Skip to main content

2016 | OriginalPaper | Buchkapitel

44. Abdominelles Aortenaneurysma

verfasst von : Univ.-Prof. Dr. med. Hans-Henning Eckstein

Erschienen in: Akutes Abdomen

Verlag: Springer Vienna

Zusammenfassung

Die häufigste Erkrankung der Aorta ist das abdominelle Aortenaneurysma (AAA). 80–90% aller AAA sind asymptomatisch (silent killer). Ein symptomatisches oder rupturiertes abdominelles Aortenaneurysma stellt eine wichtige, unmittelbar lebensbedrohliche Differenzialdiagnose des akuten Abdomens dar. Eine sofortige gezielte Diagnostik und ggf. gefäßchirurgische Therapie ist daher absolut notwendig. Für die Therapie eines AAA stehen zwei Standardverfahren zur Verfügung: Beim offenen Ersatz (open repair bzw. OR) wird die infrarenale Aorta durch eine Rohr- oder Bifurkationsprothese ersetzt, bei der endovaskulären Therapie (endovascular aortic repair bzw. EVAR) wird das AAA durch die Implantation einer Stent-Prothese über die Leistenarterien ausgeschaltet.
Literatur
Zurück zum Zitat Anonymous (1998) Mortality results for randomised controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms. The UK Small Aneurysm Trial Participants. Lancet 352(9141): 1649–1655 Anonymous (1998) Mortality results for randomised controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms. The UK Small Aneurysm Trial Participants. Lancet 352(9141): 1649–1655
Zurück zum Zitat Baigent C, Blackwell L, Collins R et al (2009) Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 373(9678): 1849–1860 Baigent C, Blackwell L, Collins R et al (2009) Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 373(9678): 1849–1860
Zurück zum Zitat Baxter BT, Terrin MC, Dalman RL (2008) Medical management of small abdominal aortic aneurysms. Circulation 117(14): 1883–1889CrossRefPubMedCentral Baxter BT, Terrin MC, Dalman RL (2008) Medical management of small abdominal aortic aneurysms. Circulation 117(14): 1883–1889CrossRefPubMedCentral
Zurück zum Zitat Brady AR, Thompson SG, Fowkes FG et al (2004) Abdominal aortic aneurysm expansion: risk factors and time intervals for surveillance. Circulation 110(1): 16–21CrossRefPubMed Brady AR, Thompson SG, Fowkes FG et al (2004) Abdominal aortic aneurysm expansion: risk factors and time intervals for surveillance. Circulation 110(1): 16–21CrossRefPubMed
Zurück zum Zitat Cao P, De Rango RP, Verzini F et al (2011) Comparison of surveillance versus aortic endografting for small aneurysm repair (CAESAR): results from a randomised trial. Eur J Vasc Endovasc Surg 41(1): 13–25CrossRefPubMed Cao P, De Rango RP, Verzini F et al (2011) Comparison of surveillance versus aortic endografting for small aneurysm repair (CAESAR): results from a randomised trial. Eur J Vasc Endovasc Surg 41(1): 13–25CrossRefPubMed
Zurück zum Zitat Cosford PA, Leng GC (2007) Screening for abdominal aortic aneurysm. Cochrane Database Syst Rev (2): CD002945 Cosford PA, Leng GC (2007) Screening for abdominal aortic aneurysm. Cochrane Database Syst Rev (2): CD002945
Zurück zum Zitat Derubertis BG, Trocciola SM, Ryer EJ et al (2007) Abdominal aortic aneurysm in women: prevalence, risk factors, and implications for screening. J Vasc Surg 46(4): 630–635PubMed Derubertis BG, Trocciola SM, Ryer EJ et al (2007) Abdominal aortic aneurysm in women: prevalence, risk factors, and implications for screening. J Vasc Surg 46(4): 630–635PubMed
Zurück zum Zitat Dillon M, Cardwell C, Blair PH et al (2007) Endovascular treatment for ruptured abdominal aortic aneurysm. Cochrane Database Syst Rev (1):CD005261 Dillon M, Cardwell C, Blair PH et al (2007) Endovascular treatment for ruptured abdominal aortic aneurysm. Cochrane Database Syst Rev (1):CD005261
