Avtor/Urednik		Šurlan, Miloš; Berden, Pavel; Klokočovnik, Tomislav; Kunst, Tomaž
Naslov		Aortna endoproteza - slikovna diagnostika, indikacije, meritve in prikaz
Prevedeni naslov		Diagnostic imaging and indications for treatment of aortic aneurysm by endoprosthesis
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 38, št. Suppl 3
Leto izdaje		1999
Obseg		str. 77-82
Jezik		slo
Abstrakt		This paper presents imaging diagnostics of an aneurysm of the aorta and indications, common contraindications and measurements for the construction and selection of an endoprosthesis. The examination using ultrasound is the most handy and economically justifiable method for detecting an aneurysm of the aorta, for monitoring asymptomatic aneurysms as well as patients having undergone an operation or those with an endoprothesis. Another examination to visualise the aortic aneurysm is computer tomography with or without contrastive medium. The plan for treating an aneurysm can be made with the help of a digital subtraction angiography, helical computer tomography angiography and/or magnetic resonance angiography. Digital subtraction angiography shows well the lightness of the aneurysm and the aorta, as well as the changes inside of it, large arteries close to the aneurysm and the condition of pelvic arteries for the selection of the approach. The helical tomographic angiography and magnetic resonance angiography in two or three dimensional reproduction in several directions enable an accurate measurement of the aneurysm, the aorta diameter above and below the aneurysm, and the evaluation of the quality of its wall. Indication areas for endoprosthesis are aneurysms of the abdominal aorta and of the descending part of the thoracic aorta. Treatment with endoprosthesis as a less invasive method is indicated in patients with a risk of a number of complications and even high mortality when treated surgically. Endoprosthesis is made of a metal stent and prosthesis. The stent attaches the endoprosthesis to the unaffected part of the aorta above and below the aneurysm, it sets the stent asunder and provides it support.(Abstract truncated at 2000 characters)
Izvleček		V prispevku avtorji prikazujejo slikovno diagnostiko anevrizme aorte, indikacije, splošne kontraindikacije in meritve za izdelavo ali izbiro aortne endoproteze. Preiskava z ultrazvokom je najbolj priročna in ekonomsko upravičena metoda za odkrivanje anevrizme aorte, spremljanje asimptomatskih anevrizem ter bolnikov po zdravljenju z operacijo ali endoprotezo. Naslednja preiskava za prikaz anevrizme aorte je računalniška tomografija brez kontrastnega sredstva in z njim. Načrt zdravljenja z endoprotezo naredimo s pomočjo digitalne substrakcijske angiografije, spiralne računalniške tomografije-angiografije in/ali magnetne resonance in angiografije. Z digitalno substrakcijsko angiografijo dobro prikažemo svetlino anevrizme in aorte ter spremembe v njej, velike arterije v bližini anevrizme in stanje medeničnih arterij za izbiro pristopa. Spiralna računalniška tomografija-angiografija in magnetno resonančna angiografija v dvo-in trodimenzionalni reprodukciji v več smereh nam omogočata natančno izmero velikosti anevrizme, premera aorte nad in pod anevrizmo ter presojo kakovosti njene stene. Indikacijski področji za endoprotezo sta anevrizma trebušne in descedentnega dela prsne aorte. Zdravljenje z endoprotezo je kot manj invazivna metoda indicirano pri bolnikih, pri katerih ima kirurško zdravljenje veliko zapletov in visoko smrtnost. Endoproteza je zgrajena iz kovinske opornice in proteze. Oportnica pritrdi endoprotezo na neprizadeti del aorte nad in pod anevrizmo, razpre protezo in ji daje oporo. Proteza je sintetična tkanina dakron, ki ima za ta namen dobre lastnosti, kot so majhna podajnost, poroznost, prepustnost in razteznost. Endoprotezo uvajamo v aorto skozi kateterski dovodni sistem. Vhodno mesto je kirurško odprta skupna stegnenična ali medenična arterija.
Deskriptorji		AORTIC ANEURYSM BLOOD VESSEL PROSTHESIS ANGIOGRAPHY ULTRASONOGRAPHY, DOPPLER