Der Tumorpatient mit gleichzeitiger Indikation zur intensiven Antikoagulation

Zusammenfassung

Tumorpatienten haben ein hohes Risiko venöse Thromboembolien, aber auch arterielle Thrombosen zu erleiden. Die gut etablierte Therapie dieser Gefäßkomplikationen wird bei Tumorpatienten oft erschwert durch Störungen des Gerinnungssystems oder der Thrombozyten. Diese bedingen, dass die Standardintervention bzw. Standardtherapie zur Antikoagulation und Therapie mit Thrombozytenfunktionshemmern schwierig ist. Da sowohl klinische Daten als auch Empfehlungen von Fachgesellschaften weitgehend fehlen, müssen viele dieser komplizierten Fälle interdisziplinär auf Einzelfallbasis entschieden werden. So kommt bei Patienten mit einem STEMI die Implantation eines eigentlich von der Gefäßsituation notwendigen Drug-eluting-Stent oft nicht in Frage. Bei Tumorpatienten mit venösen Thromboembolien und Blutungen kann die Implantation eines Vena-cava-Filters sinnvoll sein.

Abstract

Patients with cancer are at high risk to develop venous thromboembolism as well as arterial thrombosis. Well established treatment patterns of these vascular complications are often hampered in cancer patients by disturbances of coagulation or thrombocytopenia. Therefore standardized interventions or medical treatment can be difficult to perform. As data from clinical trials or recommendations from guidelines are sparse, complicated cases have to be dealt with an interdisciplinary single patient approach. Thus in patients with STEMI application of a drug eluting stent which might be the best treatment in a non-cancer patient may not be feasible. In cancer patients with venous thromboembolism and bleeding the implantation of a vena cava filter might be necessary.

Schlüsselwörter

Tumor - Antikoagulation - Thrombozytenfunktionshemmer - Vena-cava-Filter

Keywords

cancer - anticoagulation - platelet inhibitor - vena cava filter

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