Die Rezirkulationskreise der primären Varikose

Hach, W.; Hach-Wunderle, V.

doi:10.1007/978-3-662-00877-5

Cited by 90 publications

(36 citation statements)

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“…Jahrhundert durch die Arbeiten von Trendelenburg zur Physiologie und Pathophysiologie des epifaszialen Venensystems und im 20. Jahrhundert durch die Konzeption der Rezirkulationskreise nach Hach und deren notwendige Unterbrechung [17] wurden die Grundlagen für ein an pathophysiologischen Konzepten orientiertes operatives Vorgehen gelegt. Durch die Unterbrechung der Rezirkulationskreise kann eine möglichst dauerhafte Normalisierung der venösen Hämodynamik erreicht werden.…”

Section: Primäre Varikoseunclassified

Primary varicosis

Noppeney¹,

Rewerk²,

Winkler³

et al. 2007

Chirurg

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The classic varicose vein operation still represents the "gold standard" in the operative therapy of varicose veins. The results of this procedure in view of perioperative complications are very good, with the incidence of perioperative deep venous thrombosis varying between 0.05% and 0.1%. Recurrence rates between 6% and 60% are published. However, the true recurrence rate is unknown since an exact definition of recurrent varicosis is still lacking. In recurrent varices it is essential to distinguish between disease progression, including neorevascularisation, and technical errors. Endovascular procedures for elimination of the superficial venous system - radiofrequency obliteration and endovenous laser therapy - meanwhile have established themselves as alternative, minimally invasive procedures. The perioperative complication rate of endovenous procedures is very low and comparable to that of the classic operation. Good results, with occlusion rates of the treated vein around 87% to 93% up to 2 years postoperatively, have been published for both endovenous laser therapy and radiofrequency obliteration. For the latter, 5-year results were published, with occlusion of the treated vein in 87%. Results in the literature for radiofrequency are better documented than for endovenous laser treatment because there are now five prospective randomised trials for the former and most publications for endovenous laser treatment are single-center experiences. The advantage of endovenous procedures, especially radiofrequency obliteration, over the classic operation is the lower rate of perioperative pain and better quality of life. The spectrum of operative treatment methods of the superficial venous system has increased tremendously due to new technical developments. For the surgeon this implies the necessity of informing patients conscientiously about the pros and cons and available results of each procedure, and carefully weighing which methods are at the time best for the patient.

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Section: Primäre Varikoseunclassified

Primary varicosis

Noppeney¹,

Rewerk²,

Winkler³

et al. 2007

Chirurg

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“…Primäre Varikose Das operative Standardvorgehen bei der primären Varikose beruht auf der Einteilung der Stammvarikose der V. saphena magna und der V. saphena parva nach Hach [44] und der Beschreibung der Rezirkulationskreise der Stammvarikose [45]. Ziel der operativen Therapie ist es diese Rezirkulationskreisläufe zu unterbrechen, möglichst bevor es zu einer Dekompensation derselben kommt.…”

Section: Pathophysiologischer Ansatzpunkt Literaturhinweisunclassified

Erkrankungen der Venen - Diagnostik und Therapieoptionen im Wandel

Jünger¹,

Sippel²

2004

Akt Dermatol

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Venous diseases are among the most common diseases in Germany, as epidemiologic studies have shown. The socio-economical impact is increasingly noticable. In the past few decades progress has been made in the diagnostics, the rating, the research into the pathogenetics and the treatment of venous diseases. This article deals with a few of the changes that have happened over the past few years. As new part of pathophysiology the microangiopathy of the skin was described in detail for the lower limb. In the field of diagnostics there has been great advancement in the apparative phlebological methods (duplex sonography, quantifying phlebological measuring methods/functional tests, phlebography), making possible a much more accurate differentiation of the presented phlebological disease taking into account morphological and functional aspects. Diagnostic methods and therapeutic measures have become more intertwined in the course of time. Increasingly more differentiated treatment concepts were used in the phlebosurgical field, based on the phlebological disease and the stage it was in. In the past years new interventional measures were taken on, amongst others foam sclerotherapy and endoluminal laser therapy. Conservative treatment options like compressiontherapy were refined by the improvement of the compressive material and the advanced compressive systems, measures for the evaluation of compressive treatment were developed.

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“…Die Idee der klassischen Varizenchirurgie wurde im Jahr 1907 durch Babcock eingeführt und blieb seitdem im Prinzip unverändert [3]. Ziel ist es, alle krankhaften Venenabschnitte aus dem Blutkreislauf zu entfernen, um die durch Klappeninsuffizienz entstehenden Rezirkulationskreisläufe nach Hach zu unterbinden und eine Überlas-tung des tiefen Venensystems auszuschalten [19,21]. Hiermit soll ein Fortschreiten der venösen Erkrankung bis hin zum floriden Ulcus cruris vermieden werden.…”

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Moderne Varizenchirurgie

Bruning¹,

Altmann²

2011

Hautarzt

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Varicose vein operations belong to the most commonly performed surgical procedures in Germany. Besides the classic operation employing modern technology, which shows manageable recurrence rates with good cosmetic results and must be considered as the established standard therapeutic procedure, endoluminal treatment methods (endovenous radiofrequency therapy, endoluminal laser therapy) have been increasingly used in recent years. The endoluminal treatment methods offer patients reduced post-operative pain and a shorter recovery time compared to traditional surgery. Unfortunately due to limitations caused by vessel diameter and the ability to probe the vessel, they are only available to a limited range of patients. It remains to be seen how these procedures compare to the classical techniques, in particular in regards to improving the long-term quality of life and recurrence rates. A further therapeutic option is chemical endoluminal therapy, catheter-assisted foam sclerotherapy. It can be used as a safe treatment option with good postoperative results in some cases. However, the primary closure rates are inferior to surgery and endoluminal procedures.

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Die Rezirkulationskreise der primären Varikose

Cited by 90 publications

References 0 publications

Primary varicosis

Primary varicosis

Erkrankungen der Venen - Diagnostik und Therapieoptionen im Wandel

Moderne Varizenchirurgie

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