Four cases of ruptured abdominal aortic aneurysm treated by emergent endovascular aortic repair

緊急ステントグラフト内挿術で治療した破裂性腹部大動脈瘤の4例について報告する.年齢は60~90歳,男性3例,女性1例であった.術前Rutherford分類はレベﾙ1が1例,レベﾙ2が2例,レベル3が1例,Fitzgerald分類はII型1例,III型3例であった.EVARの術前評価は,2例では紹介医からの単純CTのみで,2例では造影CTでなされた.来院から手術までの時間は119±48分,全例にゴア社製エクスクルーダーが留置された.手術時間は212±93分,出血量は169±197gであった.3例はエンドリーｸなく経過したが,1例は早期にtypeⅠbエンドリークによる再破裂をきたし,瘤切除･人工血管置換術が行われた.90歳の高齢の1例を失ったが,3例は社会復帰している.

We have experienced 4 cases of endovascular repair for a ruptured abdominal aortic aneurysm. The patients were from 60 to 90 years old. The study population comprised 3 men, and 1 woman. The pre-operative Rutherford classification was level 1 for 1 patient, level 2 for 2 patients, and level 3 for 1 patient. The Fitzgerald classification was type II for 1 patient, and type III for 3 patients. CT angiography was performed for 2 patients, and only plain CT had been performed for the other 2 patients at the previous hospital. The median time interval from arrival at the hospital to the time the operation was performed was 119 ± 48 minutes. For all the patients, the endovascular repair operations were performed using the Gore Excluder device. The median operative time was 212 ± 93 minutes, and the blood loss was 169 ± 197 g. In 3 cases, there was no endoleak

破裂性腹部大動脈瘤

緊急ステントグラフト内挿術