実験的腎動脈塞栓術における脊損併発例の検討

Abstract

Transcatheter renal artery embolization was performed in four dogs with propyliodone, a contrast media for bronchography, as embolic substance. The renal artery could be embolized as aimed. Despite our careful maneuver to avoid reflux of the substance, spinal cord injury developed in 3 dogs due to embolization of anterior spinal arteries. Propyliodone is highly radio-opaque material. However, reflux or spread of this material during maneauver could not be detected by television monitoring. Postoperative routine radiograms also could not prove it. The spinal cord was isolated by autopsy and radiophoto graphed by soft x-ray. Small amount of the substance was the detected. In clinical renal artery embolization, reflux of the embolic substance may occur more frequently than anticipated. In human, iflumbo-sacral cord is supplied with the second to third lumbar arteries, namely below the renal artery, risk of spinal cord injury on renal artery embolizaticn is quite high. This maneuver should never be carried out with easy mind.