Ohki T, Veith FJ
Division of Vascular Surgery, Department of Surgery, Montefiore Medical Center and Albert Einstein College of Medicine, New York, NY 10467, USA.
Curr Treat Options Cardiovasc Med. 1999 Jun;1(1):19-26. doi: 10.1007/s11936-999-0003-y.
The mortality rate after the rupture of an abdominal aortic aneurysm is 80% to 90%; therefore, the main goal of treatment is to prevent rupture. Patients with abdominal aortic aneurysms smaller than 5 cm in diameter should be managed conservatively under close surveillance with either computed tomography or sonography every 3 to 12 months. Patients should be informed that most aneurysms continue to enlarge at an average rate of 2 to 4 mm per year and that there is a 1% to 5% annual risk for sudden rupture. Treatment of the aneurysm is generally recommended if it is larger than 5 cm in diameter, and the only effective treatment is replacement of the aneurysm with a prosthetic graft. This can be performed through a laparotomy or a groin incision using an endovascular graft. Open surgical repair carries a mortality rate of 2% to 8% and requires a hospital stay of 7 to 10 days. Patients receiving endovascular grafts can be discharged within 1 to 3 days. Long-term durability has yet to be proven, however.
腹主动脉瘤破裂后的死亡率为80%至90%；因此，治疗的主要目标是预防破裂。直径小于5 cm的腹主动脉瘤患者应在密切监测下进行保守治疗，每3至12个月进行一次计算机断层扫描或超声检查。应告知患者，大多数动脉瘤以每年平均2至4 mm的速度持续增大，且每年有1%至5%的突然破裂风险。如果动脉瘤直径大于5 cm，一般建议进行治疗，唯一有效的治疗方法是用人工血管置换动脉瘤。这可以通过剖腹手术或使用血管内移植物的腹股沟切口来完成。开放手术修复的死亡率为2%至8%，需要住院7至10天。接受血管内移植物的患者可在1至3天内出院。然而，其长期耐用性尚未得到证实。
