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Archive » 2016 » 4 » | Archive » Medical field » Fields » Internal Medicine » Kirurgija » Latest edition » Archive » Medical field » Fields » Radiology » Archive » Medical field » Fields » Surgery »

The Role of Interventional Radiology in the Management of Aortic Pathology

 

This post is also available in: enEnglish slSlovenščina (Slovenian)

Management of aortic pathology was surgical and invasive until late 1980s. Stent grafts considerably lowered the invasiveness of the procedure for patients, suitable for endovascular management. Today, endovascular management of aorta is feasible in patients with coarctations, aneurysms, pseudoaneurysms, dissections and ruptures if anatomical requirements are met a healthy neck for stent graft attachment must be present and vital aortic branches must not be covered. The majority of abdominal aneurysms are diagnosed incidentally during ultrasound examination whereas changes on thoracic aorta are often seen on chest x-rays or on computed tomography. The decision for the treatment is made at a multidisciplinary meeting. Computed tomography angiography should be performed prior to treatment when the conditions of aorta and pelvic arteries, necessary for stent graft implantation, should be determined. The examination provides the measurements for stent graft selection. The procedure itself is performed on the angiographic machine by interventional radiologists, radiographers, scrub nurses and anesthesiologists; vascular surgeons are always available on call. In Slovenia, interventional radiologists implant aortic stent grafts since 1999 and since 2007 stent grafts are in stock at the Clinical Institute for Radiology of the University Medical Centre Ljubljana, so elective and emergency management is feasible. We compared our results in 2015 with those from 2012; the number of the procedures has increased in 2015 (82 vs. 70 procedures) though the rate of elective and emergency procedures is similar. The number of the procedures will probably increase in the future and technical development will result in wider indication range for endovascular management of aorta.

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