Nicht invasive Diagnostik bei Manifestationen der Arteriosklerose

Abstract

Arteriosclerosis is a generalized disease and manifests in different vascular regions: the most important manifestations are the coronary artery disease, the peripheral artery disease and the cerebrovascular arteriosclerosis. The challenges of modern ultrasound systems to detect early vascular damage are reviewed in this article. Colour coded duplex ultrasound is the first line method for screening and diagnostic imaging in vascular disease. Indications for further imaging as CT-angiography, MR-angiography and digital subtraction angiography will be discussed in the different sections.

Die Arteriosklerose ist eine generalisierte Erkrankung, die sich in verschiedenen Gefäßregionen manifestieren kann. Eine frühzeitige Diagnostik ist wichtig und kann nicht invasiv erfolgen. Die Methode der Wahl bei peripherer Arteriosklerose ist die farbkodierte Duplexsonografie (FKDS). In diesem Beitrag werden die Indikationen zu weiteren Bildgebungsverfahren, wie CT-Angiografie (CTA), MR-Angiografie (MRA) und digitaler Subtraktionsangiografie, diskutiert.

Schlüsselwörter

Arteriosklerose - Duplexsonografie - Plaque - CT-Angiografie - MR-Angiografie

Key words

arteriosclerosis - duplex ultrasound - plaque - CT-angiography - MR-angiography

• Literatur

• 1 Fernandez-Friera L, Penalvo JL, Fernandez-Ortiz A. et al. Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study. Circulation 2015; 131: 2104-2113 . doi:10.1161/CIRCULATIONAHA.114.014310
• 2 Gallino A, Aboyans V, Diehm C. et al. Non-coronary atherosclerosis. Eur Heart J 2014; 35: 1112-1119 . doi:10.1093/eurheartj/ehu071
• 3 Meschia JF, Klaas JP, Brown Jr RD. et al. Evaluation and Management of Atherosclerotic Carotid Stenosis. Mayo Clinic proceedings 2017; 92: 1144-1157 . doi:10.1016/j.mayocp.2017.02.020
• 4 Naqvi TZ, Lee MS. Carotid intima-media thickness and plaque in cardiovascular risk assessment. JACC Cardiovasc Imaging 2014; 7: 1025-1038 . doi:10.1016/j.jcmg.2013.11.014
• 5 Touboul PJ, Hennerici MG, Meairs S. et al. Mannheim carotid intima-media thickness and plaque consensus (2004–2006–2011). An update on behalf of the advisory board of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th and 20th European Stroke Conferences, Mannheim, Germany, 2004, Brussels, Belgium, 2006, and Hamburg, Germany, 2011. Cerebrovasc Dis 2012; 34: 290-296 . doi:10.1159/000343145
• 6 Inaba Y, Chen JA, Bergmann SR. Carotid plaque, compared with carotid intima-media thickness, more accurately predicts coronary artery disease events: a meta-analysis. Atherosclerosis 2012; 220: 128-133 . doi:10.1016/j.atherosclerosis.2011.06.044
• 7 Arning C, Widder B, von Reutern GM. et al. Revision of DEGUM ultrasound criteria for grading internal carotid artery stenoses and transfer to NASCET measurement. Ultraschall in Med 2010; 31: 251-257 . doi:10.1055/s-0029-1245336
• 8 Anderson JL, Halperin JL, Albert NM. et al. Management of patients with peripheral artery disease (compilation of 2005 and 2011 ACCF/AHA guideline recommendations): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2013; 127: 1425-1443 . doi:10.1161/CIR.0b013e31828b82aa
• 9 Kolkman JJ, Geelkerken RH. Diagnosis and treatment of chronic mesenteric ischemia: An update. Best practice & research Clinical gastroenterology 2017; 31: 49-57 . doi:10.1016/j.bpg.2017.01.003
• 10 Zeller T, Macharzina R. Management of chronic atherosclerotic mesenteric ischemia. Vasa 2011; 40: 99-107 . doi:10.1024/0301-1526/a000079
• 11 Bjorck M, Koelemay M, Acosta S. et al. Editor’s Choice – Management of the Diseases of Mesenteric Arteries and Veins: Clinical Practice Guidelines of the European Society of Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2017; 53: 460-510 . doi:10.1016/j.ejvs.2017.01.010
• 12 Zeller T, Macharzina R, Rastan A. et al. Renal artery stenosis: Up-date on diagnosis and treatment. Vasa 2014; 43: 27-38 . doi:10.1024/0301-1526/a000325
• 13 Aboyans V, Ricco JB, Bartelink MEL. et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J 2018; 39: 763-816 . doi:10.1093/eurheartj/ehx095
• 14 AbuRahma AF, Yacoub M. Renal imaging: duplex ultrasound, computed tomography angiography, magnetic resonance angiography, and angiography. Semin Vasc Surg 2013; 26: 134-143 . doi:10.1053/j.semvascsurg.2014.06.001
• 15 Sarkodieh JE, Walden SH, Low D. Imaging and management of atherosclerotic renal artery stenosis. Clin Radiol 2013; 68: 627-635 . doi:10.1016/j.crad.2012.11.007
• 16 Staub D, Canevascini R, Huegli RW. et al. Best duplex-sonographic criteria for the assessment of renal artery stenosis--correlation with intra- arterial pressure gradient. Ultraschall in Med 2007; 28: 45-51 . doi:10.1055/s-2007-962881
• 17 Kaufmann C, Jacomella V, Kovacicova L. et al. Predictive value of auscultation of femoropopliteal arteries. Swiss Med Wkly 2013; 143: w13761 . doi:10.4414/smw.2013.13761
• 18 Clemens RK, Amann-Vesti BR, Thalhammer C. Peripheral Doppler pressure measurement. Dtsch Med Wochenschr 2012; 137: e10 . doi:10.1055/s-0032-1330181
• 19 Lawall H, Huppert P, Espinola-Klein C. et al. German guideline on the diagnosis and treatment of peripheral artery disease – a comprehensive update 2016. Vasa 2017; 46: 79-86 . doi:10.1024/0301-1526/a000603