{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1390282679390898304.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.11401/jsvs.16-00008"}},{"identifier":{"@type":"NAID","@value":"130005147029"}},{"identifier":{"@type":"URI","@value":"https://search.jamas.or.jp/link/ui/2017187941"}}],"dc:title":[{"@language":"ja","@value":"限局性解離を合併した胸部下行大動脈瘤によるDIC 例に対するdebranching TEVAR の1 手術例"},{"@language":"en","@value":"A Case of Debranching TEVAR for a Descending Thoracic Aortic Aneurysm with Localized Dissection Complicated by Disseminated Intravascular Coagulation"}],"dc:language":"ja","description":[{"type":"abstract","notation":[{"@language":"en","@value":"We reported a debranching TEVAR for a descending thoracic aortic aneurysm with localized dissection complicated by disseminated intravascular coagulation (DIC). A 76-year-old man was admitted to our hospital due to acute kidney dysfunction, anemia and thrombocytopenia. A computed tomographic scan revealed a descending thoracic aortic aneurysm with localized dissection. The maximum aneurysm diameter was 51 mm. He was also diagnosed as DIC due to the aneurysm with dissection. Because he was too frail to undergo open repair of the aneurysm, we decided to perform a debranching TEVAR. Recombinant thrombomodulin was administered preoperatively to alleviate DIC. An axillary-axillary-carotid bypass with a T-shaped GoreTex graft<sup>®</sup> was followed by endografting with TX2 thoracic stent grafts (34 mm, 38 mm). The disseminated intravascular coagulation was improved after surgery. Postoperative enhanced computed tomography showed shrinkage of the aneurysm sac with no endoleak. We believe that debranching TEVAR is one of the useful strategies for a descending thoracic aortic aneurysm with DIC."},{"@language":"ja","@value":"要旨：DIC を伴う胸部大動脈瘤においては，人工血管置換術は侵襲が大きく，一方ステントグラフト内挿術（TEVAR）はendoleak が残存するとDIC の悪化が危惧される．われわれは，このような症例に対しdebranching TEVAR を施行し，良好な結果を得たので報告する．症例は76 歳男性でDIC 所見を有し，造影CT で下行大動脈に51 mm の瘤と限局性の解離を認めた．大動脈瘤あるいは解離による消耗性DIC が疑われた．併存疾患が多く全身状態不良のため，人工血管置換術はハイリスクと考え，debranching TEVARを施行した．可及的な凝固能の改善を目的に，術前にトロンボモデュリン製剤（rTM）を投与した．術後DIC は速やかに消失し，造影CT でendoleak を認めず瘤の縮小を得た．DIC を伴う解離合併胸部下行大動脈瘤に対して，術前にrTM でDIC を改善させた後debranching TEVAR を施行し，DIC を消失せしめ良好な結果を得た．"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1420001326225398912","@type":"Researcher","personIdentifier":[{"@type":"KAKEN_RESEARCHERS","@value":"80745464"},{"@type":"NRID","@value":"1000080745464"},{"@type":"NRID","@value":"9000272992329"},{"@type":"NRID","@value":"9000321624481"},{"@type":"NRID","@value":"9000318136378"},{"@type":"RESEARCHMAP","@value":"https://researchmap.jp/Fukuba_R"}],"foaf:name":[{"@language":"ja","@value":"福場 遼平"},{"@language":"en","@value":"Fukuba Ryohei"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine"},{"@language":"ja","@value":"奈良県立医科大学胸部・心臓血管外科学"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282679390898307","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000321624482"}],"foaf:name":[{"@language":"ja","@value":"多林 伸起"},{"@language":"en","@value":"Tabayashi Nobuoki"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine"},{"@language":"ja","@value":"奈良県立医科大学胸部・心臓血管外科学"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282679390898304","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000321624483"}],"foaf:name":[{"@language":"ja","@value":"廣瀬 