冠動脈バイパス術後の膝窩動脈内膜摘除術の1例
74歳男性．右下肢閉塞性動脈硬化症および足部難治性皮膚潰瘍で当科紹介となった．下肢血管造影で膝関節部に限局した膝窩動脈閉塞ならびに下腿動脈閉塞病変を認めた．術前精査で心機能低下ならびに冠動脈病変が判明したため，冠動脈バイパスを先行し，2期的に下肢血行再建の方針とした．バイパスに適した自家静脈が欠如しており，後方アプローチによる膝窩動脈内膜摘除および静脈パッチ形成術を施行した．足部潰瘍は治癒し，術後1年の経過は良好である．...
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| Published in | 日本心臓血管外科学会雑誌 Vol. 51; no. 3; pp. 183 - 186 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本心臓血管外科学会
15.05.2022
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0285-1474 1883-4108 |
| DOI | 10.4326/jjcvs.51.183 |
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| Abstract | 74歳男性．右下肢閉塞性動脈硬化症および足部難治性皮膚潰瘍で当科紹介となった．下肢血管造影で膝関節部に限局した膝窩動脈閉塞ならびに下腿動脈閉塞病変を認めた．術前精査で心機能低下ならびに冠動脈病変が判明したため，冠動脈バイパスを先行し，2期的に下肢血行再建の方針とした．バイパスに適した自家静脈が欠如しており，後方アプローチによる膝窩動脈内膜摘除および静脈パッチ形成術を施行した．足部潰瘍は治癒し，術後1年の経過は良好である． |
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| AbstractList | 74歳男性．右下肢閉塞性動脈硬化症および足部難治性皮膚潰瘍で当科紹介となった．下肢血管造影で膝関節部に限局した膝窩動脈閉塞ならびに下腿動脈閉塞病変を認めた．術前精査で心機能低下ならびに冠動脈病変が判明したため，冠動脈バイパスを先行し，2期的に下肢血行再建の方針とした．バイパスに適した自家静脈が欠如しており，後方アプローチによる膝窩動脈内膜摘除および静脈パッチ形成術を施行した．足部潰瘍は治癒し，術後1年の経過は良好である． |
| Author | 松本, 春信 山本, 貴裕 佐藤, 哲也 橋本, 和憲 伊藤, 智 |
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| References | 5) Babalik E, Gülbaran M, Gürmen T et al. Fracture of popliteal artery stents. Circ J 2003 ; 67 : 643-5. 11) Mills JL Sr, Conte MS, Armstrong DG et al. The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System : risk stratification based on wound, ischemia, and foot infection (WIfI). J Vasc Surg 2014 ; 59 : 220-34. 2) Abbas M, Claydon M, Ponosh S et al. Open endarterectomy of the SPT segment : an experience. Ann Vasc Surg 2007 ; 21 : 39-44. 9) Farkouh ME, Rihal CS, Gersh BJ et al. Influence of coronary heart disease on morbidity and mortality after lower extremity revascularization surgery : a population-based study in Olmsted County, Minnesota (1970-1987). J Am Coll Cardiol 1994 ; 24 : 1290-6. 10) Kimura N, Nonaka T, Matsumoto H. Treatment strategy of coronary artery disease in patients with peripheral artery disease. Jpn Coron Assoc 2018 ; 24 : 119-24. 3) Aboyans V, Ricco JB, Bartelink MEL et al. 2017 ESC Guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS) : document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries endorsed by : the European Stroke Organization (ESO) The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J 2018 ; 39 : 763-816. 4) Soga Y, Tomoi Y, Sato K et al. Clinical outcome after endovascular treatment for isolated common femoral and popliteal artery disease. Cardiovasc Interv Ther 2013 ; 28 : 250-7. 7) Inahara T, Toledo AC. Endarterectomy of the popliteal artery for segmental occlusive disease. Ann Surg 1978 ; 188 : 43-8. 8) Valentine RJ, Wind GG. Anatomic Exposures in Vascular Surgery. 4th ed. Philadelphia : Wolters Kluwer Health ; 2020, pp 464-7. 6) Kumar N, Verma R, Krishna V. Open endarterectomy in short atherosclerotic occlusion of the popliteal artery. Indian J Thorac Cardiovasc Surg 2013 ; 29 : 230e4. 1) Nasr H, Hobbs S, Abrew C et al. Popliteal endarterectomy for localized popliteal artery disease. Ann Vasc Surg 2015 ; 291 : 50-4. |
| References_xml | – reference: 5) Babalik E, Gülbaran M, Gürmen T et al. Fracture of popliteal artery stents. Circ J 2003 ; 67 : 643-5. – reference: 7) Inahara T, Toledo AC. Endarterectomy of the popliteal artery for segmental occlusive disease. Ann Surg 1978 ; 188 : 43-8. – reference: 11) Mills JL Sr, Conte MS, Armstrong DG et al. The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System : risk stratification based on wound, ischemia, and foot infection (WIfI). J Vasc Surg 2014 ; 59 : 220-34. – reference: 8) Valentine RJ, Wind GG. Anatomic Exposures in Vascular Surgery. 4th ed. Philadelphia : Wolters Kluwer Health ; 2020, pp 464-7. – reference: 2) Abbas M, Claydon M, Ponosh S et al. Open endarterectomy of the SPT segment : an experience. Ann Vasc Surg 2007 ; 21 : 39-44. – reference: 6) Kumar N, Verma R, Krishna V. Open endarterectomy in short atherosclerotic occlusion of the popliteal artery. Indian J Thorac Cardiovasc Surg 2013 ; 29 : 230e4. – reference: 10) Kimura N, Nonaka T, Matsumoto H. Treatment strategy of coronary artery disease in patients with peripheral artery disease. Jpn Coron Assoc 2018 ; 24 : 119-24. – reference: 3) Aboyans V, Ricco JB, Bartelink MEL et al. 2017 ESC Guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS) : document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries endorsed by : the European Stroke Organization (ESO) The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J 2018 ; 39 : 763-816. – reference: 1) Nasr H, Hobbs S, Abrew C et al. Popliteal endarterectomy for localized popliteal artery disease. Ann Vasc Surg 2015 ; 291 : 50-4. – reference: 4) Soga Y, Tomoi Y, Sato K et al. Clinical outcome after endovascular treatment for isolated common femoral and popliteal artery disease. Cardiovasc Interv Ther 2013 ; 28 : 250-7. – reference: 9) Farkouh ME, Rihal CS, Gersh BJ et al. Influence of coronary heart disease on morbidity and mortality after lower extremity revascularization surgery : a population-based study in Olmsted County, Minnesota (1970-1987). J Am Coll Cardiol 1994 ; 24 : 1290-6. |
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| SubjectTerms | 下肢閉塞性動脈硬化症 内膜摘除術 膝窩動脈閉塞 |
| Title | 冠動脈バイパス術後の膝窩動脈内膜摘除術の1例 |
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