial of Infrapopliteal Balloon Angioplasty Versus Sirolimus-Eluting Stenting in Patients With Ischemic Peripheral Arterial Disease. JACC Cardiovasc Interv 9:259–267CrossRefPubMed Katsanos K, Spiliopoulos S, Diamantopoulos A, Siablis D, Karnabatidis D, Scheinert D (2016) Wound Healing Outcomes and Health-Related Quality-of-Life Changes in the ACHILLES Trial: 1‑Year Results From a Prospective Randomized Controlled Trial of Infrapopliteal Balloon Angioplasty Versus Sirolimus-Eluting Stenting in Patients With Ischemic Peripheral Arterial Disease. JACC Cardiovasc Interv 9:259–267CrossRefPubMed
14.
Zurück zum Zitat Bosiers M, Scheinert D, Peeters P et al (2012) Randomized comparison of everolimus-eluting versus bare-metal stents in patients with critical limb ischemia and infrapopliteal arterial occlusive disease. J Vasc Surg 55:390–398CrossRefPubMed Bosiers M, Scheinert D, Peeters P et al (2012) Randomized comparison of everolimus-eluting versus bare-metal stents in patients with critical limb ischemia and infrapopliteal arterial occlusive disease. J Vasc Surg 55:390–398CrossRefPubMed
15.
Zurück zum Zitat Schmidt A, Ulrich M, Winkler B et al (2010) Angiographic patency and clinical outcome after balloon-angioplasty for extensive infrapopliteal arterial disease. Catheter Cardiovasc Interv 76:1047–1054CrossRefPubMed Schmidt A, Ulrich M, Winkler B et al (2010) Angiographic patency and clinical outcome after balloon-angioplasty for extensive infrapopliteal arterial disease. Catheter Cardiovasc Interv 76:1047–1054CrossRefPubMed
17.
Zurück zum Zitat Biancari F, Juvonen T (2014) Angiosome-targeted lower limb revascularization for ischemic foot wounds: systematic review and meta-analysis. Eur J Vasc Endovasc Surg 47:517–522CrossRefPubMed Biancari F, Juvonen T (2014) Angiosome-targeted lower limb revascularization for ischemic foot wounds: systematic review and meta-analysis. Eur J Vasc Endovasc Surg 47:517–522CrossRefPubMed
18.
Zurück zum Zitat Diamantopoulos A, Katsanos K (2014) Atherectomy of the femoropopliteal artery: a systematic review and meta-analysis of randomized controlled trials. J Cardiovasc Surg 55:655–665 Diamantopoulos A, Katsanos K (2014) Atherectomy of the femoropopliteal artery: a systematic review and meta-analysis of randomized controlled trials. J Cardiovasc Surg 55:655–665
19.
Zurück zum Zitat Dake MD, Ansel GM, Jaff MR, Ohki T et al (2013) ZilverPTX Investigators Sustained safety and effectiveness of paclitaxel-eluting for femoropopliteal lesions: 2‑year follow up from the ZILVER PTX randomized and single arm clinical studies. J Am Coll Cardiol 61:2417–2427CrossRefPubMed Dake MD, Ansel GM, Jaff MR, Ohki T et al (2013) ZilverPTX Investigators Sustained safety and effectiveness of paclitaxel-eluting for femoropopliteal lesions: 2‑year follow up from the ZILVER PTX randomized and single arm clinical studies. J Am Coll Cardiol 61:2417–2427CrossRefPubMed
20.
Zurück zum Zitat Müller-Hülsbeck S, Keirse K, Zeller T, Schroë H, Diaz-Cartelle J (2016) Twelve-Month Results From the MAJESTIC Trial of the Eluvia Paclitaxel-ElutingStent for Treatment of Obstructive Femoropopliteal Disease. J Endovasc Ther 23:701–707CrossRefPubMedPubMedCentral Müller-Hülsbeck S, Keirse K, Zeller T, Schroë H, Diaz-Cartelle J (2016) Twelve-Month Results From the MAJESTIC Trial of the Eluvia Paclitaxel-ElutingStent for Treatment of Obstructive Femoropopliteal Disease. J Endovasc Ther 23:701–707CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Cortese B, Granada JF, Scheller B et al (2016) Drug coated balloon treatment for lower extremity vascular disease intervention: an international positioning document. Eur Heart J 37:1096–1103CrossRefPubMed Cortese B, Granada JF, Scheller B et al (2016) Drug coated balloon treatment for lower extremity vascular disease intervention: an international positioning document. Eur Heart J 37:1096–1103CrossRefPubMed
22.
Zurück zum Zitat Scheinert D, Schmidt A, Zeller T et al (2016) German Center Subanalysis of the LEVANT 2 Global Randomized Study of the Lutonix Drug-Coated Balloon in the Treatment of Femoropopliteal Occlusive Disease. J Endovasc Ther 23:409–416CrossRefPubMed Scheinert D, Schmidt A, Zeller T et al (2016) German Center Subanalysis of the LEVANT 2 Global Randomized Study of the Lutonix Drug-Coated Balloon in the Treatment of Femoropopliteal Occlusive Disease. J Endovasc Ther 23:409–416CrossRefPubMed
