Aneurysmaruptur der abdominalen Aorta

Zusammenfassung

Die Aneurysmaruptur der abdominalen Aorta ist eine lebensbedrohliche Situation. Aktuell sind die offene und endovaskuläre Behandlungsmethode in hochspezialisierten Zentren gleichwertig mit niedrigen Mortalitätsraten (15 – 20%). Das individuelle Patientenmanagement ist wichtiger als die gewählte Behandlungsoption. Die permissive Hypotonie mit Flüssigkeitsrestriktion sowie die geeignete Aneurysmaanatomie für die endovaskuläre Behandlung haben einen positiven Einfluss auf das Überleben. Koronare Herzkrankheit, chronische Niereninsuffizienz und schwerer hypovolämischer Schock haben einen negativen Einfluss auf das Überleben. Die Re-Interventionsrate nach endovaskulärer Versorgung ist deutlich höher als nach offenem Ersatz und erfordert lebenslange Nachkontrollen.

Summary

Aneurysm rupture is a potentially lethal complication. Open and endovascular treatment show similar mortality rates in high volume centres (15 – 20%). Individual patient management is more important than the choice between open or endovascular repair. Permissive hypotension with fluid restriction and aneurysm morphology suitable for endovascular treatment have a positive impact on mortality after either method of repair. Coronary artery disease, chronic renal impairment, and hypovolaemic shock raise mortality. Reintervention rates after endovascular repair are high and mandate lifelong follow-up.

Schlüsselwörter

Aneurysma - Aortenruptur - Operationsplanung - endovaskuläre Therapie

Key words

ruptured abdominal aortic aneurysm - abdominal aorta - operation strategy - endovascular treatment

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