Otvoreno hirurško lečenje aneurizmi abdominalne aorte u endovaskularnoj eri

Abstract

In addition to the well-known benefits, endovascular treatment (EVAR) of abdominal aortic aneurysms has its drawbacks and limitations. That is why open surgery (OS) still has a very important place. OS should be considered as the first treatment option for degenerative AAAs with either favorable or unfavorable anatomy in low-risk patients with long life expectancy. When it comes to inflammatory AAA, OS is indicated only in patients at low risk and hydronephrosis. OS is the "gold standard" for the definitive treatment of mycotic AAAs. In cases of complete thrombosis AAA is the only viable OS. OS is the method of choice in AAA with associated significant accessory renal arteries. OS is the method of choice for the treatment of AAA in patients with connective tissue disorders. Different types of endolic, infection, collapse and stent graft migration, or aneurysmal sac rupture, require late open surgical conversion after EVAR. OS is indicated if patients with RAAA are severely hemodynamically unstable, if they do not have a favorable anatomy, or if they have a large retroperitoneal hematoma. OS AAA can be performed only in centers with a large volume of work by experienced surgeons. The younger generation of vascular surgeons must be educated for both EVAR and OH AAA.