同: 解離性動脈瘤

WordNet

a cardiovascular disease characterized by a saclike widening of an artery resulting from weakening of the artery wall (同)aneurism

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動脈瘤(りゅう)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/05/07 13:58:14」(JST)

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In medical pathology, a dissection refers to a tear within the wall of a blood vessel, which allows blood to separate the wall layers. By separating a portion of the wall of the artery (a layer of the Tunica intima or tunica media), a dissection creates two lumens or passages within the vessel, the native or true lumen, and the "false lumen" created by the new space within the wall of the artery.

Description

Dissections become threatening to the health of the organism when growth of the false lumen prevents perfusion of the true lumen and the end organs perfused by the true lumen. For example, in an aortic dissection, if the left subclavian artery orifice were distal to the origin of the dissection, then the left subclavian would be said to be perfused by the false lumen, while the left common carotid (and its end organ, the left hemisphere of the brain) if proximal to the dissection, would be perfused by the true lumen proximal to the dissection.

MRI of an aortic dissection
1 Aorta descendens with dissection

2 Aorta isthmus

Vessels and organs that are perfused from a false lumen may be well-perfused to varying degrees, from normal perfusion to no perfusion. In some cases, little to no end-organ damage or failure may be seen. Similarly, vessels and organs perfused from the true lumen but distal to the dissection may be perfused to varying degrees. In the above example, if the aortic dissection extended from proximal to the left subclavian artery takeoff to the mid descending aorta, the common iliac arteries would be perfused from the true lumen distal to the dissection but would be at risk for malperfusion due to occlusion of the true lumen of the aorta by the false lumen.

Types

Examples include:

Aortic dissection (aorta)
Coronary artery dissection (coronary artery)
Carotid artery dissection (carotid artery)
Vertebral artery dissection (vertebral artery)

Carotid and vertebral artery dissection are grouped together as "cervical artery dissection".

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English Journal

Dissecting aneurysm of the hepatic artery caused by an isolated spontaneous celiac trunk dissection.

Higashiyama H1, Ishii M2, Fujimoto K2, Oka Y2, Uehara T2, Kumada K3, Yamamoto M2.
Annals of vascular surgery.Ann Vasc Surg.2014 Jul;28(5):1316.e7-1316.e13. doi: 10.1016/j.avsg.2013.11.006. Epub 2013 Dec 21.
Dissecting hepatic artery aneurysm caused by an isolated spontaneous celiac artery dissection is a life-threatening condition with only 5 cases reported previously. We report a successful resection and revascularization of all affected arteries with an inferior mesenteric vein graft in a 59-year-old
PMID 24365084

Transient left ventricular outflow tract obstruction in a patient with ruptured dissecting aortic aneurysm.

Kawamura A1, Okura H2, Yoshida K1.
European heart journal cardiovascular Imaging.Eur Heart J Cardiovasc Imaging.2014 Jul;15(7):768. doi: 10.1093/ehjci/jeu007. Epub 2014 Feb 4.
PMID 24497514

Successful treatment of growing basilar artery dissecting aneurysm by pipeline flow diversion embolization device.

Gong D1, Yan B2, Dowling R3, Mitchell P4.
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.J Stroke Cerebrovasc Dis.2014 Jul;23(6):1713-6. doi: 10.1016/j.jstrokecerebrovasdis.2013.11.019. Epub 2014 Jan 3.
We describe a case of successful management of a growing basilar artery dissecting aneurysm by the Pipeline flow diversion embolization device (PED). A 48-year-old woman presented with severe headache, neck pain, and altered consciousness. Computed tomography showed subarachnoid hemorrhage located i
PMID 24389375

Japanese Journal

Endovascular Treatment for Ruptured Vertebral Artery Dissecting Aneurysms: Results from Japanese Registry of Neuroendovascular Therapy (JR-NET) 1 and 2

SATOW Tetsu,ISHII Daizo,IIHARA Koji,SAKAI Nobuyuki
Neurologia medico-chirurgica 54(2), 98-106, 2014
… In treating ruptured vertebral artery dissecting aneurysms (VADAs), neuroendovascular therapy (NET) represented by coil obliteration is considered to be a reliable intervention. … A total of 213 in JR-NET1 and 381 patients in JR-NET2 with ruptured VADA were included, and they were separately analyzed because several important datasets such as vasospasm and site of dissecting aneurysms in relation to the posterior inferior cerebellar artery (PICA) were collected only in JR-NET1. …
NAID 130003383300

Discrepancy between Preoperative Imaging and Postoperative Pathological Finding of Ruptured Intracranial Dissecting Aneurysm, and Its Surgical Treatment: Case Report

OTA Nakao,TANIKAWA Rokuya,KAMIYAMA Hiroyasu,MIYAZAKI Takanori,NODA Kosumo,KATSUNO Makoto,IZUMI Naoto,HASHIMOTO Masaaki
Neurologia medico-chirurgica 54(3), 219-226, 2014
… The choice of therapeutic strategy for intracranial dissecting aneurysm is often based on radiographic features, including characteristic geometry (e.g., irregular stenosis, segmental stenosis, aneurysm formation [pearl-and-string sign]), irregular fusiform or aneurysmal dilation, double lumen, and tapering occlusion. … However, there is often a discrepancy between preoperative radiographic data and actual dissecting length. …
NAID 130003383242

Subarachnoid Hemorrhage After an Ischemic Attack Due to a Bacterial Middle Cerebral Artery Dissecting Aneurysm: Case Report and Literature Review

SAITO Atsushi,KAWAGUCHI Tomohiro,HORI Emiko,KANAMORI Masayuki,NISHIMURA Shinjitsu,SANNOHE Seiya,KAIMORI Mitsuomi,SASAKI Tatsuya,NISHIJIMA Michiharu
Neurologia medico-chirurgica 54(3), 196-200, 2014
… We suspect that bacterial infection was involved in the formation of her fragile dissecting aneurysm. …
NAID 130003383224

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