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Medical, operative and percutaneous interventional therapeutic strategies are basically available.
Zusammenfassung Thorakale Aortenlasionen stellen eine seltene, aber akut lebensbedrohliche
Erkrankung dar. Zimmermann View author publications You can also search for this author in. The
aorta is the largest artery of the circulatory system, and delivers blood to all of the major organs.
Discover and download thousands of 3D models from games, cultural heritage, architecture, design
and more. When compared to catheter-based procedures, the conventional approach places patients
at an increased risk. While the arch of the prosthesis can be likened to a conventional prosthesis, the
peripheral section consists of an endovascular stent graft supported by a metal mesh, which is
expanded once it has been inserted inside the aneurysm. Standard imaging was insufficient for
accurate planning of the surgery due to the artifacts. Abstract Thoracic aorta aneurysms are life-
threatening diseases which can lead to rupture or dissection due to structural alterations. Summary
The aetiological spectrum of thoracic aortic aneurysms is extensive. Compared to open surgery,
endovascular repair is significantly less invasive, and causes much less trauma to the
patient.?Endovascular repair involves the physician inserting an endovascular stent graft through an
opening in the blood vessels in the groin, and advancing it to the site of the aneurysm. Aortic
aneurysm repair is immensely challenging in terms of the surgical techniques and strategies involved,
as well as in terms of the surgical expertise required. Blood returning to the heart is diverted to this
machine through a system of tubes. Aortic repair can be performed using conventional open surgery,
or by inserting an endovascular stent graft using a catheter-based procedure. Results of endovascular
repair of the aorta with the Talent Thoracic stent graft: the Talent Thoracic Retrospective Registry.
Hanke View author publications You can also search for this author in. Ince View author publications
You can also search for this author in. Beside the TAA, the aorta descends on the right side of the
patient (in normal cases it descends on the left side of the spine). This is why such repairs can only
be performed at specialist centers, and in close cooperation with cardiology specialists. This can be
done using either custom-tailored openings (fenestrations) or a series of separate stent grafts. (Fig.
9). The surgical therapy using graft interposition causes mortality and paraplegia rates of
approximately five to 20 per cent. Reeps View author publications You can also search for this
author in. Schlusselworter: Aneurysma, minimalinvasive Therapie, endovaskulare Therapie, thorakale
Aortenlasionen, Trauma, chirurgische Therapie Summary Endovascular Therapy of Thoracic Aortic
Lesions Lesions of the thoracic aorta are a rare but acutely life-threatening disease. As part of this
procedure, the aortic arch and the descending thoracic aorta are repaired using what is referred to as
a hybrid prosthesis. Download citation Published: 01 July 2009 Issue Date: August 2009 DOI: Share
this article Anyone you share the following link with will be able to read this content: Get shareable
link Sorry, a shareable link is not currently available for this article. Course: The treating physician
was provided with a 1:1 scale 3D printed model of the aneurysm to discuss the further treatment of
the patient. As this type of surgery requires an interruption of the blood flow, a heart-lung machine
(cardiopulmonary bypass - CPB) is used. As a result, early detection and preventative surgery to
repair the aneurysm are crucial. Abstract Thoracoabdominal aortic aneurysms (TAAA) are rare events
with an incidence of 5.9 cases per 100,000 persons per year. Large aortic aneurysms are at risk of
dissection or rupture, both of which constitute life-threatening situations.
This effectively places the body in a state of hibernation - allowing the surgeons to work on the
carotid arteries without the risk of causing harm to the patient. This model helped the surgical team
to have a much better understanding of the complexity of the fracture. Berger View author
publications You can also search for this author in. You can follow the blood flow using the model's
annotations. Infectious aneurysms (formerly mycotic aneurysms) constitute only a small percentage
of all thoracic aortic aneurysms, they are usually small and often develop as complications of
bacterial endocarditis. This ensures that, while the aneurysm is excluded, blood flow to the relevant
vessels is preserved (Fig. 7). Nowadays, a diagnosis can often be made in the symptom-free stage.
