Venöse Thrombose und Thrombophilie

Zusammenfassung

In den Industrieländern wird die Mortalitätsstatistik von kardiovaskulären Erkrankungen angeführt, wovon wesentliche Anteile auf venöse Thrombose und Thromboembolie fallen. Ursache einer Thrombose können temporäre Faktoren oder eine permanente thrombophile Diathese sein. Neue Erkenntnisse über die Pathophysiologie der Thrombose sowie neue diagnostische Methoden erleichtern die Erstellung eines Risikoprofils bezüglich venöser Thrombosen. Im Folgenden sollen verschiedene Thrombophilierisikofaktoren hinsichtlich ihrer Bedeutung und Diagnostik beschrieben und diskutiert werden. Weiterhin soll ausgeführt werden, welche prophylaktischen und therapeutischen Maßnahmen bei Thrombophiliekonstellation oder manifester Thrombose vorzunehmen sind. Hierbei wird auf zurzeit zugelassene, aber auch auf vor der Zulassung stehende neue Antikoagulanzien eingegangen (Pentasaccharid, Melagatran), deren Verwendung eine zunehmend patientenfreundliche und kosteneffiziente Prophylaxe und Behandlung venöser thromboembolischer Komplikationen verspricht.

Abstract

Cardiovascular disease, to which venous thrombosis and pulmonary embolism contribute a major part, are the leading cause of death in industrialized countries. Thrombosis is caused by temporary risk factors or by thrombophilia. Increasing knowledge concerning the pathophysiology of thrombosis and new diagnostic tools allow a thrombotic risk assessment. In this paper thrombotic risk factors will be discussed with respect to their significance and diagnosis as well as methods of prophylaxis and treatment for patients at risk for or with diagnosed thrombosis. Furthermore, currently available as well as new anticoagulants (pentasaccharide, melagatran) will be discussed and their potential for patient-oriented and cost-efficient prophylaxis and treatment of thromboembolic complications outlined.

Schlüsselwörter

Venöse Thromboembolie - Risikofaktoren - Thrombophilie - Prophylaxe - Therapiemöglichkeiten

Keywords

Venous thrombosis - risk factors - thrombophilia - prophylaxis - therapeutic options

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