Endovaskuläre Aortenchirurgie – besondere Herausforderung für die perioperative Intensivmedizin

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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