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Rofo 2012; 184(1): 15-23
DOI: 10.1055/s-0031-1281935
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Intervention an der thorakalen Aorta

Thoracic Aortic Interventions
R. Puls
1   Institut für Diagnostische Radiologie und Neuroradiologie, Universitätsmedizin der Ernst-Moritz-Arndt-Universität Greifswald
,
C. Rosenberg
1   Institut für Diagnostische Radiologie und Neuroradiologie, Universitätsmedizin der Ernst-Moritz-Arndt-Universität Greifswald
,
J. P. Kühn
1   Institut für Diagnostische Radiologie und Neuroradiologie, Universitätsmedizin der Ernst-Moritz-Arndt-Universität Greifswald
,
T. Traeger
2   Klinik für Allgemeine Chirurgie, Viszeral-, Thorax- und Gefäßchirurgie, Universitätsmedizin der Ernst-Moritz-Arndt-Universität Greifswald
,
B. Mensel
1   Institut für Diagnostische Radiologie und Neuroradiologie, Universitätsmedizin der Ernst-Moritz-Arndt-Universität Greifswald
,
A. Hoene
2   Klinik für Allgemeine Chirurgie, Viszeral-, Thorax- und Gefäßchirurgie, Universitätsmedizin der Ernst-Moritz-Arndt-Universität Greifswald
› Author Affiliations
Further Information

Publication History

21 July 2011

28 October 2011

Publication Date:
23 December 2011 (online)

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Zusammenfassung

Durch die Einführung und Weiterentwicklung interventioneller Techniken hat die Behandlung von Erkrankungen der thorakalen Aorta in den letzten Jahren einen Paradigmenwechsel erfahren. Die endovaskuläre Aortenprothesenimplantation ist bei signifikant geringerer Mortalitäts- und Komplikationsrate im Vergleich zum offen-chirurgischen Vorgehen inzwischen Therapieoption der 1. Wahl bei einem Großteil vaskulärer Erkrankungen der Aorta descendens.

Abstract

The treatment of thoracic aortic diseases has undergone a paradigm shift due to the introduction and further development of interventional techniques in recent years. Thoracic endovascular aortic repair (TEVAR) of the descending aorta has significantly lower mortality and complication rates compared to open repair. Meanwhile this endovascular approach is the first option for the treatment of the majority of thoracic aortic diseases.

Key words

aorta - interventional procedures - stents - dissection - aneurysm - thoracic endovascular aortic repair (TEVAR)
 

