Die Behandlung von Menschen mit chronischen Wunden wie dem Ulcus cruris venosum stellt eine multidisziplinäre Herausforderung dar. Von zentraler Bedeutung ist die Behandlung der zugrunde liegenden Erkrankungen und Komorbiditäten. Neben der erforderlichen Kompressionstherapie sollte eine moderne lokale Wundtherapie durchgeführt werden. Die Entscheidung für Behandlungskonzepte sollte mit den Patienten gemeinsam getroffen werden, um die Abheilung zu unterstützen und Komplikationen zu vermeiden.
{"title":"Lokale Wundtherapie bei Ulcus cruris venosum","authors":"K. Protz, J. Dissemond","doi":"10.1055/a-1966-3260","DOIUrl":"https://doi.org/10.1055/a-1966-3260","url":null,"abstract":"Die Behandlung von Menschen mit chronischen Wunden wie dem Ulcus cruris venosum stellt eine multidisziplinäre Herausforderung dar. Von zentraler Bedeutung ist die Behandlung der zugrunde liegenden Erkrankungen und Komorbiditäten. Neben der erforderlichen Kompressionstherapie sollte eine moderne lokale Wundtherapie durchgeführt werden. Die Entscheidung für Behandlungskonzepte sollte mit den Patienten gemeinsam getroffen werden, um die Abheilung zu unterstützen und Komplikationen zu vermeiden.","PeriodicalId":50885,"journal":{"name":"Phlebologie-Annales Vasculaires","volume":"52 1","pages":"37 - 47"},"PeriodicalIF":0.0,"publicationDate":"2023-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46170839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Subclavian vein effort and upper limb thrombosis, known as the Paget-Schroetter syndrome (PSS), accounts for 30–40 % of spontaneous upper extremity deep vein thromboses (UEDVTs) and 10–20 % of all upper limb deep vein thromboses (DVTs). As complication of PSS include post-thrombotic syndrome and pulmonary embolism, early recognition and prompt initiation of anticoagulant treatment is crucial in the course of its treatment. PSS is associated with single or repeated physical activity of the upper limb, combined with obstruction of venous outflow resulting from anatomical alterations. A correct diagnosis, based on a range of imaging methods, and prompt initiation of local thrombolytic therapy, surgical decompression of the thoracic outlet (when necessary), and immediate initiation of anticoagulant treatment, aim to effectively restore the patient life quality, preventing post-thrombotic syndrome and recurrent thrombosis.
{"title":"Subclavian Effort and Upper Limb Thrombosis – a Lesson Learned","authors":"Z. Krasiński, Piotr Pukacki, B. Begier-Krasińska","doi":"10.1055/a-1930-9714","DOIUrl":"https://doi.org/10.1055/a-1930-9714","url":null,"abstract":"Abstract Subclavian vein effort and upper limb thrombosis, known as the Paget-Schroetter syndrome (PSS), accounts for 30–40 % of spontaneous upper extremity deep vein thromboses (UEDVTs) and 10–20 % of all upper limb deep vein thromboses (DVTs). As complication of PSS include post-thrombotic syndrome and pulmonary embolism, early recognition and prompt initiation of anticoagulant treatment is crucial in the course of its treatment. PSS is associated with single or repeated physical activity of the upper limb, combined with obstruction of venous outflow resulting from anatomical alterations. A correct diagnosis, based on a range of imaging methods, and prompt initiation of local thrombolytic therapy, surgical decompression of the thoracic outlet (when necessary), and immediate initiation of anticoagulant treatment, aim to effectively restore the patient life quality, preventing post-thrombotic syndrome and recurrent thrombosis.","PeriodicalId":50885,"journal":{"name":"Phlebologie-Annales Vasculaires","volume":"51 1","pages":"294 - 299"},"PeriodicalIF":0.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46524682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nach einer durchgemachten COVID-19-Erkrankung ist nicht nur das Risiko fur akute Myokardinfarkte und Schlaganfalle erhoht, sondern es steigt auch das Risiko fur venose Thrombembolien an, wie eine aktuelle Fall-Kontroll-Studie aus Schweden zeigte. Dies konnte Implikationen fur den klinischen Alltag haben.
