master's thesis
USPOREDBA KIRURŠKOG I ENDOVASKULARNOG LIJEČENJA ANEURIZMI POPLITEALNIH ARTERIJA

Aron Roth (2015)
Sveučilište u Rijeci
Medicinski fakultet
Katedra za kirurgiju
Metadata
TitleUSPOREDBA KIRURŠKOG I ENDOVASKULARNOG LIJEČENJA ANEURIZMI POPLITEALNIH ARTERIJA
AuthorAron Roth
Mentor(s)Miljenko Kovačević (thesis advisor)
Abstract
Aneurizma poplitealne arterije je lokalizirano proširenje lumena poplitealne arterije koje najčešće nastaje kao posljedica ateroskleroze. Epidemiološka istraživanja pokazuju da su ovo najčešće aneurizme perifernih arterija s incidencijom od 0,1- 2,8 / 100000 ljudi zahvaćajući predominantno mušku populaciju. U oko 50% bolesnika aneurizme se nalaze bilateralno, a u 78% slučajeva pacijenti ih imaju i na drugim arterijama, poglavito (64%) na abdominalnoj aorti i ilijačnim krvnim žilama. U početku bolest je asimptomatska, a kasnije se može prezentirati bolovima, kompresijom, rijetko rupturom, a ukoliko dođe do embolizacije tromba koji potom distalno uzrokuje akutnu ishemiju ekstremiteta očituje se plavim nožnim prstima, bljedilom, ulceracijama, gangrenom te u najgorem slučaju završava amputacijm uda. Osnova dijagnostike je MSCT angiografija koja predstavlja zlatni standard, a ponekad je dovoljna i samo palpacija poplitealne jame iza koljenoga zgloba. Temelj lječenja je operativni zahvat koji se sastoji od podvezivanja i isključivanja aneurizme iz krvotoka te formiranja i zaobilaženja aneurizme premosnicom. Druga opcija je endovaskularno liječenje pri čemu se ugrađuje stent unutar aneurizme kako bi se ona isključila iz krvotoka. Prednosti ovog tipa zahvata su brz oporavak i kratko vrijeme hospitalizacije, a pogodna je u pacijenata s visokim operativnim rizikom. Ipak veliki nedostaci su veća učestalost rane tromboze i začepljenja te veći broj komplikacija u odnosu na operativnu metodu. Operacija medijalnim pristupom je najčešća operativna metoda današnjice u liječenju aneurizmi poplitealnih arterija. Najbitnije prednosti su njeni odlični dugoročni rezultati, odsutnost komplikacija, jednostavnost i kratko trajanje zhvata te zbog toga trenutačno predstavlja standard i prvu opciju u liječenju aneurizmi poplitealnih arterija.
Keywordspopliteal artery aneurysm thrombus acute ischemia popliteal fossa operative treatment medial approach posterior approach bypass ligation endovascular treatment stent
GranterSveučilište u Rijeci
Medicinski fakultet
Lower level organizational unitsKatedra za kirurgiju
PlaceRijeka
StateCroatia
Scientific field, discipline, subdisciplineBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Surgery
Study programme typeuniversity
Study levelintegrated undergraduate and graduate
Study programmeMedicine
Academic title abbreviationdr. med.
Genremaster's thesis
Language Croatian
Defense date2015
Parallel abstract (English)
Popliteal artery aneurysm is localized enlargement of lumen of popliteal artery due to atherosclerosis. Epidemiological findings show that these are the most common aneurysms of peripheral arteries with incidence of 0,1 – 2,8 / 100 000 people affecting mostly male population. In about 50% of patients aneurysms are found bilaterally and in 78% of cases patients have them on other arteries, mostly (64%) on abdominal aorta and iliac arteries. At the beginnings disease is asymptomatic and later it can be presented with pain, compression, rarely rupture and if embolization of the thrombus happens distal part of the limb will be ischemic, pale, with blue toes, ulcerations, gangrene and in worse case it will end with amputation. Diagnosis is based on MSCT angiography which is a golden standard but sometimes is even palpation of popliteal fossa behind knee articulation enough. The basis of treatment is operative procedure with ligation and bypassing the aneurysm to exclude it from the blood flow. Other option is endovascular treatment in which stent is being embedded inside of the aneurism so it can be excluded from the blood flow. The advantages of this treatment are quick recovery and short hospitalization and it is suitable for patients with high operative risk. However big disadvantages are higher rate of early thrombosis and occlusion with greater number of complications compared with operative method. Operation by medial approach is nowadays the most common operative method in treatment of popliteal artery aneurisms. Most important advantages are great long-term results, low rate of complications, simplicity and short time of intervention which makes it a standard and a first option in treating popliteal artery aneurisms.
Parallel keywords (Croatian)aneurizma poplitealne arterije tromboza akutna ishemija poplitalna jama operativno liječenje medijalni pristup stražnji pristup premosnica ligatura endovaskularno liječenje stent
Resource typetext
Access conditionAccess restricted to students and staff of home institution
Terms of usehttp://rightsstatements.org/vocab/InC/1.0/
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:184:546494
CommitterBosa Licul