Department of Vascular Surgery, Georgetown University Hospital, MedStar Health, Washington, DC, USA.
Department of Vascular Surgery, Georgetown University Hospital, MedStar Health, Washington, DC, USA.
Surg Clin North Am. 2023 Aug;103(4):595-614. doi: 10.1016/j.suc.2023.05.001. Epub 2023 Jun 9.
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.
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。