When dealing with such highly complex procedures, surgeons need to adapt their surgical strategies
to suit the individual patient's requirements. Depending on the exact diagnosis, an aortic prosthesis is
implanted using either open surgery or catheter-based procedures. Abstract Thoracoabdominal aortic
aneurysms (TAAA) are rare events with an incidence of 5.9 cases per 100,000 persons per year. Wolf
View author publications You can also search for this author in. Beside the TAA, the aorta descends
on the right side of the patient (in normal cases it descends on the left side of the spine). These
endovascular stent grafts are covered in a strong fabric mesh, and ensure that the aneurysm is
adequately excluded from the circulation. The stent consists of a wire mesh tube covered in
synthetic fibers, and is placed inside the aorta in such a way as to effectively exclude the aneurysm
from normal blood flow. Once the aorta has been repaired in this way, the affected section is no
longer at risk of dissection or even rupture. With regard to patients requiring surgery to replace
sections of the thoracic and abdominal aorta, the use of endovascular stent grafts has led to a
significant reduction in the surgical risks involved. Furthermore, there are relevant risks of
complications, such as paraplegia (up to 20?%) and the necessity for dialysis. With the aid of the
model the perfectly suitable prosthesis could be selected and inserted for testing purposes. This
slows down the body's metabolism in a way that could be likened to a state of hibernation, thus
protecting even the brain against a temporary disruption in the normal blood supply. Reeps View
author publications You can also search for this author in. Abstract One to four per cent of all deaths
in patients over 65 are caused by aneurysmatic diseases of the abdominal or thoracic aorta. The risks
associated with this procedure are higher than those associated with repair of an isolated section of
the ascending aorta (Fig. 3, Fig. 4). Investigations and diagnosis: The patient was refered to a
cardiologist. For elective surgery in abdominal aneurysms, open surgery and endovascular treatment
both demonstrate brilliant overall results. The aorta is the largest artery of the circulatory system, and
delivers blood to all of the major organs. For this reason, the end sections of the stent grafts used in
these areas are not covered in fabric (bare springs). Besides cardiopulmonary risk evaluation, clinical
assessment of patients by the physician with respect to the patient-specific anatomy influences the
allocation of patients to one treatment option or another. For the renal arteries, this is achieved by
using individual stent sections. While the arch of the prosthesis can be likened to a conventional
prosthesis, the peripheral section consists of an endovascular stent graft supported by a metal mesh,
which is expanded once it has been inserted inside the aneurysm. This approach significantly reduces
the considerable risks normally associated with this type of surgery (Fig. 6).
Investigations and diagnosis: The patient was refered to a cardiologist. The risk of rupture varies
between 46 and 74% for a diameter clearly greater than 5.5 cm and with a 2-year mortality rate of
70%. Once inside the machine, the blood is oxygenated before being returned to the body.
Furthermore, there are relevant risks of complications, such as paraplegia (up to 20?%) and the
necessity for dialysis. Eine Diagnose gelingt heute oft im symptomfreien Stadium. While the bare
springs ensure that the stent is securely anchored and allows blood to flow into the relevant arteries,
the covered sections of the stent ensure that the aneurysm is excluded from blood flow (Fig. 8). In
terms of risks to the patient, this procedure is much safer than conventional open surgery procedures
involving this section of the aorta. Discover and download thousands of 3D models from games,
cultural heritage, architecture, design and more. This may be because the aortic valve itself is
diseased, or because the aneurysm involves the aortic root, making it necessary for the valve to be
replaced as well (Fig. 5). Mortality rates after both open and endovascular procedures are
approximately 8?% depending on the extent of the repair. In dieser Analyse kamen TAAs in beiden
Geschlechtern gleich haufig vor. For the less invasive EVAR technique the technical success rate
reaches 90 to 100 per cent with mortality rates between zero to ten per cent and the risk for
paraplegia between zero to six per cent. The exact etiology is still unclear but extended life-
expectancy with arterial hypertension, positive family history for aneurysmic diseases,
atherosclerosis, smoking and chronic obstructive lung disease are all considered to be risk factors. In
Germany approximately 940 TAAA procedures are performed annually. Kotelis View author
publications You can also search for this author in. We report the case of a 39-year-old insulin-
dependent diabetic, who developed a leaking aneurysm of the thoracic aorta as a late complication
of a knee empyema with subsequent metastatic mediastinitis. The patient had an accident-related
pretreatment in which her fracture of the pelvic ring was stabilized with a screw osteosynthesis.
