tailieunhanh - Endovascular Aneurysm Repair - part 8

Hoàn toàn kỹ thuật liên quan Endovascular trước can thiệp vào hình ảnh với khả năng FEW cho nội thủ tục điều chỉnh, mở unlikable phẫu thuật ở đâu phát hiện được bất ngờ được công nhận Trong tầm nhìn trực tiếp và vấn đề được giải quyết bằng cách thao tác đơn giản. | 1 Classification of infrarenal aortic aneurysms with respect to endovascular suitability Introduction Endovascular technique relies entirely on pre-interventional imaging with few possibilities for intra-procedural adjustment unlike open surgery where unexpected findings are recognized under direct vision and problems are solved by straightforward manipulations. The morphology of aortic aneurysms is crucial for the suitability of an endovascular repair 1-3 and also important for its outcome 3 . In particular a segment of relatively normal aorta between the renal arteries and the beginning of the aneurysm namely a proximal neck is a prerequisite for fixation of the endoprosthesis. The first endovascular treatment was performed in 1991 for an infrarenal aortic aneurysm with a proximal and distal neck reliably anchoring a straight endovascular tube graft 4 . In fact tube grafts are easier to implant and require fewer manipulations than bifurcated endoprostheses. We were interested to know how many infrarenal aortic aneurysms are suitable for an endovascular tube graft repair. The aim of the study 5 was to analyze the morphology of infrarenal aneurysms based on preoperative imaging. Methods The operating charts of a consecutive series of patients were reviewed who underwent open surgical repair of an infrarenal aortic aneurysm between 1. 1. 1988 and 31. 12. 1993 at the Department of Cardiovascular Surgery University Hospital Zurich. A total of 576 patients were given elective or urgent aortic replacement. 298 patients 52 were treated by bifurcated prostheses and 278 patients 48 by tube grafts. The present study focuses on the latter group of patients. Inclusion criterion was a set of hard By kind permission of the Editor Swiss Surgery 1996 2 219-222 96 I Clinical applications copies of a contrast enhanced computer tomography CT scan with a slice thickness of 5 or 8 mm within the last two months before the operation. Measurements were taken of the diameter and length of

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