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2020 | OriginalPaper | Buchkapitel

77. Verschlusserkrankungen im femoropoplitealen Gefäßabschnitt

verfasst von : Martin Storck, Hans Krankenberg

Erschienen in: Operative und interventionelle Gefäßmedizin

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Verschlussprozesse der Arteria femoralis superficialis (AFS) und der Arteria poplitea (AP) werden häufig zusammengefasst, obwohl bei der AP indikatorische und therapeutische Besonderheiten bestehen. Die AFS ist ein 4–6 mm durchmessendes, im Wesentlichen gerade verlaufendes reines Leitungsgefäß mit einer Länge zwischen 25 und 35 cm. Das Gefäß entspringt im Bereich der Profundagabel und führt ohne Abgabe wesentlicher Äste bis zum femoropoplitealen Übergang distal des Adduktorenkanals. Das Anschlussgefäß, die AP, geht weiter distal in den als Trifurkation angelegten Truncus tibiofibularis und die nachfolgenden drei Unterschenkelgefäße A. tibialis anterior, A. tibialis posterior und A. fibularis über. Somit ist die AFS sowohl proximal als auch distal von Gefäßgabelungen begrenzt – eine Konstellation, die wegen der vermehrt auftretenden Flussturbulenzen mit einem erhöhten Atheroskleroserisiko einhergeht. Die proximale Bifurkation stellt zudem eine konkurrierende Flusssituation dar, in der der Blutfluss in der AFS wegen des Abflusses in die A. profunda femoris (APF) reduziert und somit das Atheroskleroserisiko weiter erhöht wird. Wie bei allen die Muskulatur versorgenden Gefäßen ist der periphere Widerstand in der AFS, zusätzlich durch die Verzweigung in die drei Unterschenkelgefäße, hoch (Krankenberg et al. 2006). Abb. 1 zeigt den Verschluss der AFS im 128-Zeilen-CT-Angiogramm.
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Zurück zum Zitat Endorsed by: the European Stroke Organisation (ESO), Authors/Task Force Members, Tendera M, Aboyans V, Bartelink ML, Baumgartner I, Erbel R (2011) ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries The task force on the diagnosis and treatment of peripheral artery diseases of the European Society of Cardiology (ESC). Eur Heart J 32(22):2851–2906CrossRef Endorsed by: the European Stroke Organisation (ESO), Authors/Task Force Members, Tendera M, Aboyans V, Bartelink ML, Baumgartner I, Erbel R (2011) ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries The task force on the diagnosis and treatment of peripheral artery diseases of the European Society of Cardiology (ESC). Eur Heart J 32(22):2851–2906CrossRef
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. Ann Vasc Dis 8:343–357 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. Ann Vasc Dis 8:343–357
Zurück zum Zitat Lumbsden AB, Morissey NJ (2015) Trial Co-Investigators. Randomized controlled trial comparing the safety and efficacy between the FUSION BIOLINE heparin coated vascular graft and the standard expanded polytetraflouorotheylene graft for femoropopliteal bypass. J Vasc Surg 61:703–712CrossRef Lumbsden AB, Morissey NJ (2015) Trial Co-Investigators. Randomized controlled trial comparing the safety and efficacy between the FUSION BIOLINE heparin coated vascular graft and the standard expanded polytetraflouorotheylene graft for femoropopliteal bypass. J Vasc Surg 61:703–712CrossRef
Metadaten
Titel
Verschlusserkrankungen im femoropoplitealen Gefäßabschnitt
verfasst von
Martin Storck
Hans Krankenberg
Copyright-Jahr
2020
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-53380-2_84

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