Author/Editor		Šurlan, Miloš; Salapura, Vladka; Kunst, Tomaž
Title		Diagnostic imaging, indications and measurements for the treatment of aortic aneurysm by endoprosthesis
Translated title		Slikovna diagnostika, indikacije in meritve za premostitev anevrizme aorte z endoprotezo
Type		članek
Source		Radiol Oncol
Vol. and No.		Letnik 34, št. 2
Publication year		2000
Volume		str. 101-6
Language		eng
Abstract		Background. This paper presents imaging diagnostics of an aneurysm of the aorta, 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 aneurysm as well as patients having undergone an operation or those with an endoprosthesis. Another examination to visualise the aortic aneurysm is CT with or without contrastive medium. The plan for treating an aneurysm can be made with the help of a DSA, helical CT angiography and/or MRA. DSA 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 CT angiography and MRA in two or three dimensional reproduction in several directions enable an accurate measurement of an aneurysm, the aorta diameter above and below the aneurysm, and the evaluation of the quality of its wall. Conclusions. The indication areas for endoprosthesis are aneurysm of the abdominal aorta and those of the descending part of thoracic aorta. The treatment with endoprosthesis as a less invasive method is indicated in patients who risk a number of complications and even mortality when treated surgically. Endoprosthesis is made of 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 support. The prosthesis is made of Dacron synthetic fabric, which has very good properties for this purpose such as small compliance, porosity, permeability and extensibility. The endoprosthesis is introduced into the aorta through a catheter system with the help of a special guide wire. The entering point is surgically opened common femoral or iliac artery.
Summary		Izhodišča. Avtorji prikazujejo slikovno diagnostiko anevrizme aort, indikacije, splošne kontraindikacije in meritve za izdelavo ali izbiro aortne endoproteze. Preiskava z ultrazvokom je najbolj priročna in ekonomsko upravičena metoda za odkrivanje anevrizme aort, spremljanje asimptomatskih anevrizem ter bolnikov po zdravljenju z operacijo ali endoprotezo. Naslednji preiskavi za prikaz anevrizme aorte sta računalniška tomografija brez kontrastnega sredstva in z njim. Načrt zdravljenja z endoprotezo naredimo s pomočjo digitalne substrakcijske angiografije, spiralne računalniške tomografske angiografije in/ali magnetne resonance in angiografije. Z digitalno subtrakcijsko 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 tomografska angiografija in magnetnoresonančna angiografija v dvo- in trodimenzionalni reprodukciji v več smereh nam omogočata natančno izmero velikosti anevrizme, premera aorte nad in pod anevrizmo ter presodita kakovost njene stene. Zaključki. Indikacijski področji za endoprotezo sta anevrizma trebušne aorte in descendentnega dela prsne aorte. Zdravljenje z endoprotezo kot manj invazivna metoda je indicirano pri bolnikih, pri katerih ima kirurško zdravljenje veliko zapletov in visoko smrtnost. Endoproteza je zgrajena iz kovinske opornice in proteze. Opornica pritrdi endoprotezo na prizadeti del aorte nad in pod anevrizmo, razpre protezo in ji daje oporo. Proteza je sintetična tkanina dakron, ki ima za ta namen primerne 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.
Descriptors		AORTIC ANEURYSM BLOOD VESSEL PROSTHESIS PATIENT SELECTION DIAGNOSTIC IMAGING TOMOGRAPHY, X-RAY COMPUTED MAGNETIC RESONANCE IMAGING ANGIOGRAPHY, DIGITAL SUBTRACTION