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Abdominelles Aortenaneurysma – offene vs. endovaskuläre Therapie

Entscheidungshilfe aus Sicht des Gefäßchirurgen

Abdominal aortic aneurysms—open vs. endovascular treatment

Decision-making from the perspective of the vascular surgeon

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Zusammenfassung

Klinisches/methodisches Problem

In den letzten 20 Jahren hat sich die Behandlung des abdominellen Aortenaneurysmas (AAA) im Wesentlichen fort von der operativen hin zur minimal-invasiven endovaskulären Therapie entwickelt.

Bewertung

Es gibt jedoch nach wie vor eine Reihe von klinischen Situationen, die einen operativen Eingriff sinnvoll erscheinen lassen oder sogar notwendig machen. Dies unterstreicht die Bedeutung interdisziplinärer, vaskulärer Zentren für die Behandlung komplexer Aortenpathologien und ihrer Folgeerscheinungen.

Empfehlung für die Praxis

Im folgenden Artikel werden die Argumente für die Verfahrenswahl zur Versorgung infrarenaler Aortenaneurysmen diskutiert und die Empfehlungen verschiedener Leitlinien vergleichend gegenübergestellt.

Abstract

Clinical/methodical issue

In the last 20 years, the treatment of abdominal aortic aneurysms has essentially evolved from surgical to minimally invasive endovascular treatment.

Achievements

There are still a number of clinical situations that make surgical intervention useful or even necessary. This underlines the importance of interdisciplinary vascular centers for the treatment of complex aortic pathologies and their sequelae.

Practical recommendations

In the following article, the arguments for the choice of procedure for the treatment of infrarenal aortic aneurysms are discussed and the recommendations of various guidelines are compared.

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Abbreviations

AAA:

Abdominelles Aortenaneurysma

CMD:

Custom-made device

COPD:

Chronisch-obstruktive Lungenkrankheit

EVAR:

Endovaskuläre Aortenreparatur („endovascular aortic repair“)

IfU:

Instruction for use

OR:

Offen-chirurgische Reparatur („open repair“)

Literatur

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Authors and Affiliations

  1. Klinik für Gefäßchirurgie, vaskuläre und endovaskuläre Chirurgie, München Klinik Bogenhausen, 81925, München, Deutschland

    Andreas Maier-Hasselmann & Filippo Modica

  2. Institut für Radiologie, Neuroradiologie und minimal-invasive Therapie, München Klinik Bogenhausen, München, Deutschland

    Thomas Helmberger

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  1. Andreas Maier-Hasselmann
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  2. Filippo Modica
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Correspondence to Andreas Maier-Hasselmann.

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Interessenkonflikt

A. Maier-Hasselmann gibt an Vortragshonorare von der Firma Medtronic, sowie eine Reiseunterstützung von der Firma Gore erhalten zu haben. F. Modica und T. Helmberger geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Maier-Hasselmann, A., Modica, F. & Helmberger, T. Abdominelles Aortenaneurysma – offene vs. endovaskuläre Therapie. Radiologie 62, 570–579 (2022). https://doi.org/10.1007/s00117-022-01021-7

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