Intervention an der thorakalen Aorta

Zusammenfassung

Durch die Einführung und Weiterentwicklung interventioneller Techniken hat die Behandlung von Erkrankungen der thorakalen Aorta in den letzten Jahren einen Paradigmenwechsel erfahren. Die endovaskuläre Aortenprothesenimplantation ist bei signifikant geringerer Mortalitäts- und Komplikationsrate im Vergleich zum offen-chirurgischen Vorgehen inzwischen Therapieoption der 1. Wahl bei einem Großteil vaskulärer Erkrankungen der Aorta descendens.

Abstract

The treatment of thoracic aortic diseases has undergone a paradigm shift due to the introduction and further development of interventional techniques in recent years. Thoracic endovascular aortic repair (TEVAR) of the descending aorta has significantly lower mortality and complication rates compared to open repair. Meanwhile this endovascular approach is the first option for the treatment of the majority of thoracic aortic diseases.

Key words

aorta - interventional procedures - stents - dissection - aneurysm - thoracic endovascular aortic repair (TEVAR)

• Literatur

• 1 Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vasc Surg 1991; 5: 491-499
• 2 Dake MD, Miller DC, Semba CP et al. Transluminal placement of endovascular stent-grafts for the treatment of descending thoracic aortic aneurysms. N Engl J Med 1994; 331: 1729-1734
• 3 Xenos ES, Abedi NN, Davenport DL et al. Meta-analysis of endovascular vs open repair for traumatic descending thoracic aortic rupture. J Vasc Surg 2008; 48: 1343-1351
• 4 Walsh SR, Tang TY, Sadat U et al. Endovascular stenting versus open surgery for thoracic aortic disease: systematic review and meta-analysis of perioperative results. J Vasc Surg 2008; 47: 1094-1098
• 5 Jonker FH, Trimarchi S, Verhagen HJ et al. Meta-analysis of open versus endovascular repair for ruptured descending thoracic aortic aneurysm. J Vasc Surg 2010; 51: 1026-1032
• 6 Cheng D, Martin J, Shennib H et al. Endovascular aortic repair versus open surgical repair for descending thoracic aortic disease a systematic review and meta-analysis of comparative studies. J Am Coll Cardiol 2010; 55: 986-1001
• 7 Pache G, Euringer W, Siepe M et al. CT Angiography for the pre- and postoperative evaluation of the thoracic aorta. Fortschr Röntgenstr 2011; 183: 334-346
• 8 von Tengg-Kobligk H, Ley-Zaporozhan J, Henninger V et al. Intraindividual assessment of the thoracic aorta using contrast and non-contrast-enhanced MR angiography. Fortschr Röntgenstr 2009; 181: 230-236
• 9 Krishnam MS, Tomasian A, Malik S et al. Image quality and diagnostic accuracy of unenhanced SSFP MR angiography compared with conventional contrast-enhanced MR angiography for the assessment of thoracic aortic diseases. Eur Radiol 2010; 20: 1311-1320
• 10 Rasche V, Oberhuber A, Trumpp S et al. MRI assessment of thoracic stent grafts after emergency implantation in multi trauma patients: a feasibility study. Eur Radiol 2011; 21: 1397-1405
• 11 Cejna M, Loewe C, Schoder M et al. MR angiography vs CT angiography in the follow-up of nitinol stent grafts in endoluminally treated aortic aneurysms. Eur Radiol 2002; 12: 2443-2450
• 12 Ayuso JR, de Caralt TM, Pages M et al. MRA is useful as a follow-up technique after endovascular repair of aortic aneurysms with nitinol endoprostheses. J Magn Reson Imaging 2004; 20: 803-810
• 13 Torsello GB, Kasprzak B, Klenk E et al. Endovascular suture versus cutdown for endovascular aneurysm repair: a prospective randomized pilot study. J Vasc Surg 2003; 38: 78-82
• 14 Carpenter JP. Delivery of endovascular grafts by direct sheath placement into the aorta or iliac arteries. Ann Vasc Surg 2002; 16: 787-790
• 15 MacDonald S, Cheung A, Sidhu R et al. Endovascular aortic aneurysm repair via the left ventricular apex of a beating heart. J Vasc Surg 2009; 49: 759-762
• 16 Kovacs A, Schiller W, Gerhards HM et al. Visualization of the Adamkiewicz artery in patients with acute stanford a dissections: a prospective 64-row multi-detector CT study. Fortschr Röntgenstr 2009; 181: 870-874
• 17 Riesenman PJ, Farber MA, Mendes RR et al. Coverage of the left subclavian artery during thoracic endovascular aortic repair. J Vasc Surg 2007; 45: 90-94
• 18 Gilani R, Ochoa L, Wall Jr MJ et al. Endovascular Repair of Traumatic Aortic Injury Using a Custom Fenestrated Endograft to Preserve the Left Subclavian Artery. Vasc Endovascular Surg 2011; 45: 549-552
• 19 Criado FJ, McKendrick C, Criado FR. Technical solutions for common problems in TEVAR: managing access and aortic branches. J Endovasc Ther 2009; 16: 63-79
• 20 Akin I, Kische S, Schneider H et al. Thoracic aorta aneurysms. Internist 2009; 50: 964-971
• 21 Puls R, Volzke H. Whole-body MRI in the study of health in Pomerania. Radiologe 2011; 51: 379-383
• 22 Hegenscheid K, Kuhn JP, Volzke H et al. Whole-body magnetic resonance imaging of healthy volunteers: pilot study results from the population-based SHIP study. Fortschr Röntgenstr 2009; 181: 748-759
