• Title/Summary/Keyword: 완전 폐색

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Both Carotid Endarterectomy in Obstrution of Carotid Arteries and Bypass Graft with Kidney Preservation in Obstrution of Abdominal AoRta -A Report of Case (양측 경동맥협착의 혈관내막절제수술 및 신장보호액 주입을 이용한 복부대동백 폐색 수술 치험 -1례 보고-)

  • 김병철;편승환
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.625-630
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    • 1997
  • A 56 years old male patient adklitted to our neurology department because of repeated tingling sensation in right 3, 4, 5th. (infers and weakness on grasping, which were progressively developed re ently. At this time, he had also suffered from claudication in both lower extremities. Carotid angiogram showed that right internal carotid artery was obstructed completely, and both common, both external and left internal carotid arteries had significant stenosis, Concommitantly, aortogram suggested complete obstruction just below the renal arteries. We plamled staged operation for two separated arterial lesions. Both carotid endarterectomy was performed. and we used carotid shunt for left side during operation. Abdominal aortic lesion was operated 2 weeks later We obligately clamped aorta just below the celiac artery and infuse4 kidney perservation solution to pertect kidney during ischemia. Reversed Y bypass graft and kidney perservation was successful despite of 40 minute ischemia. Postoperative courts was uneventful and patient was discharged without any specific problem.

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Thromboendarterectomy of Chronic Pulmonary Thromboembolism - A Case Report - (만성 폐색전증의 내막 절제술 1례보고)

  • Ban, Dong-Gyu;Kim, Hyuck;Kim, Young-Hak;Kang, Jung-Ho;Chung, Won-Sang;Jee, Heng-Ok;Lee, Chul-Bum;Jeon, Seok-Chol
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.792-796
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    • 2001
  • Chronic pulmonary artery thromboembolism is a relatively rare phenomenon causing hypoxia and pulmonary hypertension that eventually leads to respiratory failure and right heart failure. Patients with acute pulmonary artery thromboembolism are generally treated with antithrombotics and thrombolytics. However, in cases with chronic pulmonary artery thromboembolism the fibrinized thrombus is so strongly adhered to the pulmonary artery wall that medical treatment becomes ineffective and surgical treatment must then be considered. We report a 47year old patient, with a history of repeated admission due to unresolved chronic obstructive pulmonary disease and chronic pulmonary artery thromboembolism at a local hospital, who underwent a successful endarterectomy of pulmonary artery thromboemboli using intermittent total circulatory arrest.

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Bilateral Persistent Sciatic Arteries Complicated with Aneurysmal Dilatation and Thrombotic Occlusion: A Case Report (동맥류와 혈전성 폐색이 동반된 양측 잔류좌골동맥: 증례 보고)

  • Seo Jin Jang;Yoonhee Han;Jae Hyun Kwon
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1517-1522
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    • 2020
  • Persistent sciatic artery (PSA), a rare congenital vascular anomaly, increases susceptibility to aneurysms and accounts for 40-61% of the cases. Here, we describe a case of PSA in a 70-yearold man with a history of alcoholic liver cirrhosis. Bilateral complete PSAs were detected incidentally on computed tomography angiography during evaluation for spontaneous intramuscular bleeding in the thigh due to cirrhosis-related coagulopathy. Selective angiography of the left PSA revealed aneurysmal dilatation and thrombotic occlusion of the PSA, which was partially removed with aspiration thrombectomy. Intramuscular bleeding was succesfully managed with empirical embolization of the deep femoral artery.

Thrombolytic Therapy and Long Term Follow-up Study in a Child with Kawasaki Disease Complicated by Giant Coronary Aneurysm with Thrombosis (가와사끼병 환아에서 발생한 거대관상동맥류 내 혈전의 성공적 용해요법과 장기 치료 및 경과 1례)

  • Moon, Su Jung;Lee, Su Ya;Na, Kyong Hee;Park, Sun Young;Kim, Eun Young;Kim, Kyoung Sim;Kim, Yong Wook
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.302-307
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    • 2003
  • The long-term clinical issues in Kawasaki disease are concerned with the coronary artery lesions that result in aneurysmal formation, thrombotic occlusion, progression to ischemic heart disease, and premature atherosclerosis. We here report a 3 month old infant with Kawasaki disease complicated by giant coronary aneurysm with thrombosis. After urokinase(10,000 IU/kg) and heparin(400 IU/kg) were injected for two days as thrombolytic agents, thrombi were successfully dissolved. Even though long-term oral anticoagulation with low-dose aspirin, dipyridamole and coumadin were administered, thrombosis of the left main coronary artery was slowly increased. five years later, coronary angiography showed nearly total occlusion of the left anterior descending artery and collaterals from the right posterior branch and radionuclide scan demonstrated complete reversible perfusion defect of several portions of the left ventricle.

