症例 内胸動脈バイパスグラフトに対するPTCAの1例

冠動脈バイパス術における内胸動脈グラフトの使用増加に伴い,その術後狭窄に対するPTCAの報告がわずかながら行われている.症例は74歳の男性で,左主幹部完全閉塞と右冠動脈50%狭窄のため左前下行枝に左内胸動脈,右冠動脈に大伏在静脈を用いバイパス術を施行した.術後の冠動脈造影にて前下行枝と内胸動脈の吻合部に90%の狭窄を認めたため同部位にPTCAを試みた.大腿動脈よりアプローチし,guiding catheterは10cm短縮したJudkins-4-Right, guide wireは0.014 inch high torque floppy,balloon catheterはSimpson-Ro...

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Published in心臓 Vol. 21; no. 7; pp. 860 - 862
Main Authors 成子, 隆彦, 寺柿, 政和, 安田, 光隆, 田原, 旭, 奥, 久雄, 竹内, 一秀, 柳, 志郎, 武田, 忠直, 板金, 広, 秋岡, 要
Format Journal Article
LanguageJapanese
Published 公益財団法人 日本心臓財団 1989
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ISSN0586-4488
2186-3016
DOI10.11281/shinzo1969.21.7_860

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Abstract 冠動脈バイパス術における内胸動脈グラフトの使用増加に伴い,その術後狭窄に対するPTCAの報告がわずかながら行われている.症例は74歳の男性で,左主幹部完全閉塞と右冠動脈50%狭窄のため左前下行枝に左内胸動脈,右冠動脈に大伏在静脈を用いバイパス術を施行した.術後の冠動脈造影にて前下行枝と内胸動脈の吻合部に90%の狭窄を認めたため同部位にPTCAを試みた.大腿動脈よりアプローチし,guiding catheterは10cm短縮したJudkins-4-Right, guide wireは0.014 inch high torque floppy,balloon catheterはSimpson-Robert low profile 2.5mmを用い6気圧2分でinflationし25%狭窄を残したが開大に成功した.内胸動脈グラフトの普及に伴い術後狭窄に対するPTCAはより安全に施行でき,今後汎用される手法として期待された.
AbstractList 冠動脈バイパス術における内胸動脈グラフトの使用増加に伴い,その術後狭窄に対するPTCAの報告がわずかながら行われている.症例は74歳の男性で,左主幹部完全閉塞と右冠動脈50%狭窄のため左前下行枝に左内胸動脈,右冠動脈に大伏在静脈を用いバイパス術を施行した.術後の冠動脈造影にて前下行枝と内胸動脈の吻合部に90%の狭窄を認めたため同部位にPTCAを試みた.大腿動脈よりアプローチし,guiding catheterは10cm短縮したJudkins-4-Right, guide wireは0.014 inch high torque floppy,balloon catheterはSimpson-Robert low profile 2.5mmを用い6気圧2分でinflationし25%狭窄を残したが開大に成功した.内胸動脈グラフトの普及に伴い術後狭窄に対するPTCAはより安全に施行でき,今後汎用される手法として期待された.
Author 板金, 広
安田, 光隆
奥, 久雄
秋岡, 要
竹内, 一秀
成子, 隆彦
武田, 忠直
柳, 志郎
田原, 旭
寺柿, 政和
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  fullname: 秋岡, 要
  organization: 大阪市立大学医学部第蕊内科
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References 5) Little, B. W., Loop, F. D., Thurer, R. L., Groves, L. K., Taylor, P. C. and Cosgrove, D.: I solated left anterior descending coronary ather osclerosis: Long term comparison of inte rnal mammary artery and venous autografts. Cir culation, 61: 869, 1980.
10) Dorros, G. and Lewin, R. F.: The brachial artery method to transluminal internal mammary artery angioplasty. Cathet. Cardiovasc. Diagn., 12: 341, 1986.
12) Takashiba, K., Hamada, Y., Ohno, H., Ebihara, H., Fujii, B., Hayakuna, E., Tanimoto, Y. and Matsuda, Y.: Transluminal internal mammary artery angioplasty using the brachial a pproach. Kokyu to Junkan, 35: 787, 1987.
7) Pinkerton, C. A., Slack, J. D., Orr, C. M. and VanTassel, J. W.: Percutaneous transluminal angioplasty involving internal mammary artery bypass grafts: A femoral approach. Cathet. Cardiovasc. Diagn., 13: 414, 1987.
9) Zaidi, A., Hollman, J. et al.: Percutaneous angioplasty of internal mammary artery graft stenosis: Case report and disscussion. Cathet. Cardiovasc. Diagn., 11: 603, 1985.
2) Spencer, F. C.: The internal mammary artery: The ideal coronary bypass graft Editorial. N. Engl. J. Med., 314: 50, 1986.
11) Salinger, M., Drummer, E., Furey, K., Bott-Silverman, C. and Franco, I.: Percutaneous angioplasty of internal mammary artery graftstenosis using the branchial approach: A case report. Cathet. Cardiovasc. Diagn., 12: 261, 1986.
13) Giorgi, L. V., Hartzler, G. O., McConahay, D. R., Rutherford, B. D. and Johnson, W. L.: PTC A of distal coronary stenosis via patent interna l mammary artery grafts-Improved recent experience. J. Am. Coll. Cardiol., 7: 105 A, 1986(Abstr).
3)- Loop, F. D., Lytle, B. W., Cosgrove, D. M., Stewart, R. W., Goormastic, M., Williams, G. W., Golding, L. A. R., Gill, C., Taylor, P. C., She ldon, W. C. and Proudfit, W. S.: Influence o f the internal mammary graft on ten year surviv al and other cardiac events. N. Engl. J. Med., 314: 1, 1986.
4) Tector, A. J., Schmahl, T. M. and Canino, V. R.: Expanding the use of the internal mammary artery to improve patency in coronary artery bypass grafting. J. Thorac. Cardiovas. Surg., 91: 9, 1986.
