@article{oai:kanazawa-u.repo.nii.ac.jp:00045020,
 author = {Urayama, Hiroshi and Katada, Shoichi and Takahashi, Masao and Tsuchida, Kei and Tedoriya, Takeo and Takemura, Hirofumi and Watanabe, Yoh and 浦山, 博 and 片田, 正一 and 高橋, 政夫 and 土田, 敬 and 手取屋, 岳夫 and 竹村, 博文 and 渡辺, 洋宇},
 issue = {2},
 journal = {日本心臓血管外科学会雑誌, Japanese Journal of Cardiovascular Surgery},
 month = {},
 note = {Thromboexclusion method for thoracic aortic aneurysm was studied in 10 patients who had dissecting aneurysm in 7 and atherosclerotic aneurysm in 3. The aortic aneurysms extended from the left subclavian artery to the diaphragma or more widely. The operations were extraanatomic bypass and permanent aortic clamp proximal to the aneurysm in 9, and proximal and distal to the aneuysm in one. The follow up periods were 14 days to 80 months. Eight patients survived more than 3 months and 5 of them had thromboexclusion of aneurysm to the diaphragma. One with the aneurysms of incomplete thromboexclusion resulted in aneurysmal rupture 28 months after operation, and recovered by additional clamp distal to the aneurysm. Another had aneurysmal rupture, and died 63 months after operation. A patient had the penetration of the clamp to the pulmonary artery, and died 12 months after operation. Temporary paraplegia occurred in a patient 15 months after operation. Two patients developed constipation without ileus. Any difference of blood pressure between upper and lower extremities was not recognized, and no patient had deterioration of renal function. Indication of this method should be strictly selected, and careful follow up study is mandatory., 胸部大動脈瘤に対する血栓曠置術10症例を対象とした. 疾患は解離性大動脈瘤7例, 粥状硬化性大動脈瘤3例であり, 全例で瘤の範囲は下行大動脈の大部分を含むものであった. 術式は非解剖学的バイパスを腹側に置き, 永久クランプの部位は瘤の中枢側のみ9例で瘤末梢側の遮断は1例に行った. 術後観察期間は14日から6年8か月であった. 3か月以上観察できた8例中5例が横隔膜までの下行大動脈の完全な血栓曠置を認めた. 不完全な血栓曠置例のうち1例で28か月に瘤破裂をきたしたが末梢側遮断の追加にて治癒し, 1例にて63か月に瘤破裂をきたし死亡した. 他の1例で12か月後クランプの肺動脈穿通にて死亡した. 1例で術後15か月に一過性の脊髄障害を認めた. 2例で便秘をきたしたが腸閉塞の合併はなかった. 術後に上下肢の血圧差は認めず, また, 腎機能の悪化した症例はなかった. 本術式の適応は厳格であるべきであり, 術後の厳重な経過観察が必要であった., 金沢大学医薬保健研究域医学系},
 pages = {177--180},
 title = {胸部大動脈瘤に対する血栓曠置術の成績と問題点},
 volume = {21},
 year = {1992}
}