ステント補助下コイル塞栓術を施行した左鎖骨下仮性動脈瘤の１例

概要

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A patient in his 70s with symptoms of hoarseness and left upper chest pain was admitted to our hospital and was diagnosed with pseudoaneurysm of the left subclavian artery, induced by the arterial wall invasion of metastasis from an unknown primary malignant tumor. The maximum diameter of the pseudoaneurysm was 5.5cm, and more than 60% of the left common carotid artery stenosis was caused by compression from the pseudoaneurysm. The surgical repair of the left subclavian pseudoaneurysm was considered to be difficult by cardiovascular surgeons and intolerable for the patient, whose general condition was poor. Therefore, a minimally invasive endovascular repair with stent-assisted coil embolization was chosen. By trans-femoral and brachial approaches, the wide-neck of the pseudoaneurysm was initially covered by the bare stent, and subsequently trans-stent coiling of the aneurysm cavity was performed. Although complete embolization of the aneurysm cavity could not be achieved, the left chest pain was relieved and there was no sign of further growth or rupture of the pseudoaneurysm one month after the treatment. This technique can be used as one of the treatment options for the repair of symptomatic subclavian artery pseudoaneurysm in a patient with intolerance for invasive open surgery.
一般社団法人日本インターベンショナルラジオロジー学会の論文