Interventionelle Therapie der akuten iliofemoralen Thrombose

Zusammenfassung

Der Goldstandard in der Behandlung der Phlebothrombose ist die konservative Therapie mittels Antikoagulation und Kompression. Bei akuten proximalen iliofemoralen Thrombosen mit Beteiligung der Beckenvene muss jedoch hierbei mit einer Inzidenz für das Entstehen eines postthrombotischen Syndroms im Langzeitverlauf von bis zu 70 % gerechnet werden. Zur Prävention eines solchen Folgeschadens rückt neben der selten durchgeführten operativen venösen Thrombektomie in den letzten Jahren zunehmend die interventionelle rekanalisierende Therapie in den Fokus der Behandlungsstrategie. In dieser Übersicht werden die verschiedenen Techniken und aktuellen Entwicklungen dieser Therapie dargestellt und einer kritischen Wertung vor dem Hintergrund der bestehenden Evidenz unterzogen.

Abstract

Conservative therapy including compression stockings and anticoagulation is still the gold standard in the treatment of deep vein thrombosis. However, in acute iliofemoral deep vein thrombosis including the iliac veins a postthrombotic syndrome incidence up to 70 % is estimated in the long term. Therefore, recanalization strategies such as seldom required surgical thrombectomy and nowadays venous interventions are becoming more attractive to prevent this damage. The purpose of this article is to provide the technical aspects of these new techniques and to give a critical review about the current evidence.

Schlüsselwörter

iliofemorale Thrombose - postthrombotisches Syndrom - Katheter-gesteuerte Thrombolyse - pharmako-mechanische Thrombektomie

Key words

iliofemoral thrombosis - postthrombotic syndrome - catheter directed thrombolysis - pharmacomechanical thrombectomy

Publication History

Article published online:
05 May 2021

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