胸部大動脈ステントグラフト内挿術における左鎖骨下動脈塞栓術へのAmplatzer Vascular PlugIの使用経験

Objective：The purpose of this study is to report the use of Amplatzer Vascular Plug （AVP）Ⅰ for left subclavian artery （LSCA） occlusion during thoracic endovascular repair （TEVAR） with extra-anatomical bypass. Methods：Retrospective review was undertaken in twelve patients who underwent transcatheter occlusion of the LSCA with AVPⅠ as a part of TEVAR of thoracic aneurysm and aortic dissection at a single institution between Feb. 2014 and Jul. 2015. Result：Mean age was 72.4±9.4 years old. Seven patients were diagnosed with aortic aneurysm and 5 with aortic dissection. Mean operative time was 207.8±43.1 minutes. An extra-anatomical bypass to LSCA was performed in all cases, of which 2 cases underwent an additional extra-anatomical bypass to left carotid artery. We used 12 mm size of AVP in 1 case, 14 mm in 7 cases, and 16 mm in 4 cases. Mean follow-up time was 6.3±4.6 months. There was no death and device-related or aorta-related complications after discharge. Conclusion：We reported the use of AVPⅠ for LSCA embolization during TEVAR with extra-anatomical bypass. This result suggested that this method was effective and could be used from here on.