Two Cases of Emergency Thoracic Endovascular Aortic Repair via the Abdominal Aorta as the Access Route

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  • 腹部大動脈をアクセスルートに選択した緊急TEVARの2例

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<p>Thoracic Endovascular Aortic Repair (TEVAR) has been conducted on high-risk patients because of its minimally invasive. The femoral artery is usually used as the access route of TEVAR, making it necessary to insert a sheath having a relatively large diameter. I herein report two cases of emergency TEVAR in which the abdominal aorta was used as the access route since the femoral artery could not be used due to strong arteriosclerotic changes. Case 1: An 86-year-old female patient with fistula from the aorto-esophageal fistula (AEF). Because the abdominal aorta was significantly tortuous and the bilateral iliac artery diameter was small, the approach from the femoral artery was difficult, making it necessary to use the abdominal aorta as the access route. Case 2: An 89-year-old male patient who developed a rupture of a thoracic aortic dissection. The right femoral artery approach was attempted, but the 22 Fr. sheath did not pass due to the tortuousness and stenosis of iliac artery, thus I changed to the abdominal aorta as the access route. Because the method using the abdominal aorta as the access route is a relatively easy approach, it is considered to be a useful method when other access routes cannot be selected.</p>

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