Gluteal Blood Flow Monitoring in Endovascular Aneurysm Repair With Internal Iliac Artery Embolization

• Fujioka Shunichiro

  Department of Cardiovascular Surgery, Kitasato University School of Medicine

• Kitamura Tadashi

  Department of Cardiovascular Surgery, Kitasato University School of Medicine

• Mishima Toshiaki

  Department of Cardiovascular Surgery, Kitasato University School of Medicine

• Nakajima Riko

  Department of Cardiovascular Surgery, Kitasato University School of Medicine

• Tamura Yoshimi

  Department of Cardiovascular Surgery, Kitasato University School of Medicine

• Horikoshi Rihito

  Department of Cardiovascular Surgery, Kitasato University School of Medicine

• Araki Haruna

  Department of Cardiovascular Surgery, Kitasato University School of Medicine

• Yakuwa Kazuki

  Department of Cardiovascular Surgery, Kitasato University School of Medicine

• Tomoyasu Takahiro

  Department of Cardiovascular Surgery, Kitasato University School of Medicine

• Okamura Toru

  Department of Cardiovascular Surgery, Kitasato University School of Medicine

• Miyamoto Takashi

  Department of Cardiovascular Surgery, Kitasato University School of Medicine

• Torii Shinzo

  Department of Cardiovascular Surgery, Kitasato University School of Medicine

• Miyaji Kagami

  Department of Cardiovascular Surgery, Kitasato University School of Medicine

抄録

Background:When an internal iliac artery (IIA) has to be embolized during endovascular aneurysm repair (EVAR), buttock claudication sometimes poses problems. However, there is no established method to evaluate intraoperative blood flow to the gluteal muscles. Methods and Results:Gluteal regional oxygen saturation (rSO₂) was monitored using near-infrared spectroscopy (NIRS) during surgery, and changes in rSO₂were compared with treatment results. Twenty-seven patients who underwent EVAR and IIA embolization at our institution between April 2019 and May 2020 were included in this study. The association between intraoperative changes in rSO₂and postoperative incidence of buttock claudication was analyzed. Furthermore, the presence or absence of communication between the superior and inferior gluteal arteries and the intraoperative changes in rSO₂were compared to ascertain whether rSO₂reflects blood flow change. Postoperative buttock claudication occurred in 4 of 19 patients (21%) with unilateral occlusion of IIA and in 4 of 8 patients (50%) with bilateral occlusion of IIAs. rSO₂was found to decrease significantly further in patients with buttock claudication than in patients without buttock claudication (−15±12% vs. −4±16%, P<0.05). In addition, rSO₂was predominantly lower in patients without the communication between the superior and inferior gluteal arteries than in those with the communication. Conclusions:Gluteal rSO₂is useful as an indicator of intraoperative gluteal blood flow.

収録刊行物

• Circulation Journal

  Circulation Journal 85 (4), 345-350, 2021-03-25

  一般社団法人 日本循環器学会

キーワード

• Abdominal aortic aneurysm
• Buttock claudication
• Claudication
• Endovascular repair
• Regional oxygen saturation

詳細情報

• CRID: 1390287462800284544
• NII論文ID: 130008003048
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.cj-20-1002
• ISSN: 13474820
• ISSN: 13469843
• NDL書誌ID: 031363874
• PubMed: 33597321
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I031363874
• Web Site: https://www.jstage.jst.go.jp/article/circj/85/4/85_CJ-20-1002/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2021326852
• 本文言語コード: en
• データソース種別:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可