Endovaskularno liječenje aneurizmi i pseudoaneurizmi visceralnih ogranaka abdominalne aorte

master's thesis

• Title (english): Endovascular treatment of aneurysms and pseudoaneurysms of the visceral branches of the abdominal aorta
• Author: Jelena Svetec
• Mentor: Vinko Vidjak (mentor)
• Committee member: Ivo Lovričević (predsjednik povjerenstva)
• Committee member: Milan Radoš (član povjerenstva)
• Committee member: Vinko Vidjak (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Radiology); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Radiology

Abstract

Poboljšanje slikovnih dijagnostičkih metoda u posljednjih nekoliko desetljeća dovelo je do povećanja frekvencije otkrivanja asimptomatskih aneurizmi visceralnih arterija. Jednako tako, sve učestalija primjena perkutanih interventnih postupaka dovela je do veće incidencije pseudoaneurizmi. Ipak, aneurizme visceralnih arterija su relativno rijetka stanja, no, zbog oslabljene stijenke proširenog dijela krvne žile, sklone su rupturi koju prati krvarenje u 22% slučajeva s mortalitetom od 8.5%. Tradicionalno vaskularna kirurgija u liječenju primjenjuje otvoreni pristup s resekcijom aneurizme sa ili bez uspostave kontinuiteta arterije ili resekcijom distalnog organa, poput slezene. No te metode nije uvijek moguće primijeniti. U slučajevima pratećeg peritonitisa ili pankreatitisa, u pacijenata s prijašnjim abdominalnim operacijama ili multiplim komorbiditetima, otvoreni pristup je otežan i praćen većim morbiditetom i mortalitetom. Sve učestalija upotreba minimalno invazivnih endovaskularnih tehnika je dobra alternativa u tim indikacijama. Endovaskularna embolizacija zavojnicama i tekućim materijalima, postavljanje stent graftova i multilayered stentova se primjenjuje sve češće kako se interventna radiologija razvija. Glavne prednosti takvih transkateterskih metoda su minimalna invazivnost, manja postoperativna bol, niža stopa komplikacija, kraća hospitalizacija i brži povratak pacijenta svakodnevnim aktivnostima.

Abstract (english)

In the last few decades, advanced imaging techniques have led to increased detection of asymptomatic visceral artery aneurysms. Also, increased percutaneous endovascular interventions have raised the incidence of iatrogenic pseudoaneurysm formation. Still, aneurysms of visceral arteries are a rare condition, but, due to the weakness of dilated blood vessel wall, they are prone to rupture, resulting in life-threatening hemorrhage in 22% of cases with mortality of 8.5%. Traditional vascular surgery management involves an open exposure to excise the aneurysm with or without re-establishment of vascular continuity or end organ resection (e.g. spleen). However, these methods are not applicable in every case. In cases of concomitant peritonitis or pancreatitis, in patients with previous abdominal surgery or multiple comorbidities, the open repair becomes difficult and carries a higher morbidity and mortality. The rising use of minimally invasive endovascular techniques over the past decade offers a good alternative in these indications. Endovascular coiling, liquid embolization, placement of covered and multilayered stents are becoming more and more common as the intervention radiology develops. The main advantages of this catheter-based methods are minimal invasiveness, less post-operative pain, less complications, shorter hospitalization and sooner incorporation in the everyday activities.

• Keywords: aneurizma visceralne arterije; pseudoaneurizma; endovaskularna tehnika; minimalno invazivna
• Keywords (english): visceral artery aneurysm; pseudoaneurysm; endovascular techniques; minimally invasive
• Language: croatian
• URN:NBN: urn:nbn:hr:105:029253
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-04-13 11:22:54