外腸骨動脈破裂を合併したA型急性大動脈解離
A型急性大動脈解離に外腸骨動脈破裂を併発したきわめて稀な1例を経験した．症例は67歳・男性．突然の胸痛を訴え他院へ救急搬送となった，CT検査で急性大動脈解離と診断され，当院へ搬送された．CT画像では上行大動脈から両側腸骨動脈に及ぶ解離と左外腸骨動脈周囲に血腫を認め，左外腸骨動脈破裂を合併したA型急性大動脈解離と診断した．破裂に対してまず血管内治療（ステントグラフト内挿術）を行い，患者家族にリスクを説明した上で，一期的には治療せず翌日に上行大動脈置換を行った．患者は耐術し術後39日目にリハビリ病院へ転院となった．...
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| Published in | 日本心臓血管外科学会雑誌 Vol. 53; no. 3; pp. 147 - 150 |
|---|---|
| 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
15.05.2024
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0285-1474 1883-4108 |
| DOI | 10.4326/jjcvs.53.147 |
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| Abstract | A型急性大動脈解離に外腸骨動脈破裂を併発したきわめて稀な1例を経験した．症例は67歳・男性．突然の胸痛を訴え他院へ救急搬送となった，CT検査で急性大動脈解離と診断され，当院へ搬送された．CT画像では上行大動脈から両側腸骨動脈に及ぶ解離と左外腸骨動脈周囲に血腫を認め，左外腸骨動脈破裂を合併したA型急性大動脈解離と診断した．破裂に対してまず血管内治療（ステントグラフト内挿術）を行い，患者家族にリスクを説明した上で，一期的には治療せず翌日に上行大動脈置換を行った．患者は耐術し術後39日目にリハビリ病院へ転院となった． |
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| AbstractList | A型急性大動脈解離に外腸骨動脈破裂を併発したきわめて稀な1例を経験した．症例は67歳・男性．突然の胸痛を訴え他院へ救急搬送となった，CT検査で急性大動脈解離と診断され，当院へ搬送された．CT画像では上行大動脈から両側腸骨動脈に及ぶ解離と左外腸骨動脈周囲に血腫を認め，左外腸骨動脈破裂を合併したA型急性大動脈解離と診断した．破裂に対してまず血管内治療（ステントグラフト内挿術）を行い，患者家族にリスクを説明した上で，一期的には治療せず翌日に上行大動脈置換を行った．患者は耐術し術後39日目にリハビリ病院へ転院となった． |
| Author | 波里, 陽介 内藤, 敬嗣 中村, 優飛 髙木, 寿人 森, 久弥 |
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| References | 9) Iwakoshi S, Irie Y, Katada Y et al. Comparison of outcomes and complications among patients with different indications of acute/subacute complicated stanford type B aortic dissection treated by TEVAR: data from the JaPanese REtrospective multicenter stuDy of ThoracIc Endovascular Aortic Repair for Complicated Type B Aortic Dissection (J-Predictive Study). Cardiovasc Intervent Radiol 2022; 45: 290-7. 3) Tamura K, Kihara K, Chikazawa G et al. A case of dissection and rupture of the innominate artery in acute type A aortic dissection. Ann Vasc Dis 2016; 9: 117-9. 7) Wilson-Smith AR, Muston B, Kamalanathan H et al. Endovascular repair of acute complicated type B aortic dissection-systematic review and meta-analysis of long-term survival and reintervention. Ann Cardiothorac Surg 2021; 10: 723-30. 10) Bonamigo TP, Becker M, Weber EL et al. Outcome after surgical repair of sealed rupture abdominal aortic aneurysms: a case-control study. Clinics (Sao Paulo) 2006; 61: 29-34. 2) Zeraatian Nejad Davani S, Gholizadeh Mesgarha M, Talebi A et al. Successful liver and kidneys transplant following aortic dissection and subclavian artery rupture: a case report. Int J Surg Case Rep 2022; 98: 107526. 1) Harris KM, Nienaber CA, Peterson MD et al. Early mortality in type A acute aortic dissection: insights from the international registry of acute aortic dissection. JAMA Cardiol 2022; 7: 1009-15. 4) Kaul P, George R, Paniagua R et al. Innominate truncal dissection and rupture into right pleural cavity following acute type A dissection of the aorta with right coronary ostial avulsion and inferior STEMI. Perfusion 2011; 26: 435-40. 8) Luebke T, Brunkwall J. Outcome of patients with open and endovascular repair in acute complicated type B aortic dissection: a systematic review and meta-analysis of case series and comparative studies. J Cardiovasc Surg (Torino) 2010; 51: 613-32. 5) Lauterbach SR, Farber A, Shortell CK. Acute aortic dissection presenting as rupture of the femoral artery. Ann Vasc Surg 2004; 18: 11-3. 6) Singh RS, Danikas D, Goldenkranz R. Type B aortic dissection with rupture of the left common iliac artery: a case report. Am Surg 2002; 68: 49-51. |
| References_xml | – reference: 2) Zeraatian Nejad Davani S, Gholizadeh Mesgarha M, Talebi A et al. Successful liver and kidneys transplant following aortic dissection and subclavian artery rupture: a case report. Int J Surg Case Rep 2022; 98: 107526. – reference: 9) Iwakoshi S, Irie Y, Katada Y et al. Comparison of outcomes and complications among patients with different indications of acute/subacute complicated stanford type B aortic dissection treated by TEVAR: data from the JaPanese REtrospective multicenter stuDy of ThoracIc Endovascular Aortic Repair for Complicated Type B Aortic Dissection (J-Predictive Study). Cardiovasc Intervent Radiol 2022; 45: 290-7. – reference: 1) Harris KM, Nienaber CA, Peterson MD et al. Early mortality in type A acute aortic dissection: insights from the international registry of acute aortic dissection. JAMA Cardiol 2022; 7: 1009-15. – reference: 3) Tamura K, Kihara K, Chikazawa G et al. A case of dissection and rupture of the innominate artery in acute type A aortic dissection. Ann Vasc Dis 2016; 9: 117-9. – reference: 5) Lauterbach SR, Farber A, Shortell CK. Acute aortic dissection presenting as rupture of the femoral artery. Ann Vasc Surg 2004; 18: 11-3. – reference: 8) Luebke T, Brunkwall J. Outcome of patients with open and endovascular repair in acute complicated type B aortic dissection: a systematic review and meta-analysis of case series and comparative studies. J Cardiovasc Surg (Torino) 2010; 51: 613-32. – reference: 7) Wilson-Smith AR, Muston B, Kamalanathan H et al. Endovascular repair of acute complicated type B aortic dissection-systematic review and meta-analysis of long-term survival and reintervention. Ann Cardiothorac Surg 2021; 10: 723-30. – reference: 10) Bonamigo TP, Becker M, Weber EL et al. Outcome after surgical repair of sealed rupture abdominal aortic aneurysms: a case-control study. Clinics (Sao Paulo) 2006; 61: 29-34. – reference: 6) Singh RS, Danikas D, Goldenkranz R. Type B aortic dissection with rupture of the left common iliac artery: a case report. Am Surg 2002; 68: 49-51. – reference: 4) Kaul P, George R, Paniagua R et al. Innominate truncal dissection and rupture into right pleural cavity following acute type A dissection of the aorta with right coronary ostial avulsion and inferior STEMI. Perfusion 2011; 26: 435-40. |
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| Title | 外腸骨動脈破裂を合併したA型急性大動脈解離 |
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