Willenberg Torsten
Universitätsklinik für Angiologie, Schweizer Herz- und Gefäßzentrum, Inselspital, Bern.
Ther Umsch. 2011 Mar;68(3):149-52. doi: 10.1024/0040-5930/a000142.
Coexisting peripheral arterial disease is not uncommon (15 - 21 %) in patients with ulcera cruris primarily based on a venous etiology. Patient's history, clinical examination and detection of ABI as well as duplex scan will establish diagnosis of mixed arterial-venous ulcera. Clinical significance of coexisting arterial disease is often difficult to define and should be evaluated by a vascular specialist. The concept of treatment of mixed ulcers should always include the arterial component. Frequently peripheral arterial perfusion and healing can be improved by minimal invasive, endovascular revascularization. Compression therapy is the corner stone in treatment of venous disease and should be complemented by contemporary two piece graduated compression systems if ulcera are present. According to circumstances ablation of varicose veins must be considered.
在主要基于静脉病因的下肢溃疡患者中，并存外周动脉疾病并不少见（15%-21%）。患者病史、临床检查、踝臂指数（ABI）检测以及双功超声扫描将有助于确诊动静脉混合性溃疡。并存动脉疾病的临床意义常常难以界定，应由血管专科医生进行评估。混合性溃疡的治疗理念应始终涵盖动脉方面。通常，通过微创的血管腔内血运重建可改善外周动脉灌注及促进愈合。压迫治疗是静脉疾病治疗的基石，若存在溃疡，应辅以当代的两件式渐进性压迫系统。根据具体情况，必须考虑对静脉曲张进行消融治疗。