Medical, operative and percutaneous interventional therapeutic strategies are basically available.
Lediglich drei Prozent aller Patienten mit Aortenaneurysmen haben ein thorakales Aneurysma
(TAA). Investigations and diagnosis: The investigation and the radiological images (X-ray, CT) had
shown a further loosening of the pelvic ring. The complex femoral fracture was diagnosed between
these two endoprosthesis with several fragments and a broken stabilizing plate. At this size, an
aneurysm constitutes an immediate threat to the patient's life. Reeps View author publications You
can also search for this author in. When compared to catheter-based procedures, the conventional
approach places patients at an increased risk. Depending on the exact diagnosis, an aortic prosthesis
is implanted using either open surgery or catheter-based procedures. Harrer Authors E. Harrer View
author publications You can also search for this author in. Some patients, whose aneurysm is of
moderate size, may be able to be treated using a very simple procedure, which involves placing an
endovascular stent graft inside the aneurysm. Compared to open surgery, endovascular repair is
significantly less invasive, and causes much less trauma to the patient.?Endovascular repair involves
the physician inserting an endovascular stent graft through an opening in the blood vessels in the
groin, and advancing it to the site of the aneurysm. Wolf View author publications You can also
search for this author in. In recent years several approaches to minimize these risks have been
proposed.
Harrer Authors E. Harrer View author publications You can also search for this author in. This model
helped the surgical team to have a much better understanding of the pathology. Zimmermann View
author publications You can also search for this author in. As part of this procedure, the aortic arch
and the descending thoracic aorta are repaired using what is referred to as a hybrid prosthesis.
Beside the TAA, the aorta descends on the right side of the patient (in normal cases it descends on
the left side of the spine). Zusammenfassung Thorakale Aortenlasionen stellen eine seltene, aber
akut lebensbedrohliche Erkrankung dar. Medical, operative and percutaneous interventional
therapeutic strategies are basically available. Kische View author publications You can also search for
this author in. What is significant about this particular procedure is that the prosthesis inserted via the
right femoral artery has an opening that eventually receives a smaller prosthesis inserted via the left
femoral artery. Lediglich drei Prozent aller Patienten mit Aortenaneurysmen haben ein thorakales
Aneurysma (TAA). With the aid of the model it was possible to find much easier individual solutions
in cooperation with a manufacturer of implants. Discover and download thousands of 3D models
from games, cultural heritage, architecture, design and more. ECG and radiological investigations
revealed an induration and a stenosis of the aortic valve and the area of the aortic root and the
ascending aorta. Investigations and diagnosis: Radiological investigations revealed a significantly
distinct aortic aneurysm. There are two surgical options available for the treatment of aortic disease,
open vascular surgery and catheter-based interventions. This can be done using either custom-
tailored openings (fenestrations) or a series of separate stent grafts. (Fig. 9). This may be because the
aortic valve itself is diseased, or because the aneurysm involves the aortic root, making it necessary
for the valve to be replaced as well (Fig. 5). This involves conventional open surgery (Fig. 10,
right).?? For most patients requiring the replacement of sections of the ascending aorta and aortic
arch, conventional surgery remains the treatment of choice. This model helped the surgical team to
have a much better understanding of the complexity of the fracture and procedure could be tested
with the model in advance. The procedure could be tested with the model in advance, so that the
planning for incisions and the customization of the implant could be made accurately. Course: The
treating physician was provided with a 1:1 scale 3D printed model of the aneurysm to discuss the
further treatment of the patient. The cause of TAAA is mostly degenerative but they can also occur
on the basis of an aortic dissection or connective tissue disease (e. g. Marfan’s syndrome). Patients
often have severe comorbidities and suffer from hypertension, coronary heart disease or chronic
obstructive pulmonary disease, mostly as a result of smoking. Blood returning to the heart is diverted
to this machine through a system of tubes. Aortic aneurysm repair is immensely challenging in terms
of the surgical techniques and strategies involved, as well as in terms of the surgical expertise
required. It may be possible for such a procedure to be performed as part of a different surgical
procedure, e.g. while a patient is undergoing heart valve replacement surgery for heart valve disease
that is associated with an aortic aneurysm. Once inside the machine, the blood is oxygenated before
being returned to the body. You can follow the blood flow using the model's annotations. When
dealing with such highly complex procedures, surgeons need to adapt their surgical strategies to suit
the individual patient's requirements. Berger Authors P. Heider View author publications You can
also search for this author in. In dieser Analyse kamen TAAs in beiden Geschlechtern gleich haufig
vor.
