본문내용
y
: evaluation of patients with aneurysms
: carries a small risk of complications, such as bleeding, allergic reactions, and atheroembolism
: since the presence of mural thrombi may reduce the luminal size, aortography may underestimate the diameter of an aneurysm.
2) Treatment
- Operative repair of the aneurysm and insertion of a prosthetic graft: abdominal aortic aneurysms of any size that are expanding rapidly or are associated with symptoms
- For asymptomatic aneurysms, operation is indicated if the diameter is >5.5 cm.
- Serial noninvasive follow-up of smaller aneurysms (<5 cm) is an alternative to immediate surgery
- Percutaneous placement of endovascular stent grafts for treatment of infrarenal abdominal aortic aneurysms is available for selected patients and is associated with lower short-term morbidity but comparable long-term mortality, compared with open surgical reconstruction.
- In surgical candidates, careful preoperative cardiac and general medical evaluations (followed by appropriate therapy of complicating conditions) are essential. (Preexisting coronary artery disease, congestive heart failure, pulmonary disease, diabetes, and advanced age add to the risk of surgery.)
- β-adrenergic blockers: decrease perioperative cardiovascular morbidity and mortality
- With careful preoperative cardiac evaluation and postoperative care, the operative mortality rate approximates 12%.
- After acute rupture, the mortality rate of emergent operation is 4550%.
- Endovascular repair with stent placement is an emerging approach but, at the current time, is associated with a mortality rate of approximately 40%.
* Reference
Fauci, Braunwald, Kasper, Hauser, Longo, Jameson, Loscalzo, Harrison\'s Principles of Internal Medicine, 17th ed, McGraw-Hill, 2008, Chapter 232, 242
: evaluation of patients with aneurysms
: carries a small risk of complications, such as bleeding, allergic reactions, and atheroembolism
: since the presence of mural thrombi may reduce the luminal size, aortography may underestimate the diameter of an aneurysm.
2) Treatment
- Operative repair of the aneurysm and insertion of a prosthetic graft: abdominal aortic aneurysms of any size that are expanding rapidly or are associated with symptoms
- For asymptomatic aneurysms, operation is indicated if the diameter is >5.5 cm.
- Serial noninvasive follow-up of smaller aneurysms (<5 cm) is an alternative to immediate surgery
- Percutaneous placement of endovascular stent grafts for treatment of infrarenal abdominal aortic aneurysms is available for selected patients and is associated with lower short-term morbidity but comparable long-term mortality, compared with open surgical reconstruction.
- In surgical candidates, careful preoperative cardiac and general medical evaluations (followed by appropriate therapy of complicating conditions) are essential. (Preexisting coronary artery disease, congestive heart failure, pulmonary disease, diabetes, and advanced age add to the risk of surgery.)
- β-adrenergic blockers: decrease perioperative cardiovascular morbidity and mortality
- With careful preoperative cardiac evaluation and postoperative care, the operative mortality rate approximates 12%.
- After acute rupture, the mortality rate of emergent operation is 4550%.
- Endovascular repair with stent placement is an emerging approach but, at the current time, is associated with a mortality rate of approximately 40%.
* Reference
Fauci, Braunwald, Kasper, Hauser, Longo, Jameson, Loscalzo, Harrison\'s Principles of Internal Medicine, 17th ed, McGraw-Hill, 2008, Chapter 232, 242
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