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大動脈瘤・大動脈解離診療ガイドライン（2011 年改訂版）

Contents

1.
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3. 23 24 2010
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5. HS 173 15 43 2 1 2 3
6. 130mmHg 150mmHg 252 2 Bep 8n Ws KB I lt BUT o PAB amp SEPA BC OA BARE 20 1 20 Class Ia 1 105 120mmHg Level C 2 130mmHg Fr Level C 3
7. 9 open conversion type I Zenith neck banding anTad TypeT sac back flow
8. X PN fre
9. 16 653 R31 1 60 90 Stanford A PHIM KH WRI 50mm
10. T X PIR Me KET CE DHA CT CT 90 50 70 80
11. CT Stanford A Stanford B 1 CT 2 3 4
12. 6 AAT1 6 AAT17 AAT2 AAT3 3p22 TGFBR2 AAT4 16p13 MYH11 AAT5 9q22 TGFBR1 AAT6 10q22 ACTA2 AAT3 AAT5 TGFBRI 7GFBR2 TOREO Wi 4C742 15
13. Crawford extent I amp V ALP TAGE PIC BVT Landing cover D 99 36 c
14. CT pannel BRAG BV CAME 2336 R S TUI FILER WME HICAIBLEVALED bv HIRI Lo HEIN OO Het LC ERE L FE eT ZC EDS PEED ARETE RRE OL ee f 2235 REEDS MT SUS
15. ZrO SNP 70 2 iE 10 2003 Ws 76 2010 2005
16. 143 on 25 Class I 1 2 Class Ia Class T b 2 Class M 1 3 Stanford B 1 2 lt B
17. d FE 4 70 2 70 79 2 3 F
18. B 32 1 TEVAR Thoracic Endovascular Aortic Repair B 100 18 B IRAD B 3 75 80 19
19. 50 60 20 30 2 Caf WE WEEE AEE EHPERS BDR
20. 80mmHg 430 431 WW Va delayed closure 79 40 70 99
21. 180mmHg 2 CT MRI CT 3 6 2 6 3 1 3 6 9 12H ICH CT ULP CT
22. HORREA S X inflammatory abdominal aortic aneurysm AAA 10 450 2 OPAC Lo
23. malperfusion syndrome re entry n Class Ia Level B dynamic narrowing P9
24. Marfan 2 re entry Bune LC PATA re entry JE 5G ACE SHSM HOM CHAO HERDS
25. THOT Clk 60mm JERKS Cle 50mm 30mm blue toe mobile plaque 1
26. HS EARN IER Ie FRB RL e BRITA TC HSB Pi Wed gt 1 tis x He 35 BRAS ORE Class I 1 Level B Class Ia 1 Level B 2 Level C Class Ib 1 in situ Level B 2 Level C Class M 1 Level C 73 74 Hsu 3cm
27. MRI EVAR MRI Zenith MRI ZE MRI Excluder Powerlink 1 5 MRI 0 3 MRI
28. 2010 12 1 BER assent Ek
29. type I V 23 Type I Type IM Type I Type Type V endotension 8 26 ADN Type I WW Re intervention 20 37 C29 9 3 6 5 2 3 type I TA z 99 599 59 900
30. 1 Stanford A 2 Stanford A 48 1lmm 2 T KEIR KERESNI BD 4 Y HBI A ifii EE 12mm ULP 50mm 2 3 Stanford B gt 40mm 1 COPD DFE 4 Stanford B Aht P ULP 70 E IRI gt 53mm 2 4
31. WV 9 3 in situ 9 9 4
32. 2090100 CT CT CT 50 94 77 100 99 MRI HICAVE ZY y b OFZ P LO CR kK 90mmHg
33. 1 1 Stanford A B DeBokey II D legor IIIa 28 Ub DeBakey fear fear 2 3 2
34. 1E 31 3 14 O S CEDRIA COE CCH AA W
35. AAA OSR EVAR ACC AHA 2005 AAA55mm low or average risk OSR 2343 8 3UC v 2 EVAR OSR risk high risk EVAR 7 high risk EVAR SVS 7 3 2 4 ACC AHA 2005 OSR LAL SVS EVAR
36. http stentgraftjp randomized A
37. HSM ES SACKS WR EDS 2 CBRE LOCH 70 B Stanford
38. D 2 LOL 180mm Hg XS a mi mi
39. HEOR T R Tete ED 21 ACIE EMI ROR EEDIOE KEES IRA AAA ACC AHA 2005 OSR LOL SVS
40. Bde fL KO DRA HRP AD SOME CL ET 3 6 3 ARADR
41. 17 18 2010 X CT EONX CT JHE ULP Stanford A
42. RA 105 A 3 DB Af HESE RO 8 CH b BAPE A RC KS aR RS 1 4 2 7 1998 2002 2003 2008 CHS 4 10 1997 600 sm2 1998 160 SH 1999 1000 OZ 1991 2000 3Z 2 62 1997 2005 100 22 SCHK7O k 0 UAE CT MRI
43. strategy 79352 collateral network concept 1 el A d bU F F 2 A ni Sk AWE lt 10 13cmH 0 15mL hr 3 steal Balloon catheter 4 SHARE RO IZ MD CT MRA 5 2 W 6 7 3 5
44. 234 459 INSTEAD Trial 2009 2 remodeling vs Class Ib Level B landing zone endoleak landing zone
45. v Bd 11 12 E 6 704 13 70 80 5 1983 1984 R 152 2 16 1993 1996 BARE 315 5 BIRD 1 07 59 41 Z1 1998 2002 BARE 388 8 1 47 61 39 Z2 2003 2008 FIRE 296 Z 1 48 63 37 73 1998 2002 BARB 722 8 HBR 2 73 7Z5 25 72 2003 2008 536 2 HIRED 2 67 Z3 27 73
46. Imterventional radiology balloon catheter stenting IVR 90 30 9 3 catheter intervention fenestration KE BR SK M vw soe E 45 46
47. OE e 2 7 3 10 9 90 Stanford A B B 5D OFTE BHROS HEN k D R M EE SAEED 44 7 W
48. 2 16 1Z K 18 50mm FDP 40 19 Phase I 18 1 130mmHg 16 Stanford A Stanford B 50mm DIC FDP40 1 1 130mmHg 2
49. Melk Elephant Trunk TEVAR 5 Branched stent graft Fenestrated stent graft
50. Pape eee en i BACC STIEG DERE L Class Ib Level C Class I 1 Level C 2 Level B 3 B level B Class I a 1 IRT U RIFARSI Level B 2 BOAR EDIT Level C Class Ib 1 FOI IFTAR Level C 2 ABT U RIBARA RAER Co Level C 3 Level B Class M 1 55mm EL FR OBERE Sb LX y 5TL 24 Level C 2 HEARO VAIOSER ERASE Level B SEPA BDF ATC BOTRA Frozen elephant trunk Stented elephant trunk
51. 32 732696 42 W Mayo Clinic WW 50 30 20 3596287 2 ABHA 20 15 76 10 99 23 5 37 8
52. 13 T 10 15 1 1 SOON 2 WX peo ASH SER 3 3 RB 13 I Ila Ib Ti gt 55mm oe ae c Level A gt 50mm AEEA0 Omm amp rise Amm cider iin level C wie Level A Level C E B
53. MDCT entry 2 CT CT CT CT CT 3 ULP CT ulcer like projection ULP ULP
54. www mrisafty com MRI 1 5T MRI www mrisafty com MRI
55. CT WH AO E LZ LO FABRE 760999 1 4 24 35 36 2010 1 74 ULP 60 7 2 L 40mm
56. pseudo false aneurysm of the aorta MAE LT 3 1 2 3 R1 3 Stanford DeBakey A B 1 WH IDE a b
57. 2 thoracic thoracoabdominal abdominal R 2 E fr ascending 72 BB arch descending Crawford 10 suprarenal 3 9X 2376 Eom DN atherosclerotic traumatic infrarenal 2 WE inflammatory infected congenital atherosclerotic aneurysm of the aorta 4 BOR HOWL fusiform type 3 lt ERIE 4 amp ORRE KERR k DEREZ 1 MAE
58. D 22 167 234 458 131 57 46 2 2006 B meta analysis Tb IRAD B Clas I Level B Stanford A
59. 0 2010 Vogt in situ msiiu extra anatomical bypass Lesche 3 17 v 10
60. CT annulo aortic ectasia AAE Qr B ABO Ha ESN Clk T CT
61. sac type OL type I I touch up extension typeI Moy F Excluder ACT 578 579 BHIE SVS 9 9 590 AAA
62. 10 2010 COMBE intramural hematoma aortic i aortic intramural hematoma ZEH L 7x v i 5 25 8 1 2 tear bodie d ARBOR CT tear CT
63. 7 9 909 KEL HE TEVAR TEVAR 59 513 514 Class IT a Level C
64. DEDEFAIADIEH DOME Jg CH David Marfan AVS Class I b 7 20094E Marfan Bentall AVS AVS Class Ia L 3 Bentall AVS L Bentall Class II b 9 1
65. 10 8 33 0 2 9 0 4 2 609 meta analysis 1 9 0 8 2 3 30 H 5 3 B 1 304 meta analysis 0 2 0 30H 2 6 Shimono 6 21 5 36 88 9 59 3 B INSTEAD Trial C 5
66. 19 A CT TTE yes J AR N no enfry bas no TEVAR no ZEE EE x eee ER TEE 9 N yes gs CT Arch or Asc Root or 43 44 2010 Te 1 entry b tear
67. 50mm X32 Ghent 2010 1 222 PO 2 Z gt 2 FBN7 gt 3 Z 2 27H AEE 4 KEMARA CRESS FBN ERTER V7 y DERE FBN7 ELS ege TDD Z 2 5 Al IMASSIBA EER
