Okugi Satoshi, Azuma Takashi, Yokoi Yoshihiko, Domoto Satoru, Niinami Hiroshi
Department of Cardiovascular Surgery, The Tokyo Women's Medical University.
Ann Vasc Dis. 2020 Sep 25;13(3):326-329. doi: 10.3400/avd.cr.20-00032.
Recently, it has been reported that a fenestrated stent graft is an effective option in the treatment of pararenal artery abdominal aortic aneurysm. We report the case of a 72-year-old male patient with multiple aortic aneurysms in the distal arch, thoracoabdominal aorta, right common iliac artery, as well as a pararenal abdominal aortic aneurysm. The patient was found to have a mass with a tendency of rapid expansion within a month from its discovery. Because it was a saccular aneurysm with a tendency of rapid expansion and wide spread, the risk of rupture was judged to be high, and surgical treatment became necessary. One-stage treatment was desirable; therefore, endovascular treatment with a fenestrated stent graft was selected. Four fenestrations were made to a stent graft for the celiac artery, superior mesenteric artery, and bilateral renal arteries. The postoperative computed tomography (CT) showed no branch occlusion or endoleak, and the 2-year postoperative CT showed the shrinkage and subsequent disappearance of the aortic aneurysm at the treatment site. For extensive aortic aneurysm, including pararenal artery abdominal aortic aneurysms, one-stage treatment with fenestrated stent graft was considered to be effective as a treatment strategy. (This is a translation of Jpn J Vasc Surg 2020; 29: 9-13.).
最近，有报道称开窗支架型人工血管是治疗肾旁动脉腹主动脉瘤的一种有效选择。我们报告了一例72岁男性患者，其在主动脉弓远端、胸腹主动脉、右髂总动脉以及肾旁腹主动脉均存在多发动脉瘤。该患者被发现有一个肿物，自发现起在一个月内有快速增大的趋势。由于其为囊状动脉瘤且有快速增大和广泛扩展的趋势，判断破裂风险很高，因此有必要进行手术治疗。一期治疗是可取的；所以，选择了使用开窗支架型人工血管进行血管腔内治疗。对用于腹腔干动脉、肠系膜上动脉和双侧肾动脉的支架型人工血管制作了四个开窗。术后计算机断层扫描（CT）显示无分支闭塞或内漏，术后2年的CT显示治疗部位的主动脉瘤缩小并随后消失。对于包括肾旁动脉腹主动脉瘤在内的广泛主动脉瘤，使用开窗支架型人工血管进行一期治疗被认为是一种有效的治疗策略。（本文是对《日本血管外科学杂志》2020年；29：9 - 13的翻译。）
