CASE REPORT OF TRANSCATHETER COIL EMBOLIZATION FOR AN ISOLATED COMMON ILIAC ARTERIAL ANEURYSM

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  • 孤立性総腸骨動脈瘤に対する経皮的動脈塞栓術の1例

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Abstract

A senile patient with chronic obstructive lung disease (COLD) who had an impending ruptured aneurysm of the left common iliac artery was successfuly treated with percutaneous transcatheter embolization and femoro-femoral bypass operation. An 82-year-old man, complaining of a pain of the outer surface of the thigh and left lower abdominal pain, was admitted to the hospital for distally weakneing pulsation of the left femoral artery. CT scan, ultrasonography and DSA revealed a large saccular (5×4cm) aneurysm in the left common iliac artery and occluded left external iliac artery. On the 3rd hospital day the patient was operated because of his risky COLD. Under the spinal anesthesia, a catheter was inserted into the left brachial artery and sequentially introduced into the left common iliac artery and internal iliac artery. Gelfoam emboli was introduced into the each artery following coil embolization and immediately a femorofemoral bypass operation using 8mm ringed thin wall EPTFE was done from the left common femoral artery to the right common femoral artery. Though the pain of the left upper thigh and fever persisted, all symptoms disappeared about one month after the operation when CT and DSA revealed completely thrombed aneurysm. For the high risk cases in senile patients with solitaly iliac arterial aneurysms, graft replacement combined with percutaneous transcatheter embolization is very effective.

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