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Intensivmedizin up2date 2016; 12(02): 199-212
DOI: 10.1055/s-0042-103120
Operative Intensivmedizin
© Georg Thieme Verlag KG Stuttgart · New York

Endovaskuläre Aortenchirurgie – besondere Herausforderung für die perioperative Intensivmedizin

Dmitriy I. Dovzhanskiy
,
Moritz S. Bischoff
,
Katrin Meisenbacher
,
Dittmar Böckler
Further Information

Publication History

Publication Date:
20 April 2016 (online)

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Kernaussagen

  • Die endovaskulären Techniken spielen eine immer größere Rolle bei der Versorgung von Aortenerkrankungen.

  • Die Indikation zur Therapie eines Aortenaneurysmas ist von dessen maximalen Durchmesser und der Klinik abhängig.

  • Periprozedural sind die endovaskulären Techniken im Vergleich zu den offenen konventionellen mit wenigen Komplikationen und einer geringeren Mortalität assoziiert.

  • Besondere Herausforderungen an die perioperative Versorgung stellen Notfälle wie eine Aortenruptur sowie die Behandlung einer thorakoabdominellen Aortenerkrankung dar.

  • Zu den typischen intraoperativen Komplikationen gehören Verletzungen und Okklusionen der Zugangsgefäße sowie ein akzidenteller Verschluss aortaler Äste.

  • Zu den weiteren postoperativen Komplikationen zählen Kolonischämie, Myokardinfarkt und eine Verschlechterung der Nierenfunktion.

  • Eine spinale Ischämie tritt häufig bei der Überstentung der größeren aortalen Abschnitte auf, vorwiegend bei Operationen an der Aorta descendens.

 

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