Die Chirurgie der Vena saphena parva – endoluminal oder operativ

Zusammenfassung

Bislang existiert kein einheitlicher Standard in der operativen oder endovenösen Therapie der Parvainsuffizienz. Daher ist eine direkte Vergleichbarkeit operativer und endovenöser Verfahren bislang nur eingeschränkt möglich. Insbesondere erschweren unterschiedliche Definitionen eines Rezidivs die Vergleichbarkeit der unterschiedlichen Therapieoptionen. Prospektive randomisierte Studien zu den Langzeitergebnissen fehlen. Aufgrund der schwachen Datenlage sind grundsätzliche Empfehlungen für oder gegen die eine oder andere Therapieoption derzeit nicht möglich. Dennoch gibt es in der täglichen Praxis eindeutige Vorteile für die Operation oder für die endovenöse Therapie, auch wenn entsprechende Vergleichsstudien fehlen. Die Rezidivraten sind sowohl bei operativer- als auch bei endovenöser Behandlung hoch. Allerdings wird weder bei der Operation, noch bei der endovenösen Therapie eine komplette Ausschaltung der krankhaft veränderten Vene vorgenommen. Zukünftige Studien sollten klären, inwieweit die komplette Ausschaltung der Parvacrosse mit Umsetzung des Prinzips der Crossektomie zu einer Verbesserung der Ergebnisse beitragen kann.

Schlüsselwörter

Parvainsuffizienz - Parvacrosse - Crossektomie

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