Here, endovascular repair using a catheter-based approach is the treatment of choice. Naturally, these
grafts must leave room for vital arteries to the liver, stomach, intestine and kidneys. This is why such
repairs can only be performed at specialist centers, and in close cooperation with cardiology
specialists. The risks associated with this procedure are higher than those associated with repair of an
isolated section of the ascending aorta (Fig. 3, Fig. 4). They can be managed conservatively, by open
surgical repair, and also minimal invasive using endovascular stentgraft implantation (EVAR).
Therefore the patient was admitted to a special heart centre. Hanke View author publications You
can also search for this author in. The prosthetic tube usually needs to be anchored in areas where
important blood vessels branch off the aorta, and so it is essential that blood flow to these vessels is
preserved (carotid artery, subclavian artery, celiac artery and superior mesenteric artery). The treating
physician was considering the use of an iliac crest bone graft in the symphysis to stabilize the pelvic
ring. Surgery of TAAA should ideally be performed in high-volume centers in order to achieve better
results. The evolution of this endovascular technique offers a potential treatment possibility
particularly in high-risk patients. Once securely linked, these form a Y-shape that ensures blood
supply to the pelvis and both of the legs is maintained via the iliac arteries (Fig. 10, middle).?? In
cases where the insertion of an endovascular stent graft is not possible, the affected section of the
abdominal aorta can be replaced in a single open surgery procedure. This approach significantly
reduces the considerable risks normally associated with this type of surgery (Fig. 6). It may be
possible for such a procedure to be performed as part of a different surgical procedure, e.g. while a
patient is undergoing heart valve replacement surgery for heart valve disease that is associated with
an aortic aneurysm. The risks associated with preventative surgery are significantly lower than those
associated with emergency repair. This can be done using either custom-tailored openings
(fenestrations) or a series of separate stent grafts. (Fig. 9). This model helped the surgical team to
have a much better understanding of the complexity of the fracture. It may even be possible for an
endovascular stent graft to be performed as part of a different procedure, e.g. while a patient is
undergoing valve replacement surgery. This ensures that, while the aneurysm is excluded, blood flow
to the relevant vessels is preserved (Fig. 7). Schneider View author publications You can also search
for this author in. Clinical, radiological, biochemical and microbiological data are correlated with
histopathological findings. For elective surgery in abdominal aneurysms, open surgery and
endovascular treatment both demonstrate brilliant overall results. As this can be inserted using a
catheter-based procedure, the patient does not have to undergo complex, open surgery. Eine
Diagnose gelingt heute oft im symptomfreien Stadium. This involves conventional open surgery (Fig.
