解離性大動脈瘤
WordNet
- a special situation; "this thing has got to end"; "it is a remarkable thing"
- a separate and self-contained entity
- an action; "how could you do such a thing?"
- an artifact; "how does this thing work?"
- an entity that is not named specifically; "I couldnt tell what the thing was"
- any attribute or quality considered as having its own existence; "the thing I like about her is ..."
- a persistent illogical feeling of desire or aversion; "he has a thing about seafood"; "she has a thing about him"
- a special abstraction; "a thing of the spirit"; "things of the heart"
- a special objective; "the thing is to stay in bounds"
- a statement regarded as an object; "to say the same thing in other terms"; "how can you say such a thing?"
- an event; "a funny thing happened on the way to the..."
- a cardiovascular disease characterized by a saclike widening of an artery resulting from weakening of the artery wall (同)aneurism
- the large trunk artery that carries blood from the left ventricle of the heart to branch arteries
PrepTutorEJDIC
- 〈C〉(形のある)『物』,物体;(生物に対しての)『無生物』 / 〈C〉(形のない)『もの』,事,事柄,でき事 / 《複数形で》事情,事態,状勢,状況 / 《複数形で》(すべての)事物,事柄 / 《通例 the~》(努力・活動などの)目的,目標 / 〈C〉衣服,衣類・《one's things》持ち物,所持品,身の回り品 / 《複数形で》道具,用具・〈C〉《親愛・哀れみ・軽べつなどの感情をこめて》人,者,やつ / 《the~》《話》(…の)流行《+in+名》
- 《所有・所属》…『の』,…のものである,…に属する・《材料・要素》…『でできた』,から成る・《部分》…『の』[『中の』] ・《数量・単位・種類を表す名詞に付いて》…の・《原因・動機》…『で』,のために(because of) ・《主格関係》…『の』,による,によって・《目的格関係》…『を』,の・《同格関係》…『という』・《関係・関連》…『についての』[『の』],の点で・《抽象名詞などと共に》…の[性質をもつ] ・《『It is』+『形』+『of』+『名』+『to』 doの形で,ofの後の名詞を意味上の主語として》・《分離》…『から』・《起原・出所》…『から』[『の』](out of) ・《『名』+『of』+『a』(『an』)+『名』の形で》…のような・《『名』+『of』+『mine』(『yours, his』など独立所有格)の形で》…の…・《時》(1)《副詞句を作って》…に《形容詞句を作って》…の・《時刻》《米》…前(to,《米》before)
- 《前述の名詞または文脈でそれと分かる名詞に付けて》『その』,あの,名の / 《唯一の事物に付けて》 / 《方角・自然現象に付けて》 / 《用具・楽器・特定の病気などに付けて》 / 《修飾吾[句]を伴う名詞に付けて》 / 《単数普通名詞に付けて》(1)《種族全体》…『というもの』 / 《複数名詞または集合名詞に付けて》 / 《単位》『…につき;…単位[で]』 / 《身体の一部に付けて,所有格に代わる》 / 《形容詞に付けて》 / 《固有名詞に付けて》 / 《強意用法に》『随一の』,典型的な / 《「the+比較級,the+比較級」の形で》『…すればするほどそれだけ』 / 《比較級の前に》(…につれて,のために)『それだけ』,ますます
- 動脈瘤(りゅう)
- 大動脈
UpToDate Contents
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English Journal
- Extended replacement of the thoracic aorta.
- Hino Y, Okada K, Oka T, Inoue T, Tanaka A, Omura A, Kano H, Okita Y.SourceDepartment of Surgery, Division of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.Eur J Cardiothorac Surg.2013 Jan;43(1):176-81. doi: 10.1093/ejcts/ezs200. Epub 2012 Jun 21.
- OBJECTIVES: We present our experience of total aortic arch replacement.METHODS: Twenty-nine patients (21 males and 8 females; mean age 63.3 ± 13.3 years) with extended thoracic aortic aneurysms underwent graft replacement. The pathology of the diseased aorta was non-dissecting aneurysm in 11 pati
- PMID 22723617
- Modified four-branched graft technique without circulatory arrest and antegrade thoracic endovascular aortic repair for extensive thoracic aorta reconstruction.
- Lin CH.SourceDivision of Cardiovascular Surgery, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei; and School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan. Electronic address: m000678@ms.skh.org.tw.
- The Annals of thoracic surgery.Ann Thorac Surg.2012 Dec;94(6):e159-61. doi: 10.1016/j.athoracsur.2012.08.084.
- A modified technique is described, using four-branched graft for proximal aortic repair without the need of deep hypothermic circulatory arrest, and simultaneously using antegrade stent-graft implantation for thoracic endovascular aortic repair of distal aorta in patients with extensive aortic aneur
- PMID 23176962
- Triple-barrel Graft as a Novel Strategy to Preserve Supra-aortic Branches in Arch-TEVAR Procedures: Clinical Study and Systematic Review.
