選択的分枝塞栓術と胸部ステントグラフト内挿術が有効であった無症候性気管支動脈瘤の1例

Selective Branch Embolization and Thoracic Endovascular Aortic Repair for Asymptomatic Bronchial Artery Aneurysm：Report of a Case

はじめに　近年，画像診断技術の進歩に伴い，気管支動脈瘤を認める頻度が増えている1）．われわれは無症候性の未破裂気管支動脈瘤に対し，気管支動脈瘤からの分岐を選択的にコイル塞栓し，さらに胸部大動脈ステントグラフト内挿術（TEVAR）を追加して治療した症例を経験した．気管支動脈瘤に対し，両者を併用した症例の報告はまれなため，報告する．

Bronchial artery aneurysm （BAA） is a rare disease, for which early treatment is recommended due to the risk of rupture often resulting in severe consequences. We report a case of successful treatment of an asymptomatic BAA by selective branch embolization combined with thoracic endovascular aortic repair （TEVAR）. A 68-year-old man was accidentally found to have a bronchial artery aneurysm by computed tomography. The distance from the origin of the bronchial artery to the aneurysm was only 6 mm, at which branches were found. The BAA was completely excluded by selective branch coil embolization and deployment of a thoracic stent graft to cover the orifice of the BAA. Angiography confirmed that there was no endoleak. Selective branch embolization of BAA combined with TEVAR is effective to completely occlude the blood stream to BAA.