68. button technique E malperfusion RHW WEZI ii hemiarch replacement or partial arch replacement hemiarch replacement 1 2 partial arch replacement partial arch ii total arch replacement tear
69. 5 15 20 10 device 2 10 device website http stentgraftjp ER https www akademi jp stent EVAR 7 000 2006 7 1 2008 6 30 2
70. m W 17 EWC BU ARR Cin HERO LIS BR 100 120mmHg 2 20 A 15
71. 2 TGF f 2 7C7gX7 it 9q22 7GFBR2 3p22 77 78 2010 36 FBNI Fle LDS TGFBRI TGFBR2 DHEA 5Dz3x
72. MRI MRA 2004 44 685 691 144 MRI MRA 2009 49 503 516 145 Prince MR Grist TM Debatin JF 3D contrast MR angiography Springer 2002 146 2006 Cire J 2006 70 1569 1646 147 NSF http www radiology jp uploads photos 649 pdf 148 Shellock FG Reference manual for magnetic resonance safety implants and devices 2005 edition Biomedical Research Publishing Group 2005 149 Levine GN Gomes AS Arai AE et al Safety of magnetic resonance imaging in patients with cardiovascular devices an American Heart Association scientific statement from the Committee on Diagnostic and Interventional Cardiac Catheterization Council on Clinical Cardiology and the Council on Cardiovascular Radiology and Intervention endorsed by the
73. CT CT HOF WO JH REO AKG IRREO ARIA Hehe TE SUR SR EEFE Ih 38 e Er C OBS DIH E JAE 60mm 50mm CT 1 XX CT
74. stiff wire Er Sh WR ACHE JJ IE pull through wire TEVAR EVAR 2 6Fr ABBA mE iliac BY 488 515 516 3 Class I Level C 2 Landing zone HERS LILA KEBY Landing zone Landing zone Landing zone
75. OD 2 3 PRES 4 KIEDERE X SWE 5 HARRO ETE PN OO t BR AZ k A MO SP S SO CT MRI MR angiography CT CT MRI B 105 120mmHg Z3 amp C d 2
76. 9 V 1 ACC AHA RE 22 DeBakey 1950 PBA BI B k U Stanford A gold standard KEIR T V 1 2 V 1 3
77. OO debranching D 22 ICU QOL WS stroke T paraplegia Fenest
78. CRP IAAA CT Mantle sign CT CT CT CT T enhance E 32 AUT 5398
79. T2 150 200 mL ik Gm Class I b 3 19 A B M nou Z 8 IL 1 Stanford A B
80. 3 BeEBA EHE 29 EB fC Hl 1991 A Parodi Z Em DD bifurcation type lb device 23 BH 3 amp amp 3L 7 EVAR ope surgical repair OSR 2007 4 EVAR SVS practice guidelines SVS UKSAT United Kingdom Small Aneurysm Trial ADAM Aneurysm Detection and Management trial O iR t X z C
81. 4 Ringer s lactate solution O i DHCA stent graft 160 390 7390 A 5 32 5 10 Stanford A B 3 A 10
82. hostile abdomen EE EVAR EVAR 2 CT BARE ABAD RE C 11900 3
83. intimal flap RIL WERO 2O tear intimal tear tear FL entry FEAL GL reentry 10 communi cating aortic dissection Classic dissection double barrel aorta TES EE EI ETRAS REBEL non communi cating aortic dissection thrombosed type aortic dissection intramural hematoma tear RENI intramural hemorrhage
84. TEVAR TEVAR TEVAR Landing zone 2 1 20 27 Fr ER dH Aw 55 56 2010 15
85. RIT 29 5 abdominal aortic aneurysm AAA OEY IAAA AAA AAA W subpopulation mago 2 IAAA 99 IgG4
86. HATI TAKS SEL 20 2596 40 80 du Ala CAA HEI CT MRI
87. e zd A3 880 B LO LOOKS 3 12 6 15 990 319 37 316 870 4 9 7 11 9 20 79 39 D 10 1 db o 7279 Crawford II 2 27 10 2 0 375 378 381 207 210 278 286 331 363 381 2 OF ABI Il 3 13 2008
88. IMH A ER rei 8 9 KEIR variant 2 tear classic aortic dissection double barrel type tear obe DRAME OMH ER non communicating aortic dissection thrombosed type IMH tear ulcerlike projection ULP Hoe thrombosed false lumen with intimal defect ULP MD CT ULP ULP ULP
89. 3 13 WW 5 70 80 404 43 10 40 COPD 4 EA hs TS Web cux un mE COPD EAE 004m VI 225 EB fC Hic malperfusion syndrome
90. WRK e StL CHEMISES BTS 60 T 70 15 15q21 I CT MR 2 lt 3 Ww 4 5 qa X31 7 ERE BR ASK AD AR th BARRE 5 32
91. 40mm 22mm VEY TEVAR jvCv 23 7 HRAT 1 Stanford A Stanford A Song 9
92. 2 4 4 2010 12 TAG W L Gore amp Associates Inc Talent Medtronic 2 C TAG Valiant 2010 12 HRE TX2 Cook Inc Najuta KAWASUMI Laboratories Inc CL 0201 JUNKEN MEDICAL Najuta 5 fenestration HS CL 0201 Landings zone
93. DOH 59599 FDA US Food and Drug Administration device 5 device AnCure AneuRx Excluder Zenith PowerLink trial high risk 30 EVAR 2 9 OSR 5 1 4 EVAR 96 OSR 95 EVAR Zenith 97 type I 1 99 1 10 9 type TI
94. 1 1 5cm 2 460 275 3k REEL EJEKI o8 ST TREO TS DS FEDS 2
95. 3 PKDI PK 2 Noonan PTPNII KRAS SOS A477 Fe Alagille JAGI NOTCH2 REO HR ELN FBLN43i z T COLIAI CO7742 KE B 79 80 2010 3Z 2 HORA Cl
96. GHILE ALT amp X hematoma dissecting aneurysm of the aorta true lumen false lumen aortic dissection RIER ARER 2 lt GR2 9 a 2 KODE thoratic thoraco abdominal abdominal ia WG ER saccular type fusiform type frue dissecting pseudo atherosclerotic infected traumatic inflammatory congenital 9 true aneurysm dissecting aneurysm pseudo aneurysm
97. BEN intramural hematoma with penetrating atherosclerotic ulcer intimal defect with Biz ULP Ug Ue Uk WA A WN c WN ULP ecd A Ulcerlike projection ULP REN UIP ULP 2 3 CT ARI 8C B ADCT ear D fear COE C fear aorti ic intramural hemato
98. Tear IMH Tear Type A IMH IMH AA CT IMH WREE
99. KY ToS DNA DNA RNA mRNA DNA T 2 1 2 3 mRNA 1 2 mRNA BOM
100. 1 2 3 Bis 4 50 60mm 6 5 60mm 15 6 HEO 4mm CT MRI HAE 6 1 3 6
101. D Fei i Wa DARD BRAZ E LZ CB DRAB MERE ES 7 18 29 9 DeBakey I myonephropathic metabolic syndrome 4 DIC DIC pre DIC
102. DNA PCR 95 mRNA DNA Bx ot d WB LS 2 1 X XX 2 000 3 000 1 WRH i
103. 7 extended arch aneurysm 124 418 Elephant Trunk amp F r HANKA L Elephant trunk Landing TEVAR 2 7 W 2cm Landing zone W 99 1 Class I a Level B 26 1 Class Ib Level
104. KK BEOVPIE 2 3mm 6mm 1 20 WARE 1 3 HOFFER CH or EW RARE MLS 7 2 X X CT mess X
105. ACC AHA http circ ahajournals org manual manual IIstep6 shtml Classification of Recommendations Class I Conditions for which there is evidence and or I 1 I 2 dissection lt iles 2s rp gs ee D2 praa e apne 1 ile ps general agreement that a given procedure or treatment is useful and effective Class II Conditions for which there is conflicting evidence and or a divergence of opinion about the usefulness efficacy of a procedure or treatment Ila Weight of evidence opinion is in favor of usefulness efficacy II b Usefuln
106. 1 SAME REMAKE Congenital Contractural Arachnodactyly Beals gt E VEC MAE 2 5q23 q31 THA 2 Arterial Tortuosity Syndrome ATS Arterial Tortuosity Syndrome ATS 1 GLUT10 C2470 ATS C2470
107. XX OCT MRI KEIR KERESNI BD 4 Y Stanford A B 1 2 I A K A 46 78 2
