弓部大動脈ステントグラフト留置術後の再手術におけるカラー付き人工血管を用いた再建の工夫
症例は83歳，女性．78歳時に他院で遠位弓部から下行に及ぶ胸部大動脈瘤に対し，右腋窩動脈から左総頸動脈および左腋窩動脈へのバイパス術とzone 1を中枢landingとする胸部大動脈ステントグラフト留置術（TEVAR）を施行された．遠隔期に中枢landing zoneが拡大し，type 1 endoleakによる瘤拡大を認めたため，人工血管置換術による再建を行った．術中所見では，中枢のステントグラフト径は40 mmであり，大動脈径は45 mmと拡大していたため，26 mmのカラー付き人工血管を用い，大動脈壁で覆ったステントグラフト中枢端に人工血管のカラー部分を吻合し，再建に成功した．...
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| Published in | 日本心臓血管外科学会雑誌 Vol. 50; no. 2; pp. 114 - 118 |
|---|---|
| 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
15.03.2021
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0285-1474 1883-4108 |
| DOI | 10.4326/jjcvs.50.114 |
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| Abstract | 症例は83歳，女性．78歳時に他院で遠位弓部から下行に及ぶ胸部大動脈瘤に対し，右腋窩動脈から左総頸動脈および左腋窩動脈へのバイパス術とzone 1を中枢landingとする胸部大動脈ステントグラフト留置術（TEVAR）を施行された．遠隔期に中枢landing zoneが拡大し，type 1 endoleakによる瘤拡大を認めたため，人工血管置換術による再建を行った．術中所見では，中枢のステントグラフト径は40 mmであり，大動脈径は45 mmと拡大していたため，26 mmのカラー付き人工血管を用い，大動脈壁で覆ったステントグラフト中枢端に人工血管のカラー部分を吻合し，再建に成功した． |
|---|---|
| AbstractList | 症例は83歳，女性．78歳時に他院で遠位弓部から下行に及ぶ胸部大動脈瘤に対し，右腋窩動脈から左総頸動脈および左腋窩動脈へのバイパス術とzone 1を中枢landingとする胸部大動脈ステントグラフト留置術（TEVAR）を施行された．遠隔期に中枢landing zoneが拡大し，type 1 endoleakによる瘤拡大を認めたため，人工血管置換術による再建を行った．術中所見では，中枢のステントグラフト径は40 mmであり，大動脈径は45 mmと拡大していたため，26 mmのカラー付き人工血管を用い，大動脈壁で覆ったステントグラフト中枢端に人工血管のカラー部分を吻合し，再建に成功した． |
| Author | 金光, ひでお 山崎, 和裕 湊谷, 謙司 牧浦, 琢朗 川東, 正英 境, 次郎 熊谷, 基之 坂本, 和久 武田, 崇秀 池田, 義 |
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| DOI | 10.4326/jjcvs.50.114 |
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| References | 4) Ahmad W, Mylonas S, Majd P et al. A current systematic evaluation and meta-analysis of chimney graft technology in aortic arch diseases. J Vasc Surg 2017 ; 66 : 1602-10 e2. 9) Coselli JS, Spiliotopoulos K, Preventza O et al. Open aortic surgery after thoracic endovascular aortic repair. Gen Thorac Cardiovasc Surg 2016 ; 64 : 441-9. 1) Dake MD, Miller DC, Semba CP et al. Transluminal placement of endovascular stent-grafts for the treatment of descending thoracic aortic aneurysms. N Engl J Med 1994 ; 331 : 1729-34. 7) Davidovic L, Sladojevic M, Koncar I et al. Late complication after thoracic endovascular aortic repair : what is the role of an open surgical conversion?. Ann Vasc Surg 2018 ; 47 : 238-46. 3) Andrasi TB, Grossmann M, Zenker D et al. Supra-aortic interventions for endovascular exclusion of the entire aortic arch. J Vasc Surg 2017 ; 66 : 281-97 e2. 12) Izumi C, Eishi K, Ashihara K et al. JCS/JSCS/JATS/JSVS 2020 guidelines on the management of valvular heart disease. Circ J 2020 ; 84 : 2037-119. 2) Desai ND, Burtch K, Moser W et al. Long-term comparison of thoracic endovascular aortic repair (TEVAR) to open surgery for the treatment of thoracic aortic aneurysms. J Thorac Cardiovasc Surg 2012 ; 144 : 604-9 ; discussion 9-11. 8) Joo HC, Kwon JH, Kim JH et al. Late open conversion after thoracic endovascular aortic repair. J Vasc Surg 2019 ; 70 : 439-48 e1. 11) Jassar A, Kreibich M, Morlock J et al. Aortic replacement after TEVAR-diameter correction with modified use of the siena prosthesis. Ann Thorac Surg 2018 ; 105 : 587-91. 6) Inoue K, Hosokawa H, Iwase T et al. Aortic arch reconstruction by transluminally placed endovascular branched stent graft. Circulation 1999 ; 100 : Ii316-21. 