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Das thorakale Aortenaneurysma

Thoracic aorta aneurysms

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Zusammenfassung

Das thorakale Aortenaneurysma ist eine lebensbedrohliche Erkrankung, die durch strukturelle Veränderungen der Aorta zu Ruptur oder Dissektion führen kann. Während die genaue Ätiologie noch unklar ist, werden die verlängerte Lebenserwartung sowie die arterielle Hypertonie und eine positive Familienanamnese hinsichtlich Gefäßaneurysmen, aber auch Atherosklerose, Rauchen und chronisch obstruktive Lungenerkrankung als Risikofaktoren diskutiert. Eine Diagnose gelingt heute oft im symptomfreien Stadium. Das Risiko einer Ruptur bei einem Diameter deutlich >5,5 cm variiert zwischen 46–74% mit einer 2-Jahres-Mortalitätsrate von etwa 70%. Die 5-Jahres-Überlebensrate bei konservativer Behandlung soll bei 13–34% liegen, gegenüber 70–79% bei optimaler prophylaktischer chirurgischer Sanierung. Grundsätzlich stehen medikamentöse, operative und perkutan-interventionelle therapeutische Strategien zur Verfügung.

Abstract

Thoracic aorta aneurysms are life-threatening diseases which can lead to rupture or dissection due to structural alterations. The exact etiology is still unclear but extended life-expectancy with arterial hypertension, positive family history for aneurysmic diseases, atherosclerosis, smoking and chronic obstructive lung disease are all considered to be risk factors. Nowadays, a diagnosis can often be made in the symptom-free stage. The risk of rupture varies between 46 and 74% for a diameter clearly greater than 5.5 cm and with a 2-year mortality rate of 70%. The 5-year survival rate with conservative treatment can be as low as 13–34% compared to 70–79% after optimal surgical treatment. Medical, operative and percutaneous interventional therapeutic strategies are basically available.

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  1. Medizinische Klinik I - Kardiologie, Pulmologie, Internistische Intensivmedizin, Universitätsklinikum Rostock AöR, Ernst-Heydemann-Straße 6, 18057, Rostock, Deutschland

    I. Akın, S. Kische, H. Schneider, H. Ince &  C.A. Nienaber

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  1. I. Akın
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  2. S. Kische
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  3. H. Schneider
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  5. C.A. Nienaber
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Correspondence to C.A. Nienaber.

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Akın, I., Kische, S., Schneider, H. et al. Das thorakale Aortenaneurysma. Internist 50, 964–971 (2009). https://doi.org/10.1007/s00108-009-2361-7

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