Matsumoto Takuya
Department of Vascular Surgery, Graduate School of Medical Sciences, International University of Health and Welfare, Narita, Chiba, Japan.
Ann Vasc Dis. 2019 Sep 25;12(3):329-333. doi: 10.3400/avd.ra.19-00077.
In 2006, commercially produced endovascular aneurysm repair (EVAR) devices were approved by the Japanese Ministry of Health, Labour and Welfare, and their cost began to be covered by Japanese medical insurance. Meanwhile, the number of juxtarenal abdominal aortic aneurysms (AAA) to need the suprarenal clamp are increasing and the number of infra-renal AAAs are decreasing for open repair. In this era when EVAR has been growing rapidly for 11 years, it is a good opportunity to learn the surgical repair of AAA. I review the basic and advanced anatomy and physiology concepts which are needed for abdominal aortic repair, which are the proximal site (exposure of the proximal site, variation of renal arteries, variation of inferior vena cava and left renal vein, arcade of visceral branches of abdominal aorta, and coeliac plexus) and distal site (iliac artery, superior hypogastric plexus, ureter, inferior mesenteric artery, and lumbar arteries) separately. (This is a translation of Jpn J Vasc Surg 2019; 28: 173-177.).
2006年，商业生产的血管内动脉瘤修复（EVAR）装置获得日本厚生劳动省批准，其费用开始由日本医疗保险支付。与此同时，需要肾上钳夹的近肾腹主动脉瘤（AAA）数量在增加，而用于开放修复的肾下腹主动脉瘤数量在减少。在EVAR快速发展的11年这个时代，这是学习AAA手术修复的好机会。我分别回顾了腹主动脉修复所需的基础和高级解剖学及生理学概念，即近端部位（近端部位的暴露、肾动脉变异、下腔静脉和左肾静脉变异、腹主动脉内脏分支弓和腹腔丛）和远端部位（髂动脉、上腹下丛、输尿管、肠系膜下动脉和腰动脉）。（这是对《日本血管外科学杂志》2019年；28: 173 - 177的翻译。）
