感染性胸部大動脈瘤で2回の大動脈破裂をきたした1例

Repeated Rupture of Infective Thoracic Aortic Aneurysm：Report of a Case

はじめに　われわれは，感染性胸部大動脈瘤破裂に対して，緊急胸部ステントグラフト内挿術（TEVAR）を行った後，二期的に肋間筋弁充塡術を施行した．6ヵ月後proximal stent graft induced new entry（SINE）による再破裂をきたし，二度目の緊急TEVARを行って寛解したので，報告する．

A 79-year-old man was diagnosed with rupture of infective thoracic aortic aneurysm following septicemia caused by infective cholangitis. He underwent emergent endovascular aortic repair and discontinued antibiotics. Graft infection occurred and was treated 29 days after the first operation. He underwent emergent resection of the abscess with graft coverage using pedicled intercostal muscle flaps. Aortic re-rupture was found and treated 183 days after the second operation. He underwent emergency additional thoracic endovascular aortic repair and continued to take antibiotics again. We should continue a careful follow up.