Fiorucci Beatrice, Tsilimparis Nikolaos, Rohlffs Fiona, Heidemann Franziska, Debus Sebastian E, Kölbel Tilo
Department of Vascular Medicine, German Aortic Center Hamburg, University Heart Center, Hamburg-Eppendorf University Hospital, Hamburg, Germany.
Department of Vascular Medicine, German Aortic Center Hamburg, University Heart Center, Hamburg-Eppendorf University Hospital, Hamburg, Germany -
J Cardiovasc Surg (Torino). 2017 Apr;58(2):194-203. doi: 10.23736/S0021-9509.16.09835-9. Epub 2016 Dec 22.
Endovascular repair has become the treatment of choice for thoracic and abdominal aortic pathologies in the last decades, and is associated with excellent results in terms of perioperative, mid- and long-term morbidity and mortality. Access vessels play a central role in these procedures since access-related issues can increase the rates of technical failures and determine clinical complications for the patient. Therefore, accurate preoperative clinical evaluation and review of the preoperative images are mandatory. In this review, we report on the access-related issues that can be encountered during EVAR and TEVAR, and present solutions and strategies to minimize access-related adverse outcomes.
在过去几十年中，血管内修复已成为胸主动脉和腹主动脉病变的首选治疗方法，在围手术期、中长期发病率和死亡率方面都取得了优异的效果。入路血管在这些手术中起着核心作用，因为与入路相关的问题会增加技术失败率，并导致患者出现临床并发症。因此，准确的术前临床评估和术前影像检查是必不可少的。在本综述中，我们报告了在腔内腹主动脉瘤修复术（EVAR）和腔内胸主动脉瘤修复术（TEVAR）过程中可能遇到的与入路相关的问题，并提出了将与入路相关的不良后果降至最低的解决方案和策略。
