ステントグラフトで治療した胸部下行大動脈壁血栓の1例

Thoracic Descending Aorta Mural Thrombus Treated with Stent Graft：Report of a Case

はじめに　動脈硬化性閉塞性疾患や動脈瘤性疾患を伴わない大動脈壁血栓（thoracic aorta mural thrombus：TAMT）は比較的まれな存在である．診断がむずかしく，末梢臓器障害の原因となりうる非心原性塞栓症の重要な原因であり，複数の治療戦略が検討されうる．われわれは偶然発見されたTAMTに対し，胸部ステントグラフト内挿術（TEVAR）で良好な結果を得ることができたため報告する．

A 43-year-old male patient was admitted to our hospital with chest oppression and received percutaneous coronary intervention with a diagnosis of myocardial infarction. Two months after the event, he was referred to our department because the enhanced computed tomography （CT） image revealed a low-density area on the descending aorta, which was suspicious of a mobile plaque. He had no symptoms and there were no other signs suggesting embolization or metastatic tumor in CT image. Enhanced magnetic resonance imaging （MRI） or positron emission tomography （PET） image revealed no enhancement in the lesion and we diagnosed it as mural thrombosis on the descending aorta. We performed thoracic endovascular aortic repair （TEVAR） to compress the intra-aortic thrombus. He had no complication such as thromboembolism in the procedure and also had a good course for two years after the procedure.