{"title":"Erhöhtes Risiko für venöse Thrombembolien und Hämorrhagien nach COVID-19","authors":"K. Franke","doi":"10.1055/a-1962-6102","DOIUrl":"https://doi.org/10.1055/a-1962-6102","url":null,"abstract":"Nach einer durchgemachten COVID-19-Erkrankung ist nicht nur das Risiko fur akute Myokardinfarkte und Schlaganfalle erhoht, sondern es steigt auch das Risiko fur venose Thrombembolien an, wie eine aktuelle Fall-Kontroll-Studie aus Schweden zeigte. Dies konnte Implikationen fur den klinischen Alltag haben.","PeriodicalId":50885,"journal":{"name":"Phlebologie-Annales Vasculaires","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43942801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Kommentar zu Thromboserisiko während und nach einer stationären Behandlung","authors":"","doi":"10.1055/a-1956-7075","DOIUrl":"https://doi.org/10.1055/a-1956-7075","url":null,"abstract":"","PeriodicalId":50885,"journal":{"name":"Phlebologie-Annales Vasculaires","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43940025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zusammenfassung Hintergrund In der Vergangenheit bestand die chirurgische Therapie der Stammvarikose in Crossektomie, Stripping und falls notwendig in minichirurgischer Phlebektomie. In den letzten 10 Jahren haben endoluminale Techniken und hier speziell Lasertechniken an Bedeutung gewonnen. Komplikationen nach endoluminalen Laserprozeduren sind selten beschrieben. Methode Wir berichten erstmalig in einem Fallbericht über die intraoperative Ablösung der Lasersondenspitze bei endoluminaler Therapie einer Vena saphena magna Stammvarikose. Ein unmittelbarer sicherer Nachweis der abgelösten Sondenspitze mittels Duplexsonografie war aufgrund der infiltrierten TLA Lösung nicht möglich. Eine CT-Diagnostik blieb ergebnislos. Ergebnisse Am Tag nach der Operation ließ sich die abgelöste Sondenspitze problemlos mittels Ultraschall nachweisen. Um eine Embolisation der abgesprengten Glaspartikel sicher zu vermeiden, entschlossen wir uns zu einem offenen chirurgischen Vorgehen mit Resektion der Sondenspitze und Durchführung einer korrekten Crossektomie. Schlussfolgerung Mit zeitlicher Verzögerung (Stunden) ist eine Ortung der abgelösten Sondenspitze mittels Ultraschall sicher möglich. Chirurgische Intervention, aber auch passives Zuwarten, sind zu diskutieren. Abstract Background In the past, surgical treatment of truncal varicosis consisted of high ligation, stripping procedures and if necessary phlebectomy in a minisurgical technique. In the last decade endoluminal technique and especially laser procedures have gained important. Complications after endoluminal laser techniques are rarely desribed. Method We describe in a case report for the first time the intraoperative detachement of a laser probe tip during endonominal therapy of truncal varicosis. Direct imaging evidence of the detached probe tip was not possible by duplex sonography due to the applied TLA solution. CT diagnostics were also inconclusive. Result On the day following the operation, the torn probe tip was easily identified by ultrasound. In order to prevent embolisation of detached glass particles we decided to openly surgically remove the probe tip and subsequently to perform high ligation. Conclusion With a time delay (hours), it is possible to reliably locate the detached probe tip using ultrasound.Surgical intervention but also passive waiting are to be discussed.
{"title":"Ablösung der Lasersondenspitze – eine seltene Komplikation der endoluminalen Therapie","authors":"L. Rafi-Stenger, M. Stücker","doi":"10.1055/a-1911-3192","DOIUrl":"https://doi.org/10.1055/a-1911-3192","url":null,"abstract":"Zusammenfassung Hintergrund In der Vergangenheit bestand die chirurgische Therapie der Stammvarikose in Crossektomie, Stripping und falls notwendig in minichirurgischer Phlebektomie. In den letzten 10 Jahren haben endoluminale Techniken und hier speziell Lasertechniken an Bedeutung gewonnen. Komplikationen nach endoluminalen Laserprozeduren sind selten beschrieben. Methode Wir berichten erstmalig in einem Fallbericht über die intraoperative Ablösung der Lasersondenspitze bei endoluminaler Therapie einer Vena saphena magna Stammvarikose. Ein unmittelbarer sicherer Nachweis der abgelösten Sondenspitze mittels Duplexsonografie war aufgrund der infiltrierten TLA Lösung nicht möglich. Eine CT-Diagnostik blieb ergebnislos. Ergebnisse Am Tag nach der Operation ließ sich die abgelöste Sondenspitze problemlos mittels Ultraschall nachweisen. Um eine Embolisation der abgesprengten Glaspartikel sicher zu vermeiden, entschlossen wir uns zu einem offenen chirurgischen Vorgehen mit Resektion der Sondenspitze und Durchführung einer korrekten Crossektomie. Schlussfolgerung Mit zeitlicher Verzögerung (Stunden) ist eine Ortung der abgelösten Sondenspitze mittels Ultraschall sicher möglich. Chirurgische Intervention, aber auch passives Zuwarten, sind zu diskutieren. Abstract Background In the past, surgical treatment of truncal varicosis consisted of high ligation, stripping procedures and if necessary phlebectomy in a minisurgical technique. In the last decade endoluminal technique and especially laser procedures have gained important. Complications after endoluminal laser techniques are rarely desribed. Method We describe in a case report for the first time the intraoperative detachement of a laser probe tip during endonominal therapy of truncal varicosis. Direct imaging evidence of the detached probe tip was not possible by duplex sonography due to the applied TLA solution. CT diagnostics were also inconclusive. Result On the day following the operation, the torn probe tip was easily identified by ultrasound. In order to prevent embolisation of detached glass particles we decided to openly surgically remove the probe tip and subsequently to perform high ligation. Conclusion With a time delay (hours), it is possible to reliably locate the detached probe tip using ultrasound.Surgical intervention but also passive waiting are to be discussed.","PeriodicalId":50885,"journal":{"name":"Phlebologie-Annales Vasculaires","volume":"51 1","pages":"288 - 293"},"PeriodicalIF":0.