逆行性Stanford A型大動脈解離に対する胸部ステントグラフト内挿術後新しいエントリーを形成した2例

Occurrence of New Entry after Thoracic Endovascular Aortic Repair for Retrograde Stanford Type A Aortic Dissection；Report of Two Cases

はじめに　胸部ステントグラフト内挿術（TEVAR）は，真性瘤をはじめ急性大動脈解離（AAD）に対しても有効性が報告されている．一方，TEVARの重大な合併症として逆行性Stanford A型大動脈解離がある．当院で逆行性Stanford A型大動脈解離に対するTEVAR後，遅発性に新しいエントリーを生じた症例を経験したので報告する．

We report 2 cases of occurrence of new entry after thoracic endovascular aortic repair （TEVAR） for retrograde Stanford type A aortic dissection. Preoperative chest computed tomography （CT） demonstrated retrograde Stanford type A acute aortic dissection, and TEVAR was performed for entry closure. In the postoperative period, the aortic diameter was not dilated in either case and the false lumen of the ascending aorta disappeared in the case 2. In the chronic phase, however, Stanford type A acute aortic dissection occurred in both cases. TEVAR for acute aortic dissection to close the intimal tear might be a useful procedure, but it could cause a new aortic dissection. We should make a careful decision on surgical procedures in the retrograde Stanford type A aortic dissection.