Zurück zum Zitat Drury D, Michaels JA, Jones L, Ayiku L (2005) Systematic review of recent evidence for the safety and efficacy of elective endovascular repair in the management of infrarenal abdominal aortic aneurysm. Br J Surg 92(8): 937–946CrossRef Drury D, Michaels JA, Jones L, Ayiku L (2005) Systematic review of recent evidence for the safety and efficacy of elective endovascular repair in the management of infrarenal abdominal aortic aneurysm. Br J Surg 92(8): 937–946CrossRef
Zurück zum Zitat Eckstein HH, Bockler D, Flessenkamper I et al (2009) Ultrasonographic screening for the detection of abdominal aortic aneurysms. Dtsch Ärztebl Int 106(41): 657–663PubMedCentral Eckstein HH, Bockler D, Flessenkamper I et al (2009) Ultrasonographic screening for the detection of abdominal aortic aneurysms. Dtsch Ärztebl Int 106(41): 657–663PubMedCentral
Zurück zum Zitat Eckstein HH, Reeps C, Zimmermann A, Söllner H (2014) Ultrasound screening for abdominal aortic aneurysms: evidence from randomized controlled trials. [Ultraschallscreening auf abdominale Aortenaneurysmen (AAA): Evidenz aus randomisierten Studien]. Gefässchirurgie 19(6): 515–527 Eckstein HH, Reeps C, Zimmermann A, Söllner H (2014) Ultrasound screening for abdominal aortic aneurysms: evidence from randomized controlled trials. [Ultraschallscreening auf abdominale Aortenaneurysmen (AAA): Evidenz aus randomisierten Studien]. Gefässchirurgie 19(6): 515–527
Zurück zum Zitat Edwards JM, Teefey SA, Zierler RE, Kohler TR (1992) Intraabdominal paraanastomotic aneurysms after aortic bypass grafting. J Vasc Surg 15(2): 344–350CrossRef Edwards JM, Teefey SA, Zierler RE, Kohler TR (1992) Intraabdominal paraanastomotic aneurysms after aortic bypass grafting. J Vasc Surg 15(2): 344–350CrossRef
Zurück zum Zitat Erbel R, Aboyans V, Boileau C et al; ESC Committee for Practice Guidelines (2014) 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J 35(41): 2873–2926 Erbel R, Aboyans V, Boileau C et al; ESC Committee for Practice Guidelines (2014) 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J 35(41): 2873–2926
Zurück zum Zitat EVAR Trial Participants (2005) Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm (EVAR trial 1): randomised controlled trial. Lancet 365(9478): 2179–2186 EVAR Trial Participants (2005) Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm (EVAR trial 1): randomised controlled trial. Lancet 365(9478): 2179–2186
Zurück zum Zitat Forsdahl SH, Singh K, Solberg S, Jacobsen BK (2009) Risk factors for abdominal aortic aneurysms: a 7-year prospective study: the Tromso Study, 1994-2001. Circulation 119(16): 2202–2208CrossRef Forsdahl SH, Singh K, Solberg S, Jacobsen BK (2009) Risk factors for abdominal aortic aneurysms: a 7-year prospective study: the Tromso Study, 1994-2001. Circulation 119(16): 2202–2208CrossRef
Zurück zum Zitat Gemeinsamer Bundesausschuss (GBA) (2008) Qualitätssicherungsvereinbarung zum Bauchaortenaneurysma. Bundesanzeiger 198: 4809. www.g-ba.de/informationen/beschluesse/753/ Gemeinsamer Bundesausschuss (GBA) (2008) Qualitätssicherungsvereinbarung zum Bauchaortenaneurysma. Bundesanzeiger 198: 4809. www.g-ba.de/informationen/beschluesse/753/
Zurück zum Zitat Golledge J, Norman PE (2011) Current status of medical management for abdominal aortic aneurysm. Atherosclerosis 217(1): 57–63CrossRefPubMed Golledge J, Norman PE (2011) Current status of medical management for abdominal aortic aneurysm. Atherosclerosis 217(1): 57–63CrossRefPubMed