23.
Zurück zum Zitat Laird JR, Schneider PA, Tepe G, Brodmann M, Zeller T, Metzger C, Krishnan P, Scheinert D, Micari D, Cohen DJ, Wang H, Hasenbank MS, Jaff MR (2015) Durability of treatment effect using a drug-coated balloon for femoropopliteal lesions. J Am Coll Cardiol 66(21):2329–2338CrossRefPubMed Laird JR, Schneider PA, Tepe G, Brodmann M, Zeller T, Metzger C, Krishnan P, Scheinert D, Micari D, Cohen DJ, Wang H, Hasenbank MS, Jaff MR (2015) Durability of treatment effect using a drug-coated balloon for femoropopliteal lesions. J Am Coll Cardiol 66(21):2329–2338CrossRefPubMed
24.
Zurück zum Zitat Krishnan P, Faries P, Niazi K et al (2017) Stellarex drug-coated balloon for treatment of femoropopliteal disease: 12-month outcomes from the randomized ILLUMENATE pivotal and pharmacokinetic studies. Circulation. https://doi.org/10.1161/CIRCULATION AHA. (Epub ahead of print) Krishnan P, Faries P, Niazi K et al (2017) Stellarex drug-coated balloon for treatment of femoropopliteal disease: 12-month outcomes from the randomized ILLUMENATE pivotal and pharmacokinetic studies. Circulation. https://​doi.​org/​10.​1161/​CIRCULATION AHA. (Epub ahead of print)
25.
Zurück zum Zitat Rosenfield K, Jaff MR, White CJ et al (2015) Trial of a paclitaxel-coated balloon for femoropopliteal artery disease. N Engl J Med 9(373):145–153 Rosenfield K, Jaff MR, White CJ et al (2015) Trial of a paclitaxel-coated balloon for femoropopliteal artery disease. N Engl J Med 9(373):145–153
27.
Zurück zum Zitat Bausback Y, Botsios S, Flux J et al (2011) Outback catheter for femoropopliteal occlusions: immediate and long term results. J Endovasc Ther 18:13–21CrossRefPubMed Bausback Y, Botsios S, Flux J et al (2011) Outback catheter for femoropopliteal occlusions: immediate and long term results. J Endovasc Ther 18:13–21CrossRefPubMed
28.
Zurück zum Zitat Schmidt A, Bausback Y, Piorkowski M et al (2012) Retrograde recanalization technique for use after failed antegrade angioplasty in chronic femoral artery occlusions. J Endovasc Ther 19:23–29CrossRefPubMed Schmidt A, Bausback Y, Piorkowski M et al (2012) Retrograde recanalization technique for use after failed antegrade angioplasty in chronic femoral artery occlusions. J Endovasc Ther 19:23–29CrossRefPubMed
29.
Zurück zum Zitat Karnabatidis D, Spiliopoulos S, Tsetis D, Siablis D (2011) Quality improvement guidelines for Percutaneous Catheter-Directed Intra-Arterial Thrombolysis and Mechanical Thrombectomy for Acute Lower-Limb Ischemia. Cardiovasc Intervent Radiol 34:1123–1136CrossRefPubMed Karnabatidis D, Spiliopoulos S, Tsetis D, Siablis D (2011) Quality improvement guidelines for Percutaneous Catheter-Directed Intra-Arterial Thrombolysis and Mechanical Thrombectomy for Acute Lower-Limb Ischemia. Cardiovasc Intervent Radiol 34:1123–1136CrossRefPubMed
30.
Zurück zum Zitat Taha AG, Byrne RM, Avgerinos ED, Marone LK, Makaroun MS, Chaer RA (2015) Comparative effektiveness of endovascular versus surgical revascularisation for acute lower extremity ischemia. J Vasc Surg 61:147–154CrossRefPubMed Taha AG, Byrne RM, Avgerinos ED, Marone LK, Makaroun MS, Chaer RA (2015) Comparative effektiveness of endovascular versus surgical revascularisation for acute lower extremity ischemia. J Vasc Surg 61:147–154CrossRefPubMed
31.
Zurück zum Zitat Branco BC, Montero-Baker MF, Mills JL Sr (2015) The pros and cons of endovascular and open surgical treatment for patients with acute limb ischemia. J Cardiovasc Surg 56:401–407 Branco BC, Montero-Baker MF, Mills JL Sr (2015) The pros and cons of endovascular and open surgical treatment for patients with acute limb ischemia. J Cardiovasc Surg 56:401–407
Metadaten
Titel
Endovaskuläre First-line-Behandlung der peripheren arteriellen Verschlusskrankheit
verfasst von
Dr. Y. Bausback
S. Steiner
A. Schmidt
D. Scheinert
Publikationsdatum
29.09.2017
Verlag
Springer Medizin
Erschienen in
Gefässchirurgie / Ausgabe 6/2017
Print ISSN: 0948-7034
Elektronische ISSN: 1434-3932
DOI
https://doi.org/10.1007/s00772-017-0311-6

Weitere Artikel der Ausgabe 6/2017

Gefässchirurgie 6/2017 Zur Ausgabe

Update Gefäßmedizin

Update Gefäßmedizin

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.