- Shahverdyan R, Gawenda M, Brunkwall J.SourceDepartment of Vascular Surgery, University Hospital of Cologne, Kerpener Str. 62, D-50937 Cologne, Germany. Electronic address: robert.shahverdyan@uk-koeln.de.
- European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.Eur J Vasc Endovasc Surg.2012 Nov 2. pii: S1078-5884(12)00664-8. doi: 10.1016/j.ejvs.2012.09.023. [Epub ahead of print]
- OBJECTIVE: To report our early experience with total endovascular repair of aortic-arch aneurysm using double chimney-grafts and present a literature overview.PATIENTS AND METHODS: The double chimney-graft technique was performed in six male patients with contained ruptured aneurysm, dissecting aneu
- PMID 23123094
Japanese Journal
- Clinical Outcome of Emergency Surgery for Complicated Acute Type B Aortic Dissection
- MURASHITA Takashi,OGINO Hitoshi,MATSUDA Hitoshi,SASAKI Hiroaki,TANAKA Hiroshi,IBA Yutaka,DOMAE Keitaro,FUJIWARA Tatsuki
- Circulation journal : official journal of
- … biBackground:/i/b The aim of the present study was to review the clinical profile and outcome of emergency surgery for complicated acute type B aortic dissection. … biMethods and Results:/i/b A total of 34 consecutive patients requiring surgical treatment for complicated acute type B aortic dissection between 2003 and 2010 were examined. … The median age was 64.0 years (range, 19-82 years). …
- NAID 10030130016
- Dissecting Aneurysm in A Patient with Autosomal Dominant Polycystic Kidney Disease
- Fukunaga Naoto,Yuzaki Mitsuru,Nasu Michihiro,Okada Yukikatsu
- Annals of
- … Autosomal dominant polycystic kidney disease (ADPKD) is primarily associated with renal failure, but it also causes systemic diseases, including cysts of other systemic organs and cerebral or visceral aneurysm. … However, only a few reports of ADPKD-associated with thoracic aortic dissection have been published. … Herein, we present a case of dissecting aneurysm in a patient with hypertension and ADPKD. …
- NAID 130002148264
★リンクテーブル★
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- 英
- dissecting aortic aneurysm DAA, dissecting aneurysm of the aorta DA
- 同
- 剥離性大動脈瘤、大動脈解離
- 関
- 急性大動脈解離, 解離性動脈瘤
分類
病因
- 1. 動脈硬化性
- 2. 嚢胞性中膜壊死：特に若年者で、かつ Marfan(マルファン)症候群を合併していることが多い。
症状
- PHD.354 HIM.1565
- 突発性、激烈な前胸部痛(Stanford A型)・背部痛(Stanford B型)。移動性。
- 血管の閉塞症状(頚動脈：意識障害、麻痺、上腸間膜動脈：悪心・嘔吐、上腹部痛、下血、腎動脈：乏尿、血尿、腸骨動脈：下肢痛、チアノーゼなど)
- 循環器症状：血圧↑ ← 狭窄部より近位の血圧が増大する(IMD.474)
- 消化器症状：悪心・嘔吐(痛みから交感神経刺激)
- 腎臓：乏尿(腎血流減少、交感神経興奮)、血尿
- 全身症状：疼痛と共にショックを起こす、発汗(交感神経刺激)
- ARをきたした場合：(急性ARによる)呼吸困難、血痰、動悸
- DeBakey I型・DeBakeyI II型(Stanford A型)：大動脈弁閉鎖不全、脳卒中発作、鎖骨下動脈閉塞による上肢の疼痛(身体所見として左右上肢の血圧差)
- DeBakey III型(Stanford B型)：III型では肝・腎不全、消化器症状、(大動脈分岐部)背部痛、下肢の阻血(下肢の疼痛)
検査
血液検査
画像検査
- 胸部単純X線写真 + 胸部造影CT/胸部CT
- 心電図
- 胸部単純X線写真：縦隔陰影の拡大や胸腔内血液貯留。縦隔の拡大、カルシウムサインを認める。カルシウムサイン(血管内腔のカルシウム沈着部位)と外膜の関係から内腔の大きさを推定できる。
- 胸部CT/胸部造影CT：解離の部位・広がり・大きさ
[show details]
[show details]
- Stanford B急性大動脈解離
- 胸部大動脈にしか解離腔を認めない。
- 経胸壁：上行大動脈瘤については解離の有無、内膜亀裂の位置、解離腔に血流があるかどうか、ARの有無や心嚢液貯留の有無(IMD)
- 経食道心エコー検査：下行大動脈における解離腔の広がりや血流の状態(IMD)
- 大動脈造影：大動脈弁閉鎖不全症や解離の範囲を評価できる。
治療
- Stanford A：緊急手術
- Stanford B：降圧療法
国試
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解離性動脈瘤
- 同
- 解離性動脈瘤
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