Interlocking detachable coilを用いて治療した急性期に破裂を繰り返した解離性椎骨動脈瘤の1例

Usefulness of the interlocking detachable coil for the repeatedly ruptured dissecting aneurysm of the vertebral artery in the acute stage

I．はじめに

　1980年代より破裂解離性椎骨動脈瘤に対する治療として，血管内手術が行われるようになった^2-4,7,13）．著者らは，急性期に破裂を繰り返す解離性椎骨動脈瘤の激症例に対して，Interlocking Detachable Coil（IDC）（Tar—get Therapeutics Inc，CA，USA）を用いて血管内手術を行い救命し得たので文献的考察を加えて症例報告する．

A 44-year-old male with a repeatedly ruptured dis-secting aneurysm of the vertebral artery (VA) man-ifesting with subarachnoid hemorrhage was successful-ly treated with endovascular surgery using an interlock-ing detachable coil (IDC). He had a dissecting aneurysm in the left VA distal to the left posterior in-ferior cerebellar artery (PICA). Because the dissecting aneurysm ruptured repeatedly and his clinical condition was moribund, direct surgery was not indicated. The dissecting aneurysm was embolized with an IDC and additional platinum coils. Among patients with a rup-tured VA dissecting aneurysm, proximal occlusion is generally indicated. But the direct embolization of a dis-secting aneurysm can be applied in cases in which the aneurysm is ruptured repeatedly in the acute stage. IDC is a useful and safe material for endovascular sur-gery of a ruptured VA dissecting aneurysm.