10) Roselli EE, Abdel-Halim M, Johnston DR et al. Open aortic repair after prior thoracic endovascular aortic repair. Ann Thorac Surg 2014 ; 97 : 750-6. 13) Cohen RG, Bourne ET. Industry-generated charts for the selection of stented aortic valve prostheses : clinical tool or marketing ploy?. Ann Thorac Surg 2011 ; 91 : 1001-2. 5) Kawaguchi S, Yokoi Y, Shimazaki T et al. Thoracic endovascular aneurysm repair in Japan : experience with fenestrated stent grafts in the treatment of distal arch aneurysms. J Vasc Surg 2008 ; 48 : 24S-9S ; discussion 9S. |
| References_xml | – reference: 6) Inoue K, Hosokawa H, Iwase T et al. Aortic arch reconstruction by transluminally placed endovascular branched stent graft. Circulation 1999 ; 100 : Ii316-21. – reference: 9) Coselli JS, Spiliotopoulos K, Preventza O et al. Open aortic surgery after thoracic endovascular aortic repair. Gen Thorac Cardiovasc Surg 2016 ; 64 : 441-9. – reference: 13) Cohen RG, Bourne ET. Industry-generated charts for the selection of stented aortic valve prostheses : clinical tool or marketing ploy?. Ann Thorac Surg 2011 ; 91 : 1001-2. – reference: 5) Kawaguchi S, Yokoi Y, Shimazaki T et al. Thoracic endovascular aneurysm repair in Japan : experience with fenestrated stent grafts in the treatment of distal arch aneurysms. J Vasc Surg 2008 ; 48 : 24S-9S ; discussion 9S. – reference: 7) Davidovic L, Sladojevic M, Koncar I et al. Late complication after thoracic endovascular aortic repair : what is the role of an open surgical conversion?. Ann Vasc Surg 2018 ; 47 : 238-46. – reference: 1) Dake MD, Miller DC, Semba CP et al. Transluminal placement of endovascular stent-grafts for the treatment of descending thoracic aortic aneurysms. N Engl J Med 1994 ; 331 : 1729-34. – reference: 8) Joo HC, Kwon JH, Kim JH et al. Late open conversion after thoracic endovascular aortic repair. J Vasc Surg 2019 ; 70 : 439-48 e1. – reference: 2) Desai ND, Burtch K, Moser W et al. Long-term comparison of thoracic endovascular aortic repair (TEVAR) to open surgery for the treatment of thoracic aortic aneurysms. J Thorac Cardiovasc Surg 2012 ; 144 : 604-9 ; discussion 9-11. – reference: 10) Roselli EE, Abdel-Halim M, Johnston DR et al. Open aortic repair after prior thoracic endovascular aortic repair. Ann Thorac Surg 2014 ; 97 : 750-6. – reference: 3) Andrasi TB, Grossmann M, Zenker D et al. Supra-aortic interventions for endovascular exclusion of the entire aortic arch. J Vasc Surg 2017 ; 66 : 281-97 e2. – reference: 12) Izumi C, Eishi K, Ashihara K et al. JCS/JSCS/JATS/JSVS 2020 guidelines on the management of valvular heart disease. Circ J 2020 ; 84 : 2037-119. – reference: 4) Ahmad W, Mylonas S, Majd P et al. A current systematic evaluation and meta-analysis of chimney graft technology in aortic arch diseases. J Vasc Surg 2017 ; 66 : 1602-10 e2. – reference: 11) Jassar A, Kreibich M, Morlock J et al. Aortic replacement after TEVAR-diameter correction with modified use of the siena prosthesis. Ann Thorac Surg 2018 ; 105 : 587-91. |
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| SubjectTerms | TEVAR後再手術 カラー付人工血管 |
| Title | 弓部大動脈ステントグラフト留置術後の再手術におけるカラー付き人工血管を用いた再建の工夫 |
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