10, right).?? For most patients requiring the replacement of sections of the ascending aorta and aortic
arch, conventional surgery remains the treatment of choice. With the aid of the model it was possible
to find much easier individual solutions in cooperation with a manufacturer of implants. When
dealing with such highly complex procedures, surgeons need to adapt their surgical strategies to suit
the individual patient's requirements. Lediglich drei Prozent aller Patienten mit Aortenaneurysmen
haben ein thorakales Aneurysma (TAA). Berger Authors P. Heider View author publications You can
also search for this author in. Show submenu One level back How is heart disease diagnosed.
At this size, an aneurysm constitutes an immediate threat to the patient's life. The patient had an
accident-related pretreatment in which her fracture of the pelvic ring was stabilized with a screw
osteosynthesis. Abstract One to four per cent of all deaths in patients over 65 are caused by
aneurysmatic diseases of the abdominal or thoracic aorta. For the renal arteries, this is achieved by
using individual stent sections. The risk of rupture varies between 46 and 74% for a diameter clearly
greater than 5.5 cm and with a 2-year mortality rate of 70%. Surgery of TAAA should ideally be
performed in high-volume centers in order to achieve better results. Furthermore, there are relevant
risks of complications, such as paraplegia (up to 20?%) and the necessity for dialysis. Eine Diagnose
gelingt heute oft im symptomfreien Stadium. Even at his birth a defect of his aorta (right-sided
around the trachea) was diagnosed. Anhand dieser Darstellungen kann man dann eine exakte
Dimensionierung des Stentgrafts vornehmen. For the upper abdominal arteries (celiac trunk, superior
mesenteric aorta), this is achieved by using fenestrated stent grafts (stents with the fabric mesh
partially removed). Some patients, whose aneurysm is of moderate size, may be able to be treated
using a very simple procedure, which involves placing an endovascular stent graft inside the
aneurysm. The evolution of this endovascular technique offers a potential treatment possibility
particularly in high-risk patients. Even at his birth a defect of his aorta (right-sided around the
trachea) was diagnosed. The treating physician was considering the use of an iliac crest bone graft in
the symphysis to stabilize the pelvic ring. Standard imaging alone was insufficient for accurate
planning of the surgery. In the thoracic aorta, new endovascular procedures have led to considerable
reductions of postoperative morbidity and mortality. Investigations and diagnosis: Radiological
investigations revealed a significantly distinct aortic aneurysm. Download citation Published: 01 July
2009 Issue Date: August 2009 DOI: Share this article Anyone you share the following link with will
be able to read this content: Get shareable link Sorry, a shareable link is not currently available for
this article. The exact etiology is still unclear but extended life-expectancy with arterial hypertension,
positive family history for aneurysmic diseases, atherosclerosis, smoking and chronic obstructive
lung disease are all considered to be risk factors. Treatment and course: The existing screw
osteosynthesis posed an enhanced risk for the accurate planning of the further treatment due to
artifacts in the area of the sacroiliac joints. With the aid of the model the perfectly suitable prosthesis
could be selected and inserted for testing purposes. With regard to patients requiring surgery to
replace sections of the thoracic and abdominal aorta, the use of endovascular stent grafts has led to a
significant reduction in the surgical risks involved. Mortality rates after both open and endovascular
procedures are approximately 8?% depending on the extent of the repair. Lediglich drei Prozent aller
Patienten mit Aortenaneurysmen haben ein thorakales Aneurysma (TAA). Show submenu One level
back How is heart disease diagnosed. In dieser Analyse kamen TAAs in beiden Geschlechtern gleich
haufig vor. Download citation Published: 05 February 2016 Issue Date: March 2016 DOI: Share this
article Anyone you share the following link with will be able to read this content: Get shareable link
Sorry, a shareable link is not currently available for this article. The cause of TAAA is mostly
degenerative but they can also occur on the basis of an aortic dissection or connective tissue disease
(e. g. Marfan’s syndrome). Patients often have severe comorbidities and suffer from hypertension,
coronary heart disease or chronic obstructive pulmonary disease, mostly as a result of smoking. For
the less invasive EVAR technique the technical success rate reaches 90 to 100 per cent with mortality
rates between zero to ten per cent and the risk for paraplegia between zero to six per cent.