108. 2 1 Bentall Carrel patch Button Bentall 3 2 gt 22 2010 ACCF AHA AATS ACR ASA SCA SCAI SIR STS SVM Guidelines 1 Class I 1 Level C 2 Marfan Loeys Dietz Ehlers Danlos Valsalva David reimplantation Bentall 42X44 Level B 2
109. 33 p TGF H ARB 99 99 2
110. 2 tear Stanford A A tear tear tear von Segesser Stanford A 817 Kaji 14
111. 4 8 0 703 EN to AEP AB WIE LIC ERO Ey RARO do ARTIC
112. 2010 Ghent R32 Z gt 2 gt 3 7g 7 TRIK potential MFS EL 1 Loeys Dietz syndrome LDS E
113. 7 CT CT CT CT HERO AIRILOREE CT CT MDCT multidetector row CT CT EK 300mglmL 3mrL 100mL MDCT D Imm CT CT MDCT VR volume rendering MPR mult planar reconstruction
114. 7 1 0 Kaji p pe prae QA 2 3 7 5 90 9 9 79 Song 85 3 83 Kitai 50 10 89 9 T Stanford A HEIL 9 59 56 182 186 2010 A
115. i L UNS 207 210 278 286 331 363 381 2008 24 2008 at o H 47 48 2010 20 3500 3000 Bon rial 2000 F 2500 _ 1500 1000 Ji i 500 H 24 FEBRERO ED HSEREDA SIBI O FRR 2008 836 20 2 4 677 2239 1790 113 6 3 BBB Rf 165 13 7 9 452 22 4 9 348 35 10 1 11 0 0 0 952 39 995 1 730 20 2 7 2 open stent a EB EE 74 0 0 0 b 142 13 9 2 6 0 0 0
116. tear 10 19 Stanford B Stanford B A B 30 10 TOD WW
117. 92 type 1 TIND EVAR type I 10 9 ZORZI kO TVUS
118. CT 3DCT 8 16 MASS 3cm 5 1 O 3 5mm CT 55mm
119. 2010 LDL SAAR RIO IEE 9 interleukin INF y O KJEE cytokine matrix metalloproteinase MMP 22 38 39 2 aortic dissection dissecting aneurysm of the aorta JEJE classic aortic dissection tear true lumen false lumen flap
120. 30 50 1 2 TIA stroke CH A 3 2 N 40 BC PBST AMARA C re entry 7k 20 36 2 55 9
121. ACE 60 O Morphine buprenorphine 48 H HE 100 120mmHg
122. Slonim 5 40 24 I 14 2 v2 9 37 93 DD 10 25 30 3 B 9 B complicated type B ORD
123. AAT1 11q23 q24 FAA1 707 AAT2 5q13 TAAD1 708 AAT3 3p24 25 TGFBR2 TAAD2 LDS 709 AATA 16p13 MYHII PDA 710 AAT5 9q22 TGFBR I LDS AAT6 10q22 ACTA2 B SB EIRE AAAI 19q13 717 AAA2 4q31 A AAA3 9p21 Z19 TE 3p24 25 TGFBR2 3p22 l Hiratzka LF Bakris GL Beckman JA et al 2010 ACCF AHA AATS ACR ASA SCA SCAI SIR STS SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease Executive summary Circulation 2010 121 1544 1579 2 Erbel R Alfonso F Boileau C et al Diagnosis and management of aortic dissection Recommendation of the task force on aortic dissection European Society of Cardiology Eur Heart J 2001 22 1642 1681 3 Hirst AE Jr Johns VJ Jr Kime SW Jr Dissecting aneurysm of the aorta A review of 505 cases Medicine 1958 37 217 279 4 Vilacosta I San Roman JA Ferreiros J et al Natural history and serial morphology of aortic intramural hematoma a novel variant of aortic dissection Am Heart J 1997 134 495 507 5 Gore I Seiwert VJ Dissecting aneurysm of the aorta pathologic aspects an analysis of eighty five fatal cases AMA
124. 9 Stanford A Mohr Kahaly 1994 3 72 2 3 NA Nienaber 1995 12 52 4 5 NA Sueyoshi 1997 13 70 1 8 4 8 Kaji 1999 22 65 1 22 02720 Shimizu 2000 13 NA 3 11 NA Hagan 2000 17 NA 4 8 NA Nishigami 2000 8 72 1 8 2 8 Song 2001 24 67 1 18 7 13 Sohn 2001 13 NA 0 13 NA Kaji 2002 30 67 1 30 17 30 Song 2002 41 65 3 41 24 36 Evangelista 2003 12 NA 1 5 2 5 von Kodolitsch 2003 38 NA 6 11 NA Moizumi 2004 41 67 3 30 NA Evangelista 2005 29 NA 3 9 NA Kita 2009 66 68 2 50 30 50 Song 2009 101 65 6 85 NA 29 30 2010 ULP
125. VW 1 10 D 20 EJ BARI cats 11 20 7
126. Mehard CT high attenuating crescent sign ERD SVL EPI SBE RERO D TU MHS 2v 5 aortic cobweb KE BETHA positive predictive value 53 2 8mm CT 6 5mm fi C d
127. ULP ULP IU partial thrombus in false lumen thrombosed false lumen communicating with true lumen Stanson penetrating atherosclerotic ulcer PAU fe bee M epus penetration E PAU Svensson p PAU scene CML
128. Class La Level B Class Ib Level C 2753 1 LZE Brockenbrough Colapinto INEN 12 15mm 20 40mm FOF WEA LAN YOUMRICE ND TI y PERV 2 PTA CTA WETA pu
129. Marfan 0 2 FF A 27 v LASTER INA 78 AMP HO AT EZ ltr HE V distal perfusion heparin coating X coating heparin HCA 9 39 3
130. ULP 1 3 1 3 7 8 2 2 48 5 1 2 WA 3 RAHELILMBL DI 1 Stanford A 60 70 f XI S
131. 1 4 2 7 1998 2002 2003 2008 CT MRI 11 Z000 6000 5000 4000 3000 E 2000 D 1000 0 2004 2005 2006 200Z 2008 IE 2010 400 300 250 al i 200 150 100 50 1200 1000 800 all i 600 12 2002 2008 alli 0 9 10 19 20 29 30
132. Type attachment site leak WW 90 risk 40 sac EVAR 1 14 1 10 1 type I A 2 type ILB EVAR 9 2 type 41 3 8 cavity cavity 15mm WW
133. WM 4 S RAT 9 RCT S BIT FRE
134. KEY kT eT FOP 21 Landing Zone 0 Zone 1 BigBSDBK IRA 2 D A SERE IRE EC Zone 2 AZAB BK y IRA DY 5 ESAS PF SARA USB E C Zone 3 ASH FSI I ZR 2 5 Th 4 Zone 4 Th4 Landing zone Ishimaru Landing zone 21 DEMME FIR cover BORE RIE cover BEALS ABI 7e cover Zone2 Landing cover 59 O cover
135. Level C Class IL b 1 level C Class M 1 Level C Level C Level C Level C 27 28 2010 8 Stanford B Class I 1 ULP B 2 Level C BAS 3 B Le
136. 15 XP CT DEBES We FARES CT ee 4 5cm 4 5 5 5cm 5 5cm FE RER a ee CT Y CT 7 gutem 0 5cm 0 5cm i 1 CT CT 4 5cm 8 BT CT 45mm
137. E Xing aortomegaly annulo aortic ectasia 30mm 20mm 1 5 45mm pend 30mm GERENCIA L 72 9 Gc D aneurysm doce aneurysmal dilatation COVIKD MBER C do UA b SETA E II fusiform type aortic aneurysm P41 RTN TICK IC saccular type aortic aneurysm 2
138. 28mm Zenith Flex Talent 32mm 2 6 7mm 3 distal neck 10mm Zenith suprarenal 45 Powerlink unibody OCDE EVAR CT 2 neck 15mm Talent 10mm 60 5 553 550 Class I Level A 30 Zenih Cook Excluder Gore Powerlink Endologix TALENT Medtr
139. deploy 5mm 10mm 5 95 92 24 0 45 migration 623 624 migration neck 15mm 7 neck neck gt 45 PHK neck 0 BETE IEOH 20 oversizing 959 629 620 EVAR follow EVAR EVAR follow 1 1 3 6 1 1 follow open conversion
140. ACC AHA LAL fe ene a s ETT
141. 10 4 HE malperfusion 5 LPL 60 E WRS
142. 130mmHg DD 3 6 CT MRI f L 1 L CT 7030 LPL QOL 50mm
143. 24 TOM TRAD 23 Iu ADIER MEHR
144. EVAR 1 743 0 3 2 0 5 type I 1 0 typeI 114 96 typelll 0 6 typelV 0 1 6 02 https www akademi jp stenttyousa_ kekka pdf EVAR AAA OSR LOL EVAR ACC AHA risk 4 Mets EVAR 7
145. OREZ 3 7 Stanford A 3 9 ESI DRA ALTER KY SRENET Ye CONDE ei 3 7 E JIH Tr
146. F F px e EO e vic cold LCCA LSA ii open proximal anastomosis RHMWA HAWES AD MEW EF 252 Adamkiewicz Adamkiewicz Pat iti
147. WV translumber L C 2 4 MERZIT 2599 99 ERE Hk 1 Type defect leak overlap Ox type A type B 5 Type TypeIVY porosity leak EVAR 30 leak TypeV endotension Excluder 13 WW Gore
148. CT 18 CT CT MOPE CT CT 2 22 2010
