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Dtsch Med Wochenschr 2021; 3(03): 195-205
DOI: 10.1055/a-1483-3356
Herz und Kreislauf

Antithrombotische Therapie der peripheren arteriellen Verschlusskrankheit

Rupert Bauersachs
,
Christine Espinola-Klein
,
Holger Lawall
,
Martin Storck
,
Thomas Zeller
,
Sebastian Debus
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Update of:

Antithrombotische Therapie der peripheren arteriellen Verschlusskrankheit – ein Überblick über aktuelle Evidenz, Praxis und AusblickDtsch Med Wochenschr 2019; 144(10): 683-689
DOI: 10.1055/a-0826-2868

Die periphere arterielle Verschlusskrankheit ist eine häufige, chronische Störung der arteriellen Durchblutung vor allem der unteren Extremitäten mit Stenosen- und Thrombenbildung. Bei betroffenen Patienten liegt ein hohes Risiko für kardiovaskuläre Komplikationen vor. Daher besteht Optimierungsbedarf bei der antithrombotischen Therapie. Der Beitrag schildert die aktuelle Studienlage dazu, die den behandelnden Ärzten bekannt sein sollte.
Kernaussagen

  • Die PAVK geht mit hohen Komplikationsraten an den Extremitäten sowie einer hohen systemischen kardiovaskulären Morbidität und Mortalität einher. Nach Eingriffen am arteriellen Gefäßsystem steigt die Häufigkeit kardiovaskulärer Ereignisse.

  • Die Optimierung der antithrombotischen Therapie hat großes Potenzial. Zur Rolle der Mehrfach-Thrombozytenaggregationshemmung durch neue Arzneimittelklassen werden in den nächsten Jahren Studiendaten erwartet.

  • Über die Thrombozytenaggregationshemmung hinaus zeigte die zusätzliche Hemmung der Gerinnungskaskade klinisch nicht mehr zu vernachlässigende Vorteile für Patienten mit PAVK – bei vertretbarem Sicherheitsprofil.

  • Die Versorgung von Patienten mit PAVK erfordert sektorenübergreifende Planung und Kommunikation, um die Adhärenz der Patienten von ärztlicher und nicht ärztlicher Seite zu motivieren. Behandelnde Ärzte aller Versorgungsstufen sollten über die Therapieansätze bei der PAVK informiert sein.

Schlüsselwörter

PAVK - Atherosklerose - Risikomanagement - Thrombozytenaggregationshemmer - Antikoagulanzien


Publication History

Article published online:
28 July 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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