Zurück zum Zitat Golledge J, Muller J, Daugherty A, Norman P (2006) Abdominal aortic aneurysm: pathogenesis and implications for management. Arterioscler Thromb Vasc Biol 26(12): 2605–2613CrossRef Golledge J, Muller J, Daugherty A, Norman P (2006) Abdominal aortic aneurysm: pathogenesis and implications for management. Arterioscler Thromb Vasc Biol 26(12): 2605–2613CrossRef
Zurück zum Zitat Greenhalgh RM, Brown LC, Kwong GP et al (2004) Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomised controlled trial. Lancet 364(9437): 843–848CrossRef Greenhalgh RM, Brown LC, Kwong GP et al (2004) Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomised controlled trial. Lancet 364(9437): 843–848CrossRef
Zurück zum Zitat Greenhalgh RM, Brown LC, Powell JT et al (2010) Endovascular versus open repair of abdominal aortic aneurysm. N Engl J Med 362(20): 1863–1871 Greenhalgh RM, Brown LC, Powell JT et al (2010) Endovascular versus open repair of abdominal aortic aneurysm. N Engl J Med 362(20): 1863–1871
Zurück zum Zitat Hackam DG, Thiruchelvam D, Redelmeier DA (2006) Angiotensin-converting enzyme inhibitors and aortic rupture: a population-based case-control study. Lancet 368(9536): 659–665CrossRef Hackam DG, Thiruchelvam D, Redelmeier DA (2006) Angiotensin-converting enzyme inhibitors and aortic rupture: a population-based case-control study. Lancet 368(9536): 659–665CrossRef
Zurück zum Zitat Holt PJ, Poloniecki JD, Gerrard D et al (2007a) Meta-analysis and systematic review of the relationship between volume and outcome in abdominal aortic aneurysm surgery. Br J Surg 94(4): 395–403PubMed Holt PJ, Poloniecki JD, Gerrard D et al (2007a) Meta-analysis and systematic review of the relationship between volume and outcome in abdominal aortic aneurysm surgery. Br J Surg 94(4): 395–403PubMed
Zurück zum Zitat Holt PJ, Poloniecki JD, Loftus IM et al (2007b) Epidemiological study of the relationship between volume and outcome after abdominal aortic aneurysm surgery in the UK from 2000 to 2005. Br J Surg 94(4): 441-448cCrossRefPubMed Holt PJ, Poloniecki JD, Loftus IM et al (2007b) Epidemiological study of the relationship between volume and outcome after abdominal aortic aneurysm surgery in the UK from 2000 to 2005. Br J Surg 94(4): 441-448cCrossRefPubMed
Zurück zum Zitat Hoornweg LL, Wisselink W, Vahl A, Balm R (2007) The Amsterdam Acute Aneurysm Trial: suitability and application rate for endovascular repair of ruptured abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 33(6): 679–683CrossRef Hoornweg LL, Wisselink W, Vahl A, Balm R (2007) The Amsterdam Acute Aneurysm Trial: suitability and application rate for endovascular repair of ruptured abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 33(6): 679–683CrossRef
Zurück zum Zitat Imperial College London (2011) Evaluation of effect of angiotensin-converting enzyme (ACE) inhibitors on small aneurysm growth rate (AARDVARK). http://clinicaltrials.gov/ct2/show/NCT01118520 Imperial College London (2011) Evaluation of effect of angiotensin-converting enzyme (ACE) inhibitors on small aneurysm growth rate (AARDVARK). http://clinicaltrials.gov/ct2/show/NCT01118520
Zurück zum Zitat Kantonen I, Lepantalo M, Brommels M et al (1999) Mortality in ruptured abdominal aortic aneurysms. The Finnvasc Study Group. Eur J Vasc Endovasc Surg 17(3): 208–212CrossRef Kantonen I, Lepantalo M, Brommels M et al (1999) Mortality in ruptured abdominal aortic aneurysms. The Finnvasc Study Group. Eur J Vasc Endovasc Surg 17(3): 208–212CrossRef
