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[血管内手术与传统血管手术——过时的观念?第1部分:主动脉干预]

[Endovascular versus conventional vascular surgery - old-fashioned thinking? Part 1: interventions on the aorta].

作者信息

Debus E S, Kölbel T, Manzoni D, Behrendt C-A, Heidemann F, Grundmann R T

机构信息

Klinik und Poliklinik für Gefäßmedizin, Universitäres Herzzentrum Hamburg, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.

, In den Grüben 144, 84489, Burghausen, Deutschland.

出版信息

Chirurg. 2016 Mar;87(3):195-201. doi: 10.1007/s00104-015-0146-1.

Abstract

Endovascular therapy has widely replaced conventional open vascular surgical reconstruction. For this reason both techniques were widely considered to be competing approaches. Evidence-based data from randomized prospective trials, meta-analyses and clinical registries, however, demonstrated that both techniques should be used to complement each other. It became increasingly more evident that the use of either procedure depends on the underlying disease and the anatomical conditions, whereby a combination of both (hybrid approach) may be the preferred option in certain situations. This review focuses on the treatment of complicated acute type B aortic dissection, descending thoracic aortic aneurysms, thoracoabdominal aortic aneurysms as well as asymptomatic and ruptured abdominal aortic aneurysms.

摘要

血管内治疗已广泛取代传统的开放性血管外科重建术。因此,这两种技术曾被广泛认为是相互竞争的方法。然而,来自随机前瞻性试验、荟萃分析和临床登记处的循证数据表明,这两种技术应相互补充。越来越明显的是,采用哪种手术方法取决于基础疾病和解剖条件,在某些情况下,两者结合(杂交手术)可能是首选方案。本综述重点关注复杂性急性B型主动脉夹层、降主动脉瘤、胸腹主动脉瘤以及无症状和破裂性腹主动脉瘤的治疗。

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