Pulmonary Thromboendanterectomy of Chronic Pulmonary Thromboembol ism -A case Report- (만성 폐색전증의 색전제거술 -치험 1례 보고-)

  • 신윤철;지현근
    • Journal of Chest Surgery
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    • v.29 no.5
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    • pp.569-572
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    • 1996
  • A sixty nine-year-old mate patient was admitted with a chief complaint of exertional dyspnea. Lung perfusion scan revealed total perfusion defect of the of left lung and CT anglography showed the ab- rupt cutoff left pulmonary artery. He denied of trauma history, previous lower leg symptom and sign, or any embolic history. With the impression of chronic pulmonary thromboembolism of unknown etiology, operation was done under the cardiopulmonary bypass through a median sternotomy. After main pulmonary artery clamping and pulmonary arteriotomy, thromboembolectomy was done. Postoperative lung perfusion scan and CT angiography showed near normal left pulmonary blood flow. The patient was discharged on the postoperative 9th day without any postoperative complication.

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Retroperitoneal Abscess Caused by Staphylococcus intermedius in a Dog (개에서 Staphylococcus intermedius에 의한 복막후농양 발생례)

  • Lee, Sang-Gwan;Hoh, Woo-Phil;Eom, Ki-Dong;Lee, Keun-Woo;Oh, Tae-Ho
    • Journal of Veterinary Clinics
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    • v.26 no.2
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    • pp.176-180
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    • 2009
  • Two year-old female miniature schnauzer was presented with depression, abdominal pain and inappetence. Physical examination revealed tachypnea, fever, and abdominal pain. Leukocytosis with neutrophilia was shown in complete blood count. Radiograph revealed the increase of opacity in parallel to vertebra and dislocation of descending colon. Calculi and sludge in bladder, hydronephrosis and dilation of proximal ureter in right kidney were observed in ultrasonographic examination; also, irregular shape of structure in retroperitoneal cavity was observed. Urinalysis showed protein urine and hemtauria. Many epithelial cells, spindle cells, calcium oxalate dihydrate crystals, struvite crystals, amorphous crystals and granular casts, WBC, cocci were examined in urine sediment test. ERD-kit test result was highly positive. Based on those test and excretory urogram pyelonephritis and complete unilateral obstruction of ureter were confirmed. A balloon type structure in retroperitoneal cavity was found through the exploratory laparotomy. In cytologic examination of aspirated fluid from dilated area many degenerated neutrophils and phagocytized cocci were observed. Staphylococcus intermedius was cultured from aspirated fluid. Based on these clinical results retroperitoneal abscesses caused by Staphylococcus intermedius was diagnosed with ureter obstruction and concurrent cystic calculi. Nephrectomy of right kidney with ureter was performed.

Determination of the Soil-water Characteristic Curve Using the Flow Pump Technique (피스톤 펌프 기법을 이용한 흙-수분 특성곡선 측정방법)

  • 황창수;김태형
    • Journal of the Korean Geotechnical Society
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    • v.19 no.5
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    • pp.155-162
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    • 2003
  • The soil-water characteristic curve (SWCC) represents the essential constitutive relationship for solving various problems in unsaturated soil mechanics. A reliable and convenient experimental method is needed for the determination of the SWCC in engineering applications. This study introduces and proves that the suction-saturation experimental measurement based on the flow pump technique is a convenient and accurate method for obtaining the SWCC. The flow pump technique provides complete control over the test conditions and is capable of detecting all the important elements of the SWCC. In particular, it is capable of defining continuous drying and wetting curves, the moment of air occlusion, and the hysteretic behavior of unsaturated soils. Not only the optimal testing procedure but also the analysis technique for the flow pump technique has been established in this study. Especially, the method of the suction drop measurement was developed to measure the SWCC. This method is a convenient and time saving method without losing accuracy.

