スタンフォードB型急性大動脈解離に対する緊急胸部ステントグラフト挿入症例の検討
症例1は55歳男性。他地域で急性大動脈解離B型を発症し転送され，真腔の高度狭窄，腹腔および上腸間膜動脈の血流低下を認めた。ステントグラフト挿入（TEVAR）後，血流は回復したが，臓器障害にて血液浄化，透析を施行した。症例2は68歳女性。胸背部痛にて他院にてCT中に胸腔内への破裂を認め緊急搬送し，TEVARにて救命した。救命率向上には患者搬送と最適デバイスを早期に準備する体制整備が重要である。...
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| Published in | 脈管学 Vol. 58; no. 5; pp. 85 - 89 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本脈管学会
10.05.2018
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0387-1126 1880-8840 |
| DOI | 10.7133/jca.18-00010 |
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| Abstract | 症例1は55歳男性。他地域で急性大動脈解離B型を発症し転送され，真腔の高度狭窄，腹腔および上腸間膜動脈の血流低下を認めた。ステントグラフト挿入（TEVAR）後，血流は回復したが，臓器障害にて血液浄化，透析を施行した。症例2は68歳女性。胸背部痛にて他院にてCT中に胸腔内への破裂を認め緊急搬送し，TEVARにて救命した。救命率向上には患者搬送と最適デバイスを早期に準備する体制整備が重要である。 |
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| AbstractList | 症例1は55歳男性。他地域で急性大動脈解離B型を発症し転送され，真腔の高度狭窄，腹腔および上腸間膜動脈の血流低下を認めた。ステントグラフト挿入（TEVAR）後，血流は回復したが，臓器障害にて血液浄化，透析を施行した。症例2は68歳女性。胸背部痛にて他院にてCT中に胸腔内への破裂を認め緊急搬送し，TEVARにて救命した。救命率向上には患者搬送と最適デバイスを早期に準備する体制整備が重要である。 |
| Author | 大谷, 則史 赤坂, 伸之 菊池, 悠太 國岡, 信吾 |
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| Copyright | 2018 一般社団法人日本脈管学会 |
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| References | 8) Wilkinson DA, Patel HJ, Williams DM, et al: Early open and endovascular thoracic aortic repair for complicated type B aortic dissection. Ann Thorac Surg 2013; 96: 23–30; discussion, 230 10) Alsac JM, Girault A, El Batti S, et al: Experience of the Zenith Dissection Endovascular System in the emergency setting of malperfusion in acute type B dissections. J Vasc Surg 2014; 59: 645–650 9) Andersen LW, Mackenhauer J, Roberts JC, et al: Etiology and therapeutic approach to elevated lactate. Mayo Clin Proc 2013; 88: 1127–1140 3) Fattori R, Tsai TT, Myrmel T, et al: Complicated acute type B dissection: is surgery still the best option?: a report from the International Registry of Acute Aortic Dissection. J Am Coll Cardiol Intv 2008; 1: 395–402 7) Ma T, Dong ZH, Fu WG, et al: Incidence and risk factors for retrograde type A dissection and stent graft-induced new entry after thoracic endovascular aortic repair. J Vasc Surg 2018; 67: 1026–1033 4) Miyairi,T, Motomura N, Takamoto S, et al: Influence of timing after thoracic endovascular aortic repair for acute type B aortic dissection. Ann Thorac Surg; Accessepted 1) Trimarchi S, Nienaber CA, Rampoldi V, et al; IRAD Investigators: Role and results of surgery in acute type B aortic dissection: insights from the International Registry of Acute Aortic Dissection (IRAD). Circulation 2006; 114 Suppl: I357–I364 2) Fattori R, Cao P, De Rango P, et al: Interdisciplinary expert consensus document on management of type B aortic dissection. J Am Coll Cardiol 2013; 61: 1661–1678 5) Slonim SM, Miller DC, Mitchell RS, et al: Percutaneous balloon fenestration and stenting for life-threatening ischemic complications in patients with acute aortic dissection. J Thorac Cardiovasc Surg 1999; 117: 1118–1126 6) 饗場正宏，川田忠典，丸田一人，他：臓器虚血を伴った急性大動脈解離に対する外科治療．日血外会誌2003; 12: 581–586 |
| References_xml | – reference: 8) Wilkinson DA, Patel HJ, Williams DM, et al: Early open and endovascular thoracic aortic repair for complicated type B aortic dissection. Ann Thorac Surg 2013; 96: 23–30; discussion, 230 – reference: 10) Alsac JM, Girault A, El Batti S, et al: Experience of the Zenith Dissection Endovascular System in the emergency setting of malperfusion in acute type B dissections. J Vasc Surg 2014; 59: 645–650 – reference: 1) Trimarchi S, Nienaber CA, Rampoldi V, et al; IRAD Investigators: Role and results of surgery in acute type B aortic dissection: insights from the International Registry of Acute Aortic Dissection (IRAD). Circulation 2006; 114 Suppl: I357–I364 – reference: 2) Fattori R, Cao P, De Rango P, et al: Interdisciplinary expert consensus document on management of type B aortic dissection. J Am Coll Cardiol 2013; 61: 1661–1678 – reference: 5) Slonim SM, Miller DC, Mitchell RS, et al: Percutaneous balloon fenestration and stenting for life-threatening ischemic complications in patients with acute aortic dissection. J Thorac Cardiovasc Surg 1999; 117: 1118–1126 – reference: 9) Andersen LW, Mackenhauer J, Roberts JC, et al: Etiology and therapeutic approach to elevated lactate. Mayo Clin Proc 2013; 88: 1127–1140 – reference: 7) Ma T, Dong ZH, Fu WG, et al: Incidence and risk factors for retrograde type A dissection and stent graft-induced new entry after thoracic endovascular aortic repair. J Vasc Surg 2018; 67: 1026–1033 – reference: 4) Miyairi,T, Motomura N, Takamoto S, et al: Influence of timing after thoracic endovascular aortic repair for acute type B aortic dissection. Ann Thorac Surg; Accessepted – reference: 6) 饗場正宏，川田忠典，丸田一人，他：臓器虚血を伴った急性大動脈解離に対する外科治療．日血外会誌2003; 12: 581–586 – reference: 3) Fattori R, Tsai TT, Myrmel T, et al: Complicated acute type B dissection: is surgery still the best option?: a report from the International Registry of Acute Aortic Dissection. J Am Coll Cardiol Intv 2008; 1: 395–402 |
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| Title | スタンフォードB型急性大動脈解離に対する緊急胸部ステントグラフト挿入症例の検討 |
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