日本救急医学会雑誌
Online ISSN : 1883-3772
Print ISSN : 0915-924X
ISSN-L : 0915-924X
経皮経肝的胆管ステントにより緊急止血しえた外腸骨動脈瘤破裂の1例
中田 康城植田 俊夫小倉 裕司田中 裕嶋津 岳士杉本 壽岡田 篤哉
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1999 年 10 巻 11 号 p. 683-687

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Endovascular covered stent placements have been recently utilized as nonurgent treatment for aneurysms in large vessels. However, the effects of covered stent placements for urgent hemostasis has not been clarified. We experienced a case in whom an endovascular covered stent was successfully used for urgent hemostasis of a ruptured external iliac aneurysm. A 72-year-old male was admitted to the Osaka University hospital 2 hours after awakening with severe right lumbago. He developed to severe shock due to the right retroperitoneal hemorrhage. A diagnostic aortogram revealed a rupture of an aneurysm of the isolated right external iliac artery. Medical history disclosed that he had been suffering from cardiomyopathy for 10 years, so he was subject to heart failure. Because of this underlying heart disease endovascular management was applied. We placed the biliary covered stent, which is the only commercially available covered stent in Japan, and thus, provided urgent hemostasis of the aneurysm. He recovered from hemorrhagic shock, and was transferred to another hospital without further complication after 11 days of hospitalization. Our experience suggest that the urgent placement of covered stent should be considered for uncontrollable hemorrhage of large vessels. The commercial supply of covered stents should include different types in Japan.
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