Update Aortenerkrankungen

Zusammenfassung

Die vorliegende Arbeit berichtet über die neuesten wissenschaftlichen Erkenntnisse im Zusammenhang mit Aortenaneurysmen und -dissektionen. Schwerpunkt hierbei sind die Pathophysiologie und Genetik, der Einfluss von Fluorochinolonen auf Aortenaneurysmen und -dissektionen sowie Marker der Aortitis. Ferner werden die wichtigsten aktuellen Leitlinienempfehlungen aus den Jahren 2017 bis 2020 zusammengefasst – der Fokus liegt hierbei auf dem Screening, der Diagnostik, den Grenzwerten für die Therapieindikationen, der Art und den technischen Details der Behandlung sowie Nachsorge von Aneurysmen der Aorta ascendens, des Aortenbogens, der Aorta descendens und abdominalis, Penetrating aortic Ulcers, bei genetisch bedingten Bindegewebserkrankungen mit Aortenbeteiligungen, Aortitis und mykotischen Aneurysmen.

Abstract

The most recent scientific findings related to aortic aneurysms and dissections are reported for pathophysiology and genetics and the role of fluoroquinolones for aortic aneurysms and dissections, as well as markers of aortitis. Furthermore, most important guideline recommendations of the years 2017 until 2020 are summarized for the screening, diagnostics, indication of therapy, type and technical details of therapy and follow-up of aneurysms of the ascending aorta, aortic arch, descending aorta, abdominal aorta, penetrating aortic ulcers, genetically-related connective tissue diseases with aortic involvement, aortitis and mycotic aneurysms.

Was ist wichtig?

• Frauen haben schlechtere Verläufe als Männer, werden dennoch weniger gescreent.

• Diabetes mellitus korreliert negativ mit der Entwicklung von abdominellen Aortenaneurysmen.

• Die Rolle von Inflammationsmarkern und Non-coding-mRNA wurde näher erforscht.

• Neue Tiermodelle für Aortenaneurysmen wurden entwickelt und Gewebsbanken eingerichtet.

• Fluoroquinolone sollten nicht bei Patienten mit einem Risikoprofil für Aortenaneurysmen eingesetzt werden.

• Neue Radiotracer wurden identifiziert.

• Screening für abdominelle Aortenaneurysmen wird für Männer empfohlen.

• Die Grenzwerte für Aortendurchmesser für eine Therapieindikation wurden in den aktuellen Leitlinien angehoben.

• Die endovaskuläre Versorgung wird in den meisten Fällen inzwischen bevorzugt.

Schlüsselwörter

Aneurysma - Dissektion - Aortitis - endovaskuläre Therapie - rupturiertes Aortenaneurysma

Keywords

aneurysm - dissection - ruptured aortic aneurysm - aortitis - endovascular therapy

Publikationsverlauf

Artikel online veröffentlicht:
12. April 2022

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