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肾下型腹主动脉瘤。

Infrarenal Abdominal Aortic Aneurysm.

机构信息

Department of Vascular Surgery, Georgetown University Hospital, MedStar Health, Washington, DC, USA.

Department of Vascular Surgery, Georgetown University Hospital, MedStar Health, Washington, DC, USA.

出版信息

Surg Clin North Am. 2023 Aug;103(4):595-614. doi: 10.1016/j.suc.2023.05.001. Epub 2023 Jun 9.

Abstract

Abdominal aortic aneurysms are found in up to 6% of men and 1.7% of women over the age of 65 years and are usually asymptomatic. The natural history of aortic aneurysms is continued dilation leading to rupture, which is associated with an overall 80% mortality. Of the patients with ruptured aneurysms that undergo intervention, half will not survive their hospitalization. Reduction in aneurysm mortality is therefore achieved by prophylactic repair during the asymptomatic period. On a population-based level, this is supported by abdominal aortic aneurysm screening programs. Approximately 60% of abdominal aortic aneurysms are confined to the infrarenal portion of the aorta and are amenable to repair with off-the-shelf endovascular devices. Endovascular techniques have now replaced open surgery as the primary modality for aneurysm repair.

摘要

腹主动脉瘤在 65 岁以上的男性中发生率高达 6%,在女性中发生率为 1.7%,通常无症状。主动脉瘤的自然病程是持续扩张导致破裂,破裂的总体死亡率为 80%。接受介入治疗的破裂动脉瘤患者中,有一半会在住院期间死亡。因此,通过在无症状期进行预防性修复,可以降低动脉瘤的死亡率。在基于人群的层面上,这得到了腹主动脉瘤筛查计划的支持。大约 60%的腹主动脉瘤局限于肾下主动脉段,可使用市售的血管内装置进行修复。血管内技术现已取代开放手术,成为动脉瘤修复的主要方式。

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