血管形成術後に視機能の改善を示した腕頭動脈狭窄症の1例

Improvement of Visual Function after Balloon Angioplasty for Innominate Artery Stenosis : a case report

I．はじめに

　腕頭動脈の動脈硬化性狭窄性病変は頸動脈の同病変に比して稀な病態であるが，網膜の虚血症状を来すことがあるとされている^2,7,9）．一方，近年の血管内手術の進歩に伴い，この部位においても血管形成術が試みられている^6,13,14）．

　今回われわれは，網膜循環の低下により視機能の障害を来した腕頭動脈狭窄症に対し，血管形成術を施行し，症状の改善を認めた1例を経験したので報告する．

Occlusive disease of the innominate artery is relatively rare, but visual disturbance is a frequently en-countered manifestation of this disease.

A 48-year-old man presented with a 1-year history of right amaurosis fugaxs. During the nine years prior to admission, the patient had undergone aortic artery-coronal artery bypass surgery two times. Upon ophthalmological examination, the patient was found to have impaired right retinal sensitivity and pro-longed right arm-to-retina circulation time. Aortic arch angiography demonstrated severe stenosis of the in-nominate artery near its origin. The stenosis was successfully treated by balloon angioplasty. Subsequently, right retinal sensitivity improved and right arm-to-retina circulation time normalized following the proce-dure.

These findings indicate that this patient had sufferred impaired visual function due to hemodynamic re-tinal ischemia caused by innominate artery stenosis.