Das abdominale Aortenaneurysma

Fazit

Das AAA hat eine Gesamtprävalenz von ca. 4 – 8% der über 65-jährigen Männer und von 0,5 – 1,5 % der über 65-jährigen Frauen. Es ist eine multifaktorielle Erkrankung, bei der Entzündungs- und Degenerationsprozesse vor allem in der Media und Adventitia der Aorta sowie Matrixmetalloproteinasen eine entscheidende Rolle spielen.

Den ausschlaggebenden Risikofaktor für die Entstehung und die rasche Progredienz des AAA stellt das Rauschen dar.

Das Screening auf AAA kann nachweislich das Langzeitüberleben bestimmter Risikogruppen verbessern. Besondere Risikogruppen sind vor allem männliche Raucher über 65 Jahren. Für Frauen steht der Nachweis eines generellen Nutzens des Aorten-Screenings noch aus.

Die Spiral-CTA gilt aufgrund der hohen Auflösung weiterhin als Goldstandard für die EVAR-Planung. Besondere Beachtung erfordern vor allem kontrastmittelassoziierte Komplikationen.

Die farbkodierte Duplexsonografie stellt bei Verwendung einer Kontrastmittelverstärkung eine valide Alternative bei der Suche nach Endoleckagen nach EVAR dar.

• Literatur

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