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Fenestrierte Prothesen am thorakoabdominalen Aortenabschnitt

Fenestrated graft placement at the thoracoabdominal aortic segment

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Zusammenfassung

Fenestrierte Stentprothesen können zur gezielten Therapie von Aneurysmen mit kurzen Halsstücken eingesetzt werden. Dank individueller Fenestrierungen bleibt die Durchgängigkeit wichtiger Gefäßseitenäste, wie z. B. der Aa. renales und der A. superior mesenterica, erhalten, wobei die Aortenprothese über diese Gefäße positioniert wird. Mit Hilfe der endovaskulären Implantation von verzweigten Prothesen können para-, suprarenale und thorakoabdominale Aneurysmen behandelt werden. Durch die Verwendung von fenestrierten Prothesen und der Implantation von beschichteten Stents durch die Prothesenfenster kann der gleiche Effekt wie bei der Verwendung von verzweigten Prothesen erzielt werden. Beide Therapieoptionen sind gut durchführbar, jedoch mit ihren ganz eigenen Vor- und Nachteilen behaftet. In diesem Artikel werden die Indikationen, das technische Vorgehen, die Limitationen der Methoden und die Resultate der beiden Techniken diskutiert.

Abstract

Fenestrated stent-grafts initially aimed at treating short-necked aneurysms. Thanks to customized fenestrations, patency of vital side branches such as the renal arteries and the superior mesenteric artery can be maintained, whilst positioning the graft over these aortic side branches. Pararenal, suprarenal and thoracoabdominal aneurysms can only be treated by endovascular means with branched grafts. This can be achieved with the same fenestrated grafts, but with the use of covered stents through the fenestrations or by fully branched grafts. Both options are feasible and present with specific advantages and disadvantages. This report discusses the following aspects of these techniques: indications, technical principles, limitations and results.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung hin: Vorträge für Fa. Cook, wissenschaftliches Stipendium von Fa. Cook.

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Authors and Affiliations

  1. Abteilung für Chirurgie, Bereich Gefäßchirurgie, Universitätsklinik Groningen, PO Box 30001, 9700, RB Groningen, Niederlande

    E.L.G. Verhoeven MD, PhD, C.J. Zeebregts, I.F.J. Tielliu, W.T.G.J. Bos & J.J.A.M. van den Dungen

  2. Abteilung für Radiologie, Universitätsklinik Groningen, Groningen, Niederlande

    T.R. Prins

Authors
  1. E.L.G. Verhoeven MD, PhD
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  2. T.R. Prins
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  3. C.J. Zeebregts
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  4. I.F.J. Tielliu
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  5. W.T.G.J. Bos
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  6. J.J.A.M. van den Dungen
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Correspondence to E.L.G. Verhoeven MD, PhD.

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Verhoeven, E., Prins, T., Zeebregts, C. et al. Fenestrierte Prothesen am thorakoabdominalen Aortenabschnitt. Gefässchirurgie 12, 331–337 (2007). https://doi.org/10.1007/s00772-007-0546-8

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  • DOI: https://doi.org/10.1007/s00772-007-0546-8

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