Juxtarenale, suprarenale und Abschnitt-IV-Aneurysmen

  • D. Mayer
  • T. Pfammatter
  • M. Lachat
Chapter

Zusammenfassung

Epidemiologie Juxta-, suprarenale und Abschnitt-IV-Aneurysmen sind im Vergleich zu abdominalen Aneurysmen selten. In einer großen autoptischen Serie von Patienten mit aortoiliakalen Aneurysmen zeigte sich die folgende relative Häufigkeit nach Lokalisation: abdominale Aorta allein 65%; thorakale Aorta allein 19%; abdominale Aorta plus Iliakalarterien 13%; thorakoabdominale Aorta 2%; und isolierte Iliakalarterien 1% [11]. In einer vergleichenden Studie von 429 Patienten mit abdominalen und juxtarenalen Aortenaneurysmen präsentierten sich 86% als infrarenal, und 14% erstreckten sich bis an oder über die Nierenarterien [4]. Abschnitt-IV-Aneurysmen werden bei 10–26% der thorakoabdominalen Aortenaneurysmen beschrieben [12]. Juxtarenale Aneurysmen sind etwa 3-bis 4-mal häufiger als suprarenale Aneurysmen [43]. Populationsbasierte Studien schätzen die Inzidenz von klinisch offenkundigen abdominalen Aortenaneurysmen auf 21 pro 100.000 Personenjahre [8] und von thorakalen Aortenaneurysmen auf 6 pro 100.000 Personenjahre [8].Epidemiologisch verhalten sich abdominale (inklusive juxta- und suprarenale) Aneurysmen und Abschnitt-IV-Aneurysmen unterschiedlich. Erstere kommen in einem Verhältnis Mann zu Frau von 2:1 bis 6:1, letztere in einem Verhältnis 1:1 bis 4:1 vor. Die Inzidenz von rupturierten abdominalen Aortenaneurysmen in der allgemeinen Bevölkerung wird mit 6,3 pro 100.000, diejenigen bei über 65-Jährigen mit 35,5 pro 100.000 angegeben [28]. Obwohl man annehmen müsste, dass die Zunahme der elektiven Versorgung die Anzahl der Rupturen senken sollte, konnte dieser Effekt bisher nicht eindeutig nachgewiesen werden [29]. Auch konnte nicht klar aufgezeigt werden, dass juxta- und suprarenale Aneurysmen häufiger rupturieren würden, wie von einigen Autoren vermutet.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • D. Mayer
    • 1
  • T. Pfammatter
    • 2
  • M. Lachat
    • 3
  1. 1.Klinik für Herz- und GefässchirurgieUniversitätsspital ZürichZürichSchweiz
  2. 2.Institut für Diagnostische und Interventionelle RadiologieUniversitätsSpital ZürichZürichSchweiz
  3. 3.Klinik für Herz- und GefässchirurgieUniversitätsspital ZürichZürichSchweiz

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