Therapie des Bauchaortenaneurysmas: Stellenwert des chirurgischen Ersatzes im Zeitalter der Stent-Prothesen

Intact (iAAA) and ruptured (rAAA) abdominal aortic aneurysms are complex diseases, which according to recent data are increasingly being treated by endovascular aortic repair (EVAR, iAAA 73 % versus rAAA 35 %). Constant improvement of commonly used endovascular techniques increases the feasibility of even challenging AAA pathologies. Various meta-analyses, systematic reviews and randomized controlled trials have examined the short-term and long-term outcome of EVAR versus open abdominal aortic repair (OAR). In contrast to OAR, EVAR seems to be beneficial in terms of 30-day mortality; nevertheless, OAR still has an accepted importance in the therapy of AAA. This article provides an overview on current treatment options of AAA regarding the correct individual indications in consideration of recent data on short-term and long-term outcome of EVAR.