SVS practice guidelines for the care of patients with an abdominal aortic aneurysm: Executive summary
SVS practice guidelines for the care of patients with an abdominal aortic aneurysm: Executive summary
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DOI：
10.1016/j.jvs.2009.07.001
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发表时间：
2009-10-01
影响因子：
4.3
通讯作者：
Veith, Frank J.
中科院分区：
文献类型：
--
作者：
Chaikof, Elliot L.;Brewster, David C.;Veith, Frank J.
血管外科学会临床实践理事会委托一个编写委员会负责更新2003年首次发布的实践指南，供参与腹主动脉瘤（AAA）患者术前、手术和术后护理的外科医生和医生使用。1本文是主要实践指南文件的执行摘要，并提供了评估患者的建议，包括动脉瘤破裂和相关医学共病的风险，选择手术或血管内介入治疗的指南，术中策略，围手术期护理，长期随访和晚期并发症的治疗。2与AAA患者护理相关的决策是复杂的。动脉瘤存在不同的破裂风险，患者特定因素影响预期寿命、手术风险和干预需求。在AAA解剖特征的影响下，仔细注意手术策略的选择，沿着医学共病的最佳治疗对于获得良好结局至关重要。此外，适当的术后患者监测和及时干预的情况下，晚期并发症是必要的，以尽量减少随后的麻醉相关的死亡或发病率。所有这些临床决策都是在成本效益最终决定为尽可能多的人群提供最佳护理的能力的环境中确定的。在制定这些建议时，对目前可用的临床数据集进行了审查。然而，本文件的一个重要目标是明确确定需要进一步临床研究的领域。
The Clinical Practice Council of the Society for Vascular Surgery charged a writing committee with the task of updating practice guidelines, initally published in 2003, for surgeons and physicians who are involved in the preoperative, operative, and postoperative care of patients with abdominal aortic aneurysms (AAA). 1 This article is an executive summary of the main practice guidelines document and provides recommendations for evaluating the patient, including risk of aneurysm rupture and associated medical co-morbidities, guidelines for selecting surgical or endovascular intervention, intraoperative strategies, perioperative care, longterm follow-up, and treatment of late complications. 2Decision making related to the care of patients with AAA is complex. Aneurysms present with varying risks of rupture, and patient-specific factors influence anticipated life expectancy, operative risk, and the need to intervene. Careful attention to the choice of operative strategy, as influenced by anatomic features of the AAA, along with optimal treatment of medical co-morbidities is critical to achieving excellent outcomes. Moreover, appropriate postoperative patient surveillance and timely intervention in the case of a late complication is necessary to minimize subsequent aneurysm-related death or morbidity. All of these clinical decisions are determined in an environment where cost-effectiveness will ultimately dictate the ability to provide optimal care to the largest possible segment of the population. Currently available clinical data sets have been reviewed in formulating these recommendations. However, an important goal of this document is to clearly identify those areas where further clinical research is necessary.