Zurück zum Zitat Landon BE, O’Malley AJ, Giles K et al (2010) Volume-outcome relationships and abdominal aortic aneurysm repair. Circulation 122(13): 1290–1297CrossRef Landon BE, O’Malley AJ, Giles K et al (2010) Volume-outcome relationships and abdominal aortic aneurysm repair. Circulation 122(13): 1290–1297CrossRef
Zurück zum Zitat Lederle FA, Johnson GR, Wilson SE et al (1997a) Prevalence and associations of abdominal aortic aneurysm detected through screening. Aneurysm Detection and Management (ADAM) Veterans Affairs Cooperative Study Group. Ann Intern Med 126(6): 441–449CrossRef Lederle FA, Johnson GR, Wilson SE et al (1997a) Prevalence and associations of abdominal aortic aneurysm detected through screening. Aneurysm Detection and Management (ADAM) Veterans Affairs Cooperative Study Group. Ann Intern Med 126(6): 441–449CrossRef
Zurück zum Zitat Lederle FA, Johnson GR, Wilson SE et al (1997b) Relationship of age, gender, race, and body size to infrarenal aortic diameter. The Aneurysm Detection and Management (ADAM) Veterans Affairs Cooperative Study Investigators. J Vasc Surg 26(4): 595–601CrossRefPubMed Lederle FA, Johnson GR, Wilson SE et al (1997b) Relationship of age, gender, race, and body size to infrarenal aortic diameter. The Aneurysm Detection and Management (ADAM) Veterans Affairs Cooperative Study Investigators. J Vasc Surg 26(4): 595–601CrossRefPubMed
Zurück zum Zitat Lederle FA, Nelson DB, Joseph AM (2003) Smokers' relative risk for aortic aneurysm compared with other smoking-related diseases: a systematic review. J Vasc Surg 38(2): 329–334CrossRef Lederle FA, Nelson DB, Joseph AM (2003) Smokers' relative risk for aortic aneurysm compared with other smoking-related diseases: a systematic review. J Vasc Surg 38(2): 329–334CrossRef
Zurück zum Zitat Lederle FA, Freischlag JA, Kyriakides TC et al (2009) Outcomes following endovascular vs open repair of abdominal aortic aneurysm: a randomized trial. JAMA; 302(14):1535–1542CrossRef Lederle FA, Freischlag JA, Kyriakides TC et al (2009) Outcomes following endovascular vs open repair of abdominal aortic aneurysm: a randomized trial. JAMA; 302(14):1535–1542CrossRef
Zurück zum Zitat Lindholt JS, Norman P (2008) Screening for abdominal aortic aneurysm reduces overall mortality in men. A meta-analysis of the mid- and longterm effects of screening for abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 36(2): 167–171CrossRef Lindholt JS, Norman P (2008) Screening for abdominal aortic aneurysm reduces overall mortality in men. A meta-analysis of the mid- and longterm effects of screening for abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 36(2): 167–171CrossRef
Zurück zum Zitat Locati P, Socrate AM, Costantini E (2000) Paraanastomotic aneurysms of the abdominal aorta: a 15-year experience review. Cardiovasc Surg 8(4): 274–279CrossRef Locati P, Socrate AM, Costantini E (2000) Paraanastomotic aneurysms of the abdominal aorta: a 15-year experience review. Cardiovasc Surg 8(4): 274–279CrossRef
Zurück zum Zitat Moll FL, Powell JT, Fraedrich G et al (2011) Management of abdominal aortic aneurysms clinical practice guidelines of the European society for vascular surgery. Eur J Vasc Endovasc Surg 41(Suppl 1): S1–S58PubMed Moll FL, Powell JT, Fraedrich G et al (2011) Management of abdominal aortic aneurysms clinical practice guidelines of the European society for vascular surgery. Eur J Vasc Endovasc Surg 41(Suppl 1): S1–S58PubMed
