coral reef aortaに対して血管内治療を施行した1例

A Case of Coral Reef Aorta Successfully Treated by Endovascular Stenting

要旨　症例は45歳の喫煙男性．2型糖尿病に対する血糖コントロール目的で入院した際に，7分間程度の歩行で両下肢脱力感が出現する間歇性跛行，両側足背動脈の触知不良を認めた．腹部CT検査，腹部MRI検査で腎動脈下腹部大動脈に限局した石灰化を伴う動脈硬化性の狭窄病変を認め，coral reef aortaと診断した．本症例に対する治療として，大動脈内ステント留置術を施行した．術中および術後合併症は認めず良好に経過した．術後，両側足背・大腿動脈の触知は良好となり，間歇性跛行は消失した．

　A 45-year-old male smoker was admitted to our hospital for glycemic control for diabetes mellitus. He was recognized to have intermittent claudication after 7 minutes of walking, and the dorsalis pedis artery on both sides was not palpable. Abdominal computed tomography and magnetic resonance imaging revealed atherosclerotic constriction with calcification in the infrarenal abdominal aorta, which was diagnosed as coral reef aorta.

　As a treatment, he underwent endovascular repair using a 14 x40mm Luminexx stent in the abdominal aorta. The postoperative course was uneventful. The femoral and the dorsalis pedis artery on both sides were quite palpable, and intermittent claudication had subsided after the procedure.

　Endovascular treatment can be successfully employed in coral reef aorta in the right setting as an alternative procedure to surgcal graft replacement.