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DOI: 10.1055/a-0631-6187
Gefäßverschließende Methoden (Embolotherapie)
Embolization therapyPublication History
Publication Date:
30 August 2018 (online)
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Das therapeutische Spektrum von Embolisationen hat in den letzten Jahrzehnten deutlich zugenommen. Die Vielfalt heute verfügbarer Embolisationsmaterialien und -techniken erfordern genaue Kenntnisse über den Freisetzungsmechanismus, die Embolisationsebene, das Wirkprinzip und die potenziellen Nebenwirkungen. Dieser Artikel soll einen Überblick über die verschiedenen modernen Embolisationsmaterialien und ihre Einsatzbereiche geben.
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Die möglichen Indikationen für den Einsatz der Embolisationstherapie haben in den letzten Jahren deutlich zugenommen ([Tab. 1]). Profunde Kenntnisse über Embolisationsebene, Wirkprinzip, Freisetzungsmechanismus und Nebenwirkung der verschiedenen Materialien sind mittlerweile unerlässlich.
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Plugs und Coils eignen sich vor allem für den Verschluss großer bis mittelgroßer Gefäße. Sie benötigen allerdings immer eine funktionierende Blutgerinnung.
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Partikuläre Embolisationsmaterialien finden vor allem in der Embolisation gutartiger und maligner Tumoren Anwendung, da sie tief in das Gewebe eindringen können. Einige Partikel können mit einem Chemotherapeutikum beladen werden. Das resorbierbare Gelfoam eignet sich zur Blutungsembolisation.
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Flüssigembolisate sind vielseitig einsetzbar – vor allem Endoleaks und arteriovenöse Malformationen können hiermit gezielt und sicher behandelt werden.
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Sklerosierungsmittel spielen eine wichtige Rolle in der interventionellen Behandlung angeborener Slow-Flow-Gefäßmalformationen.
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