日本 IVR 学会第 36 回中部・第 35 回関西合同地方 …

1 IVR 36 35 26 2 1 9 10 17 47 IVR 1 NBCA- NBCA-Lpd NBCA-Lpd 4Fr 2 NBCA Lpd 1 1 2mm 1mm 2mm NBCA-Lpd 5 NBCA-Lpd SMA NBCA-Lpd 1 NBCA -Lpd 2 NBCA- lipiodol -ethanol NLE [ ] NLE NLE NBCA- lipiodol NL NBCA ethanol NLE [ ] NL(NBCA:Lp=1:1 ) NLE NBCA: lipiodol :ethanol =1:1.

2 2 5Fr NL NLE 10 2 HE [ ] NL NLE [ ] NLE NBCA ethanol NL NLE NL NLE NL NLE 3 RM RM RMP RMP RMP 200-500 m 500 -1000 m RMP 7 50 KDa 110 C 115 C 118 C 120 C 122 C 125 C 24 37 C RMP200-500 m A 500 -1000 m B 2 1 2 3 24 48 2 RMP 120 C RMP200-500 m 500 -1000 m 120 CRMP 24 A B RMP A 100 -200 m B 200 -500 m RMP

3 4 TAE RFA Peter Isfort Andreas Mahnken Thomas Schmitz-Rode ( ) bland-TAE RFA 20 5 Group1a 40 m TAE+RFA Group1b RFA+40 mTAE Group2a 250 mTAE+RFA Group2b RFA+250 mTAE Group3 RFA CT/Angio 40 day1 day28 CT : Group1a( ) Group1b( P= ) Group2a( P= ) Group2b( P= ) Group3( P< ) Group1b( ) 40 m 250 m RFA bland-TAE RFA 5 Amplatzer Vascular Plug EVAR Amplatzer Vascular Plug-II AVPII EVAR AVPII 5 ( 3 ) 9mm 14mm 1 AVP-II 4/5(80%) 2 EVAR NBCA AVP-II 6 Amplatzer Vascular Plug 2 GS GS 1 AVP I12mm II12mm 2 AVP I14mm P5 AVP II18mm 2 CT 1 316ml 486ml( ) 2 482ml( )

4 697ml( ) Grade2 2-7 7 Amplatzer Vascular Plug 5 Amplatzer Vascular Plug AVP 5 6 AVP 5 2 3 15 83 49 3 2 AVP 6mm 2 8mm 4 10mm 1 AVP 8 AZUR AZUR MRI 16 24 AZUR 12 AZUR 12 AZUR AZUR AZUR 0% 0/12 3 2-6 AZUR 42% 5/12 1- 18 AZUR 9 TARGET

5 Target Detachable Coils (TDC) 2013 9 TDC GDC Flexibility Pushability TDC TDC Y Y TDC TDC TDC 10 (AVM) NBCA 3 (6 ) (6 ) (12 ) AVM 24 retrospective 5 19 43 4 74) Cho Type I 3 1 ) II 1 IIIa ) IIIb ) AVM Type II 6 Type IIIa 9 Type IIIb 9 23 ( ) 1 ( ) 2 ( ) (1 ) (2 ) AVM 11 US 1 50 CT 3cm US US 8mm US 12 BRTO BRTO 2004 2013 IVR 10 7 3 65 C 5 B 1 B+C 2 1 nonBnonC1 BRTO 1 1 3 1 3 BRTO 7 1 BRTO (p= )

6 Child-Pugh score MELD score BRTO 3 (100%) BRTO 7 1 14%) 1 5 1 1 2 3 5 BRTO 1 3 BRTO 1 BRTO BRTO 13 IVR non-fiberd 60 1 B-RTO PTO 25mmHg non-fiberd 14 Amplatzer Vascular Plug 1 60 2 NH3 CT (PV) P6 P5,P8,P3 PV Amplatzer Vascular Plug (AVP)

7 -II 5 NH3 4 NH3 AVP 15 1 11 0 11 ( ) CT POBA 10 4cm 16 IVR PSE 7 44 (GS 30 14) GS 17 13 GS GS 1 CRP GS 17 (CS) (BS) CS (SO) 2010 5 13 6 33 CS 7 78 / = 3/4 5 2 SO 2 1 5 CS BS T Niti-S ComVi 4 3 SO 18 IVR 1 T PTBD Bare-stent(10mm 4cm ) Covered-stent(10mm 6cm )

8 2 PTBD 19 1 63 S S1,3,4,5 ERCP B1,8 1 100ml B1,8 3 3 CT 20 IVR 2004 4 2013 7 CT 20 10 5 2 3 3 NG NG 1 1 21 TEVAR in situ fenestration RIBS 2 Zone2 Zone3 TEVAR 2 (RIBS retrograde in situ fenestration)

9 Zone1 TEVAR Zone0 AX- AX AX-LCCA 8Fr-12cm 4Fr 18G-20cmEcho-tip Gore TAG 45mm 20cm zone0 18G 8mm PTA 14Fr Gore Excluder Leg7cm 10mm TAG 2 In situ fenestration zone0 18G RIBS 22 TEVAR 2 fabric tear 1 72 (61mm) Talent (34- 100) TEVAR CT 2 1 CT (63mm) CT type IIIB TEVAR 4F type IIIB Relay (36- 200) Talent 23 Chimney graft technique Debranching TEVAR perigraft gutter leak NBCA-Lp 1 75 Stanford A chimney two debranching TEVAR Follow up CT perigraft gutter leak re-entry entry perigraft gutter leak perigraft gutter leak NBCA-Lp 1 CT 24 1 52 14 B 5 Y 2013 9 12 CT TX2

10 25 EVAR 1 81 AAA 37mm WBC 2013 8 CT WBC CRP AAA EVAR CT Extravasation EVAR 26 1 70 CT (ENDURANT iliac extension) 10 27 Trans-Lumbar Access typeII endoleak NBCA- lipiodol 1 IVR 77 2010