Clinic for Cardiovascular Surgery, University Hospital, Zurich, Switzerland Department of Surgery, Stockholm South Hospital, SE-118 83 Stockholm, Sweden
Clinic for Cardiovascular Surgery, University Hospital, Zurich, Switzerland.
Eur Heart J. 2016 Jan 7;37(2):145-51. doi: 10.1093/eurheartj/ehv593. Epub 2015 Nov 4.
During the last two decades, endovascular technology has revolutionized the management of patients with abdominal aortic aneurysm (AAA). Today, endovascular aortic repair (EVAR) is the treatment of choice for the majority of patients with an AAA. Randomized controlled trials provide robust evidence for the indication of AAA repair and the rationale for the use of EVAR in selected patients. However, despite that, practice varies and several areas need further elucidation. Important future challenges and areas of research include the role of medical therapy in AAA, whether the indication for repair should be any different in women and in the elderly, and long-term follow-up of patients undergoing complex EVAR with adjuncts, both for elective treatment and for ruptured AAA. Continuous rapid technical and clinical development is to be expected. In this paper, we review the current practice and evidence of stenting in AAA.
在过去的二十年中,血管内技术彻底改变了腹主动脉瘤(AAA)患者的治疗方式。如今,血管内主动脉修复术(EVAR)是大多数 AAA 患者的首选治疗方法。随机对照试验为 AAA 修复的适应证以及在选定患者中使用 EVAR 的原理提供了有力的证据。然而,尽管如此,实践仍存在差异,还有几个领域需要进一步阐明。重要的未来挑战和研究领域包括 AAA 中药物治疗的作用、在女性和老年人中修复的适应证是否应该有所不同,以及接受复杂 EVAR 治疗和辅助治疗的患者的长期随访,无论是择期治疗还是破裂性 AAA。可以预期,技术和临床的快速发展将持续下去。在本文中,我们回顾了 AAA 中支架的当前实践和证据。