Zurück zum Zitat Moller AM, Villebro N, Pedersen T, Tonnesen H (2002) Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial. Lancet 359(9301): 114–117CrossRef Moller AM, Villebro N, Pedersen T, Tonnesen H (2002) Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial. Lancet 359(9301): 114–117CrossRef
Zurück zum Zitat Myers JN, White JJ, Narasimhan B, Dalman RL (2010) Effects of exercise training in patients with abdominal aortic aneurysm: preliminary results from a randomized trial. J Cardiopulm Rehabil Prev 30(6): 374–383CrossRef Myers JN, White JJ, Narasimhan B, Dalman RL (2010) Effects of exercise training in patients with abdominal aortic aneurysm: preliminary results from a randomized trial. J Cardiopulm Rehabil Prev 30(6): 374–383CrossRef
Zurück zum Zitat Ogata T, MacKean GL, Cole CW et al (2005) The lifetime prevalence of abdominal aortic aneurysms among siblings of aneurysm patients is eightfold higher than among siblings of spouses: an analysis of 187 aneurysm families in Nova Scotia, Canada. J Vasc Surg 42(5): 891–897CrossRefPubMedCentral Ogata T, MacKean GL, Cole CW et al (2005) The lifetime prevalence of abdominal aortic aneurysms among siblings of aneurysm patients is eightfold higher than among siblings of spouses: an analysis of 187 aneurysm families in Nova Scotia, Canada. J Vasc Surg 42(5): 891–897CrossRefPubMedCentral
Zurück zum Zitat Ouriel K, Clair DG, Kent KC, Zarins CK (2010) Endovascular repair compared with surveillance for patients with small abdominal aortic aneurysms. J Vasc Surg 51(5): 1081–1087CrossRef Ouriel K, Clair DG, Kent KC, Zarins CK (2010) Endovascular repair compared with surveillance for patients with small abdominal aortic aneurysms. J Vasc Surg 51(5): 1081–1087CrossRef
Zurück zum Zitat Powell JT, Thompson SG, Thompson MM et al (2009) The Immediate Management of the Patient with Rupture: Open Versus Endovascular repair (IMPROVE) aneurysm trial - ISRCTN 48334791 IMPROVE trialists. Acta Chir Belg 109(6): 678–680 Powell JT, Thompson SG, Thompson MM et al (2009) The Immediate Management of the Patient with Rupture: Open Versus Endovascular repair (IMPROVE) aneurysm trial - ISRCTN 48334791 IMPROVE trialists. Acta Chir Belg 109(6): 678–680
Zurück zum Zitat Powell JT, Sweeting MJ, Brown LC et al (2011) Systematic review and metaanalysis of growth rates of small abdominal aortic aneurysms. Br J Surg 98(5): 609–618CrossRef Powell JT, Sweeting MJ, Brown LC et al (2011) Systematic review and metaanalysis of growth rates of small abdominal aortic aneurysms. Br J Surg 98(5): 609–618CrossRef
Zurück zum Zitat Sadat U, Boyle JR, Walsh SR et al (2008) Endovascular vs open repair of acute abdominal aortic aneurysms - a systematic review and meta-analysis. J Vasc Surg 48(1): 227–236 Sadat U, Boyle JR, Walsh SR et al (2008) Endovascular vs open repair of acute abdominal aortic aneurysms - a systematic review and meta-analysis. J Vasc Surg 48(1): 227–236
Zurück zum Zitat Sakalihasan N, Limet R, Defawe OD (2005) Abdominal aortic aneurysm. Lancet 365(9470): 1577–1589CrossRef Sakalihasan N, Limet R, Defawe OD (2005) Abdominal aortic aneurysm. Lancet 365(9470): 1577–1589CrossRef
Zurück zum Zitat Salem MK, Rayt HS, Hussey G et al (2009) Should Asian men be included in abdominal aortic aneurysm screening programmes? Eur J Vasc Endovasc Surg 38(6): 748–749CrossRef Salem MK, Rayt HS, Hussey G et al (2009) Should Asian men be included in abdominal aortic aneurysm screening programmes? Eur J Vasc Endovasc Surg 38(6): 748–749CrossRef