Operative Treatment of Mitral Valve Regurgitation due to Papillary Muscle Rupture from Acute Myocardial Infarction Under ECMO -A case report- (급성심근경색 후 발생한 유두근 파열로 인한 승모판 판막 폐쇄부전의 체외막 산소화 장치하 승모판막 치환술 - 1예 보고 -)

  • Joo, Seok;Choo, Suk-Jung;Jung, Sung-Ho;Je, Hyoung-Gon
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.172-175
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    • 2010
  • A 61-year-old man presented with chest pain and ST elevation, and he underwent coronary angiography under the impression of acute myocardial infarction. Coronary intervention under intra-aortic balloon pumping was necessary due to his hemodynamic instability from the acute total occlusion of a large obtuse marginal branch. In spite of successful intervention, the cardiogenic shock persisted, and so extracoporeal membranous oxygenation was performed to treat this. Afterwards, the cardiogenic shock still persisted, and the auscultatory and echocardiographic findings revealed severe acute mitral valve regurgitation. Emergency mitral valve replacement was then performed. The ECMO and IABP were removed on the $2^{nd}$ postoperative day. The patient was discharged on the $48^{th}$ postoperative day.

Clinical esxperiences of Carotid Endarterectomy for Carotid Stenosis (경동맥 내막 절제술을 이용한 경동맥 협착증 치료에 대한 임상적 고찰)

  • 최인석;박주철;정경천;장대일
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1087-1092
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    • 1999
  • 배경 :경동맥 내막 절제술의 목적은 뇌졸중 예방에 있다. 경동맥 내막 절제술시 경동맥 혈류를 차단하였을 때 뇌허혈 상태를 초래하는지 가 가장 중요한 문제이다. 경동맥 혈류 역류압은 뇌내 측부혈류 상태를 반영하므로 경동맥 혈류 차단시 역류압과 뇌파검사 소견에 딸라 shunt 삽입여부 기준을 알아보려고 하였다 대상 및 방법 : 1996년 2월부터 1999년 3월까지 경동맥 내막 절제술을 시행받은 16명을 대상으로 하였다 남자가 14명있고 여자가 2명이었으며 평균연령은 66.35$\pm$6.53이었다 수술부위 경동맥 협착은 평균 73.8$\pm$12.33%였고 반대측 경동맥 협착은 평균 60.99$\pm$23.03%였다. 수술중 모든 환자에서 뇌파감시를 하였으며 경동맥 혈류압을 측정하여 40 mmHg 이하이거나 수술반대측 경동맥 완전폐색이 있는 경우 shunt를 삽입하였다 결과 : 술후 1례에서 사망이 있었는데 이 환자는 전, 중 뇌내동맥 영역에 큰 뇌경색이 있으며 동측에 심한 경동맥 협착이 있고 의식은 기면 상태여서 바로 응급수술을 하였다 수술시경동맥 혈류 역류압은 35mmHg 여서 shunt를 사용하였다 술후 1일째 의식이 혼수상태로 나빠져 뇌 단층촬영한 결과 뇌경색 부위에 출혈이 발생하여 사망하였다. 수술 직후 모든 환자에서 뇌허혈에 따른 합병증 및 사망은 없었고 1례에서 수술후 1일째 수술부위 반대편에 적은 뇌경색이 발생하였다 평균 21.5$\pm$11.85개우러의 외래 추적 검사에서 뇌졸중 재발이 없었다. 결론 : 뇌졸중이환후 경동맥 내막 절제술은 최소 4-6주 이상 안정화 시킨 다음 수술하는 것이 좋다고 생각된다 경동맥 내막 절제술은 뇌졸중 예방에 효과적인 치료방법이며 경동맥 혈류역류압이 40mmHg 이하일 경우 shunt를 설치하여 수술하는 것이 안전하다고 사료된다.

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Transcatheter Closure of Patent Ductus Arteriosus with a Amplatzer$^{(R)}$ Vascular Plug in Two Dogs (개에서 Amplatzer$^{(R)}$ vascular plug를 이용한 동맥관개존증의 폐쇄 2 증례)

  • Kang, Min-Hee;Kim, Jung-hyun;Moon, So-Jeung;Kim, Seung-gon;Yeo, Jung-Jin;Lee, Chang-Min;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.28 no.6
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    • pp.591-594
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    • 2011
  • A 9-month-old, intact female Maltese dog and one-year-old, intact female beagle dog were presented with continuous heart murmur. These 2 dogs were diagnosed as patent ductus arteriosus (PDA) based on the two-dimensional echocardiography and angiography. Due to the large shunt size, commercially available ductal occlude device was used for transcatheter occlusion of PDA. After Amplatzer$^{(R)}$ vascular plug placement, cardiac murmur was abruptly disappeared in Maltese dog and mildly decreased in beagle dog. Complications and safety after the procedure were evaluated regularly in these 2 dogs. This is first clinical application of Amplatzer$^{(R)}$ vascular plug for transcatheter closure of PDA in two dogs in Korea.