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内脏动脉瘤

Visceral artery aneurysms.

作者信息

Juntermanns B, Bernheim J, Karaindros K, Walensi M, Hoffmann J N

机构信息

Department of Vascular Surgery and Phlebology, Contilia Heart and Vascular Center, Elisabeth Hospital, Klara-Kopp-Weg 1, 45138 Essen, Germany.

Practice for Vascular Surgery and Phlebology, Contilia Heart and Vascular Center, Essen, Germany.

出版信息

Gefasschirurgie. 2018;23(Suppl 1):19-22. doi: 10.1007/s00772-018-0384-x. Epub 2018 Apr 20.

Abstract

Visceral artery aneurysms are rare with an incidence of only 0.01-0.1% of the population. Open surgical or endovascular elimination should be performed for aneurysms greater than 2 cm in size. The risk of aneurysm rupture is then approximately 25-40%. If the aneurysm ruptures the mortality can be as high as 76%. For mycotic aneurysms or spurious aneurysms there is no lower limit to the diameter size for the need of treatment. Sudden abdominal pain during pregnancy can be caused by visceral artery aneurysms and must be further clarified. The indications for surgery during pregnancy should be made generously. The clinical symptoms (abdominal complaints) of visceral artery aneurysms are manifold. The treatment can be either an open surgical approach or endovascular treatment. In the emergency setting, if endovascular treatment is no longer possible, an open surgical treatment needs to be performed. There are so far no randomized studies which could identify one of the procedures (open surgery vs. endovascular surgery) as clearly being superior. The prognosis after treatment is satisfactory with a 5-10 year survival rate of approximately 90%.

摘要

内脏动脉瘤较为罕见,发病率仅占总人口的0.01 - 0.1%。对于直径大于2厘米的动脉瘤,应进行开放手术或血管内消除治疗。此时动脉瘤破裂的风险约为25 - 40%。如果动脉瘤破裂,死亡率可高达76%。对于感染性动脉瘤或假性动脉瘤,治疗所需的直径大小没有下限。孕期突发腹痛可能由内脏动脉瘤引起,必须进一步明确病因。孕期手术指征应放宽。内脏动脉瘤的临床症状(腹部不适)多种多样。治疗方法可以是开放手术或血管内治疗。在紧急情况下,如果无法进行血管内治疗,则需要进行开放手术治疗。迄今为止,尚无随机研究能够明确指出哪种手术方式(开放手术与血管内手术)更为优越。治疗后的预后良好,5至10年生存率约为90%。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e7e/5997106/346a306c797a/772_2018_384_Fig1_HTML.jpg

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