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41764886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Protokoll der Mitgliederversammlung der Deutschen Gesellschaft für Phlebologie vom 30.9.2022, Hannover Congress Centrum","authors":"","doi":"10.1055/a-1959-5958","DOIUrl":"https://doi.org/10.1055/a-1959-5958","url":null,"abstract":"","PeriodicalId":50885,"journal":{"name":"Phlebologie-Annales Vasculaires","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46961693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Wir sind Gastgeber des European Venous Forum 2023 (21. – 23. Juni, Berlin)","authors":"","doi":"10.1055/a-1959-6114","DOIUrl":"https://doi.org/10.1055/a-1959-6114","url":null,"abstract":"","PeriodicalId":50885,"journal":{"name":"Phlebologie-Annales Vasculaires","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43470898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Die Gabe von Heparin soll bei hospitalisierten Patienten Thrombembolien verhindern. Die Thromboseprophylaxe auch nach dem stationaren Aufenthalt fortzufuhren, scheint nach derzeitiger Studienlage allerdings keinen Benefit zu bringen und sorgt stattdessen fur mehr Blutungskomplikationen. Moglicherweise auch, weil dabei keine adaquate Selektion der Patienten mit dem hochsten Thrombose- und dem geringsten Blutungsrisiko stattfindet.
{"title":"Thromboserisiko während und nach einer stationären Behandlung","authors":"S. Grawert","doi":"10.1055/a-1953-6051","DOIUrl":"https://doi.org/10.1055/a-1953-6051","url":null,"abstract":"Die Gabe von Heparin soll bei hospitalisierten Patienten Thrombembolien verhindern. Die Thromboseprophylaxe auch nach dem stationaren Aufenthalt fortzufuhren, scheint nach derzeitiger Studienlage allerdings keinen Benefit zu bringen und sorgt stattdessen fur mehr Blutungskomplikationen. Moglicherweise auch, weil dabei keine adaquate Selektion der Patienten mit dem hochsten Thrombose- und dem geringsten Blutungsrisiko stattfindet.","PeriodicalId":50885,"journal":{"name":"Phlebologie-Annales Vasculaires","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45394477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rezension des Buches von Wolfgang Hach: „Die Medizin in meiner Zeit“","authors":"","doi":"10.1055/a-1906-8627","DOIUrl":"https://doi.org/10.1055/a-1906-8627","url":null,"abstract":"","PeriodicalId":50885,"journal":{"name":"Phlebologie-Annales Vasculaires","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48132312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Type I and type IV hypersensitivity can play an important role in phlebology with potential severe consequences for patients and treatment results. Methods A review of literature was performed for allergic reactions in patients treated for venous insufficiency and venous leg ulcers (VLU), together with a study in the Dutch and European centre for adverse drug reactions. Besides, we performed a survey among 37 Dutch medical hospitals to investigate the incidence of treatment allergies. Results Hypersensitivity reaction is seen in 46–76% of patient with VLU; about 20% of these reactions are caused by wound dressings products. In 11 centres urticarial and respiratory complaints were seen and 3 systemic allergic reactions in phlebological treatments. In Europe 25 cases of systemic reactions were reported. Conclusion Patients with VLU with slow healing tendency should undergo allergy tests. Type I hypersensitivity with anaphylactic reaction, also to sclerosing fluid or tumescent, is very rare.
{"title":"Allergies in Phlebology: A National Survey and Review of Literature","authors":"Birgitte M. Visch, K. de Roos","doi":"10.1055/a-1736-5246","DOIUrl":"https://doi.org/10.1055/a-1736-5246","url":null,"abstract":"\u0000 Background Type I and type IV hypersensitivity can play an important role in phlebology with potential severe consequences for patients and treatment results.\u0000 Methods A review of literature was performed for allergic reactions in patients treated for venous insufficiency and venous leg ulcers (VLU), together with a study in the Dutch and European centre for adverse drug reactions. Besides, we performed a survey among 37 Dutch medical hospitals to investigate the incidence of treatment allergies.\u0000 Results Hypersensitivity reaction is seen in 46–76% of patient with VLU; about 20% of these reactions are caused by wound dressings products. In 11 centres urticarial and respiratory complaints were seen and 3 systemic allergic reactions in phlebological treatments. In Europe 25 cases of systemic reactions were reported.\u0000 Conclusion Patients with VLU with slow healing tendency should undergo allergy tests. Type I hypersensitivity with anaphylactic reaction, also to sclerosing fluid or tumescent, is very rare.","PeriodicalId":50885,"journal":{"name":"Phlebologie-Annales Vasculaires","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49426462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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