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10.1016/BE07-9783437228780.10001-8
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Intervalle sonographischer Verlaufsuntersuchungen bei AAA
AAA-Durchmesser | Untersuchungsinteralle |
Männer | |
3,0–3,9 cm | Alle 2 Jahre |
4,0–4,9 cm | Jährlich |
5,0–5,4 cm | Alle 6 Monate |
Frauen | |
3,0–3,9 cm | Alle 2–3 Jahre |
4,0–4,5 cm | Alle 6 Monate |
> 4,5 – 4,9 cm | Alle 3 Monate |
Einteilung der Prothesenleckagen nach ihrer Ätiologie
Typ | Ätiologie | |
I | Undichtigkeit an der Landezone der Stent-Graft-Prothese | |
Ia | Undichtigkeit an der proximalen (aortalen) Landezone | |
Ib | Undichtigkeit an der distalen (iliakalen) Landezone | |
II | Retrograder Zufluss in den Aneurysmasack (Lumbalarterien, A. mesenterica inferior) | |
III | Undichtigkeit an der Prothese | |
IIIa | Dislokation an der Andockstelle innerhalb der Prothese | |
IIIb | Defekt durch Materialfehler an der Prothese | |
IV | Diffuse Undichtigkeit der Prothesenmembran (kommt kaum noch vor) | |
V | Dysfunktion ohne direkten Leckagenachweis, Durchmesserzunahme der Aorta |
Aneurysmatische Erkrankungen der Arterien
7.1
Abdominelles Aortenaneurysma (AAA)
Definition und Basisinformation
Symptomatik und klinisches Bild
Diagnostik
Klinische Untersuchung
Apparative Untersuchung
Weitere Diagnostik
Therapie
-
●
bei der unbehandelt praktisch regelhaft tödlichen Ruptur als Notfalleingriff,
-
●
bei Symptomatik (Penetrationsschmerz) wegen des dann deutlich erhöhten Rupturrisikos,
-
●
bei peripherer Embolisation aus dem Aneurysma,
-
●
wenn der Querdurchmesser 5,5 cm (Männer) oder 5,0 cm (Frauen; 22) übersteigt,
-
●
bei rascher Expansion (des Querdurchmessers um > 0,7 cm in 6 Monaten oder > 1,0 cm in 1 Jahr).
Nachsorge
7.2
Poplitealarterienaneurysma
Definition und Basisinformation
Diagnostik
Therapie
7.3
Andere Aneurysmen
7.3.1
Degenerative Aneurysmen
7.3.2
Aneurysmen bei entzündlichen Erkrankungen
7.3.3
Infektiöse „mykotische“ Aneurysmen
Definition und Basisinformation
Symptomatik und klinisches Bild
Diagnostik
Therapie
7.3.4
Aneurysmata falsa (spuria)
Autoren
Leitlinien
L1.
Anderson JL, Halperin JL, Albert NM, et al.: Management of patients with peripheral artery disease (compilation of 2005 and 2011 ACCF/AHA guideline recommendations): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 127 (2013) 1425–1443.
L2.
Debus S, Heidemann F, Gross-Fengels W, et al.: S3-Leitlinie zu Screening, Diagnostik, Therapie und Nachsorge des Bauchaortenaneurysmas. AWMF-Registernummer 004-14, 2018.
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