2023 Fiscal Year Final Research Report
Mechanism of sac expansion after endovascular aortic repair analyzed. with X-ray phase-contrast tomography
| Project/Area Number |
21K08837
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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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| Review Section |
Basic Section 55030:Cardiovascular surgery-related
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| Research Institution | Shinshu University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
瀬戸 達一郎 信州大学, 学術研究院医学系, 教授 (70362118)
和田 有子 信州大学, 学術研究院医学系, 講師 (30419410)
築部 卓郎 神戸大学, 医学研究科, 非常勤講師 (50304100)
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| Project Period (FY) |
2021-04-01 – 2024-03-31
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| Keywords | 位相差X線CT / 大動脈瘤 / 瘤径拡大 / ステントグラフト内挿術 / 密度解析 |
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| Outline of Final Research Achievements |
Although endovascular aortic repair(EVAR) has become less invasive repair for aortic aneurysm, in some case, the sac expansion after EVAR was occurred without evident a detectable endoleak and some patients have lost their lives due to rupture of the aortic aneurysm. In this study,X-ray phase-contrast tomography analysis showed that the aortic wall after EVAR was thinned and its density was significantly decreased. This suggests that ischemic changes caused by stent graft insertion, which shut off aortic blood supply from aortic blood flow into aneurysmal wall, may have induced sac expansion.
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| Free Research Field |
心臓血管外科、大動脈
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| Academic Significance and Societal Importance of the Research Achievements |
ステントグラフト内挿術(EVAR)は大動脈瘤に対する低侵襲な治療法として普及したが遠隔期に瘤径拡大する症例が散見される。本研究によってエンドリークがなくてもEVAR後に瘤径拡大する症例の原因はステントグラフト挿入により引き起こされる大動脈壁の虚血が原因になっており、そのEVAR後の大動脈壁の構造変化をstet-graft induced aortopathy(SGIA)として提唱した。今後EVAR後の瘤壁の虚血性変化を強くきたす症例やその要因の検討ができればEVARの適応を検討する際に有用な判断材料になると考えられる。
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