腎動脈瘤に対してコイル塞栓術を施行した経験

Abstract

腎動脈瘤に対しコイル塞栓術を施行した2例を経験した.症例1は73歳男性.脳梗塞, 心筋梗塞で経過観察中に肉眼的血尿で著者ら施設へ紹介となった.X線, DIP, CTで右腎盂上方に11×10mmの円形石灰化を示す動脈瘤を認め, コイル塞栓術を施行した.術後動脈瘤内の血流は完全に消失し, 末梢への血流は十分保たれていた.症例2は52歳女性.健康診断で両側腎門部に石灰化病変を指摘され紹介受診した.DIP, CTで両側腎門部に動脈瘤を認め, コイル塞栓術を施行した.術後両動脈瘤内の血流は消失し, 末梢への血流は良好に保たれていた.2症例とも外来で定期観察をしているが, コイルの位置の変動は認めていない.腎動脈瘤のコイル塞栓術は簡便で安全に実施でき, 治療適応を広げる可能性があると思われた

Selective transcatheter embolization using an interlocking detachable coil was performed in two cases with renal artery aneurysms. Case 1, a 73-year-old male, was referred to our department complaining of macrohematuria persisting for three days. Case 2, a 52-year-old female, visited our department because calcifications in both renal pedicle areas were found in a health check up. Drip infusion pyelography (DIP) and computerized tomography (CT) revealed in case 1 an aneurysm which was 11 x 10 cm in diameter with nearly circumferential calcification in the right renal pedicle area and in case 2 two aneurysms, one 12 x 10 cm in the right and one 22 x 20 cm in the left with imperfect calcification. Enhanced CT confirmed blood flow in the aneurysms. Because abdominal surgery, was considered to be a highrisks in both cases 1 and 2 the coil embolization was performed. The patients have been followed up after the embolization without any particular complications or changes in the coil location.