Aktueller Forschungsstand zur akuten Extremitätenischämie

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• 作者：Dr. M. Duran ; A. Oberhuber ; H. Schelzig ; F. Simon
• 关键词：Acute limb ischemia ; Thrombectomy ; Thrombolysis ; Percutaneous mechanical thrombectomy ; Amputation
• 刊名：Gef?sschirurgie
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：21
• 期：2
• 页码：83-90
• 全文大小：385 KB
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• 作者单位：Dr. M. Duran (1)
  A. Oberhuber (1)
  H. Schelzig (1)
  F. Simon (1)
  
  1. Klinik für Gefäß- und Endovaskularchirurgie, Universitätsklinikum der Heinrich-Heine-Universität, Moorenstr. 5, 40225, Düsseldorf, Deutschland
  
• 刊物主题：Vascular Surgery;
• 出版者：Springer Berlin Heidelberg
• ISSN：1434-3932

文摘

Acute limb ischemia (ALI) is a danger to the life as well as the affected limb of the patient and has a high amputation and mortality rate; therefore, ALI is a vascular emergency which requires immediate revascularization. The causes of ALI are lower extremity embolisms originating from the heart, proximal arterial aneurysms, arterial thrombosis, thrombosis of a bypass graft, aortic dissection and arterial injury. The 30-day risk of major amputation is 10–30 % while the 30-day mortality is 15–20 %. The extent of symptoms is dependent on the presence of sufficient collateral perfusion. The clinical symptoms of ALI can be classified according to the 6 Ps of Pratt and the Rutherford classification. There are two kinds of ischemia: complete ischemia with the full extent of symptoms and an incomplete form of ischemia without sensory loss and muscle weakness. Acute limb compartment syndrome and a life-threatening reperfusion syndrome may be complications of ALI. The use of computed tomography angiography (CTA) in cases with a complex history can be helpful for therapy planning. The standard procedures for diagnostics are duplex sonography and angiography. Treatment options are open surgery, endovascular therapy and a combination of both (hybrid procedure). Endovascular therapy and open surgery now have a comparable status in the treatment of ALI.