「血管内手術の現状と今後の展望」 腹部・胸部大動脈瘤に対するステントグラフト内挿術の現状―胸部・腹部大動脈瘤に対する適切な治療法の選択―

Abstract

It is inevitable that the patients with abdominal aortic aneurysms (AAA) will face a life threatening crisis if they do not undergo surgical treatment. In 1952 the first synthetic synthetic graft of Vinyon -N implantation was performed by Arthur Voorhees. Knitted Dacron fabric, a polyester polymer, was developed by Michael DeBakey and associates in Houston and has been an almost ideal graft material even to this day. Dacron grafts have undergone several improvements since 1952. From the 1960s to 1990s Dacron and Teflon grafts have been implanted in patients with AAA with a 95% success rate. In 1991, Parodi first reported the successful endovascular repair of an AAA. The design of stentgrafts was substantially improved, giving in better stability. The stentgraft system is an innovative device designed to be a minimally invasive treatment option for high risk patients with AAA. In the 2000s endovascular aneurysm repair (EVAR) and thoracic endovascular aneurysm repair (TEVAR) have been developed as standard procedures for AAA and descending thoracic aneurysms.