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Endovaskuläre Rekonstruktion der thorakalen Aorta: eine klinische Standortbestimmung nach 6-jähriger Erfahrung

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Zusammenfassung

In einem 6-Jahres-Zeitraum von 1997 bis 2003 wurden bei 80 Patienten insgesamt 102 thorakale Endoprothesen implantiert. Bei 52 (65%) Patienten erfolgte die Implantation in einer Notfallsituation. Das Indikationsspektrum umfasste 40 Aneurysmen, 24 Dissektionen, 8 aortobronchiale Fisteln und 8 Aortenabrisse nach Polytrauma. Die Krankenhaussterblichkeit betrug 7% bei elektiven Patienten (2 von 28) und 21% bei Notfallpatienten (11 von 52). Der wissenschaftliche Nachweis des Vorteils der endovaskulären Therapie steht noch aus, die klinische Effizienz der Methode, insbesondere beim Risiko- und Notfallpatienten, ist hingegen evident.

Abstract

During a 6-year period from March 1997 to October 2003, endovascular stent graft repair of the thoracic aorta was performed in 80 patients (mean age: 60 years, range: 28–82 years). A total of 102 endograft devices were implanted: 40 patients (50%) had atherosclerotic aneurysms, 24 aortic dissections, 8 aortobronchial fistula, and 8 traumatic ruptures. In 52 patients (65%) the endografting was performed as an emergency procedure. The mortality rate for elective cases was 7% (2 of 28 patients) and for emergency repair 21% (11 of 52 patients). Thoracic endovascular reconstruction, although in evolution, appears to be a safe and effective alternative to open repair for many patients with a wide spectrum of thoracic aortic disease. Prospective trials for individual diseases will be necessary to define its ultimate role.

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Authors and Affiliations

  1. Abteilung für Gefäßchirurgie, Universitätsklinikum Heidelberg

    J.-R. Allenberg & H. Schumacher

  2. Abteilung für Gefäßchirurgie, vaskuläre und endovaskuläre Chirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg

    J.-R. Allenberg

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  2. H. Schumacher
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Correspondence to J.-R. Allenberg.

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Allenberg, JR., Schumacher, H. Endovaskuläre Rekonstruktion der thorakalen Aorta: eine klinische Standortbestimmung nach 6-jähriger Erfahrung. Gefässchirurgie 8 (Suppl 1), S75–S84 (2003). https://doi.org/10.1007/s00772-003-0322-3

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  • DOI: https://doi.org/10.1007/s00772-003-0322-3

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