Zurück zum Zitat Schermerhorn ML, O’Malley AJ, Jhaveri A et al (2008) Endovascular vs. open repair of abdominal aortic aneurysms in the Medicare population. N Engl J Med 358(5): 464–474CrossRef Schermerhorn ML, O’Malley AJ, Jhaveri A et al (2008) Endovascular vs. open repair of abdominal aortic aneurysms in the Medicare population. N Engl J Med 358(5): 464–474CrossRef
Zurück zum Zitat Scott RA, Wilson NM, Ashton HA, Kay DN (1995) Influence of screening on the incidence of ruptured abdominal aortic aneurysm: 5-year results of a randomized controlled study. Br J Surg 82(8): 1066–1070 Scott RA, Wilson NM, Ashton HA, Kay DN (1995) Influence of screening on the incidence of ruptured abdominal aortic aneurysm: 5-year results of a randomized controlled study. Br J Surg 82(8): 1066–1070
Zurück zum Zitat Semmens JB, Norman PE, Lawrence-Brown MM, Holman CD (2000) Influence of gender on outcome from ruptured abdominal aortic aneurysm. Br J Surg 87(2): 191–194CrossRef Semmens JB, Norman PE, Lawrence-Brown MM, Holman CD (2000) Influence of gender on outcome from ruptured abdominal aortic aneurysm. Br J Surg 87(2): 191–194CrossRef
Zurück zum Zitat Shantikumar S, Ajjan R, Porter KE, Scott DJ (2010) Diabetes and the abdominal aortic aneurysm. Eur J Vasc Endovasc Surg 39(2): 200–207CrossRef Shantikumar S, Ajjan R, Porter KE, Scott DJ (2010) Diabetes and the abdominal aortic aneurysm. Eur J Vasc Endovasc Surg 39(2): 200–207CrossRef
Zurück zum Zitat Steinmetz E, Abello N, Kretz B et al (2010) Analysis of outcome after using high-risk criteria selection to surgery versus endovascular repair in the modern era of abdominal aortic aneurysm treatment. Eur J Vasc Endovasc Surg 39(4): 403–409CrossRef Steinmetz E, Abello N, Kretz B et al (2010) Analysis of outcome after using high-risk criteria selection to surgery versus endovascular repair in the modern era of abdominal aortic aneurysm treatment. Eur J Vasc Endovasc Surg 39(4): 403–409CrossRef
Zurück zum Zitat Sun Z (2006) Diagnostic value of color duplex ultrasonography in the followup of endovascular repair of abdominal aortic aneurysm. J Vasc Interv Radiol 17(5): 759–764CrossRef Sun Z (2006) Diagnostic value of color duplex ultrasonography in the followup of endovascular repair of abdominal aortic aneurysm. J Vasc Interv Radiol 17(5): 759–764CrossRef
Zurück zum Zitat Ten Bosch JA, Rouwet, Peters CT et al (2010) Contrast-enhanced ultrasound versus computed tomographic angiography for surveillance of endovascular abdominal aortic aneurysm repair. J Vasc Interv Radiol 21(5): 638–643CrossRef Ten Bosch JA, Rouwet, Peters CT et al (2010) Contrast-enhanced ultrasound versus computed tomographic angiography for surveillance of endovascular abdominal aortic aneurysm repair. J Vasc Interv Radiol 21(5): 638–643CrossRef
Zurück zum Zitat The Vascular Society of Great Britain and Ireland (2010) Developing an AAA screening programme - SOPs and workbook 2010. http://www.vascularsociety.org.uk/library/aaa-screening.html The Vascular Society of Great Britain and Ireland (2010) Developing an AAA screening programme - SOPs and workbook 2010. http://www.vascularsociety.org.uk/library/aaa-screening.html
Zurück zum Zitat Trenner M, Haller B, Söllner H et al (2013a) 12 Jahre »Qualitätssicherung BAA« der DGG: Teil 1: Trends in Therapie und Outcome des nicht rupturierten abdominellen Aortenaneurysmas in Deutschland zwischen 1999 und 2010. Gefässchirurgie 18(3): 206–213CrossRef Trenner M, Haller B, Söllner H et al (2013a) 12 Jahre »Qualitätssicherung BAA« der DGG: Teil 1: Trends in Therapie und Outcome des nicht rupturierten abdominellen Aortenaneurysmas in Deutschland zwischen 1999 und 2010. Gefässchirurgie 18(3): 206–213CrossRef