149. www mrisaftycom 25 26 2010 5 Adamkiewicz Jg 1 Adamkiewicz Adamkiewicz MRI MDCT
150. 1 1999 44 48 462 Dorros G Cohn JM Adenosine induced transient cardiac asystole enhances precise deployment of stent grafts in the thoracic or abdominal aorta J Endovasc Surg 1996 3 270 272 463 KENT SATU ZIT BAT 2000 9 172 suppl 464 Xiong J Jiang B Guo W et al Endovascular stent graft placement in patients with type B aortic dissection a meta analysis in China J Thorac Cardiovasc Surg 2009 138 865 872 465 Kato M Kaneko M Kuratani T et al New operative method for distal aortic arch aneurysm combined cervical branch bypass and endovascular stent graft implantation J Thorac Cardiovasc Surg 1999 117 832 834 466 Hughes GC Daneshmand MA Balsara KR et al Hybrid repair of aneurysms of the transverse aortic arch midterm results Ann Thorac Surg 2009 88 1882 1887 discussion 1887 1888 467 Weigang E Parker J Czerny M et al Endovascular aortic arch repair after aortic arch de branching Ann Thorac Surg 2009 87 603 607 468 Saleh HM Inglese L Combined surgical and endovascular treatment of aortic arch aneurysms J Vasc Surg 2006 44 460 466 469 Hughes GC Nienaber JJ Bush EL et al Use of custom Dacron branch grafts for hybrid aortic debranching during endovascular repair of thoracic and thoracoabdominal aortic aneurysms
151. Or 09 4 BR CT Je RE static obstruction dynamic obstruction UU 5
152. 1993 12 179 185 134 Nienaber CA von Kodolitsch Y et al The diagnosis of thoracic aortic dissection by noninvasive imaging procedures N Engl J Med 1993 328 1 9 135 Erbel R Engberding R et al Echocardiography in diagnosis of aortic dissection Lancet 1989 1 457 461 136 Hashimoto S Kumada T et al Assessment of transesophageal Doppler echocardiography in dissecting aortic aneurysm J Am Coll Cardiol 1989 14 1253 1262 137 Banning AP Masani ND et al Transesophagesl echocardiography as the sole diagnostic investigation in patients with suspected thoracic aortic dissection Br Heart J 1994 72 461 465 138 Nienaber CA Spielmann RP et al Diagnosis of thoracic aortic dissection Magnetic resonance imaging versus transesophageal echocardiography Circulation 1992 85 434 447 139 MR Mi 2010 140 Higgins CB Roos A Cardiovascular MRI amp MRA LIPPINCOTT WILLIAMS amp WILKINS 2002 141 TL MRI 2003 GN 2003 75 81 142 Prince MR Gadolinium enhanced MR aortography Radiology 1994 191 155 164 143 Side
153. 17 Stanford B 40mm ULP 1 4 DIC FDP40 1 2 3 1 1 130mmHg 2 3 ADL 4 AR BS 358 BERE TERR 1 2 30 2 EE amp gHg 3 4H 90 3 5 6H 4 258 9 14 HES A 5 iH 9 10B 50
154. 3 Stanford B 4 Stanford A 1 Stanford B 3 Stanford B level C level C Level C Level B Level B Level B Level B Level B Level C Level C Level B 2 static compression Stanford B level C 3 Stanford BWS A Level C Class II b Level C hi 51 52 2010
155. 77 7 7 19 720 72 90 2 E 70 79
156. 2 CT fu 100 120mmHg ACE v A CT Ent Y s o v ZEB in L iios SPAR AN BERE OMS EH vy WBC Hb XP CRP D dimer Y N ACS sce DERI i
157. deploy 18 21 Fr KRDI REELT KEER L TIT NTA ABAGIIR BL CITI HDS Ch 100 kg ACT 250 300 stiff wire 65 66 2010 RO landing zone touch up
158. Masuda 7 Stanford A Class I SKE Class Ia 1 A 1 I 2 1 2 A II 1 I 3 level C 3
159. 4 70 80 painless dissection 6 4 3 25959 9 20 baroreceptor Stanford A 44
160. TR UREA M FER 2 Shprintzen Goldberg o SO BECA 98
161. Z 2 RARR 1 4 il Cu CIE TA I i5 20 Z 3 m El 2 1 lt 2 1 E ET Qu lt 1 lt 2 M E TA GE tE lt lt 5 3 BRBZUSIT HEM FRE 1 e 15 3D 1 e A 33 HR xus I HEPA BE Y ES A Level C 1 8 Level C o 3
162. ARE Adamkiewicz Th9 L2 85 90 MDCT 0 2 CT EEO AIKILOR EAD IR D RIERS KIC BU 2 HEE LEEW high density crescent sign 5x CT VR MPR CT 129 1267 OR TEE BED KD oon HSLDA D WE OO RE Ze o RE OE PELE A BR 25 d 3 1
163. microfibril fibrillin 1 72 9 fibrillin microfibril fibrillin OP fibrillin 1 transforming growth factor f TGF f fransfortm matrix metalloproteinase MMP elastolysis 69 70 2010 cystic medial necrosis L D
164. risk factor 3 AAA WV LY bay EMI Id DSA stiff touch up device SVS EVAR AA
165. 2 18 ASARA RARE cE OPERA EFE 100 754 504 aS Beh HERIISENE 254 3 0 3 9cm 213 33 ADB 2010 14 3 3 9cm 2 0mm 4 4 9cm 3 4mm 5 5 9cm 6 4mm 215 3 29 EME SITS AP WN EW EDO KA WI Gs 380 I8 RE REP PEE DH e 7e 79795 ERK CED AM OO BEER US E RODE
166. 2010 2011 Guidelines for Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection JCS 2011 H A a Jom amp X X Wu E BE ak a Jn
167. 1E2330 50mm 21 Class I Level B EAO PRR RE x 20 25 HAIN SAE 2 6 HV SE CHIRK AZ IME FZ PAP BIH 0 LEB Bh ARIS ARE do A v SR KAMEN JEM PPE LY VCE AERE S OT v g 0929 HMGCoA Class Ib Level B A T VEBSKSIg IREE ALE ORES 72759 RCT ACE Class Ib Level B 15 326 Z ORKER T BOE EEG O 3 12 ACE 8 ARB 2 5 ACEH ORAS DDR RR 23 6m RCT B Class M Level A B RCT propranolol
168. Stanford A B WREST IRE OAPI 10 Class I 1 gt 5mm 6 level C 2 z 60mm level C 3 50mm level C Class T a 1 Level C 2 55 60mm level C 3 50mm level C Class IL b 1 50 55mm
169. CT BEO 1 1 MRI MRA EH REX EDI HKD CIUS CT Bl15 KS SILLY 45mm CT 1 1 CT 55mm
170. entry re canalization 2010 o re dissection ded dissecting aneurysm of the Hee ADKL OE oa tear intramural hematoma IMH 7 82 Athi intramural hemorrhage amp fk tear 7 IMH
171. 9 99 W 40mm MRI wrist sign TE thumb sign ele metacarpal index 2 5 gt 8 77 bulla
172. 3 ADL 4 AR BS 18 D 30 3 90 1Z 3 BE Tl 7 1 6 7 2
173. A tear tear elephant trunk RRA EOD es TBVAR entry elephant trunk 4 munde ZTT 3 Frozen elephant trrunk 2 Sp ed Hybrid 99 Te B B A 1 20
174. ARDRE AE boe TE PVC 3 2596 50 X CT 1 4 D CT MRI
175. Ulcer like projection ULP tear ULP ULP ULP 0 DIB ULP 50mm 11mm 2 3
176. 10 4 2mm 5mm ROK cu 8 reduction CABG 50 9 TIA BNOKSEOS 40mm 0 40 50mm 0 5 5 96 50 60mm 3 15 60 70mm 10 20 70 80mm 20 40 96 80mm 30 50 6
177. MRI MRI MRI D 60mm 5mm6 WA DEDI ulcerlike projection ULP ULP MRI SSFP
