大動脈解離による腹部分枝動脈狭窄に対してステント治療を施行した4例

概要

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Aortic dissection is complicated by peripheral vascular ischemic symptoms in 20-40% of patients. The management of visceral ischemic complication is important because of the increased mortality of patients with renal and mesenteric ischemia. We report 4 cases of endovascular branch vessel and aortic true lumen stenting for visceral malperfusion (renal artery 2; renal failure 2, superior mesenteric artery 2; ischemic colitis 1 and acute mesenteric ischemia 1). In all cases, stent placement was successfully performed, and reperfusion was obtained. Withdrawal from dialysis was achieved in 2 of 2 cases with renal artery involvement. Ischemic colitis disappeared in one case with superior mesenteric artery involvement. However, one superior mesenteric artery case had recurrent aortic dissection 2 hours after stent placement, and was died of multiorgan failure 28 days later. There was no complication associated with the procedure. Visceral artery stenting could provide a safe and effective treatment for visceral malperfusion associated with stable aortic dissection.
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