Behandlung von akuten Blutungen mit gecoverten Stents

Der Einsatz von gecoverten Stent-Systemen stellt eine wichtige Säule des endovaskulären Managements akuter arterieller Blutungen unterschiedlicher Ätiologie dar. Die Implantation dieser Stents zielt dabei auf die Abdichtung eines blutenden Gefäßsegments unter Aufrechterhaltung des Perfusionsstroms in die Peripherie ab. Dieser Artikel erläutert Indikationen, technische Umsetzung, Besonderheiten und Limitationen dieser Therapieoption.

Abstract

The use of covered stents is an important part of the endovascular management of acute arterial haemorrhage of various aetiologies. The aim of covered stenting is to seal a bleeding vessel segment while maintaining peripheral blood flow. This article discusses the indications, technical implementation, characteristics and limitations of this therapeutic option with regard to arterial haemostasis. In addition, images are presented to illustrate the feasibility of this endovascular technique. Finally, the limiting factors for the use of covered stents are critically discussed.

Kernaussagen

• In den Händen eines erfahrenen Interventionisten stellt die endovaskuläre Therapie von akuten arteriellen Blutungen mit gecoverten Stents eine sichere und effektive Methode dar.

• Im Gegensatz zur gefäßlumenverschließenden Embolotherapie handelt es sich beim Einsatz von gecoverten Stents um einen lumenerhaltenden Therapieansatz, der auf die Abdichtung des Gefäßes und die Aufrechterhaltung der peripheren Perfusion abzielt.

• Vor Einsatz dieser Stent-Systeme sollte ein interdisziplinärer Konsensus zugunsten einer endovaskulären Therapie vorliegen.

• Ein entscheidender Vorteil der Therapie mit gecoverten Stents im Vergleich zum operativen Vorgehen liegt in der geringeren Invasivität und einem geringeren technischen Risiko vor allem bei voroperiertem Situs.

• Offene Fragen bestehen in Bezug auf die Langzeitoffenheit, das Stent-Frakturrisiko und die anzustrebende Antikoagulationstherapie.

Schlüsselwörter

gecoverte Stents - akute arterielle Blutung - endovaskuläre Therapie

Keywords

covered stents - acute arterial haemorrhage - endovascular therapy

Publication History

Article published online:
01 March 2024

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