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Aneurysmen des Aortenbogens: Interventionelle Therapie

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Operative und interventionelle Gefäßmedizin

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Zusammenfassung

Die interventionelle Therapie von Erkrankungen des Aortenbogens zählt zu den aktuellen großen Herausforderungen der interventionellen Gefäßmedizin. Die Schwierigkeiten des endovaskulären Zugangs für die oft großkalibrigen Stentprothesen, die Krümmung des Aortenbogens mit den daraus resultierenden Appositionsschwierigkeiten der rigiden Implantate, die stark variable Anatomie abgehender supraaortaler Arterien und die häufig komplexe Morphologie der Erkrankungen mit Einbeziehung abgehender Aortenbogengefäße stellen nur einige der operativen Schwierigkeiten dar. Therapeutische Manipulationen im Aortenbogen sind mit dem Risiko der Embolisierung von soliden Bestandteilen, Thrombus und Luft und dem Risiko der Verlegung von hirnversorgenden Arterien verbunden. Im Falle des Auftretens intraoperativer Komplikationen ist im Gegensatz zu weiter distal gelegenen Aorteninterventionen die Konversion zum offen-chirurgischem Vorgehen mit größeren instrumentell-technischen Anforderungen (z. B. extrakorporale Zirkulation) und anderen Schwierigkeiten verbunden. Interventionen am Aortenbogen sollten daher nur in Zentren erfolgen, die alle technischen und fachlichen Voraussetzungen für endovaskuläre und offene Eingriffe an der herznahen Aorta vorhalten.

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Authors and Affiliations

  1. Klinik und Poliklinik für Gefäßmedizin, Deutsches Aortenzentrum Hamburg, Universitäres Herzzentrum GmbH, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    Tilo Kölbel

  2. Klinik und Poliklinik für Gefäßmedizin, Deutsches Aortenzentrum Hamburg, Universitäres Herz- und Gefäßzentrum Hamburg, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    Eike Sebastian Debus

Authors
  1. Tilo Kölbel
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  2. Eike Sebastian Debus
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Correspondence to Eike Sebastian Debus .

Editor information

Editors and Affiliations

  1. Klinik und Poliklinik für Gefäßmedizin, Universitäres Herzzentrum GmbH, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany

    Eike Sebastian Debus

  2. Radiologie, Allgemeines Krankenhaus Harburg Abt. Diagnostische und Interventionelle, Hamburg, Germany

    Walter Gross-Fengels

Section Editor information

  1. Klinik und Poliklinik für Gefäßmedizin, Universitäres Herz- und Gefäßzentrum Hamburg, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    Eike Sebastian Debus

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Kölbel, T., Debus, E.S. (2019). Aneurysmen des Aortenbogens: Interventionelle Therapie. In: Debus, E., Gross-Fengels, W. (eds) Operative und interventionelle Gefäßmedizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45856-3_64-1

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  • DOI: https://doi.org/10.1007/978-3-662-45856-3_64-1

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-45856-3

  • Online ISBN: 978-3-662-45856-3

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