Der Chirurg

, Volume 83, Issue 4, pp 395–406 | Cite as

Thorakales Aortenaneurysma

CME Zertifizierte Fortbildung
First Online:

Zusammenfassung

Das thorakale Aortenaneurysma (TAA) ist die häufigste Pathologie der thorakalen Aorta. Das TAA kommt mit steigender Inzidenz vor (10,4 Fälle pro 100.000 Personen-Jahren) und ist am häufigsten atherosklerotisch bedingt. Es gibt weiterhin hereditäre, inflammatorische und infektiöse pathogenetische Faktoren. Das TAA verursacht zunächst keine Symptome und wird deswegen meistens als Zufallsbefund diagnostiziert. Die CT- und MR-Angiographie sind für die Diagnostik und Therapieplanung Mittel der Wahl. Die durchschnittliche Wachstumsrate eines TAA beträgt 0,10–0,42 cm pro Jahr. Eine Operationsindikation ist ab einem Durchmesser von 6 cm zu stellen. Neben der medikamentösen Begleittherapie bieten die endovaskuläre Verfahren (TEVAR) heutzutage gewisse Vorteile in der Therapie von TAA gegenüber der offenen Chirurgie. Dies gilt auch für Pathologien des Aortenbogens. Der Nachsorge nach TEVAR kommt eine wichtige Bedeutung zu, um den Therapieerfolg dauerhaft zu gewährleisten.

Schlüsselwörter

Thorakales Aortenaneurysma Aorta TEVAR Aortenbogen Nachsorge 

Thoracic aortic aneurysm

Abstract

Thoracic aortic aneurysms (TAA) are the most common pathology of the thoracic aorta. TAA are occuring with increasing incidence (10.4 cases per 100,000 person years) and are most commonly caused by atherosclerosis. There are also hereditary, inflammatory and infectious pathogenic factors. A TAA initially causes no symptoms and is therefore usually diagnosed as an incidental finding. Computed tomography angiography (CTA) and magnetic resonance angiography (MRA) are the diagnostic tools of choice for diagnosis and treatment planning. The mean growth rate of TAA is estimated to be 0.10 to 0.42 cm per year. A diameter of 6 cm is considered to be an indication for surgery. Besides medicinal therapy, thoracic endovascular aortic repair (TEVAR) nowadays offers certain advantages compared to conventional open repair. The same applies to the region of the aortic arch. Follow up examinations after TEVAR are of major importance in order to ensure long-term therapeutic success.

Keywords

Thoracic aortic aneurysm Aorta Thoracic endovascular aortic repair Aortic arch Follow up 
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Notes

Interessenkonflikt

Der korrespondierende Autor weist für sich und seine Koautoren auf folgende Beziehungen hin: D. Böckler ist Berater für die Firmen Medtronic, W.L. Gore und Siemens. D. Kotelis, P. Geisbüsch und M. Hakimi haben keinen Interessenkonflikt.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • D. Kotelis
    • 1
  • P. Geisbüsch
    • 1
  • M. Hakimi
    • 1
  • D. Böckler
    • 1
  1. 1.Klinik für Gefäßchirurgie und endovaskuläre ChirurgieUniversitätsklinikum HeidelbergHeidelbergDeutschland

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