右鎖骨下動脈瘤に対してハイブリッド治療を施行した1例

Hybrid Treatment of the Intrathoracic Right Subclavian Artery Aneurysm：Report of a Case

はじめに　鎖骨下動脈瘤に対する外科治療では，胸骨正中切開によるアプローチを必要とすることが一般的である．われわれは，開心術後に右鎖骨下動脈瘤を合併した症例に対してステントグラフトを併用したハイブリッド治療を施行し，良好な結果を得たので報告する．

A 78-years-old woman was referred to our institution for the treatment of right subclavian artery （SCA） aneurysm. She previously underwent total arch replacement via median sternotomy approach. Preoperative computed tomography revealed a 55 mm sized SCA aneurysm. Stent graft was inserted from brachiocephalic artery to right common carotid artery via the graft anastomosed. The orifice of the right SCA was covered with stent graft inserted into the right common carotid artery-brachiocephalic artery and the right SCA was occluded with coils distal to the aneurysm, carotid-SCA bypass was performed with 8 mm ePTFE graft. Postoperative examination confirmed complete exclusion of the aneurysm and patency of the bypass graft. We thought that hybrid treatment for this patient was a less invasive alternative to conventional surgical procedure.