상기 환자 초음파 위해 방문
췌장 직하방에 대동맥 직경
약 위아래로 10 cm 정도 복부 대동맥류가 관찰되며 전후방 직경은 5~5.5 cm
동맥경화반(화살표)도 관찰된다.
혈관의 벽까지 포함하여 최대의 좌우 직경을 다시 측정하면 > 5.5 cm 이 확인된다.
1년전 관상동맥 스텐트 삽입시 복부 혈관 CT를 시행한 것으로 문진상 확인되며, 대학병원 심장내과에서 우선 기존 모습과 크기 변화등 확인 후 수술에 대해 상담하도록 안내하였다.
For most patients with asymptomatic infrarenal AAA <5.5 cm, we recommend conservative management (watchful waiting) rather than elective AAA repair (Grade 1A). The risk of aneurysm rupture does not exceed the risk of repair until the aneurysm diameter reaches 5.5 cm. For good risk surgical candidates (open or endovascular repair) with AAA >5.5 cm, we recommend elective AAA repair (Grade 1A). Situations for which elective repair of asymptomatic AAA <5.5 cm may also be appropriate include :
•Rapidly expanding (>0.5 cm in six months or >1 cm per year) infrarenal AAA in well-documented serial studies. Rapid expansion may represent instability of the aortic wall, and some studies suggest that rapidly expanding AAAs have a higher risk of rupture.
•Patients with associated arterial disease such as coexisting iliac, femoral, or popliteal artery aneurysms, or symptomatic peripheral artery disease.
•For the same diameter of AAA, the risk for AAA rupture is higher for women than for men. Elective repair of asymptomatic AAA >5 cm may be appropriate; however, the risk of death from elective repair is also increased in women. A lower threshold for repair is best reserved for women who have a low risk for perioperative morbidity and mortality.
처음 발견되어 추적 계획중인 경우
동대문구 답십리 우리안애, 우리안愛 내과, 건강검진 클리닉 내과 전문의 전병연
Comments