| Project/Area Number |
17K10762
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Cardiovascular surgery
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| Research Institution | Nagoya City University |
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Principal Investigator |
Hashizume Takuya 名古屋市立大学, 医薬学総合研究院(医学), 准教授 (80611582)
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| Project Period (FY) |
2017-04-01 – 2022-03-31
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| Project Status |
Completed (Fiscal Year 2021)
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| Budget Amount *help |
¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
Fiscal Year 2020: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2019: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2018: ¥260,000 (Direct Cost: ¥200,000、Indirect Cost: ¥60,000)
Fiscal Year 2017: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
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| Keywords | ステントグラフト / TEVAR / 大動脈解離 / リモデリング / 大血管外科学 |
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| Outline of Final Research Achievements |
The purpose of this study was to determine the factors associated with aortic remodeling after thoracic endovascular aortic repair (TEVAR) in patients with chronic aortic dissection.
The pressure measurement of false and true lumen were performed in 4 cases. Shrinkage of the aneurysm diameter were observed in 2 cases, stabilization in 2. There was no tendency about the changes of pressure ratio in true and false lumen with these cases.
The association between aortic remodeling and dissection of viceral branch or thrombosis of the false lumen were investigated in 17 cases. Although the false lumen in visceral segment being patent, aneurysmal changes were well controlled with thrombosis of false lumen in thoracic lesion. Shrinkage of aneurysm were observed in about 6 months after TEVAR. In cases with enlargement of aneurysm, the association of type1 or 3 endoleak were suspected.
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| Academic Significance and Societal Importance of the Research Achievements |
発症後1年以上経過した後期慢性期の解離性大動脈瘤に対するステントグラフト治療では、急性期あるいは亜急性期症例に比べ、瘤化制御が困難であることが問題とされてきた。この一因として腹部分枝の関与による腹部偽腔の開存が問題とされてきた。当研究では胸部の偽腔の血栓化を得ることで、腹部偽腔が開存したままの症例でも高率に瘤制御に成功することが示された。また縮小症例では6ヶ月程度と早期に瘤径変化が得られることが明らかとなった。
本研究により段階的治療が正当化され、初回治療での腹部分枝への過大な介入を回避することで、低侵襲化や医療費削減に寄与すると考えられる。
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