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血管内治疗时代主动脉瘤管理概述

Overview of aortic aneurysm management in the endovascular era.

作者信息

Calero Aurelia, Illig Karl A

机构信息

Division of Vascular and Endovascular Surgery, University of South Florida Health, Morsani College of Medicine, 2 TGH Circle, STC 7016, Tampa, FL 33606.

Division of Vascular and Endovascular Surgery, University of South Florida Health, Morsani College of Medicine, 2 TGH Circle, STC 7016, Tampa, FL 33606.

出版信息

Semin Vasc Surg. 2016 Mar;29(1-2):3-17. doi: 10.1053/j.semvascsurg.2016.07.003. Epub 2016 Jul 15.

Abstract

Management of aortic aneurysm disease has changed in the endovascular era, with the majority of patients opting for stent-graft repair of abdominal and thoracic aneurysms. An understanding of this vascular condition is important for primary care, emergency medicine, medicine specialists, and vascular surgeons alike. Awareness of the patient risk factors for aneurysmal degeneration, sac rupture, and medical management allows physicians to screen appropriate patient populations, which decreases aneurysm-related mortality due to rupture. The evolving endovascular techniques available today have made more patients eligible for this less-invasive repair, which has lower mortality and morbidity compared with open surgery with aorta replacement. This review provides contemporary information on the etiology, natural history, evaluation, and management of aortic aneurysm disease. The complications of prior aortic repair, whether performed via endovascular or open surgery intervention, are equally important to understanding not only for vascular surgeons performing these procedures, but also for primary care, emergency department, and medicine specialists who are evaluating these patients in an office or hospital setting.

摘要

在血管腔内治疗时代,主动脉瘤疾病的管理方式发生了变化,大多数患者选择对腹主动脉瘤和胸主动脉瘤进行支架移植物修复。对于基层医疗、急诊医学、医学专家以及血管外科医生而言,了解这种血管疾病都很重要。了解患者发生动脉瘤退变、瘤体破裂及药物治疗的风险因素,有助于医生筛选合适的患者群体,从而降低因破裂导致的动脉瘤相关死亡率。如今不断发展的血管腔内技术使更多患者适合接受这种侵入性较小的修复治疗,与行主动脉置换的开放手术相比,其死亡率和发病率更低。本综述提供了有关主动脉瘤疾病的病因、自然史、评估及管理的当代信息。既往主动脉修复的并发症,无论其是通过血管腔内还是开放手术干预进行的,对于实施这些手术的血管外科医生,以及在门诊或医院环境中评估这些患者的基层医疗、急诊科和医学专家而言,了解其情况同样重要。

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