178. E Heart View 2008 12 1380 1386 643 Greenberg RK Sternbergh WC 3rd Makaroun M et al Intermediate results of a United States multicenter trial of fenestrated endograft repair for juxtarenal abdominal aortic aneurysms J Vasc Surg 2009 50 730 737 el 644 Donas KP Lachat M Rancic Z et al Early and midterm outcome of a novel technique to simplify the hybrid procedures in the treatment of thoracoabdominal and pararenal aortic aneurysms J Vasc Surg 2009 50 1280 1284 645 Rehring TF Brewster DC Kaufman JA et al Regression of perianeurysmal fibrosis and ureteral dilation following endovascular repair of inflammatory abdominal aortic aneurysm Ann Vasc Surg 2001 15 591 593 646 Ruppert V Verrel F Kellner W et al Endovascular repair of inflammatory abdominal aortic aneurysms a valuable alternative Case report and review of literature Ann Vasc Surg 2004 18 357 360 647 Stroosma OB Kootstra G Schurink GW Management of aortic aneurysm in the presence of a horseshoe kidney Br J Surg 2001 88 500 509 648 Lau LL O Reilly M J Johnston LC et al Endovascular stent graft repair of primary aortocaval fistula with an abdominal aortoiliac aneurysm J Vasc Surg 2001 33 425 428 649 Leon LR Jr Arslan B Ley E et al Endovascular therapy of spontaneous aortocaval fistulae associated with abdominal aortic aneurysms Vascular 2007 15 35 4
179. KE W CT 1 09 Stanford A Bentall type Stanford B
180. thoracic aortic aneurysm TAA thoracoabdominal aortic aneurysm TAAA abdominal aortic aneurysm AAA Bl3a 3b 1 3 a b
181. nitnol PME IS thin wall Dacron graft e PTFE graft delivery system 24 Fr Teflon sheath pre load CHS RE 453 461 distal migration ATP deployment stabilizer E Rapid pacing 179 179 490 452 456 70 8 94 4 2 8 19 Hi 2 7 13
182. RCP arch first technique HCA HCA RCP SCP open proximal technique F EC KB EU e EB 3 A 1 5 6 4 5 7 8 5 6 spiral incision 8 10mm
183. r2 EOS REN V7 T SCP open distal anastomosis elephant trunk LEYAL TAPASZ ii aortic valve sparing operation KE fas Ze BU REO TRES OY Ui ANI ETA open distal anastomosis
184. 30 7 hE 1 2Z 27 survival Re intervention rate i 3 5 i 3 5 m 5 3 5 CINE 1 5 10 4 0 5 TAA Pee 2 806 80 95 67 90 50 87 5 17 10 14 23 o emergent 3 8 lt 40 9 2 6 at s Yay 4 15 57 10104 58 oo o uq uo E 22 LG WSS D Ej e B 14 TUA LUU 2s j a TA A L A3 ASE PRN 1 NA TEVAR 1 debranch TEVAR HRA AZA AREER SA 8 X LTEVAR 2 debranch TEVAR ARSI gt UAR BIR
185. 1 4 1 0 CT 9 V type I V 9999 Type IT attachment site leak type I A HH Bl type I B type I proximal I p RASMI type I distal Id Aorto uniiliac AUI iliac occluder plug type I CLS Type L AX z E19 Z BO RERUT O 7 23 27 05 cu ff 9 7 1anding zone balloon expandable open conversion Type I B
186. 50mm 2 IL 1 4 3 1 6 RCT 5mm 6 386 387 3 FREE ANA SEES L eo TUS BLEEDS S viii 2 HAIG SERED ELD ABE SPAT 2D 1 9596 12 Amie ape aO SEE 1 4 BEDRE 3 5 IC AGES SAN KERER BEDI Z CT TRT AA 2 R Jen TESDUKCHS
187. v TR b gt BTE IL 4 MRI magnetic resonance imaging Class I a 139 142 MRI MRI Tv
188. QOL 0 29 Class Ia Level B 21 Class I Class IL a Class I b Class M Doxycyclin Propranorol Level B Level B Level B Level A Roxithromycin ACE level B level B 39 gt 2010 Chlamydia Pneumoniae metalloproteinase doxycycline 2 roxithromycin 12 7 RCT Ek a tocopherol vitamin E b carotene KERE OE
189. Class Ia Level B HE EVAR 635 AAA TAAA EVAR neck AAA TAAA EVAR 0 custom made A debranching EVAR hybrid 1 9 AAA AAA OSR EVAR EVAR A 645 646 AAA 25 FAIS neck EVAR
190. SMA Ab MEYAL TRATHA ii open proximal anastomosis x malperfusion debris LSA GRESIK REDIR ATR WR LCCA 18C WHIT fx flush out Wass ii
191. true aneurysm of the aorta pseudoaneurysm of the aorta hematoma lt k SJ TREGS Ch 2 4 aortic dissection dissecting aneurysm of the aorta ZERA OE Marfan BRE OSE EI JO SEE C EDU 2 RRASA D 4 REAKSIE
192. 5 3 99 1 2 MEAR extra anatomical bypass in sitm
193. 5 WP CT CT CPR 1 Gme resolved MRA T 3 4mL 1 9 9 time resolved MRA Adamkiewicz high spatial resolution 57 80 9999 time resolved MRA i C X 69 84 v2 MRA CT
194. 2 Shimono 37 24 5 HT 2 97 3 78 3 Hansen ix 24 2 17 4 2 INSTEAD Trial 2 88 9 94 4 at 59 54 2010 See ee e
195. IAAA 40mm 50mm mantle 34 Class I 1 level C 2 50mm Level C Class Ia 1
196. KEAR aortic aneurysm MBEKI fusiform type aortic aneurysm EARKI saccular type aortic aneurysm PARED amp SEDGE 015155 ECR LRA AERA RRE FIRE LT PO BAKERE thoracic aortic aneurysm TAA 3 4 EC 3 4 thoracoabdominal aortic aneurysm TAAA Crawford 4 1 3 2 1 10 abdominal aortic aneurysm AAA inflammatory abdominal aortic aneurysm IAAA true aneurysm of the aorta FRRELASRO BRED 6 ODS HAAS
197. 1 40mm 0 40 49mm 0 1 4 50 59mm 4 3 1696 60mm 10 19 Perko 60mm 60mm 5 5 40mm 0 40 49mm 3 8 5 50 59mm T X 7 7 8 5 96 60mm 13 28 6 1 5 K88JKf 52mm 35 100mm T 85 64 David 151 1 3 8 83 2 79 Kazui 56 O45 RE 50
198. 79 6 99 90 17 25 WTS 20 EEA X LDH 72 D dimer
199. MRI MDCT MRI MDCT T CT T Adamkiewicz 4 64 MDCT 180152 MDCT 1mm 350 370 mgI mL 9 Adamkiewicz MPR multiplanar reformation Adamkiewicz OC
200. SIRS 1 38C 30 Aortic intramural hematoma Aortic intramural hemorrhage tear tear tear CT 377
201. 45mm KW OKA amp CHIN IZ CT 45 55mm 65 1 6 JJBpu 10 48 0 risk CT 80 16 CT Blt 65 BMH 68 75 98 100 oo AA CT RAHI IME 4 5cm 2 525 50m 5 5cm 6cm 1 CT ee LR Ew 1 CT
202. 20104 M M IU Biology Society of Interventional Radiology and the ACC AHA Task Force on Practice Guidelines Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation National Heart Lung and Blood Institute Society for Vascular Nursing TransAtlantic Inter Society Consensus and Vascular Disease Foundation Circulation 2006 113 e463 654 32 Tilson MD Stansel HC Differences in results for aneurysm vs occlusive disease after bifurcation grafts results of 100 elective grafts Arch Surg 1980 115 1173 1175 33 Clifton MA Familial abdominal aortic aneurysms Br J Surg 1977 64 765 766 34 Verloes A Sakalihasan N Koulischer L et al Aneurysms of the abdominal aorta familial and genetic aspects in three hundred thirteen pedigrees J Vasc Surg 1995 21 646 655 35 Blanchard JF Epidemiology of abdominal aortic aneurysms Epidemiol Rev 1999 21 207 221 36 Wilmink AB Quick CR Epidemiology and potential for prevention of abdominal aortic aneurysm Br J Surg 1998 85 155 162 37 Golledge J van Bockxmeer F Jamrozik K et al Association between serum lipoproteins and abdominal aortic a
203. RN 20 26 EH 1993 NA RH oe d ia 2008 3 v A E 2004 20064F REDUCE zx 26 MEARNS XS OX 5
204. 3 5 8 75 59 43 3 2008 18 8 10 209 20 80 9 5 10 15 94 64 35 79 IX Phase I 1 2 Phase I 2 Phase MZ 14
205. PA AP OX SARI AERA A IS X 1 H C409 Tti
206. 2010 1 A A EDIR W i 80 AR ii annuloaortic ectasia AAE
207. A S amp S OS ow MR MRI MRI MRI
208. eene 61 UNI LLL EHE 69 I JU y V BEWERE cone tenere tese eene enira 69 2 eee eene 71 3 BEREMEJCBUMRGRE eee enne 73 W 75 l 75 2 75 3 WB eee eme eene 77 PX t 81 9 amp 6 0 0 2006 2006 5 SLT IMH
