• 제목/요약/키워드: Artery-to-artery embolism

검색결과 78건 처리시간 0.024초

한방병원에 입원한 심인성 뇌색전증 환자에 대한 고찰 (A Review of Cardioembolic Stroke Patients Hospitalized in Hospital of Korean Medicine)

  • 박영화;임보라;전경륭;권도익
    • 대한중풍순환신경학회지
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    • 제18권1호
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    • pp.55-65
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    • 2017
  • ■ Objectives Atrial fibrillation is the most common cause of cardioembolic stroke. Of the 44 ischemic stroke patients with atrial fibrillation who were hospitalized in hospital of Korean Medicine from July 1, 2014 to June 30, 2017, we selected 39 patients who have had Magnetic Resonance Angiography. We divided them into Atrial Fibrillation group with no stenosis or less than 50% stenosis in the ipsilateral artery of the lesion and Artery to Artery Embolism group with more than 50% stenosis or occlusion in the ipsilateral artery of the lesion. ■ Methods Clinical characteristics, examination and evaluation tools were collected from the patient's electronic medical records. CHADS2, Initial National Institutes of Health Stroke Scale, 8-item Stroke Scale and Improved 8-item Stroke Scale Number were checked. ■ Results & Atrial Fibrillation group showed differences in age, brain lesion location, vascular lesion, Conclusion initial National Institutes of Health Stroke Scale, initial 8-item Stroke Scale and progress compared to Artery to Artery Embolism group.

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폐 전이를 동반한 주폐동맥의 혈관 내막 육종 (Pulmonary Artery Intimal Sarcoma with Lung Metastasis)

  • 김인섭;정성철;김우식;배윤숙;신용철;정승혁;유환국;이정호;김병열
    • Journal of Chest Surgery
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    • 제36권12호
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    • pp.979-984
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    • 2003
  • 원발성 폐동맥 육종은 매우 드문 질환이다. 임상증상과 방사선학적 소견이 폐동맥 색전증과 유사하기 때문에 진단 시 폐동맥 색전증으로 오진되는 예가 빈번하고, 본 질환의 빠른 진행속도로 인하여, 사망 후 부검을 통해 확인되는 예도 있다. 따라서 폐동맥 색전증으로 진단된 환자가 혈전의 원발병소가 불분명하면서 항응고제에 반응하지 않는다면, 원발성 폐동맥 육종을 의심해 보아야 한다. 폐동맥 색전증으로 진단받은 57세 남자 환자가 5개월간의 항응고제 치료 후에도 우측폐의 종괴모양 병변이 증가하고 주폐동맥 색전증의 크기가 증가되어 수술적인 치료과정에서 폐동맥 내막육종(Pulmonary artery intimal sarcoma)으로 확인되었다. 수술전 혈전으로 의심되었던 저음영의 종괴는 동결조직검사 상 폐동맥 육종으로 의심되었으며, 심낭에 침윤이 있었다. 그 병변과 독립적으로 우폐동맥과 폐실질에서도 혈관육종이 발견되었으며, 인공심폐기하에서 주폐동맥의 완전 절제술 시행 후 Gore-tex graft 치환술과 우측 전폐절제술을 시행하였다. 수술 후 2차례의 항암치료를 시행한 후에 퇴원하였다.

PET/CT로 혈전증과 감별된 원발성 폐동맥 육종 1례 (A Case of Primary Pulmonary Artery Sarcoma Mimicking Pulmonary Embolism: Role of PET/CT for Differential Diagnosis)

  • 임상수;홍구현;신재민;김윤섭;지영구;명나혜;박석건;박재석
    • Tuberculosis and Respiratory Diseases
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    • 제62권3호
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    • pp.232-236
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    • 2007
  • 폐동맥 육종은 극히 드문 질환으로 폐동맥 혈전증과 혼동되는 경우가 많다. 육종에서는 FDG 섭취가 증가되므로 $^{18}F-FDG-PET$를 시행하면 FDG 섭취가 없는 색전증과 구별할 수 있지만 해상도가 떨어지는 단점이 있다. 그러므로 CT 영상을 접목한 PET/CT는 폐동맥 육종과 혈전증을 보다 선명하게 구별할 수 있다. 저자들은 혈전증과 감별이 어려운 폐동맥 병변에 대해 PET/CT로 폐동맥 육종의 진단에 도움을 받았던 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

말초동맥 전색에 대한 혈전 제거술 (3례) (Embolectomy in Peripheral Arteries: 3 Cases)

