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Successful Endovascular Therapy for Bilateral Popliteal Thrombotic Occlusions

양측 슬와동맥 혈전 폐색증에서 성공적인 내혈관 치료 1예

  • Park, Soo Hyung (Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Jang, Won Young (Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Hyun, Hak Jun (Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Choi, Seong Ji (Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Kim, Min Jung (Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Rha, Seung-Woon (Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine)
  • 박수형 (고려대학교 의과대학 구로병원 순환기내과) ;
  • 장원영 (고려대학교 의과대학 구로병원 순환기내과) ;
  • 현학준 (고려대학교 의과대학 구로병원 순환기내과) ;
  • 최성지 (고려대학교 의과대학 구로병원 순환기내과) ;
  • 김민정 (고려대학교 의과대학 구로병원 순환기내과) ;
  • 나승운 (고려대학교 의과대학 구로병원 순환기내과)
  • Received : 2016.08.16
  • Accepted : 2017.09.08
  • Published : 2018.08.01

Abstract

The popliteal artery is a relatively short vascular structure, but acute occlusion can decrease blood flow into the lower extremities and cause subsequent critical limb ischemia, amputation, and even mortality. Further, peripheral artery disease patients frequently have combined cardio-cerebrovascular disease. Here, we report a rare case of sudden bilateral thrombotic total occlusion in the popliteal arteries of a patient with dilated cardiomyopathy and left ventricular thrombi. This patient has been successfully managed by endovascular therapy and subsequent intra-arterial thrombolytic therapy.

본 증례에서는, 좌심실박출률이 저하된 확장심근병과 관상동맥 질환이 있는 환자에서 심첨부의 혈전이 심장초음파로 확인이 되었고, 이것이 밀초동맥색전증의 원인으로 생각되었다. 이후 혈관조영술 및 혈관내 스텐트를 통하여 기계적 혈전흡인술, 풍선확장술 그리고 동맥내 혈전용해제 투여를 한 후 혈관 폐색 부위의 성공적인 재개통을 이룰 수 있었다. 전신적인 혈전색전증의 일환으로 다발성, 양측성 슬와동맥 혈전색전증이 발생한 것은 비교적 드문 경우이며, 이러한 상황에서 수술이나 Fogarty의 풍선 카테터를 이용한 혈전제거술을 하지 않고 경피적 중재 시술을 통하여 효과적으로 치료한 경우로 이에 보고하는 바이다.

Keywords

References

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