8) Kereiakes, D. J., George, B., Stertzer, S. H. and Myler, R. K.: Percutaneous transluminalang ioplasty of left internal mammary artery grafts. Am. J. Cardiol., 55: 1215, 1985.
1) Lytle, B. W., Loop, F. D., Cosgrove, D. M., Ratliff, N. B., Easley, K. and Taylor, P. C.: Long-term (two to 12 years) serial studie s of internal mammary artery and saphenous vein coronary bypass grafts. J. Thorac. Cardiovasc. Surg., 89: 248, 1985.
6) Kereiakes, D. J., George, B., Stertzer, S. H. and Myler, R. K. Percutaneous transluminalang ioplasty of left internal mammary grafts. A m. J. Cardiol., 55: 1215, 1985.
References_xml – reference: 1) Lytle, B. W., Loop, F. D., Cosgrove, D. M., Ratliff, N. B., Easley, K. and Taylor, P. C.: Long-term (two to 12 years) serial studie s of internal mammary artery and saphenous vein coronary bypass grafts. J. Thorac. Cardiovasc. Surg., 89: 248, 1985.
– reference: 10) Dorros, G. and Lewin, R. F.: The brachial artery method to transluminal internal mammary artery angioplasty. Cathet. Cardiovasc. Diagn., 12: 341, 1986.
– reference: 12) Takashiba, K., Hamada, Y., Ohno, H., Ebihara, H., Fujii, B., Hayakuna, E., Tanimoto, Y. and Matsuda, Y.: Transluminal internal mammary artery angioplasty using the brachial a pproach. Kokyu to Junkan, 35: 787, 1987.
– reference: 8) Kereiakes, D. J., George, B., Stertzer, S. H. and Myler, R. K.: Percutaneous transluminalang ioplasty of left internal mammary artery grafts. Am. J. Cardiol., 55: 1215, 1985.
– reference: 2) Spencer, F. C.: The internal mammary artery: The ideal coronary bypass graft Editorial. N. Engl. J. Med., 314: 50, 1986.
– reference: 13) Giorgi, L. V., Hartzler, G. O., McConahay, D. R., Rutherford, B. D. and Johnson, W. L.: PTC A of distal coronary stenosis via patent interna l mammary artery grafts-Improved recent experience. J. Am. Coll. Cardiol., 7: 105 A, 1986(Abstr).
– reference: 5) Little, B. W., Loop, F. D., Thurer, R. L., Groves, L. K., Taylor, P. C. and Cosgrove, D.: I solated left anterior descending coronary ather osclerosis: Long term comparison of inte rnal mammary artery and venous autografts. Cir culation, 61: 869, 1980.
– reference: 6) Kereiakes, D. J., George, B., Stertzer, S. H. and Myler, R. K. Percutaneous transluminalang ioplasty of left internal mammary grafts. A m. J. Cardiol., 55: 1215, 1985.
– reference: 9) Zaidi, A., Hollman, J. et al.: Percutaneous angioplasty of internal mammary artery graft stenosis: Case report and disscussion. Cathet. Cardiovasc. Diagn., 11: 603, 1985.
– reference: 4) Tector, A. J., Schmahl, T. M. and Canino, V. R.: Expanding the use of the internal mammary artery to improve patency in coronary artery bypass grafting. J. Thorac. Cardiovas. Surg., 91: 9, 1986.
– reference: 11) Salinger, M., Drummer, E., Furey, K., Bott-Silverman, C. and Franco, I.: Percutaneous angioplasty of internal mammary artery graftstenosis using the branchial approach: A case report. Cathet. Cardiovasc. Diagn., 12: 261, 1986.
– reference: 7) Pinkerton, C. A., Slack, J. D., Orr, C. M. and VanTassel, J. W.: Percutaneous transluminal angioplasty involving internal mammary artery bypass grafts: A femoral approach. Cathet. Cardiovasc. Diagn., 13: 414, 1987.
– reference: 3)- Loop, F. D., Lytle, B. W., Cosgrove, D. M., Stewart, R. W., Goormastic, M., Williams, G. W., Golding, L. A. R., Gill, C., Taylor, P. C., She ldon, W. C. and Proudfit, W. S.: Influence o f the internal mammary graft on ten year surviv al and other cardiac events. N. Engl. J. Med., 314: 1, 1986.
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Snippet 冠動脈バイパス術における内胸動脈グラフトの使用増加に伴い,その術後狭窄に対するPTCAの報告がわずかながら行われている.症例は74歳の男性で,左主幹部完全閉塞と右冠動...
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Title 症例 内胸動脈バイパスグラフトに対するPTCAの1例
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