209. EVAR re intervention re intervention EVAR EVAR re intervention high risk EVAR EVAR trial 1 OSR high risk E EVAR EVAR trial 2 T HA OSR 60 55mm I E00 SJ JE dbb COPD 1 338 EVAR 166 A 172 EVAR 1 frial 4 endpon
210. Clas I b AHCPR R23 AVS KIE sino tubular junction PIMA BVT sino tubular junction 29 EMMAL T open distal anastomosis 1 7
211. CT amp MRI CT MRI Adamkiewicz Adamkiewicz HE 23 f 90090359 CT MRI
212. EVAR Strong Moderate EVAR lc amp V WERTE AAA 2 46 EVAR EVAR 30 AAA CT EVAR EVAR L EVAR J ry gt OSR 57 8 35 3 EVAR
213. FO cover AAA AAA EVAR dp 99 069 AAA bridge EVAR AAA EVAR TT deploy EVAR
214. tear Sib gir tear Elephant trunk tear CT MRI A tear Marfan A elephant frunk 0 1 2 If EAP ASPIRE malperfusion W MOMS LOOKER Me PRAT 5 c 62325 2
215. 0 3 2 6 79 48 EVAR32 16 C BMRA 42 14 427 428 BREE HS BA SIRE 30 W CT CT CT
216. KANO MY CT MRI DSA CT DSA DSA 4 5 Fr
217. cm 0 5cm cie i 1 CT CT 19 20 2010 6 IRA RMR AME cm 4 0 45 Oa 5 SO 3 15 GT 10 20 729 20 40 8 30 50 115 3 T EVI B 675 T Cd S S YU TERUCURIE4CC 6 ft
218. Class I a 9 R na LOS wm D el KEIR KERESNI BD 4 Y 30 40 2 180 18D 48mm WW 50mm JA E 99 19 55mm DEO 35 z vs 3 re bL 7 45 11mm EI E 16mm Stanford A EF
219. 8 t Ue NZ AAA a B tear ULP OC O A 60 62 64 ABA Aortic aneurysm aneurysm 1 BEDW 3 m 4 ADOR 1 REO IC Loc true aneurysm of the aorta Pes ems ROM C O E pseudoaneurysm of the aorta FA DBE LEWES A
220. AAA EVAR EVAR EUROSTAR European Collaborators on Stent graft techniques for aortic aneurysm repair 2002 mS nk EVAR 3 075 retrospective OSR 2 525 A OSR 399 A t Bit 151 C 30 A 2 0 B 4 8 CHE C5396 4 27 79 EVAR Endovascular aneurysm repair trial 1 DREAM Dutch Endovascular Aneurysm Management trial EVAR 2 OSR b EVAR Randomized controlled study RCT EVAR trial 1 60 55
221. CT MRI Adamkiewicz 90 429 COMPS E EB MABE IC LAB 9 II 1 Z 8 Stanford A Stanford A 1 2 19059
222. QOL Tear Valsalva annulo aortic ectasia AAE Bentall remodeling Yacoub reimplantation David Bentall 3 EACH 20 40 43 L1 BH 2ESR IC EY 3 5 10 SPARKS 30 4096 30 30 2 DaO
223. 9 15 11 QOL Phase Phase I deconditioning 1 500m Phase Phase CH 2 3 1 QOL
224. NAR THAI extra anatomical bypass Branched stent graft Fenestrated stent graft TCADA NOH OWES 5999 Class II b Level C Class I Level B
225. CO 3A7 X X34 BK ZEB PKD1 PKD2 AXED PTPN11 KRAS AAF7 ZURIA SOSI JAGI NOTCH2 HARE SLC2A10 ELN RB Db TR FBINA DNA MLPA 1 E
226. M ulcer like projection ULP protrusion tear ROW AA L ULP rupture re dissection re canalization IME DS l RABEL extension enlargement
227. Level C Ba 1 Class IL a 2 1 Level C C ARE E 2 PRBS SBS EE EG IBOTAERIOTRS level C 3 45mm Level C EB 4 AB 40mm 1A C ZS He MEHL EB AG RIG inflammatory abdominal aortic x uui see 2 MM aneurysm IAAA iX 1935 James 1 1972 71 72 2010 Walker 9 COROBH RIE RENE
228. 2 19 6 317 EVAR 0 5 1 55mm RCT 2 22 X 55mm 50mm Zanz 60 499 40 50mm 40mm Sp
229. tear 20C tear 3 2 AAS HD GS AIRE FT open distal anastomosis tear tear Bevel hemiarch Teflon felt 3 M KREE b R
230. 5 6 TERA Mg SK SOIRS AAT HFM Ayena PITA AGI extra anatomical lt bypass TEVAR ABRA
231. EVAR 63 64 2010 OSR EVAR LAL 962 569 2010 4 EVAR trial 1 8 EVAR 626 fil OSR 626 4 re intervention EVAR DREAM trial EVAR 173 OSR 178 6 2 WW EVAR re intervention OSR
232. MOAB CULE LU ARERR IME ASCE BKOWET RE E LAL IAAA 1 2mm 3 4mm 3 A EDR GER 47
233. 1 2 SEE 5 85 10 Stanford A 34 23 23 Kozai et al 2001 196 83 78 73 lt 2000 71 MM 36 86 3 kenad ek 196 83 79 79 Kaji et al 2003 60 Stanford B 87 7496 4896 Akutsu et al 2004 199 8496 6496 4896 Kozai et al 2001 196 10096 97 97 Kaji et al 2003 60 Stanford B 95 74 56 Akutsu et al 2004 199 97 90 63 Kozai et al 2001 196 31 32 2010 12 BK EIR Class I 1 60mm level C Class Ia 1 50 60mm C Level C 2 50mm level C Class T b 1 50 60mm level C 2 50mm level C Class M 1
234. d E cp d JE H HE Tr HR H i hk HR t TD BE Al E E dk EF E Ap db dS WWW F E dc JE 8 Be XL X
235. 2011 1 BENE S Teo Coen eei aede 2 4 BEBb HEBR eee mne 12 I ER JH EASHE YER M 3 E Zee MM 15 l WARS CA BUE Ed hia ets GR RUE AES e oer eu RUNG EL wields Dad 3 l id Gp aig Ses iaa ede SAN a aia dre TOALETI TITTAT RECETA 15 LL P 6 2 XX X CT en 20 Rae NER E 7 9 c ER 23 2010 4 MRI magnetic resonance imaging Class Ia 24 5 Adamkiewicz Jj KK pU 26 Ul jWHEONRU eee Hmmm 27 1 SA p A caiers Se ceaaanneeaangednes 27 2 Mad SK Ol A 5 CS LOS S TERES OO BAR Ic GEO rM C a 31 3 Of ERA SCR LOS A AREO BRC DU E OO 39 W PUREE ce cece eme eee eene 24 1 HH 34 2 Wi AGRO ee e mmm 37 3 BERRI IIR eem 39 V BEBHABE mmm me 40 l BEE KSAMR eee 40 PAR CES UL EE RE 48 M 51 1 a 51 2 ONSEXSUORIXITSATLZMZ7 ee 54 3
236. Level C 4 Level C 5 level C 6 CT ARI 1 Level C BENDHA 3 6 1 Level C 7 CT MRI 3 6 Level C 1 level C 37 38 2010 fe 105 120mmHg
237. WW 1 5 gt 1 4 8 393 395 398 403 3 zo ACC AHA O Bid B M m AE 1 2 1 3 NYHA Class V 4 AV block af VT 5 METs
238. IAAA IgG4 TIAAA IgG4 IAAA 2 79 99 rgG4 ILAAA IgG4 IAAA AAA E CORRELA 15 6 679 9 07 4 9 3 TC WW ERRORIS RKE ex TZEK Ek
239. 20 A 1997 1 223 22 2 2000 1 901 18 3 2005 2 816 fil 14 6 2008 3 283 13 0 L B 1997 105 34 2 2000 116 33 6 2005 177 24 2 2008 180 22 8 A 80 malperfusion 80 CPAOA CT
240. HOR PDA 11 20 MMP 37
241. V 1 4 H 1 E DHA Valsalva Bental Ross aortic valve sparing surgery AVS Bentall 79 2010 Ross
242. Z 2 lt 58 MVPS ESS RHE neos 5 6 278 7 20 Z 2 20 Z 3 Shprintzen Goldberg loeys Dieiz 7GFBR7 2 CO 347 Z 2 FBNI 3 FN FB7 4 MASS
243. cover spinal drainage 2010 9 TAG W L Gore amp Associates Inc Talent Medtronic 2 Class I amp B 2 451 488 515 516 PMDA 1 Low Profile 2 Branch Fenestrated type 3
244. 3 E36 1 WI 1 2 15q21 FBNI FBNI 280kb 65
245. 4 E2 13 mu mul 59 60 2010 23 leak perigraft leak Type I leqk side branch Endoleak 2leak Cconnection leak fobric leak amp 5 T TypeV porosily leak porosify leak Type V Endoleak Endotension Type I Type M Open conversion 1 2 3 2 SHR AGED WH SOIR Risk factor 1 2 AGORA OBERE 3
246. CT X207 1 CT 1 2 3 A 4 dynamic study Entry E T entry CT 93
247. EFF VARA fenestration spe 1991 stent graft 1994 1998 1999 entry TOMAR ULP WK COB WAAR 909
248. MR CT WEY MLS 33S IC X 0 Adamkiewicz SIR amp FEL ClassILb 3 Class I a MEP SEP Class ILb 0 372 8 1 HCA WZ EX AVY TDR LAL PRIVY EO ERE RD AG STUCv 5 4
249. T ME AA Wk