• 23 Coady MA, Rizzo JA, Hammond GL et al. What is the appropriate size criterion for resection of thoracic aortic aneurysms?. J Thorac Cardiovasc Surg 1997; 113: 476-491 ; discussion 489–491
• 24 Svensson LG, Kouchoukos NT, Miller DC et al. Expert consensus document on the treatment of descending thoracic aortic disease using endovascular stent-grafts. Ann Thorac Surg 2008; 85: 1-41
• 25 Cho KR, Stanson AW, Potter DD et al. Penetrating atherosclerotic ulcer of the descending thoracic aorta and arch. J Thorac Cardiovasc Surg 2004; 127: 1393-1399
• 26 Demers P, Miller DC, Mitchell RS et al. Stent-graft repair of penetrating atherosclerotic ulcers in the descending thoracic aorta: mid-term results. Ann Thorac Surg 2004; 77: 81-86
• 27 Corbillon E, Bergeron P, Poullie AI et al. The French National Authority for Health reports on thoracic stent grafts. J Vasc Surg 2008; 47: 1099-1107
• 28 Prinssen M, Verhoeven EL, Buth J et al. A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms. N Engl J Med 2004; 351: 1607-1618
• 29 [Anonym]. Endovascular aneurysm repair versus open repair in patients with abdominal aortic aneurysm (EVAR trial 1): randomised controlled trial. Lancet 2005; 365: 2179-2186
• 30 De Bruin JL, Baas AF, Buth J et al. Long-term outcome of open or endovascular repair of abdominal aortic aneurysm. N Engl J Med 2010; 362: 1881-1889
• 31 Makaroun MS, Dillavou ED, Kee ST et al. Endovascular treatment of thoracic aortic aneurysms: results of the phase II multicenter trial of the GORE TAG thoracic endoprosthesis. J Vasc Surg 2005; 41: 1-9
• 32 Bavaria JE, Appoo JJ, Makaroun MS et al. Endovascular stent grafting versus open surgical repair of descending thoracic aortic aneurysms in low-risk patients: a multicenter comparative trial. J Thorac Cardiovasc Surg 2007; 133: 369-377
• 33 Makaroun MS, Dillavou ED, Wheatley GH et al. Five-year results of endovascular treatment with the Gore TAG device compared with open repair of thoracic aortic aneurysms. J Vasc Surg 2008; 47: 912-918
• 34 Fairman RM, Criado F, Farber M et al. Pivotal results of the Medtronic Vascular Talent Thoracic Stent Graft System: the VALOR trial. J Vasc Surg 2008; 48: 546-554
• 35 Matsumura JS, Cambria RP, Dake MD et al. International controlled clinical trial of thoracic endovascular aneurysm repair with the Zenith TX2 endovascular graft: 1-year results. J Vasc Surg 2008; 47: 247-257
• 36 Riambau V, Zipfel B, Coppi G et al. Final operative and midterm results of the European experience in the RELAY Endovascular Registry for Thoracic Disease (RESTORE) study. J Vasc Surg 2011; 53: 565-573
• 37 Nienaber CA, Rousseau H, Eggebrecht H et al. Randomized comparison of strategies for type B aortic dissection: the INvestigation of STEnt Grafts in Aortic Dissection (INSTEAD) trial. Circulation 2009; 120: 2519-2528
• 38 Dake MD, Kato N, Mitchell RS et al. Endovascular stent-graft placement for the treatment of acute aortic dissection. N Engl J Med 1999; 340: 1546-1552
• 39 Mossop PJ, McLachlan CS, Amukotuwa SA et al. Staged endovascular treatment for complicated type B aortic dissection. Nat Clin Pract Cardiovasc Med 2005; 2: 316-321
• 40 Midulla M, Renaud A, Martinelli T et al. Endovascular fenestration in aortic dissection with acute malperfusion syndrome: Immediate and late follow-up. J Thorac Cardiovasc Surg 2011; 142: 66-72
• 41 Schumacher H, Bockler D, von Tengg-Kobligk H et al. Acute traumatic aortic tear: open versus stent-graft repair. Semin Vasc Surg 2006; 19: 48-59
• 42 Dosios TJ, Salemis N, Angouras D et al. Blunt and penetrating trauma of the thoracic aorta and aortic arch branches: an autopsy study. J Trauma 2000; 49: 696-703
• 43 von Oppell UO, Dunne TT, De Groot MK et al. Traumatic aortic rupture: twenty-year metaanalysis of mortality and risk of paraplegia. Ann Thorac Surg 1994; 58: 585-593
• 44 Rousseau H, Elaassar O, Marcheix B et al. The Role of Stent-Grafts in the Management of Aortic Trauma. Cardiovasc Intervent Radiol 2011;
• 45 Tang GL, Tehrani HY, Usman A et al. Reduced mortality, paraplegia, and stroke with stent graft repair of blunt aortic transections: a modern meta-analysis. J Vasc Surg 2008; 47: 671-675
• 46 Akowuah E, Angelini G, Bryan AJ. Open versus endovascular repair of traumatic aortic rupture: a systematic review. J Thorac Cardiovasc Surg 2009; 138: 768-769
• 47 Bailey CJ, Force S, Milner R et al. Thoracic endovascular repair as a safe management strategy for aortobronchial fistulas. J Vasc Surg 2011; 53: 1202-1209
• 48 Chiesa R, Melissano G, Marone EM et al. Endovascular treatment of aortoesophageal and aortobronchial fistulae. J Vasc Surg 2010; 51: 1195-1202
• 49 Roche-Nagle G, de Perrot M, Waddell TK et al. Neoadjuvant aortic endografting. Ann Vasc Surg 2009; 23: 781-785
• 50 Geisbusch P, Hoffmann S, Kotelis D et al. Reinterventions during midterm follow-up after endovascular treatment of thoracic aortic disease. J Vasc Surg 2011; 53: 1528-1533