低侵襲アプローチによる大動脈内遺残ガイドワイヤー除去の1例

Residual Guidewire Removal in the Aorta Using Minimally Invasive Approach：Report of a Case

はじめに　経皮的冠状動脈インターベンション（PCI）に伴うガイドワイヤーなどの異物遺残は医原性の合併症であり，慎重な対応を要する．多くは緊急手術の適応となるが1，2），虚血症状がない場合は保存的な対応を行う例も存在する．われわれは，4年前に施行したPCI中にガイドワイヤーが断裂し体内に遺残した症例に対して，低侵襲心臓手術（MICS）で異物除去を施行した症例を経験したので報告する．

An 80-year-old man had a guidewire in his aorta since catheter laboratory accident 4 years ago. He recently started to suffer mental distress and underwent coronary angiography that revealed an entrapped guidewire and significant stenoses in each of three major coronary arteries. The guidewire could not be removed using transcatheter technique. Thus, after careful consideration, we decided to perform entrapped guidewire removal through minimally invasive surgical approach instead of median sternotomy. Post-operative course was uneventful. Although surgical approach should be tailored in each case, minimally invasive approach can be a choice for entrapped guidewire removal.