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Interventionelle Radiologie Scan 2014; 02(03): 235-250
DOI: 10.1055/s-0034-1377583
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© Georg Thieme Verlag KG Stuttgart · New York

Rekanalisation des benignen Venenverschlusses: Bildgebung, Behandlung und Resultate

Rick de Graaf
,
Houman Jalaie
,
Anna M. Sailer
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Publication History

Publication Date:
01 September 2014 (online)

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Zusammenfassung

Die Behandlung chronischer Becken- und unterer Hohlvenenverschlüsse beschränkte sich lange Zeit auf die offene Bypass-Chirurgie. Mit der Einführung neuer Bildgebungsverfahren, Rekanalisationstechniken und Stent-Designs stellt die endovaskuläre Behandlung eine wertvolle Alternative zur Operation dar und hat sich inzwischen als primäre Behandlungsstrategie etabliert. Erfahrungen aus dem Zentrum der Autoren und anderen Zentren zeigen die noch kritischen Punkte sowie den notwendigen Konsens in der endovaskulären venösen Behandlung. Dies betrifft zum einen den Einsatz reproduzierbarer Bildgebung zur Indikationsstellung und Behandlungsplanung, zum anderen den Bedarf an Studien zur Analyse von Offenheitsraten für die Wahl des optimalen Stent-Designs und der zu verwendenden Stenting-Technik. Des Weiteren ist die Auswirkung von hybriden Verfahren mit Anlegen von vorübergehenden arteriovenösen Fisteln im Hinblick auf Stent-Offenheitsraten weiter unklar. Der vorliegende Artikel beschreibt die Bildgebung von chronisch-venösen Verschlüssen, schildert deren Behandlung und liefert eine technische Bewertung von derzeit verfügbaren endovaskulären Methoden.

 

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