250. EVAR CAESAR Comparison of surveillance vs Aortic Endografting for Small Aneurysm Repair tria PIVOTAL Positive Impact of endoVascular Options for Treating Aneurysm earLy trial PIVOTAL trial 3 20 12 EVAR 0 6 bY EVAR KE 50mm AAA EVAR 29 d I uu ILa EE an Ib 2 0 AESI CAT 5386 neck 3 DSA 4 5 BARE 55mm 50mm AAA 1 AAA 40mm 50mm
251. I 98 5 86 6 8 1 c 1 5 D W 1 2
252. juxtarenal aneurysm 2 MRI 5 MRA maximum intensity projection EC CT X
253. selective cerebral perfusion SCP i XUI X open distal anastomosis LEEAOWE RHE LW OOD lt X PRM 6 e ER SSO iv Marfan V Staged EE dfi a 903 2 B i
254. Class I 1 Stroke Level B Class I a 1 XTBLA BB ABA OGXGBGeBUX LC AB ESSDBKGE E CREE ISIE POMS Bieter SEU Level B 2 KB Sed S k SAKER TEA PASEO mu REB Level B 3 Level B 4 CABG Level C Class M 1 LFESLVSRARIMASOGEMCHUYC Level B 3 Class I 1 Leve
255. MRA MRA nephrogenic systemic fibrosis MIP multiplanar reconstruction Hm ima MRI 10 5 7 5 200
256. 3 neck 4 is neck Level A Level C Level C Level C Level A Level C Level B Level C Level B Level C Level B Level A 61 62 20104 T EVAR AAA OSR Class I a Level B EVAR AAA Cook Zenith Gore Excluder Endologix fl Powerlink Medtronic Talent AAA O 4 f Xl O device R30 24 device IFU 1 proximal neck
257. BOE CH 13 15 100 120mmHg 1 nicardipine nitroglycerin diltazem Class Ia 1 180mmHg Level C 2 CT 1 3 6
258. i CPB PANTO Tak cramshell hemiarch EK BEWYS AAA SOS ESL elephant trunk t 8 A L Hx 2 HC
259. level C 2008 A 6 5 48 744 B 8 7 70 806 15 0 7 9 13 9 V 1 4 2008 A 22 2 96 418 B 4 2 8 190 VI 2 2 Kaplan Meier R
260. 500ng mL 46 696 96 6 15 16 2010 14 XX K df 40 ITRAD
261. 97 Marfan Ehlers Danlos AAA EAVR EVAR trial device EVAR 7 000 device EVAR AAA AAA EVAR BVAR migration VI 1 gt res Marfan p 1896 15 000 20 000 1 20 30
262. ACE ARB cg 90mmHg 130mmHg 60 E BCH SZ up 130mmHg 150mmHg ROK up KE Lvs 5
263. E a 1 M Ti 2 g UH CO7347 2q31 7 7 mRNA RT PCR HA mRNA NMD
264. aortic aneurysm a survey of 170 patients Ann Thorac Surg 1995 59 1204 1209 206 David TE Ivanov J Armstrong S et al Aortic valve sparing operations in patients with aneurysms of the aortic root or ascending aorta Ann Thorac Surg 2002 74 S1758 1761 discussion S1792 1799 207 Kazui T Washiyama N Muhammad BA et al Improved results of atherosclerotic arch aneurysm operations with a refined technique J Thorac Cardiovasc Surg 2001 121 491 499 208 Safi HJ Miller CC 3rd Estrera AL et al Staged repair of extensive aortic aneurysms long term experience with the elephant trunk technique Ann Surg 2004 240 677 684 209 Estrera AL Miller CC 3rd Huynh TT et al Staged repair of extensive aortic aneurysms Ann Thorac Surg 2002 74 1803 1805 210 Crawford ES Crawford JL Safi HJ et al Thoracoabdominal aortic aneurysms preoperative and intraoperative factors determining immediate and long term results of operations in 605 patients J Vasc Surg 1986 3 389 404 211 Coselli JS LeMaire SA Koksoy C et al Cerebrospinal fluid drainage reduces paraplegia after thoracoabdominal aortic aneurysm repair results of a randomized clinical trial J Vasc Surg 2002 35 631 639 212 Coselli JS Conklin LD LeMaire SA Thoracoabdominal aortic aneurysm repair review and update of current strategies Ann Thorac Surg 2002 74 1881 1884 213 Powell JT Greenhalgh RM Clinical practice Small abdominal aortic
265. OE Adamkiewicz iX CT Adamkiewicz Va CT MRI MRI 92 CT 58 PD Volume rendering VR Adamkiewicz OE GH WW CT
266. Stanford A 59 83 63 83 99 199 97 98 99 99635 2 66 989699 CHS OA MOM PHAR AOR
267. 2 2 92 4 Okita 648 70 8 6 70 15 6 5 59 X8 JK E50 59mm73 PATA RIE B k OS DAS ORE Clk IMR RLY somatosensory evoked potential MAO ATRIA 5 OPE MERA D N TRARRE DE BREIL 5 PERE E CHEF LC viz 79 72 5 10 5 62 74 42 60mm
268. 200 T entry NTZ Hum P open proximal anastomosis B 318 319 337 2 1 Marfan sey ARE AL CAT Bentall
269. Adamkiewicz Adamkiewicz OED Ik Adamkiewicz CPR curved planar reformation 1 3 5 9 50 50 1 VR volume rendering MDCT Adamkiewicz 80 90 E 29 60 106 150 152 E MRI 1 5 MRA MR angiography MRA Adamkiewicz 2 1 high spatial resolution MRA C 0 2 mL
270. WO W7 2 in situ ATH extra anatomical bypass extra anatomical bypass in situ 10 15 299 in situ 80 10 16 7 2
271. original Excluder 25 64 TypeV neck EVAR neck 1 5 16 9 neck migration type I neck 1 13 2 21 3 19 WW neck 0 7 2 1mm 1 0 9 1 9mm 2 neck matrix metalloproteinases MMP MMP doxycycline neck device migration Type I Ly FY Z OFF FE lk device M migration lt 2 O migration A Hi fll o SL HI A migration 25 amp 2 CT migration
272. x fg CT Za hA Yes suspect no T ios Re M iJ Stanford A Stanford B follow follow CT EOP TIECT Informed Consent IC IC CT Stanford A or B CE OAK AP CECO CREM EIT Stanford B BE ARE Stanford B
273. 50mm AGC level C BE 1 5 review s review 1 Juvonen Odds 2 6 Odds 2 3 Odds 3 6 Odds 1 5 Coady Davies I
274. Arena E IMH 2S eo 2s a ulcer like projection ULP PAU IMH PAU Xe Marfan Ehlers Danlos JE 9 integsrity TGF B receptor O k Loeys Dietz LDS LDS
275. level C 2 Level C 40mm level C EN Ss cT oe Uk EU Cd 2 IM RBEHCHEUEN NEYSNERI See 3 7 1885 Osler ES IRL KMS MU EGO T Iz i6 2 6 130 5 1 396 9 0 EJ Bii Lk Ie PELs PIE 28 D gt 5 OWIE AP RAE PESE ER DS EE
276. iE NMD nonsense mediated decay mRNA PTC premature termination codon mRNA RFF O 25 KEIRA 890 279 40 1 4 AGBS 2 ARAM ML zr NER AV FEE KG BRIE ATI CE MC Fete PRR OD AA LACT I IRE OD Be
277. landing amp 4 z 59 59 Aba a BPW SB IC I 1 VERE 112 TAS 40 WW BBR AT IS 12 11 9 139 MAAPERE MERL 0 9 SVS Class II a LevelB EJ EVAR EVAR migration migration 4 0 777 bHARIZE3 9 type I 6 8 type IE 10 3 type M 4 2 587 23
278. re intervention 80 X28 2010 12 688 EX TEE 31 8 19 64 534 154 6 0 9 72 8 9 1 18 96 57 8 3 Bis EBA E m 586 A1 6 096 ZEE 523 4 538 49 464 10 2 4f PETER 63 1 z 4 58 1 30 102 AREA AK 4 A IS 2 HARRE BAR 16 2 396 B 8Z 5 TURT 3 642 93 3 a 4 20 2 9 E 22 3 2 BRR 0 0 0 4 0 6 0 0 0 7 1 0 1 0 2 2 154 22 4 253 473 ABE EDK 527 76 6 BEA SMA BE PulHhrough 13Z 19 9 EI
279. 50 20 Gris flocculi ER ACTA2 HARE Pe v279 A B 48 20 4C742 DNA 77777 7
280. 5317 264 5 0 Gen Thorac Cardiovasc Surg 2010 58 9 493 Bentall 278 286 363 365 382 0 8 96 3 278 286 363 365 382 2008 2 86 200 180 160 r 140 H 120 I ME 3 H 100 r 80 r 60 F 40 r 20 H 3 18 2 366 368 370 372 375 6 3
281. gt 16mm ULP 60mm BIKE 8 1 14 1 15 6 50 60mm 6 5 11 8 109 200 ADL 70 1 25 p 0 03 2 12 FRE Clk DREO 10 489 437 5 11 Kaplan Meire