  • Literatur

  • 1 Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vasc Surg 1991; 5: 491-499
    CrossrefPubMedSearch in Google Scholar
  • 2 Dake MD, Miller DC, Semba CP et al. Transluminal placement of endovascular stent-grafts for the treatment of descending thoracic aortic aneurysms. N Engl J Med 1994; 331: 1729-1734
    CrossrefPubMedSearch in Google Scholar
  • 3 Xenos ES, Abedi NN, Davenport DL et al. Meta-analysis of endovascular vs open repair for traumatic descending thoracic aortic rupture. J Vasc Surg 2008; 48: 1343-1351
    CrossrefPubMedSearch in Google Scholar
  • 4 Walsh SR, Tang TY, Sadat U et al. Endovascular stenting versus open surgery for thoracic aortic disease: systematic review and meta-analysis of perioperative results. J Vasc Surg 2008; 47: 1094-1098
    CrossrefPubMedSearch in Google Scholar
  • 5 Jonker FH, Trimarchi S, Verhagen HJ et al. Meta-analysis of open versus endovascular repair for ruptured descending thoracic aortic aneurysm. J Vasc Surg 2010; 51: 1026-1032
    CrossrefPubMedSearch in Google Scholar
  • 6 Cheng D, Martin J, Shennib H et al. Endovascular aortic repair versus open surgical repair for descending thoracic aortic disease a systematic review and meta-analysis of comparative studies. J Am Coll Cardiol 2010; 55: 986-1001
    CrossrefPubMedSearch in Google Scholar
  • 7 Pache G, Euringer W, Siepe M et al. CT Angiography for the pre- and postoperative evaluation of the thoracic aorta. Fortschr Röntgenstr 2011; 183: 334-346
    Thieme ConnectPubMedSearch in Google Scholar
  • 8 von Tengg-Kobligk H, Ley-Zaporozhan J, Henninger V et al. Intraindividual assessment of the thoracic aorta using contrast and non-contrast-enhanced MR angiography. Fortschr Röntgenstr 2009; 181: 230-236
    PubMedSearch in Google Scholar
  • 9 Krishnam MS, Tomasian A, Malik S et al. Image quality and diagnostic accuracy of unenhanced SSFP MR angiography compared with conventional contrast-enhanced MR angiography for the assessment of thoracic aortic diseases. Eur Radiol 2010; 20: 1311-1320
    CrossrefPubMedSearch in Google Scholar
  • 10 Rasche V, Oberhuber A, Trumpp S et al. MRI assessment of thoracic stent grafts after emergency implantation in multi trauma patients: a feasibility study. Eur Radiol 2011; 21: 1397-1405
    CrossrefPubMedSearch in Google Scholar
  • 11 Cejna M, Loewe C, Schoder M et al. MR angiography vs CT angiography in the follow-up of nitinol stent grafts in endoluminally treated aortic aneurysms. Eur Radiol 2002; 12: 2443-2450
    PubMedSearch in Google Scholar
  • 12 Ayuso JR, de Caralt TM, Pages M et al. MRA is useful as a follow-up technique after endovascular repair of aortic aneurysms with nitinol endoprostheses. J Magn Reson Imaging 2004; 20: 803-810
    CrossrefPubMedSearch in Google Scholar
  • 13 Torsello GB, Kasprzak B, Klenk E et al. Endovascular suture versus cutdown for endovascular aneurysm repair: a prospective randomized pilot study. J Vasc Surg 2003; 38: 78-82
    CrossrefPubMedSearch in Google Scholar
  • 14 Carpenter JP. Delivery of endovascular grafts by direct sheath placement into the aorta or iliac arteries. Ann Vasc Surg 2002; 16: 787-790
    CrossrefPubMedSearch in Google Scholar
  • 15 MacDonald S, Cheung A, Sidhu R et al. Endovascular aortic aneurysm repair via the left ventricular apex of a beating heart. J Vasc Surg 2009; 49: 759-762
    CrossrefPubMedSearch in Google Scholar
  • 16 Kovacs A, Schiller W, Gerhards HM et al. Visualization of the Adamkiewicz artery in patients with acute stanford a dissections: a prospective 64-row multi-detector CT study. Fortschr Röntgenstr 2009; 181: 870-874
    PubMedSearch in Google Scholar
