Gefäßmedizinische Rehabilitation bei Patienten mit peripher arterieller Verschlusskrankheit (pAVK)

Patienten mit pAVK sind hinsichtlich der Verordnungshäufigkeit von Reha-Maßnahmen [1] und der Kontrolle der Risikofaktoren im Vergleich zu Patienten mit koronarer Herzerkrankung (KHK) bei Hausärzten schlechter eingestellt [2] [3] [4]. Sie erkennen das erhöhte kardiovaskuläre Risiko und die damit verbundene Notwendigkeit einer Lebensstiländerung und Therapietreue nicht in dem Maße wie Patienten mit KHK [5]. Dieser Beitrag widmet sich der Frage, warum die Entwicklung spezialisierter gefäßmedizinischer Versorgungsstrukturen angestrebt wurde und wie sich dies zu einem eigenständigen Gebiet der Rehabilitation weiterentwickeln kann und sollte.

Kernaussagen

• Patienten mit pAVK haben ein erhöhtes Risiko für kardiovaskuläre Ereignisse wie Herzinfarkt und Schlaganfall.

• Patienten mit pAVK sind bezüglich der Risikofaktorkontrolle und Sekundärprävention schlechter eingestellt als Patienten mit KHK.

• Die pAVK ist eine Volkskrankheit, die oft asymptomatisch verläuft und daher häufig unentdeckt bleibt.

• Sekundärprävention durch Medikamenteneinnahme und Lebensstiländerungen, wie Raucherentwöhnung, ist essenziell, wird aber oft nicht konsequent umgesetzt.

• Spezialisierte gefäßmedizinische Rehabilitation kann die Adhärenz der Patienten gegenüber der Sekundärprävention erhöhen und zur nachhaltigeren Durchführung der gefäßspezifischen Sport- und Bewegungstherapie beitragen.

• Es besteht eine deutliche Unterversorgung an spezialisierten Rehabilitationsangeboten für pAVK-Patienten in Deutschland.

• Entwicklung und Zertifizierung von spezialisierten Rehabilitationskliniken mit gefäßmedizinischer Expertise sind sinnvoll, um die Versorgung zu verbessern.

Gehtraining und gefäßspezifische Bewegungstherapie sind entscheidend für die Therapie von pAVK und wissenschaftlich gut belegt.

Schlüsselwörter

periphere arterielle Verschlusskrankheit (pAVK) - Sekundärprävention - Gehtraining - gefäßmedizinische Rehabilitation - Risikofaktorkontrolle

Publication History

Article published online:
19 December 2025

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