血管内治療

[O-8-7] 若年男性の外傷性総大腿動脈閉塞に対する血管内治療の一例

^〇朴澤耕治, 長沼亨 (新東京病院)

Keywords:Endovascular Treatment, Traumatic artery obstruction

A 16 years-old-male was admitted on our hospital for resting leg pain and severe claudication. He had traffic accident for left common femoral site on riding bicycle 2 weeks prior to this admission. CT angiography showed occlusion between left external iliac artery and common femoral artery. Ankle brachial index(ABI) was 1.08/-.--. At first, we planned endovascular treatment therapy for injury site of obstruction. The approach site of intervention was bilateral common femoral artery with retrograde puncture. After 6 French guiding sheath inserted from contralateral site and then the 8F sheath inserted from ipsilateral site. Hydrophilic J tip 0.035inch guidewire with bidirectional approach was passed only subintimal lumen. Hydrophilic 0.014inch gudewire and 0.018inch stiff guidewire with bidirectional approach using IVUS could be passed intra-true lumen. We performed ballooning and aspiration with distal protection. After the procedure, ABI was improved to 1.05/0.62. His symptom had disappeared after the procedure.Conclusion: Endovascular therapy was effective and safety for traumatic common femoral artery obstruction of young male. In the future, if recoil in the damaged site of artery, may be required the revascularization as patch-plasty with autogenous vein.