  • 17 Riesenman PJ, Farber MA, Mendes RR et al. Coverage of the left subclavian artery during thoracic endovascular aortic repair. J Vasc Surg 2007; 45: 90-94
    CrossrefPubMedSearch in Google Scholar
  • 18 Gilani R, Ochoa L, Wall Jr MJ et al. Endovascular Repair of Traumatic Aortic Injury Using a Custom Fenestrated Endograft to Preserve the Left Subclavian Artery. Vasc Endovascular Surg 2011; 45: 549-552
    CrossrefPubMedSearch in Google Scholar
  • 19 Criado FJ, McKendrick C, Criado FR. Technical solutions for common problems in TEVAR: managing access and aortic branches. J Endovasc Ther 2009; 16: 63-79
    PubMedSearch in Google Scholar
  • 20 Akin I, Kische S, Schneider H et al. Thoracic aorta aneurysms. Internist 2009; 50: 964-971
    CrossrefPubMedSearch in Google Scholar
  • 21 Puls R, Volzke H. Whole-body MRI in the study of health in Pomerania. Radiologe 2011; 51: 379-383
    CrossrefPubMedSearch in Google Scholar
  • 22 Hegenscheid K, Kuhn JP, Volzke H et al. Whole-body magnetic resonance imaging of healthy volunteers: pilot study results from the population-based SHIP study. Fortschr Röntgenstr 2009; 181: 748-759
    Thieme ConnectPubMedSearch in Google Scholar
  • 23 Coady MA, Rizzo JA, Hammond GL et al. What is the appropriate size criterion for resection of thoracic aortic aneurysms?. J Thorac Cardiovasc Surg 1997; 113: 476-491 ; discussion 489–491
    CrossrefPubMedSearch in Google Scholar
  • 24 Svensson LG, Kouchoukos NT, Miller DC et al. Expert consensus document on the treatment of descending thoracic aortic disease using endovascular stent-grafts. Ann Thorac Surg 2008; 85: 1-41
    CrossrefPubMedSearch in Google Scholar
  • 25 Cho KR, Stanson AW, Potter DD et al. Penetrating atherosclerotic ulcer of the descending thoracic aorta and arch. J Thorac Cardiovasc Surg 2004; 127: 1393-1399
    CrossrefPubMedSearch in Google Scholar
  • 26 Demers P, Miller DC, Mitchell RS et al. Stent-graft repair of penetrating atherosclerotic ulcers in the descending thoracic aorta: mid-term results. Ann Thorac Surg 2004; 77: 81-86
    CrossrefPubMedSearch in Google Scholar
  • 27 Corbillon E, Bergeron P, Poullie AI et al. The French National Authority for Health reports on thoracic stent grafts. J Vasc Surg 2008; 47: 1099-1107
    CrossrefPubMedSearch in Google Scholar
  • 28 Prinssen M, Verhoeven EL, Buth J et al. A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms. N Engl J Med 2004; 351: 1607-1618
    CrossrefPubMedSearch in Google Scholar
  • 29 [Anonym]. Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm (EVAR trial 1): randomised controlled trial. Lancet 2005; 365: 2179-2186
    CrossrefPubMedSearch in Google Scholar
  • 30 De Bruin JL, Baas AF, Buth J et al. Long-term outcome of open or endovascular repair of abdominal aortic aneurysm. N Engl J Med 2010; 362: 1881-1889
    CrossrefPubMedSearch in Google Scholar
  • 31 Makaroun MS, Dillavou ED, Kee ST et al. Endovascular treatment of thoracic aortic aneurysms: results of the phase II multicenter trial of the GORE TAG thoracic endoprosthesis. J Vasc Surg 2005; 41: 1-9
    CrossrefPubMedSearch in Google Scholar
  • 32 Bavaria JE, Appoo JJ, Makaroun MS et al. Endovascular stent grafting versus open surgical repair of descending thoracic aortic aneurysms in low-risk patients: a multicenter comparative trial. J Thorac Cardiovasc Surg 2007; 133: 369-377
    CrossrefPubMedSearch in Google Scholar
  • 33 Makaroun MS, Dillavou ED, Wheatley GH et al. Five-year results of endovascular treatment with the Gore TAG device compared with open repair of thoracic aortic aneurysms. J Vasc Surg 2008; 47: 912-918
    CrossrefPubMedSearch in Google Scholar