  • 정영환;김공수;김근호
    • Journal of Chest Surgery
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    • 제3권1호
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    • pp.31-38
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    • 1970
  • This is a report of three cases of successful embolectomy in peripheral arteries. First case was the patient who received a mitral commissurotomy 8 months ago. In that time, there was no evidence of left atrial thrombosis. He showed an embolism in the middle portion of left brachial artery without complaining of any ischemic pain. Embolectomy was performed 15 days after disappearance of radial pulse and resulted in no return of radial pulse postoperatively. Second case was a case of an embolism in lower portion of right brachial artery. She complained severe ischemic pain and cyanosis in the right forearm and fingers. She was also in the beginning state of cardiac failure, which was suspected from her hypertension associated with cardiomegaly and arrythmia Embolectomy was performed 17 hours after onset of acute pain. Immediate full pulsation of radial artery was obtained after embolectomy and the acute ischemic symptoms subsided gradually. Third case was an embolism in superior mesenteric artery which occured 24 hours after pneumonectomy for right bronchogenic carcinoma and the patient suddenly complained diffuse abdominal colicky pain. 7 hours after attack of abdominal pain. embolectomy with extensive reset ion of the small intestine was performed with uneventful recovery and without complication, such as short bowel syndrome, postoperatively. Histopathologically, the embolus was consisted of a tissue of anaplastic cell carcinoma, which was identical to the tumor of the resected right lung. Histological findings of other emboli of first and second case were old thrombus.

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급성 폐동맥 색전증으로 의심된 원발성 폐동맥 골육종 -1예 보고- (Primary Pulmonary Artery Osteosarcoma Mimicking Acute Pulmonary Artery Embolism - A case report-)

  • 박상현;손정환;지현근;신윤철;유병수;박우정;박혜림;김응중
    • Journal of Chest Surgery
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    • 제37권11호
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    • pp.929-932
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    • 2004
  • 원발성 폐육종은 미국의 경우 전체 원발성 폐암 발생률의 0.4% 정도의 비율로 발생하는 드문 질환이며 이중 원발성 폐동맥 골육종은 전 세계적으로 극히 드물게 보고되고 있다. 본 증례는 63세 여자 환자로 흉통과 호흡곤란, 어지러움을 주소로 응급실로 내원하여 검사 중 갑자기 쇼크상태에 빠졌다. 반복적인 심폐소생술을 시행하며 심초음파를 실시한 결과 급성 폐동맥 색전증으로 인한 우심부전증으로 진단하여 인공심폐기 가동하에 응급수술을 시행하였다. 주폐동맥을 절개하였을 때 혈전이 주폐동맥에서 좌우 폐동맥에 걸쳐 존재하였고 종괴가 주폐동맥의 우상부쪽 내막에 붙어 있어서 종괴와 혈전을 제거하였다. 환자는 특별한 문제없이 회복되었으며 술 후 조직검사에서 종괴는 폐동맥 골육종으로 진단되었다. 술 후 시행한 검사에서 폐 이외의 장기에서는 골육종이 발견되지 않았으며 좌하행 폐동맥 내에 잔존하는 종괴와 좌우 폐야에서 다발성 결절들이 관찰되어 혈행성 전이가 의심되어 항암치료와 방사선치료를 시행하였으며 수술 후 16개월에 환자는 잔존하는 종괴와 전이성 결절들의 크기는 줄어든 상태로 특별한 증상 없이 지내고 있다.

대동맥판협착증에 동반된 우관상동맥의 석회성 색전증 (Fibrocalcific Embolism of Right Coronary Artery Combined with Aortic Valvular Stenosis)

  • 장성욱;박정옥;김영권;이명용;류재욱;박성식;서필원;김삼현
    • Journal of Chest Surgery
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    • 제36권11호
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    • pp.858-861
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    • 2003
  • 대동맥판막질환에 동반된 허혈성 심질환의 원인은 대부분 전신적인 동맥경화의 진행에 따른 것이며, 심한 석회화가 초래된 대동맥판협착증 환자에서 대동맥판막의 일부가 떨어져 나와서 관상동맥 색전증 및 협착을 유발시킨 예는 매우 드물다. 저자들은 흉부압박감을 주소로 내원한 73세 여자 환자에서 심초음파검사와 관상동맥조영술을 시행하여 중증 대동맥판협착증과 우관상동맥의 색전증을 진단하고 대동맥판치환술과 우관상동맥의 색전제거술 및 관상동맥성형술을 시행하였던 예를 치험하였다. 수술 후 우관상동맥 색전의 원인 물질이 대동맥판막으로부터 떨어져 나온 석회성 판막조직으로 판단되었기에 이와 관련된 문헌고찰과 함께 보고하는 바이다.

원발성 폐동맥 육종 (Primary Pulmonary Artery Sarcoma A Case Report -A Case Report-)

  • 김성완;구본원
    • Journal of Chest Surgery
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    • 제30권10호
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    • pp.1036-1039
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    • 1997
  • 원발성 폐동맥 육종은 드물며, 흔히 폐동맥 색전증으로 오진하기 쉽다. 예후는 매우 좋지않아서 치료하지 않았을 때의 생존율이 약 1.5개월이며,수술후에도 생존율을 일년정도까지 연장할 수있다. 본 교실에서는 원발성 폐동맥 육종을 1례 치험하였기에 보고하고자 한다. 환자는 55세 여자로 주증상은 호흡곤란, 우측흉통, 및 객혈이었다. 술전 흉부 전산화단층촬영상 폐동맥 색전증과 유사한 종괴음영을 나타내었다. 수술은 부분 체외순환하에 폐동맥 성형술과 우측전폐 절제술이 시행되었다. 술후 조직학적 진단은 미분화 육종이었고, 증상은 다소 호전되었으나 술후 3개월에 원인 미상으로 사망하였다.

