Viszerale Aneurysmen und Pseudoaneurysmen

Aneurysmen viszeraler Arterien sind selten und werden häufig als Zufallsbefund entdeckt oder wenn sie z. B. aufgrund ihrer Größe, einer gedeckten Perforation oder einer aktiven Blutung symptomatisch werden. Wegen der potenziell lebensbedrohlichen Komplikationen ist die Kenntnis über viszerale Aneurysmen und deren Behandlungsoptionen essenziell. Endovaskuläre Therapieverfahren sind meist das Mittel der Wahl und zeigen gute Ergebnisse.

Abstract

Visceral artery aneurysms are rare and are often discovered incidentally or when they become symptomatic, for example, due to their size, a contained perforation, or active bleeding. Due to the potentially life-threatening complications, knowledge of visceral aneurysms and their treatment options is essential. Endovascular treatment methods are usually the preferred approach and show good results. Various forms of treatment are available, which offer different advantages and disadvantages depending on the characteristics of the aneurysm and the patient. Conscientious pre-therapeutic planning is an important prerequisite for successful treatment. In addition, interdisciplinary cooperation is crucial for the patient's outcome.

Kernaussagen

• Viszeralarterienaneurysmen sind selten, bleiben häufig asymptomatisch oder führen zu unspezifischen abdominellen Beschwerden.

• Viszeralarterienaneurysmen und ‑pseudoaneurysmen können akut lebensbedrohlich sein.

• Die Wahl der Therapieoption richtet sich maßgeblich nach der Morphologie und Anatomie des Aneurysmas. Eine genaue Beurteilung sowohl der Art des Aneurysmas als auch von Träger- und Zugangsgefäß beeinflusst die Therapieentscheidung.

• Es bestehen diverse Therapieoptionen von Watch-and-wait über interventionell-radiologische bis hin zu offen-chirurgischen Verfahren. Die endovaskuläre Behandlung ist aufgrund des Risiko-Nutzen-Verhältnisses der offen-chirurgischen Therapie vorzuziehen.

• Für die Verlaufskontrolle von nicht therapierten Aneurysmen und die Nachsorge ist eine CTA in arterieller Kontrastmittelphase am besten geeignet. Grundsätzlich sind aber auch andere Untersuchungsmodalitäten möglich. Ein Modalitätswechsel sollte jedoch vermieden werden, da hierdurch eine Verlaufsbeurteilung erschwert wird.

Schlüsselwörter

Aneurysma - Pseudoaneurysma - viszeral - interventionelle Radiologie - Embolisation

Keywords

aneurysma - pseudoaneurysma - visceral - interventional radiology - embolization

Publication History

Article published online:
20 September 2024

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