友亮"},{"@language":"en","@value":"Hirose Tomoaki"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine"},{"@language":"ja","@value":"奈良県立医科大学胸部・心臓血管外科学"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282679390898306","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000321624484"}],"foaf:name":[{"@language":"ja","@value":"丹羽 恒介"},{"@language":"en","@value":"Niwa Kosuke"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine"},{"@language":"ja","@value":"奈良県立医科大学胸部・心臓血管外科学"}]},{"@id":"https://cir.nii.ac.jp/crid/1420001326216780544","@type":"Researcher","personIdentifier":[{"@type":"KAKEN_RESEARCHERS","@value":"10161506"},{"@type":"NRID","@value":"1000010161506"},{"@type":"NRID","@value":"9000336385085"},{"@type":"NRID","@value":"9000356500991"},{"@type":"NRID","@value":"9000273003653"},{"@type":"NRID","@value":"9000367409281"},{"@type":"NRID","@value":"9000021494419"},{"@type":"NRID","@value":"9000406380152"},{"@type":"NRID","@value":"9000253467388"},{"@type":"NRID","@value":"9000259853765"},{"@type":"NRID","@value":"9000242257342"},{"@type":"NRID","@value":"9000340450617"},{"@type":"NRID","@value":"9000238883692"},{"@type":"NRID","@value":"9000345283855"},{"@type":"NRID","@value":"9000283345716"},{"@type":"NRID","@value":"9000001983106"},{"@type":"NRID","@value":"9000006264825"},{"@type":"NRID","@value":"9000403989193"},{"@type":"NRID","@value":"9000256758801"},{"@type":"NRID","@value":"9000265260126"},{"@type":"NRID","@value":"9000403417764"},{"@type":"NRID","@value":"9000391513249"},{"@type":"NRID","@value":"9000345298891"},{"@type":"NRID","@value":"9000411828950"},{"@type":"NRID","@value":"9000415229234"},{"@type":"NRID","@value":"9000415136519"},{"@type":"NRID","@value":"9000018801914"},{"@type":"NRID","@value":"9000024767407"},{"@type":"NRID","@value":"9000021778656"},{"@type":"NRID","@value":"9000398250398"},{"@type":"NRID","@value":"9000283345812"},{"@type":"NRID","@value":"9000263044310"},{"@type":"NRID","@value":"9000024758668"},{"@type":"NRID","@value":"9000024758455"},{"@type":"NRID","@value":"9000380134218"},{"@type":"NRID","@value":"9000265260120"},{"@type":"NRID","@value":"9000398379258"},{"@type":"NRID","@value":"9000321624485"},{"@type":"NRID","@value":"9000399221818"},{"@type":"NRID","@value":"9000273003732"},{"@type":"NRID","@value":"9000258271470"},{"@type":"NRID","@value":"9000380477488"},{"@type":"NRID","@value":"9000391513302"},{"@type":"NRID","@value":"9000253499908"},{"@type":"NRID","@value":"9000263044772"},{"@type":"NRID","@value":"9000261023841"},{"@type":"NRID","@value":"9000018718573"},{"@type":"NRID","@value":"9000368417700"},{"@type":"NRID","@value":"9000402587999"},{"@type":"NRID","@value":"9000335561245"},{"@type":"NRID","@value":"9000363170273"},{"@type":"NRID","@value":"9000258271195"},{"@type":"NRID","@value":"9000258271438"},{"@type":"NRID","@value":"9000265258851"},{"@type":"NRID","@value":"9000005862644"},{"@type":"NRID","@value":"9000021740990"},{"@type":"NRID","@value":"9000021807495"},{"@type":"NRID","@value":"9000360581005"},{"@type":"NRID","@value":"9000403988884"},{"@type":"NRID","@value":"9000273003628"},{"@type":"NRID","@value":"9000007157939"},{"@type":"NRID","@value":"9000020492962"},{"@type":"NRID","@value":"9000253467621"},{"@type":"NRID","@value":"9000362191661"},{"@type":"NRID","@value":"9000345291016"},{"@type":"NRID","@value":"9000399230602"},{"@type":"NRID","@value":"9000258254252"},{"@type":"NRID","@value":"9000238931244"},{"@type":"NRID","@value":"9000238917567"},{"@type":"NRID","@value":"9000021428337"},{"@type":"NRID","@value":"9000391587370"},{"@type":"NRID","@value":"9000297495725"},{"@type":"NRID","@value":"9000256386054"},{"@type":"NRID","@value":"9000010311748"},{"@type":"NRID","@value":"9000367408249"},{"@type":"NRID","@value":"9000370734695"},{"@type":"NRID","@value":"9000259333800"},{"@type":"NRID","@value":"9000345227852"},{"@type":"NRID","@value":"9000256883989"},{"@type":"NRID","@value":"9000258271588"},{"@type":"NRID","@value":"9000258254352"},{"@type":"NRID","@value":"9000258254151"},{"@type":"RESEARCHMAP","@value":"https://researchmap.jp/read0161544"}],"foaf:name":[{"@language":"ja","@value":"吉川 公彦"},{"@language":"en","@value":"Kichikawa Kimihiko"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Radiology, Nara Medical University School of Medicine"},{"@language":"ja","@value":"奈良県立医科大学放射線医学"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282679390898308","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000321624486"}],"foaf:name":[{"@language":"ja","@value":"谷口 繁樹"},{"@language":"en","@value":"Taniguchi Shigeki"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Thoracic and Cardiovascular Surgery, Nara Medical University School of Medicine"},{"@language":"ja","@value":"奈良県立医科大学胸部・心臓血管外科学"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"09186778"},{"@type":"EISSN","@value":"1881767X"}],"prism:publicationName":[{"@language":"en","@value":"Japanese Journal of Vascular Surgery"},{"@language":"ja","@value":"日本血管外科学会雑誌"},{"@language":"ja","@value":"日血外会誌"},{"@language":"en","@value":"Jpn. J. Vasc. Surg."}],"dc:publisher":[{"@language":"en","@value":"JAPANESE SOCIETY FOR VASCULAR SURGERY"},{"@language":"ja","@value":"特定非営利活動法人 日本血管外科学会"}],"prism:publicationDate":"2016","prism:volume":"25","prism:number":"0","prism:startingPage":"154","prism:endingPage":"158"},"url":[{"@id":"https://search.jamas.or.jp/link/ui/2017187941"}],"availableAt":"2016","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=%E8%83%B8%E9%83%A8%E4%B8%8B%E8%A1%8C%E5%A4%A7%E5%8B%95%E8%84%88%E7%98%A4","dc:title":"胸部下行大動脈瘤"},{"@id":"https://cir.nii.ac.jp/all?q=%E5%A4%A7%E5%8B%95%E8%84%88%E8%A7%A3%E9%9B%A2","dc:title":"大動脈解離"},{"@id":"https://cir.nii.ac.jp/all?q=%E6%92%AD%E7%A8%AE%E6%80%A7%E8%A1%80%E7%AE%A1%E5%86%85%E5%87%9D%E5%9B%BA%E7%97%87%E5%80%99%E7%BE%A4%EF%BC%88DIC%EF%BC%89","dc:title":"播種性血管内凝固症候群（DIC）"},{"@id":"https://cir.nii.ac.jp/all?q=TEVAR","dc:title":"TEVAR"},{"@id":"https://cir.nii.ac.jp/all?q=descending%20thoracic%20aortic%20aneurysm","dc:title":"descending thoracic aortic aneurysm"},{"@id":"https://cir.nii.ac.jp/all?q=aortic%20dissection","dc:title":"aortic dissection"},{"@id":"https://cir.nii.ac.jp/all?q=disseminated%20intravascular%20coagulation%20(DIC)","dc:title":"disseminated intravascular coagulation (DIC)"},{"@id":"https://cir.nii.ac.jp/all?q=thoracic%20endovascular%20aortic%20repair%20(TEVAR)","dc:title":"thoracic endovascular aortic repair (TEVAR)"}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2000967723"},{"@type":"CIA","@value":"130005147029"}]}