Zurück zum Zitat Trenner M, Haller B, Söllner H et al (2013b) 12 Jahre »Qualitätssicherung BAA« der DGG: Teil 2: Trends in Therapie und Outcome des rupturierten abdominellen Aortenaneurysmas in Deutschland zwischen 1999 und 2010. Gefässchirurgie 18(5): 372–380CrossRef Trenner M, Haller B, Söllner H et al (2013b) 12 Jahre »Qualitätssicherung BAA« der DGG: Teil 2: Trends in Therapie und Outcome des rupturierten abdominellen Aortenaneurysmas in Deutschland zwischen 1999 und 2010. Gefässchirurgie 18(5): 372–380CrossRef
Zurück zum Zitat Trenner M, Haller B, Söllner H et al (2014) 12 Jahre Qualitätssicherung zum rupturierten und nicht rupturierten abdominalen Aortenaneurysma der Deutschen Gesellschaft für Gefäßchirurgie und Gefäßmedizin (DGG): Teil 3: Prädiktoren für das perioperative Ergebnis unter besonderer Berücksichtigung der Fallzahl/Jahr. Gefässchirurgie 19(6): 573–585CrossRef Trenner M, Haller B, Söllner H et al (2014) 12 Jahre Qualitätssicherung zum rupturierten und nicht rupturierten abdominalen Aortenaneurysma der Deutschen Gesellschaft für Gefäßchirurgie und Gefäßmedizin (DGG): Teil 3: Prädiktoren für das perioperative Ergebnis unter besonderer Berücksichtigung der Fallzahl/Jahr. Gefässchirurgie 19(6): 573–585CrossRef
Zurück zum Zitat United Kingdom Small Aneurysm Trial Participants (2002) Long-term outcomes of immediate repair compared with surveillance of small abdominal aortic aneurysms. N Engl J Med 346(19): 1445–1452 United Kingdom Small Aneurysm Trial Participants (2002) Long-term outcomes of immediate repair compared with surveillance of small abdominal aortic aneurysms. N Engl J Med 346(19): 1445–1452
Zurück zum Zitat van Marrewijk CJ, Leurs, Vallabhaneni SR et al (2005) Risk-adjusted outcome analysis of endovascular abdominal aortic aneurysm repair in a large population: how do stent-grafts compare? J Endovasc Ther 12(4): 417–429 van Marrewijk CJ, Leurs, Vallabhaneni SR et al (2005) Risk-adjusted outcome analysis of endovascular abdominal aortic aneurysm repair in a large population: how do stent-grafts compare? J Endovasc Ther 12(4): 417–429
Zurück zum Zitat Visser JJ, van Sambeek MR, Hamza TH et al (2007) Ruptured abdominal aortic aneurysms: endovascular repair versus open surgery - systematic review. Radiology 245(1): 122–129CrossRef Visser JJ, van Sambeek MR, Hamza TH et al (2007) Ruptured abdominal aortic aneurysms: endovascular repair versus open surgery - systematic review. Radiology 245(1): 122–129CrossRef
Zurück zum Zitat Waasdorp EJ, de Vries JP, Hobo R et al (2005) Aneurysm diameter and proximal aortic neck diameter influence clinical outcome of endovascular abdominal aortic repair: a 4-year EUROSTAR experience. Ann Vasc Surg 19(6): 755–761CrossRef Waasdorp EJ, de Vries JP, Hobo R et al (2005) Aneurysm diameter and proximal aortic neck diameter influence clinical outcome of endovascular abdominal aortic repair: a 4-year EUROSTAR experience. Ann Vasc Surg 19(6): 755–761CrossRef
Zurück zum Zitat Zeebregts CJ, Geelkerken RH, van der PJ et al (2004) Outcome of abdominal aortic aneurysm repair in the era of endovascular treatment. Br J Surg 91(5): 563–568CrossRef Zeebregts CJ, Geelkerken RH, van der PJ et al (2004) Outcome of abdominal aortic aneurysm repair in the era of endovascular treatment. Br J Surg 91(5): 563–568CrossRef
Metadaten
Titel
Abdominelles Aortenaneurysma
verfasst von
Univ.-Prof. Dr. med. Hans-Henning Eckstein
Copyright-Jahr
2016
Verlag
Springer Vienna
DOI
https://doi.org/10.1007/978-3-7091-1473-5_44

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.