Endovaskuläre Rekanalisation von Beckenvenenverschlüssen

Zusammenfassung

Die Inzidenz der tiefen Venenthrombose (TVT) beträgt in Westeuropa 1 / 1000 Einwohner pro Jahr. Je nach Lokalisation und Ausdehnung der TVT entwickeln 20 – 83 % der Patienten ein postthrombotisches Syndrom trotz einer optimalen Antikoagulation und Kompressionstherapie. Endovaskuläre Thrombektomieverfahren mit Wiedereröffnung der iliofemoralen venösen Strombahn haben das Ziel, mittel- und langfristig ein postthrombotisches Syndrom zu vermeiden. Bei Patienten mit chronischen Vena cava- und Beckenvenenverschlüssen stehen heutzutage spezielle Rekanalisationstechniken mit Einsatz von speziellen venösen Stents zur Verfügung.

Abstract

Deep vein thrombosis (DVT) is associated with a high cost burden for health care systems because of secondary cost intensive complications like pulmonary embolism and especially the post thrombotic syndrome (PTS). The current standard therapy of anticoagulation for DVT therapy has not changed through the years leaving patients especially with iliofemoral vein thrombus on a high-risk situation for developing PTS. Current study situation for endovascular treatment of iliofemoral DVT treatment gives a rationale for active thrombus removal using catheter directed therapy (CDT) or pharmacomechanical thrombectomy (PMT) which improves valvular vein function and luminal patency reducing the potential complication of PTS. For patients with chronich obstruction of the iliac vein system dedicated venous stents and recanalization techniques are today available.

Schlüsselwörter

tiefe Beinvenenthrombose - Beckenvenenverschluß - Thrombektomie - venöse Stentimplantation

Keywords

deep vein thrombosis - chronic iliac vein occlusion - thrombectomy - venous stent implantation

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