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Neurologie und Karotisinterventionen

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Neurology and carotid artery interventions

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Zusammenfassung

Bei der Behandlung von Patienten mit Karotisstenosen ist eine interdisziplinäre Zusammenarbeit zwischen Chirurgen, Neurologen und Interventionalisten für die Entscheidungsfindung der bestmöglichen Therapie notwendig. Diagnostische Bausteine stellen die Ultraschalluntersuchung der hirnzuführenden Gefäße und in Ergänzung die kontrastmittelgestütze CT/CMRT bzw. die DSA dar. Für symptomatische Stenosen ergeben sich differente Behandlungspfade als für asymptomatische. Die Entscheidung für eines der 3 Therapieverfahren (rein konservativ, zusätzlich Karotisendarterektomie oder Karotisstentangioplastie) erfolgt aufgrund von Charakteristika der Stenose, zerebraler Läsionslast und internistischem Gesamtzustand des Patienten. Eine weitere kontinuierliche Betreuung mit Kontrolle und Einstellung der vaskulären Risikofaktoren ist zur Risikominimierung bei bestehender arteriosklerotischer Grunderkrankung erforderlich.

Abstract

Optimum therapy for patients with carotid stenosis requires the interdisciplinary cooperation of surgeons, neurologists and angiologists. Important diagnostic methods are ultrasound sonography, contrast-enhanced computed tomography, magnetic resonance tomography and digital subtraction angiography. Treatment of carotid artery stenosis depends on whether the stenosis is symptomatic or asymptomatic. The treatment of choice (medical therapy only vs. carotid artery stenting vs. carotid endarterectomy) depends on the characteristics of the stenosis, the presence of cerebral lesions and the general physical condition of the patient. After the intervention continuous monitoring and treatment of vascular risk factors are mandatory.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. T. Reiff und P.A. Ringleb geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Neurologische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland

    T. Reiff & P.A. Ringleb

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  1. T. Reiff
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  2. P.A. Ringleb
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Correspondence to T. Reiff.

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Reiff, T., Ringleb, P. Neurologie und Karotisinterventionen. Herz 38, 696–700 (2013). https://doi.org/10.1007/s00059-013-3963-3

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