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Surgical Extraction of an Embolized Atrial Septal Defect Occluder Device into Pulmonary Artery after Percutaneous Closure

  • Yolcu, Mustafa;Kaygin, Mehmet Ali;Ipek, Emrah;Ulusoy, Fatih Rifat;Erkut, Bilgehan
    • Journal of Chest Surgery
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    • 제46권2호
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    • pp.135-137
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    • 2013
  • An atrial septal defect is the most common type of congenital heart disease among adults. Surgical repair or percutaneous closure of the defect is the treatment options. Even though percutaneous closure seems to be less risky than surgical repair, it may result in fatal complications like device embolism, cardiac perforation and tamponade. Herein we report a case of the embolism of a device into the pulmonary artery after one hour of percutaneous closure in which the embolized device was surgically removed and the defect was closed with a pericardial patch.

High-Resolution Intracranial Vessel Wall MRI Findings Among Different Middle Cerebral Artery Territory Infarction Types

  • So Yeon Won;Jihoon Cha;Hyun Seok Choi;Young Dae Kim;Hyo Suk Nam;Ji Hoe Heo;Seung-Koo Lee
    • Korean Journal of Radiology
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    • 제23권3호
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    • pp.333-342
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    • 2022
  • Objective: Intracranial atherosclerotic stroke occurs through various mechanisms, mainly by artery-to-artery embolism (AA) or branch occlusive disease (BOD). This study evaluated the spatial relationship between middle cerebral artery (MCA) plaques and perforating arteries among different MCA territory infarction types using vessel wall magnetic resonance imaging (VW-MRI). Materials and Methods: We retrospectively enrolled patients with acute MCA infarction who underwent VW-MRI. Thirty-four patients were divided into three groups according to infarction pattern: 1) BOD, 2) both BOD and AA (BOD-AA), and 3) AA. To determine the factors related to BOD, the BOD and BOD-AA groups were combined into one group (with striatocapsular infarction [BOD+]) and compared with the AA group. To determine the factors related to AA, the BOD-AA and AA groups were combined into another group (with cortical infarction [AA+]) and compared with the BOD group. Plaque morphology and the spatial relationship between the perforating artery orifice and plaque were evaluated both quantitatively and qualitatively. Results: The plaque margin in the BOD+ group was closer to the perforating artery orifice than that in the AA group (p = 0.011), with less enhancing plaque (p = 0.030). In the BOD group, plaques were mainly located on the dorsal (41.2%) and superior (41.2%) sides where the perforating arteries mainly arose. No patient in the AA group had overlapping plaques with perforating arteries at the cross-section where the perforator arose. Perforating arteries associated with culprit plaques were most frequently located in the middle two-thirds of the M1 segment (41.4%). The AA+ group had more stenosis (%) than the BOD group (39.73 ± 24.52 vs. 14.42 ± 20.96; p = 0.003). Conclusion: The spatial relationship between the perforating artery orifice and plaque varied among different types of MCA territory infarctions. In patients with BOD, the plaque margin was closer and blocked the perforating artery orifice, and stenosis degree and enhancement were less than those in patients with AA.

Magnetic Resonance Imaging and Pathologic Correlation of Cerebral Fat Embolism using Oleic Acid

  • Park, Byung-Rae
    • 대한의생명과학회지
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    • 제10권2호
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    • pp.115-120
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    • 2004
  • To investigate the correlation between the magnetic resonance imaging (MRI) of cerebral fat embolism that is induced by injecting oleic acid into 10 cats, and a pathologic diagnosis. Using a microcatheter, 30 ${mu}ell$ of oleic acid was injected into the internal carotid artery of 10 cats. MR T2-weighted image (T2WI), diffusion-weighted image (DWI) and Gadolinium-enhanced T1-weighted image (Gd-enhanced T1WI) were obtained after 30 minutes and 2 hours of embolization. After 30 minutes of the embolization, lesions of very high signal intensity were detected by T2WI in 6 cats, and of slightly high signal intensity in 2 cats; in the remaining 2 cats, signal intensity was normal. DWI showed lesions of very high intensity in 9 cats and of slightly high intensity in one cat. According to the findings of light microscopic examination, infarcted lesions mainly involved the gray matter, but also some white matter. A magnetic resonance imaging diagnosis for cerebral fat embolism that was induced by oleic acid through the internal carotid artery in cats showed high signal intensity on the T2WI and the DWI within an initial 2 hours, and with a well enhancement on the Gd-enhanced T1WI. Considering cellular edema, cerebrovascular injury and extracellular space widening, we assumed pathologically that cytotoxic and vasogenic edema exists at the same time.

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