Powerlink 内挿1 年目に脚狭窄に伴う右下肢血流障害に対し血管内治療を要した1 例  [in Japanese] A Case of Limb Stenosis after Endovascular Abdominal Aneurysm Repair with Powerlink<sup>®</sup>  [in Japanese]

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Author(s)

    • 岡 克彦 Oka Katsuhiko
    • 京都府立医科大学心臓血管外科学|京都府立医科大学心臓血管低侵襲治療学 Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine|Department of Minimally Invasive Cardiovascular Surgery, Kyoto Prefectural University of Medicine
    • 坂井 修 Sakai Osamu
    • 京都府立医科大学心臓血管外科学|京都府立医科大学心臓血管低侵襲治療学 Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine|Department of Minimally Invasive Cardiovascular Surgery, Kyoto Prefectural University of Medicine
    • 渡辺 太治 Watanabe Taiji
    • 京都府立医科大学心臓血管外科学 Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine
    • 神田 圭一 Kanda Keiichi
    • 京都府立医科大学心臓血管外科学 Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine
    • 夜久 均 Yaku Hitoshi
    • 京都府立医科大学心臓血管外科学 Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine

Abstract

要旨:腹部大動脈分岐部が細い囊状腹部動脈瘤に対して,Powerlink<sup>®</sup> を用いたEVAR 施行1 年後に脚狭窄を来し,再治療を要した1 例を経験したので報告する.症例は67 歳,男性.終末部腹部大動脈径が細い囊状腹部大動脈瘤に対して,Powerlink<sup>®</sup> を用いたEVAR を施行.術後1 年後に,右下肢の跛行症状を訴えて再入院した.右ABI は0.66 と低下し,CT ではステントグラフト右脚が,細い腹部大動脈終末部で左脚による圧排を受け狭窄していた.Metallic stent による血管内治療で狭窄を解除し,右ABI は1.19 と改善した.再手術後24 カ月経過した現在,再狭窄やABI の低下なく経過している.囊状動脈瘤や終末部腹部大動脈径が細い症例に対しては,脚狭窄を生じにくいPowerlink<sup>®</sup> が良い適応であるといわれているが,大動脈終末部に確実に騎乗できない際には脚狭窄を生じる可能性があり,注意が必要である.

A 67-year-old man who had a saccular abdominal aortic aneurysm (AAA) with narrow terminal aorta was underwent endovascular aortic aneurysm repair (EVAR) by Endologix Powerlink<sup>®</sup>. He complained ischemic right leg pain, one year after EVAR. The computed tomography showed stenosis of Powerlink<sup>®</sup> right limb. The right limb was compressed by the left limb of Powerlink<sup>®</sup> at narrow terminal aorta. We performed re-intervention to dilate narrow terminal aorta with Palmatz XL stent<sup>®</sup> (Cordis) and bilateral limbs with kissing stenting of Express Vascular LD<sup>®</sup> (Boston Scientific). After operation his ankle brachial pressure index arise from 0.66 to 1.19. Powerlink<sup>®</sup> is said that hard to complicate limb stenosis even if narrow terminal aorta case due to its sit on the bifurcation of aorta system. Even through, careful observation is needed at quit narrow terminal aorta cases, which may happen not to sit on stentgraft main body at terminal aorta.

Journal

  • Japanese Journal of Vascular Surgery

    Japanese Journal of Vascular Surgery 24(1), 31-35, 2015

    JAPANESE SOCIETY FOR VASCULAR SURGERY

Codes

  • NII Article ID (NAID)
    130004843172
  • Text Lang
    JPN
  • ISSN
    0918-6778
  • Data Source
    J-STAGE 
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