Zusammenfassung
Atherosklerotisch verengte, kurven- und knickreiche, aber auch aneurysmatisch erweiterte Beckengefäße können die endovaskuläre Implantation von Gefäßendoprothesen in die abdominelle und thorakale Aorta erschweren. Die Verwendung der A. femoralis communis als Zugangsgefäß ist in diesen Fällen nicht ohne weitere Maßnahmen möglich. Neben endovaskulären Maßnahmen zur Erweiterung des Durchmessers der Beckengefäße können offene Zugänge zu den Iliakalarterien und der Aorta sowie Conduits verwendet werden. Die supraaortalen Gefäße, die Herzspitze und der transseptale Zugang bieten weitere potenzielle Möglichkeiten, um bei unzureichenden aortoiliakalen Zugangsgefäßen Stentprothesen in die Aorta einzuführen.
Abstract
Stenotic, elongated, kinked and aneurysmatic aorto-iliac vessels can complicate endovascular access for introduction and deployment of aortic stent grafts. The common femoral artery cannot be used as an access vessel in these cases without further measures. Endovascular techniques can be used to achieve a sufficient diameter of the pelvic arteries. Furthermore open retroperitoneal access to the aorto-iliac arteries with or without the use of graft conduits can facilitate safe and successful placement of an aortic endograft. Rarely, supra-aortic vessels are required as an access for endograft delivery. Transapical and transseptal approaches to access the ascending aorta are further potential routes to reach the thoracic aorta.
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Kölbel, T., Larena-Avellaneda, A., Carpenter, S. et al. Alternative Zugangswege zur abdominellen und thorakalen Aorta bei Aortenstentbehandlungen. Gefässchirurgie 16, 160–167 (2011). https://doi.org/10.1007/s00772-011-0887-1
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DOI: https://doi.org/10.1007/s00772-011-0887-1