腹部大動脈瘤に対するステントグラフト留置術のコツと留意点

概要

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Conventional management of abdominal aortic aneurysm (AAA) has been open surgical repair. However, recently endovascular aneurysm repair (EVAR) has been alternative treatment for AAA, and so far over 12000 cases have been treated with stent graft in Japan. For successful EVAR, it is very important to learn device specific characteristics and how to troubleshoot in diffficult cases. Basically the indication of EVAR is limited to patients at high surgical risk having suitable anatomy. However, the indications are expanded to anatomically EVAR unfit cases (so-called "outside IFU"). There are unsuitable conditions, for example, short proximal neck, tortuous aorta, and small diameter iliac artery. Even in such cases, we can conduct a successful EVAR procedure by analyzing correctly the anatomical information, considering device specific characteristics, and understanding technical pitfalls. Besides, I refer to additional procedures of internal iliac artery embolization, safe method for tortuous access site, and avoiding coverage of renal arteries. We should continue to learn device specific managements and make efforts to obtain new device information.
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