  • 34 Fairman RM, Criado F, Farber M et al. Pivotal results of the Medtronic Vascular Talent Thoracic Stent Graft System: the VALOR trial. J Vasc Surg 2008; 48: 546-554
    CrossrefPubMedSearch in Google Scholar
  • 35 Matsumura JS, Cambria RP, Dake MD et al. International controlled clinical trial of thoracic endovascular aneurysm repair with the Zenith TX2 endovascular graft: 1-year results. J Vasc Surg 2008; 47: 247-257
    CrossrefPubMedSearch in Google Scholar
  • 36 Riambau V, Zipfel B, Coppi G et al. Final operative and midterm results of the European experience in the RELAY Endovascular Registry for Thoracic Disease (RESTORE) study. J Vasc Surg 2011; 53: 565-573
    CrossrefPubMedSearch in Google Scholar
  • 37 Nienaber CA, Rousseau H, Eggebrecht H et al. Randomized comparison of strategies for type B aortic dissection: the INvestigation of STEnt Grafts in Aortic Dissection (INSTEAD) trial. Circulation 2009; 120: 2519-2528
    CrossrefPubMedSearch in Google Scholar
  • 38 Dake MD, Kato N, Mitchell RS et al. Endovascular stent-graft placement for the treatment of acute aortic dissection. N Engl J Med 1999; 340: 1546-1552
    CrossrefPubMedSearch in Google Scholar
  • 39 Mossop PJ, McLachlan CS, Amukotuwa SA et al. Staged endovascular treatment for complicated type B aortic dissection. Nat Clin Pract Cardiovasc Med 2005; 2: 316-321
    CrossrefPubMedSearch in Google Scholar
  • 40 Midulla M, Renaud A, Martinelli T et al. Endovascular fenestration in aortic dissection with acute malperfusion syndrome: Immediate and late follow-up. J Thorac Cardiovasc Surg 2011; 142: 66-72
    CrossrefPubMedSearch in Google Scholar
  • 41 Schumacher H, Bockler D, von Tengg-Kobligk H et al. Acute traumatic aortic tear: open versus stent-graft repair. Semin Vasc Surg 2006; 19: 48-59
    CrossrefPubMedSearch in Google Scholar
  • 42 Dosios TJ, Salemis N, Angouras D et al. Blunt and penetrating trauma of the thoracic aorta and aortic arch branches: an autopsy study. J Trauma 2000; 49: 696-703
    CrossrefPubMedSearch in Google Scholar
  • 43 von Oppell UO, Dunne TT, De Groot MK et al. Traumatic aortic rupture: twenty-year metaanalysis of mortality and risk of paraplegia. Ann Thorac Surg 1994; 58: 585-593
    CrossrefPubMedSearch in Google Scholar
  • 44 Rousseau H, Elaassar O, Marcheix B et al. The Role of Stent-Grafts in the Management of Aortic Trauma. Cardiovasc Intervent Radiol 2011;
    PubMedSearch in Google Scholar
  • 45 Tang GL, Tehrani HY, Usman A et al. Reduced mortality, paraplegia, and stroke with stent graft repair of blunt aortic transections: a modern meta-analysis. J Vasc Surg 2008; 47: 671-675
    CrossrefPubMedSearch in Google Scholar
  • 46 Akowuah E, Angelini G, Bryan AJ. Open versus endovascular repair of traumatic aortic rupture: a systematic review. J Thorac Cardiovasc Surg 2009; 138: 768-769
    CrossrefPubMedSearch in Google Scholar
  • 47 Bailey CJ, Force S, Milner R et al. Thoracic endovascular repair as a safe management strategy for aortobronchial fistulas. J Vasc Surg 2011; 53: 1202-1209
    CrossrefPubMedSearch in Google Scholar
  • 48 Chiesa R, Melissano G, Marone EM et al. Endovascular treatment of aortoesophageal and aortobronchial fistulae. J Vasc Surg 2010; 51: 1195-1202
    CrossrefPubMedSearch in Google Scholar
  • 49 Roche-Nagle G, de Perrot M, Waddell TK et al. Neoadjuvant aortic endografting. Ann Vasc Surg 2009; 23: 781-785
    PubMedSearch in Google Scholar
  • 50 Geisbusch P, Hoffmann S, Kotelis D et al. Reinterventions during midterm follow-up after endovascular treatment of thoracic aortic disease. J Vasc Surg 2011; 53: 1528-1533
    CrossrefPubMedSearch in Google Scholar