282. 55mm PA E 00 85868 So HE Ao PE SD IRE VO LT 40mm Z b 54mm DAT BR 06388 6 SEDIS OTI BI LC Uv X 728 dk ACC AHA2005 AAA 55mm 40 55mm AAA 6 12 CrawfordV 55 60mm EVAR EVAR AAA type I 544 545 migration open conversion 54mm AAA EVAR 90 AAA EVAR AAA EVAR
283. B 0 5 97 i ULP ULP 40mm 10mm B 10 2
284. 2010 ACC AHA IMH with ULP IMH 1 CT IMH Tear Tear reentry CT Intramural Hematoma IMH
285. steady state free procession true FISP FIESTA balanced TFE true SSFP MRA magnetic resonance angiography MRA time of flight TOF phase contrast PC fresh blood imagsing MRA MRA T1 iss TOF PC 140 141 143 147 OABMIEO MRI MRI 1 HO 2 3 KAS D 5 1
286. 5 93 A 17 Stanford A We NK NM MN AN lt A tear LT B C lear leqr 3 Stanford B Stanford B A 29
287. 896 2 5 2 6 1 va 451 481 493 515 516 28 2 40 87 5 590 3 17 5 FAVE A AL MERE LANE 3 5 4E 00 HAW C80 90 T WEF i RIL 95 98 2 530 Secondary intervention XE X 3 10 5 4E E HUES NTH 999 7599 conversion rate 1 2 1 5 1 endoleak
288. Open conversion EVAR open conversion open conversion neck migration IRH Z 18 device EVAR 67 68 2010 DREAM 1 8 2 2001 2004 Medicare 45000A 1 6 3 FDA pivotal trial 0 Excluder Zenith 1 6 Powerlink 628 open conversion open conversion open conversion 7 8 62
289. 197 201 230 Nevitt MP Ballard DJ Hallett JW Jr Prognosis of abdominal aortic aneurysms A population based study N Engl J Med 1989 321 1009 1014 231 Fisher DF Jr Yawn DH Crawford ES Preoperative disseminated intravascular coagulation associated with aortic aneurysms A prospective study of 76 cases Arch Surg 1983 118 1252 1255 232 Miyashita T Ando M Hanafusa Y et al An analysis of risk factors of perioperative bleeding in surgical repair of abdominal aortic aneurysm J Cardiovasc Surg 2000 41 595 599 233 Braunwald E Heart disease a textbook of cardiovascular medicine 6th ed Philadelphia PA Saunders 2001 234 Nienaber CA Eagle KA Aortic dissection new frontiers in diagnosis and management part II therapeutic management and follow up Circulation 2003 108 772 778 235 Takeshita S Sakamoto S Kitada S et al Angiotensin converting enzyme inhibitors reduce long term aortic events in patients with acute type B aortic dissection Circ J 2008 72 1758 1761 236 Kodama K Nishigami K Sakamoto T et al Tight heart rate control reduces secondary adverse events in patients with type B acute aortic dissection Circulation 2008 118 14 Suppl S167 170 237 DeBakey ME McCallum CH Crawford ES et al Dissection and dissecting aneurysms of the aorta twenty year follow up of five hundred twenty seven patients treated surgically Surgery 1982 92 1118 1134 238
290. 223 233 405 Fleisher LA Beckman JA Brown KA et al ACC AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery Executive Summary A Report of the American College of Cardiology American 93 94 20104 T Heart Association Task Force on Practice Guidelines Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery Developed in Collaboration With the American Society of Echocardiography American Society of Nuclear Cardiology Heart Rhythm Society Society of Cardiovascular Anesthesiologists Society for Cardiovascular Angiography and Interventions Society for Vascular Medicine and Biology and Society for Vascular Surgery Circulation 2007 116 1971 1996 406 Mangano DT Layug EL Wallace A et al Effect of atenolol on mortality and cardiovascular morbidity after noncardiac surgery Multicenter Study of Perioperative Ischemia Research Group N Engl J Med 1996 335 1713 1720 407 Poldermans D Boersma E Bax JJ et al The effect of bisoprolol on perioperative mortality and myocardial infarction in high risk patients undergoing vascular surgery Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography Study Group N Engl J Med 1999 341 1789 1794 408 Poldermans D Bax JJ Kertai MD et al Statins are associated with
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343. EN level C ai stu BIR CE gt TUS SHB Level C ete Level C bitis ERT HAG Level C 2 LIME CIA COSI ORR 27 LEK SOR OBEY AZ ORMMIL JEDER 1 50mm 99 210 29 5 2 v 55mm 6 18 2 R 14 JA OE BEER D Bh IE OH DHT O BOA EY b BEY APSR 7 2 a ORE e A 219 220 3 3 SUCHE ZU EEZSES l 0020 22 HEREA BEDRMS SE ENTS 7 6 5 6 7 25 0
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367. ess efficacy is less well established by evidence opinion Class III Conditions for which there is evidence and or general agreement that the procedure treatment is not useful effective and in some cases may be harmful Level of Evidence Level of Evidence A Data derived from multiple randomized clinical trials Level of Evidence B Data derived from a single randomized trial or non randomized studies Level of Evidence C Consensus opinion of experts true lumen false lumen W flap 1 aan tear RIL AR HX WERO eee ROAR CAME communicating aortic dissection non communicating aortic dissection thrombosed type v5 ZO 723211 initial tear primary tear entry FRAT SROe AOE re entry v5
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375. l B 2 Level B Class I a 1 MEP SEP Level B 2 Level B 3 Level B Class IL b 1 Level B 2 RVR Level B 3 MEP amp
376. ma intramural hematoma tear intramural hematoma CT Culcer like projection ULP tear Kite PRR CHSCEDRES NTH y 19 0 0 RAT PIA Y CILULP HRB CS IRE E PF IE C M7 tear BEBE MIA M8 May se Me penetrating atherosclerotic ulcer PAU DANIAE M7 E8iU ER ULP ULP ULP
377. mm AAA 1 082 EVAR 543 A OSR 539 device EVAR trial 1 EVAR 1 7 OSR 4 8 13 EVAR 3 5 96 OSR 6 3 EVAR 4 EVAR OSR DREAM trial EVAR trial 1 50mm AAA 345 AXES UE EVAR 171 A OSR 174 BVAR 1 2 OSR 4 6 EVAR 4 796 OSR 9 8 EVAR RCT re intervention EVAR OSR 4 SNES IX EVAR New York 2002 1 60
378. mplantation Cabrol 4 Piehler Bentall 2000 wrapping WAT ICME b 3E Valsalva Cabrol ANE ATM ORE PAO Button Bentall A 41 42 2010 Bentall
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381. onic ePTFE ePTFE ag Ul ae 2 Sey Suprarenal45 N A N A N A Infrarenal60 18 32mm Infrarenal60 19 26mm Infrarenal60 18 32mm SHE Infrarenal60 18 26mm 15mm 15mm 15mm 10mm N A N A 90 2 N A ZA ER BS If E 7 5 20mm 8 18 5mm A 10 14mm A 8 22mm H 7 5mm SME 6 8mm 7 0mm AZ 8 0mm SHE 18 20Fr 18Fr 21Fr 22 24Fr 14 16Fr 12 18 Fr 9Fr 18 20Fr 24 AAA device Zenith Excluder Powerlink Talent Cook Gore Endologix Medtronic yr LAN ay WoO R WY M N PN M M A M p FAY SH Le Aonobody Profile type AAA OSR EVAR OSR high risk high risk
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