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Angiofibel pp 83–223Cite as

Arterielle Interventionen

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Zusammenfassung

Zur diagnostischen Beurteilung der Aorta ist die digitale Subtraktionsangiographie (DSA) zugunsten der Schnittbildverfahren CT und MRT sowie Ultraschall zurückgetreten [19][6]. Die diagnostischen Aortendarstellungen sind in domo heute sehr limitiert und umfassen nur noch äußerst selten rein diagnostische Fragestellungen. So stehen bei uns die meisten diagnostischen Aortographien immer in Zusammenhang mit einem sich in derselben Sitzung anschließenden, minimal-invasivem, radiologischen Eingriff [10]. Dabei handelt es vor allem um Auxiliareingriffe im Rahmen der TPEG(„transluminal placed endovascular grafts“)‑Behandlung (z. B. ein Coiling der A. iliaca interna bei Aneurysma oder Embolisation einer Endoleckage).

Unterschieden werden die Klassifikationen der Aortendissektion nach de Bakey und Stanford (◘ Abb. 10.1).

De-Bakey-Klassifikation:

  • Typ I (29–34 %): Dissektion der Aorta ascendens mit Fortsetzung in die Aorta descendens, Aorta abdominalis oder sogar die Iliakalarterien

  • Typ II (12–24 %): Dissektion auf die Aorta ascendens begrenzt

  • Typ III (50 %): Dissektion im Bereich des Aortenisthmus (Übergang Arcus in die Aorta descendens) und setzt sich nach caudal fort

Stanford-Klassifikation:

  • Typ A: Dissektion ab Aorta ascendens oder retrograde Dissektion einer Dissektion der Aorta descendens

  • Typ B: Dissektion ab Aortenbogen (nach dem Abgang der A. subclavia sinistra) oder der Aorta descendens

  1. 1.

    Wiederauffüllung des Aneurysmasacks proximal oder distal (meist Migration des TPEG)

Therapie: Verlängerung des TPEG, Operation (durch Gefäßchirurgie)

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Authors and Affiliations

  1. Abteilung Diagnostische und Interventionelle Radiologie, Radiologische Klinik und Poliklinik, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland

    Marc-André Weber Prof. Dr. med.

  2. Klinik für Diagnostische und Interventionelle Radiologie, Katharinenhospital, Kriegsbergstraße 60, 70174, Stuttgart, Deutschland

    Goetz M. Richter Prof. Dr. med.

  3. Radiologische Klinik, Abteilung Diagnostische und Interventionelle Radiologie, Universität Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland

    Boris A. Radeleff Prof. Dr.

  4. Neurologische Klinik, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland

    Stefan Rohde

  5. Abteilung für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland

    Nikolas Kortes, Ulrike Stampfl PD Dr. med. & Nadine Bellemann Dr. med.

  6. Abteilung Radiologie, Klinik im Park, Seestraße 220, 8027, Zürich, Schweiz

    Stefan Siebert Dr. med.

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  1. Marc-André Weber Prof. Dr. med.
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    Boris A. Radeleff

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Weber, MA. et al. (2013). Arterielle Interventionen. In: Radeleff, B. (eds) Angiofibel. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-33230-2_10

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