プラーク破綻が成因と考えられた上行大動脈内血栓症の1例

Ascending Aortic Mural Thrombus Caused by Plaque Destruction：Report of a Case

はじめに　大動脈内血栓症（aortic mural thrombus：AMT）は剖検例の0.9％に認め，そのうち半数は動脈瘤に起因しないものとされる1）．われわれは比較的まれな孤立性の上行大動脈のAMTに対し外科的治療を施行した．術後の組織診断で血栓はプラーク破綻（plaque destruction）に起因するものと考えられ，本症の成因や治療について若干の文献的考察を加えて報告する．

A 52-year-old male with complaints of pain and cold sensation on left upper-extremity was admitted to a hospital. He was diagnosed with acute left brachial artery occlusion and accordingly underwent emergency thrombectomy. Contrast-enhanced computed tomography （CT） revealed an ascending aortic mural thrombus （AMT）. After his transferring to our institution, the AMT was removed, and the ascending aorta was replaced under cardiac arrest. Based on histopathological findings, the thrombus was caused by the destruction of an atheromatous plaque. The patient’s postoperative course was uneventful, and no recurrence of AMT was presented for 12 months after operation.