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はじめに 近年,胸部大動脈瘤(TAA)に対して胸部ステントグラフト内挿術(TEVAR)が広く行われるようになっている.さらにzone 2~3にかかる弓部大動脈瘤に対しては,弓部分枝にバイパス術を加えるdebranching TEVERが行われ,その手術成績も良好な結果が得られている1).また破裂性弓部大動脈瘤に対するTEVARは,開胸手術より低侵襲で行うことができ,術後合併症も少ないと報告されている2).われわれは超高齢者の破裂性弓部大動脈瘤に対し,debranching TEVARを行い救命することができた症例を報告する.
Recently, thoracic endovascular aortic repair (TEVAR) has emerged as an alternative to open repair. We reported a case of a 92-year-old woman who underwent successful TEVAR for impending rupture of aortic arch aneurysm. The patient presented with back pain. Computed tomography revealed an impending rupture site at the aortic arch and left hemothorax. First, an axilo-axilo-carotid artery bypass was performed, and then 2 thoracic stent grafts were deployed successfully. Her postoperative course was uneventful, and at day 20, she was discharged. Debranching TEVAR is an effective procedure for aortic arch aneurysms in elderly patients.
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