右側大動脈弓に合併した異所性左鎖骨下動脈狭窄に対する経皮的血管形成術の1例

Percutaneous Transluminal Angioplasty Using a Stent for an Aberrant Left Subclavian Artery Stenosis with a Right-sided Aortic Arch: A Case Report

Ⅰ．はじめに

　異所性左鎖骨下動脈は，多くの例で右側大動脈弓に合併する稀な破格である．今回，この破格に合併した左鎖骨下動脈狭窄および左頚動脈狭窄に対して経皮的血管形成術を同時に施行した例を経験した．異所性左鎖骨下動脈に対する血管内治療の報告は，われわれが過去の報告を渉猟し得た限りではほとんどない．若干の文献的考察を加えて報告する．

　An aberrant left subclavian artery is a rare variant that has been reported to coexist with the right-sided aortic arch in many cases. We encountered a case in which percutaneous transluminal angioplasty using a stent was performed for an aberrant left subclavian artery and left carotid artery. The patient was a 63-year-old man in whom left carotid artery stenosis and abnormal flow pattern of the left vertebral artery was accidently found during an ultrasound screening of his carotid artery. The right-sided aortic arch with the aberrant left subclavian artery was revealed by a cerebral angiogram via the right femoral artery. Despite difficulty in inserting a catheter at the origin of the aberrant left artery, the treatment was completed successfully. To our knowledge, endovascular treatment for an aberrant left subclavian artery has not been reported until date.