高安病患者における高血圧を治療目的とした外科的血行再建術の1例

A Case Report of Corrected Hypertension after Surgical Revascularization for Takayasu's Disease Associated with Severe Hypertension

　胸腹部大動脈の高度な石灰化を伴う高安病患者の高血圧と，腹部大動脈の狭窄による上下肢間の圧較差を治療目的にして外科的に治療した．患者は59歳の女性で上肢血圧290／120mmHgで入院した．右腎動脈99％狭窄に対し右総腸骨動脈-腎動脈間バイパスを施行して腎血流を確保し，腹部大動脈縮窄（圧較差70mmHg）に対しては右腋窩-外腸骨動脈間バイパスを行い，圧較差を補正した．1年後の血管造影，心カテーテル検査では上下肢間の圧較差は消失しており，血圧は160mmHgと改善していた．二つの目的を手術的に果たしたが，このような症例はまれであり若干の文献的考察を加えて報告した．

A 59 year old woman presenting with headache subse-quently diagnosed as having Takayasu's disease as-sociated with marked systemic hypertension of 290/120 was operated on. She had a 90% constriction of the right renal artery, 70 mmHg pressure gradient accross coarctation of abdominal aorta and severe calcification of thoracic and abdominal aorta. In order to correct the hypertension and the coarctation, right axilla-femoral artery and renal artery revascuralization were perfor-med. Study carried out one year later showed blood pressure 160/80 and no pressure gradient between upper and lower extremities.