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Erschienen in: Gefässchirurgie 4/2017

21.06.2017 | Aneurysmen | CME

Rupturiertes Bauchaortenaneurysma

Endovaskuläre versus offene Behandlung

verfasst von: PD Dr. A. Oberhuber, N. Ertas, M. Duran, N. Floros, F. Simon, H. Schelzig

Erschienen in: Gefässchirurgie | Ausgabe 4/2017

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Zusammenfassung

Das rupturierte Bauchaortenaneurysma ist eine lebensbedrohliche Erkrankung. Entscheidend sind eine schnelle Diagnosestellung und eine umgehende operative Versorgung, um die Blutung zu stoppen und das Aneurysma auszuschalten. Hierzu stehen das offene und das endovaskuläre Verfahren zur Verfügung. Bislang konnte keine der randomisierten Studien nachweisen, dass eines der beiden Verfahren einen Überlebensvorteil gegenüber dem anderen bietet. Trotz aller Einschränkungen, die diese Studien haben, konnte jedoch gezeigt werden, dass bei vergleichbarem Überleben die Komplikationsraten nach endovaskulärem Aortenersatz (EVAR) signifikant vermindert waren. In spezialisierten Zentren mit hoher Anzahl an elektiven EVAR ist die Mortalität deutlich niedriger als beim offenen Ersatz. Aufgrund der Studienlage kann keine eindeutige Empfehlung für ein Verfahren ausgesprochen werden. Jedes Zentrum muss aufgrund der eigenen Expertise und v. a. der eigenen Struktur Behandlungspfade entwickeln. Wichtig ist es, die eigenen Mortalitäts- und Morbiditätsraten zu kennen, um evtl. Änderungen an den eigenen Behandlungspfaden vornehmen zu können. Als zertifiziertes Gefäßzentrum werden diese Kennzahlen im Rahmen des jährlichen Reportings automatisch mitgeteilt und können somit zur Entwicklung von z. B. SOP („standard operation procedures“) herangezogen werden.
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Metadaten
Titel
Rupturiertes Bauchaortenaneurysma
Endovaskuläre versus offene Behandlung
verfasst von
PD Dr. A. Oberhuber
N. Ertas
M. Duran
N. Floros
F. Simon
H. Schelzig
Publikationsdatum
21.06.2017
Verlag
Springer Medizin
Erschienen in
Gefässchirurgie / Ausgabe 4/2017
Print ISSN: 0948-7034
Elektronische ISSN: 1434-3932
DOI
https://doi.org/10.1007/s00772-017-0287-2

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