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Updated: Feb 16, 2026

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Porcine Model of Infrarenal Abdominal Aortic Aneurysm
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タイプIIエンドリークによる二次性腹部大動脈動脈瘤破裂の保守的な管理
Cheok Lam Chan1, Arvind Dhas Lee1
1Department of Vascular Surgery, Nepean Hospital, Kingswood, NSW, Australia.
Vascular
|February 14, 2026
まとめ
EVAR後のII型エンドリークからの破裂はまれである. このケースは,高齢の患者の選択された腹部大動脈動脈瘤 (rAAA) の非手術的管理が可能であることを示し,緊密な監視を強調しています.
科学分野:
- 血管外科 血管外科
- 内血管動脈瘤修復 (EVAR) とは
- 腹部大動脈動脈瘤 (AAA) とは
背景:
- 破裂した腹部大動脈動脈瘤 (rAAA) の生存データは限られている.
- タイプII内皮炎 (T2EL) に二次的なrAAA生存に関する文献は存在しない.
- 血管内動脈瘤修復 (EVAR) はAAAの一般的な治療法です.
研究 の 目的:
- T2ELに関連したrAAA.の非運用的な管理の希少なケースを報告する.
- 主要なrAAAと比較して,EVAR後のrAAAの自然史について議論する.
- 特定のrAAAケースにおける非オペレティブマネジメントの可能性を強調する.
主な方法:
- 89歳の男性で,EVAR歴があり,rAAA.を呈するT2ELが持続している症例報告.
- コンピュータトモグラフィ・アニオグラフィ (CTA) は,rAAAとレトロペリトニアル血腫を確認した.
- 非手術による治療は,患者の年齢,併発性疾患,および好みを考慮して選択されました.
主要な成果:
- 患者は蘇生後の血液動力学的に安定しており,退院しました.
- フォローアップのCTAでは,血液腫の解消と軽度の動脈瘤袋の拡大が示されました.
- 患者は選択栓塞を施され,1年後にエンドリークなしで安定した状態でした.
結論:
- T2ELからの破裂は,EVAR後の患者で発生することがあります.
- 非手術による管理は,EVAR後にrAAAを有する血液動力学的に安定した患者を選択する際の有効な選択肢である可能性があります.
- EVAR.に続くリスク集団にとって,密接な監視は極めて重要です.
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