Fujiwara Keishi, Ogawa Yukihisa, Murakami Kenji, Arai Yasunori, Nishimaki Hiroshi, Mimura Hidefumi, Nakajima Yasuo
Department of Radiology, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-Ku Kawasaki, Kanagawa, 216-8511, Japan.
Department of Cardiovascular Surgery, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-Ku Kawasaki, Kanagawa, 216-8511, Japan.
Cardiovasc Intervent Radiol. 2017 Sep;40(9):1469-1472. doi: 10.1007/s00270-017-1667-4. Epub 2017 May 9.
A 64-year-old man was scheduled to undergo endovascular aneurysm repair for an abdominal aortic aneurysm (AAA). Since preoperative computed tomography showed an AAA with common iliac artery and internal iliac artery (IIA) aneurysms, IIA embolization was scheduled. Embolization using a coil was supposed to be performed; however, the lateral sacral artery could not be selected. For this reason, IIA embolization using N-butyl-2-cyanoacrylate (NBCA) was undertaken. During embolization, the median sacral artery was unexpectedly embolized through the lateral sacral artery. The patient complained of drop foot just after embolization; he was diagnosed with iatrogenic common peroneal nerve palsy. We have learned that sciatic nerve palsy can occur in cases of embolization with a liquid NBCA-Lipiodol mixture to the lateral or sacral median artery.
一名64岁男性计划接受腹主动脉瘤（AAA）的血管内动脉瘤修复术。由于术前计算机断层扫描显示为伴有髂总动脉和髂内动脉（IIA）动脉瘤的AAA，因此计划进行IIA栓塞。原本打算使用弹簧圈进行栓塞；然而，无法选择骶外侧动脉。因此，采用了使用N-丁基-2-氰基丙烯酸酯（NBCA）进行IIA栓塞。在栓塞过程中，骶正中动脉意外地通过骶外侧动脉被栓塞。栓塞后患者立即出现足下垂；他被诊断为医源性腓总神经麻痹。我们了解到，在使用液态NBCA-碘油混合物栓塞至骶外侧或骶正中动脉的情况下，可能会发生坐骨神经麻痹。
