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Aortenerkrankungen

Moderne diagnostische und therapeutische Empfehlungen
CME
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Zusammenfassung

Unter Aortenerkrankungen werden sowohl thorakale als auch abdominelle Formen zusammengefasst. Ätiologisch spielen kardiovaskuläre Risikofaktoren, insbesondere die arterielle Hypertonie, aber auch Rauchen und Fettstoffwechselstörungen eine wichtige Rolle. Zunehmend werden auch genetische Prädispositionen identifiziert, die zu familiär gehäuft nachweisbaren Aortenerkrankungen führen. Selbst Aortenaneurysmen bleiben lange asymptomatisch und werden oft erst im Rahmen akuter Ereignisse manifest. Das Screening auf abdominelle Aortenaneurysmen hat an Bedeutung gewonnen. Zu den akuten Aortenerkrankungen gehören die akute Aortendissektion, das intramurale Hämatom, das penetrierende Aortenulkus und die traumatischen Verletzungen der Aortenwand. Unter Verwendung vorgegebener Algorithmen wird in der Notaufnahme gewährleistet, dass eine schnelle und sichere Diagnostik mit der evtl. notwendigen Entscheidung zur operativen oder/und endovaskulären/interventionellen Therapie („thoracic/endovascular aortic repair“, TEVAR/EVAR) in speziell ausgerichteten Zentren erfolgt.

Schlüsselwörter

Aortenaneurysma Aortensklerose Aortendissektion Intramurales Hämatom Penetrierendes Aortenulkus 

Aortic diseases

Modern diagnostic and therapeutic strategies

Abstract

Aortic diseases include not only the thoracic but also the abdominal part of the aorta. In the etiology cardiovascular risk factors, such as hypertension, smoking and hyperlipoproteinemia play a major role, but more and more genetic diseases with familiar predisposition are being identified. Even large aneurysms remain asymptomatic as long as other organs in the neighborhood are not damaged and no acute aortic event occurs including aortic dissection, intramural hematoma, penetrating aortic ulcer, and traumatic aortic injury. Standardized algorithms allow precise and rapid diagnosis for initiating medicinal therapy or operative and/or endovascular interventions (thoracic/endovascular aortic repair, TEVAR/EVAR) in this emergency situation. Specialized aortic centers are recommended to form localized regional networks.

Keywords

Aortic aneurysm Aortic sclerosis Aortic dissection Aortic intramural hematoma Penetrating aortic ulcer 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

R. Erbel gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Institut für Medizinische Informatik, Biometrie und EpidemiologieUniversitätsklinikum Essen, Universität Duisburg-EssenEssenDeutschland

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