From April 2010 to April 2021, we examined 12 patients（including 2 patients from other hospitals）who underwent LOC after EVAR at our hospital. During this period, the number of EVARs in our hospital was 234, and the LOC rate in our hospital was 4.3%（10/234 cases）. The stent grafts（SG）used were Endurant in 6 cases, Excluder in 4 cases, Zenith and AFX in 1 case each. The aortic diameter before EVAR was 57.5 ± 8.9 mm, the period from EVAR to LOC was 35.5 ± 21.6 months, and the aortic diameter before LOC was 65.3 ± 13.5 mm. The reasons for LOC were 1 case of enlargement of aneurysm due to migration, 10 cases of enlargement of aneurysm due to endoleak（EL）, and 2 cases of infection（1 case was aorto-duodenal fistula）. Nine patients underwent aneurysmorrhaphy and aneurysmal neck banding. In one case of migration, the SG trunk was cut below the renal artery, the native aorta and the SG trunk were anastomosed bifurcated vascular prosthesis, and the distal vascular prosthesis was fixed with a bare stent in the SG leg. In infected cases, aneurysmorrhaphy, aneurysmal neck banding and omentopexy were performed in one case, and in aorto-duodenal fistula case, complete debridement and omentopexy around aorto-duodenal fistula and SG were performed. Of the 9 cases caused by EL, 7 cases showed aneurysm shrinkage, but 1 case remained unchanged and 1 case showed a slight enlargement. In our department, we basically performed aneurysmorrhaphy and aneurysmal neck banding with preserving SG, but it was considered that strict follow-up was required even after surgery.

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[in Japanese]

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[in Japanese]

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概　　要：大腿骨骨折や脛骨骨折で骨接合術を施行した後に骨癒合がなかなか得られない場合，骨 癒合を得るためにdynamizationという手技を行うことがあり，当院ではこの15年で３例を施行した． １例については骨癒合が得られず，髄内釘交換・骨移植手術が必要であったが，２例については骨 癒合が得られた．dynamizationは，開放性骨折，萎縮性骨癒合不全などの施行すべきでない場合もあ るが，患者の肉体的，経済的負担が少ない方法として選択しうると考える．その施行時期について は，通常は初回手術後 12週程度の報告が多いが，症例２では24週で施行し骨癒合が得られた．また， 経過観察において，疼痛が軽減，消失すれば，長期経過であっても骨癒合が得られる可能性がある と考えられた.

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Abstract：We report two cases of stent placement for malignant inferior vena cava syndrome. The patients were suffering from biliary duct cancer and liver metastases. As the tumors progress, inferior vena cava was compressed and venous return from lower extremity was impended severely. By stenting to the narrow area of inferior vena cava, their symptoms were improved. Although there are some issues left unanswered, this treatment is valid for the intractable symptoms in these end- stage patients.

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Abstract：A rectal cancer patient with the hepatic cirrhosis was performed surgery with ileal conduit diversion for suspected on invasion of the bladder. A few years postoperated, stomal varices was formed in the ileal conduit. Due to the repeated bleeding from stomal varices, we treated with percutaneous transphepatic obliteration（PTO）. We approached stomal varices through the portal vein by percutaneous transhepatic route. Using balloon catheter, the embolization was performed with sclerosing agents and metallic coils. After PTO, as it was recurrent the repeated bleeding, it was treated in the similar procedure. After that, although it was repeated bleeding slightly, it was going on follow-up that controlled by treatments of manual compression and hemostatic agents.

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