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Die Anaesthesiologie

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29.11.2016 | Allgemeinanästhesie | Leitthema

Anästhesiologisches Management bei endovaskulären Gefäßeingriffen

verfasst von: Dr. T. Rössel, R. Paul, T. Richter, S. Ludwig, T. Hofmockel, A. R. Heller, T. Koch

Erschienen in: Die Anaesthesiologie | Ausgabe 12/2016

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Zusammenfassung

Die Gefäßerkrankungen stellen eine der wichtigsten Ursachen für die Morbidität und die Letalität in Deutschland dar. Aufgrund des erhöhten Risikoprofils erfordert die Behandlung der betroffenen Patienten ein interdisziplinäres und multimodales Therapiekonzept. In den vergangenen Jahren haben sich endovaskuläre Gefäßeingriffe fest innerhalb dieses Konzepts etabliert. Die unterschiedlichen anatomischen Lokalisationen pathologischer Gefäßveränderungen machen jedoch die Anwendung verschiedenster endovaskulärer Therapieverfahren notwendig. Dementsprechend variieren auch die Anforderungen an das anästhesiologische Management und verlangen ein differenziertes Vorgehen. Endovaskuläre Gefäßeingriffe können sowohl in Regional- (RA) als auch in Allgemeinanästhesie durchgeführt werden. Die gegenwärtig existierenden Untersuchungen zeigen jedoch keine entscheidenden Vorteile im Hinblick auf Letalität und Morbidität durch Anwendung der RA. Allerdings konnte für einige endovaskuläre Eingriffe die Reduktion pulmonaler Komplikationen nachgewiesen werden. Rückenmarknahe RA-Verfahren sollten vor dem Hintergrund der aktuellen Studienlage und der regelhaft vorliegenden Therapie mit Antikoagulanzien, nur nach sorgfältiger Risiko-Nutzen-Abwägung, sowie unter Beachtung der entsprechenden anästhesiologischen Leitlinien angewendet werden. Der vorliegende Beitrag erläutert die anästhesiologischen Besonderheiten anhand einiger ausgewählter endovaskulärer Gefäßeingriffe.

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Titel: Anästhesiologisches Management bei endovaskulären Gefäßeingriffen
verfasst von: Dr. T. Rössel
R. Paul
T. Richter
S. Ludwig
T. Hofmockel
A. R. Heller
T. Koch
Publikationsdatum: 29.11.2016
Verlag: Springer Medizin
Schlagwörter: Allgemeinanästhesie
Angiologische Interventionen
Aneurysmen
Aneurysmen
Erschienen in: Die Anaesthesiologie / Ausgabe 12/2016
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI: https://doi.org/10.1007/s00101-016-0241-9

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