Endovaskuläre vs. konventionelle Gefäßchirurgie – antiquiertes Denken?

Teil 1: Eingriffe an der Aorta

Endovascular versus conventional vascular surgery – old-fashioned thinking?

Part 1: interventions on the aorta

Der Chirurg volume 87, pages195–201(2016)Cite this article

Zusammenfassung

Die endovaskuläre Gefäßchirurgie hat die konventionelle operative Gefäßchirurgie in weiten Bereichen verdrängt. Dies hat dazu geführt, dass beide Techniken vielerorts als miteinander konkurrierende Verfahren angesehen werden. Evidenzbasierte Daten aus randomisierten Studien, Metaanalysen und klinischen Registern belegen jedoch zunehmend deutlich, dass sich die beiden Technologien komplementär ergänzen. Dabei ist es von der jeweiligen Grunderkrankung und der Anatomie abhängig, welcher der beiden Vorgehensweisen der Vorzug zu geben ist – wobei auch die kombinierte Nutzung beider Verfahren (Hybridtechnik) sinnvoll sein kann. Die vorliegende Übersicht konzentriert sich auf die Versorgung der akuten komplizierten Aortendissektion Typ B, auf Aneurysmen der deszendierenden thorakalen Aorta, auf thorakoabdominelle Aortenaneurysmen sowie das asymptomatische und rupturierte Bauchaortenaneurysma.

Abstract

Endovascular therapy has widely replaced conventional open vascular surgical reconstruction. For this reason both techniques were widely considered to be competing approaches. Evidence-based data from randomized prospective trials, meta-analyses and clinical registries, however, demonstrated that both techniques should be used to complement each other. It became increasingly more evident that the use of either procedure depends on the underlying disease and the anatomical conditions, whereby a combination of both (hybrid approach) may be the preferred option in certain situations. This review focuses on the treatment of complicated acute type B aortic dissection, descending thoracic aortic aneurysms, thoracoabdominal aortic aneurysms as well as asymptomatic and ruptured abdominal aortic aneurysms.

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Author information

Affiliations

  1. Klinik und Poliklinik für Gefäßmedizin, Universitäres Herzzentrum Hamburg, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland

    Prof. Dr. E. S. Debus, T. Kölbel, D. Manzoni, C.-A. Behrendt & F. Heidemann

  2. In den Grüben 144, 84489, Burghausen, Deutschland

    R. T. Grundmann

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  1. Prof. Dr. E. S. Debus
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  2. T. Kölbel
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  3. D. Manzoni
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  4. C.-A. Behrendt
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  5. F. Heidemann
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  6. R. T. Grundmann
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Corresponding author

Correspondence to Prof. Dr. E. S. Debus.

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Interessenkonflikt

E.S. Debus, T. Kölbel, D. Manzoni, C.-A. Behrendt, F. Heidemann und R.T. Grundmann geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Den Beitrag „Endovaskuläre vs. konventionelle Gefäßchirurgie – antiquiertes Denken? Teil 2: Karotisstenose und periphere arterielle Verschlusskrankheit“ finden Sie in Ausgabe 4/2016 von Der Chirurg oder unter DOI:10.1007/s00104-015-0149-y

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Debus, E.S., Kölbel, T., Manzoni, D. et al. Endovaskuläre vs. konventionelle Gefäßchirurgie – antiquiertes Denken?. Chirurg 87, 195–201 (2016). https://doi.org/10.1007/s00104-015-0146-1

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Schlüsselwörter

  • Endovaskulär
  • Offene Chirurgie
  • Aortendissektion
  • Thorakales Aortenaneurysma
  • Abdominelles Aortenaneurysma

Keywords

  • Endovascular repair
  • Open repair
  • Aortic dissection
  • Thoracic aortic aneurysm
  • Abdominal aortic aneurysm