In zahlreichen Fallen kritischer Ischämie an der unteren Extremität bietet die Umgehung des arteriellen Kreislaufs im Bereich der infrapoplitealen Gefäβe eine Möglichkeit, die Gliedmaβe vor Amputation zu bewahren. Dennoch wird ein erheblicher Anted dieser kleinkalibrigen Gefäβtransplantate im postoperativen Verlauf von einem unerwarteten Verschluβ betroffen. Die Therapie kann durch die Gabe des Prostazyklin-Analogons Iloprost unterstützt werden, das intraoperativ in das Gefäβtransplantat infundiert wird. Iloprost senkt den peripheren Widerstand, erzeugt eine anhaltende Durchfluβerhöhung im Gefäβtransplantat und scheint auβerdem einen günstigen Einfluβ auf die Transplantatdurchgängigkeit in der Frühphase zu haben. Bei kritischer Ischämie der unteren Extremität können mit Hilfe dieser Therapie die Ergebnisse der Gefäβrekonstruktion verbessert werden.

Keywords:
Kritische Ischämie der unteren Extremität, Infrapoplitealer Bypass, Prostazyklin, Iloprost
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© 1994 S. Karger AG, Basel
1994
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