Various branches of the aorta can by atherosclerosis, fibromuscular dysplasia or other causes are closed, leading to symptoms and signs of ischemia or infarction. The diagnosis is made by imaging methods. The treatment consists of embolectomy, angioplasty or sometimes a surgical bypass supply.
The occlusion may be Bauchaortenäste
Various branches of the aorta can by atherosclerosis, fibromuscular dysplasia or other causes are closed, leading to symptoms and signs of ischemia or infarction. The diagnosis is made by imaging methods. The treatment consists of embolectomy, angioplasty or sometimes a surgical bypass supply. The occlusion of the Bauchaortenäste may be Acute: From embolism, atherothrombosis or dissection resulting Chronic: from atherosclerosis, fibromuscular dysplasia or external compression by mass lesions result to the predilection sites of occlusion are superior mesenteric celiac axis renal artery bifurcation A chronic occlusion of the celiac axis occurs for unclear reasons often in women. Symptoms and signs Clinical manifestations (eg. As pain, organ failure, necrosis) caused by ischemia or infarction and vary depending on the involved artery and acuity. An acute Mesenterialarterienverschluss (acute mesenteric ischemia) caused an intestinal ischemia and infarction, resulting in severe diffuse abdominal pain that are not in relation to the minimum physical findings. Acute occlusion of the celiac axis can lead to liver – lead and Milzinfarkten. The chronic vascular insufficiency of the mesenteric arteries rarely causes symptoms, except when both the superior mesenteric artery and the celiac axis are significantly constrained because the collateral circulation between the larger branches usually pronounced. Symptoms of chronic vascular insufficiency of the mesenteric arteries typically occur on postprandial (as angina intestinalis), since the digestion requires a higher mesenteric blood flow; the pain starts about 30 minutes to one hour after the meal, and is constant, strong, normally localized periumbilical and is facilitated by the sublingual administration of nitroglycerin. Patients get to eat fear, an extreme weight loss is common. Rarely malabsorption develops and contributes to weight loss. Patients may have abdominal noise, nausea, vomiting, diarrhea, constipation and black stools. An acute embolism in the renal artery caused flank pain followed by hematuria (renal artery and renal artery occlusion: Acute renal artery occlusion). A chronic closure may be asymptomatic or come in a new onset, difficult to control hypertension and other consequences of kidney failure or kidney failure expressed. Acute occlusion of the aortic bifurcation or distal side branches can have a sudden onset of pain at rest, pallor, paralysis, lack of peripheral pulses and cold sensation in the legs cause (Acute peripheral arterial occlusion). Chronic closures can intermittent claudication in the legs and buttocks and erectile dysfunction (Leriche syndrome) cause. Femoral pulses are missing. The limb may be at risk. Diagnostic imaging methods The diagnosis is made primarily based on history and physical examination, and confirmed by duplex sonography, CT angiography, MR angiography or conventional angiography. Treatment embolectomy or percutaneous angioplasty in acute closure surgery or angioplasty in chronic closure An acute closure is a surgical emergency requiring an embolectomy or percutaneous transluminal angioplasty (PTA) with or without stent graft. A symptomatic chronic closure may require a surgical procedure or angioplasty. The modification of risk factors and platelet inhibitors can help. The acute Mesenterialarterienverschluss (z. B. in the superior mesenteric artery), which has a significant morbidity and mortality, requiring immediate revascularization. The prognosis is poor if revascularization is not received within 4-6 h. In chronic occlusion of the superior mesenteric artery or celiac axis a change in diet may temporarily relieve the symptoms. If the symptoms are strong, the surgical bypass from the aorta leading to the Splanchnikusarterien distal to the closure commonly used for revascularization. The long-term patency of the grafts is> 90%. In appropriately selected patients (v. A. In elderly patients who are poor candidates for surgical care are) can be successful revascularization by PTA with or without stent graft. The symptoms can be resolved quickly and the weight be regained. An acute occlusion of the renal artery requires embolectomy. Sometimes a PTA can be performed. The initial treatment of chronic occlusion is to antihypertensives. If the blood pressure can not be controlled adequately or when kidney function deteriorates, a PTA is carried out with the stent graft, or, if the PTA is impossible, an open surgical bypass or endarterectomy for improving the blood flow. A closure of the aortic bifurcation requires an urgent embolectomy which is usually carried out transfemoral. If a chronic occlusion of the aortic bifurcation causes intermittent claudication, a aortoiliac or aortofemoraler graft can be used to bypass the occlusion site surgically. The PTA is an alternative in selected patients.