• Korean Journal of Radiology
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• v.2 no.1
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• pp.52-56
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• 2001

Extracranial carotid artery dissection may manifest as arterial stenosis or occlusion, or as dissecting aneurysm formation. Anticoagulation and/or antiplatelet therapy is the first-line treatment, but because it is effective and less invasive than other procedures, endovascular treatment of carotid artery dissection has recently attracted interest. We encountered two consecutive cases of trauma-related extracranial internal carotid artery dissection, one in the suprabulbar portion and one in the subpetrosal portion. We managed the patient with suprabulbar dissection using a self-expandable metallic stent and managed the patient with subpetrosal dissection using a balloon-expandable metallic stent. In both patients the dissecting aneurysm disappeared, and at follow-up improved luminal patency was observed.

• Journal of KIISE:Software and Applications
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• v.30 no.9
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• pp.821-828
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• 2003

The virtual angioscopy was implemented using MR angiography image of carotid artery Inside of the carotid artery is one of the body region not accessible by real optical endoscopy but can be visualized with virtual endoscopy. In order to determine the navigation path, we segmented the common carotid artery and internal carotid artery from the MR angiography image. We used the coordinates as a navigation path for virtual camera that were calculated from medial axis transformation. We used the perspective projection and marching cube algorithm to render the surface from volumetric MRA image data. A stroke occurs when brain cells die because of decreased blood flow to the brain. The carotid artery is the primary blood vessel that supplies the blood flow to the brain. Therefore, the carotid artery stenosis is the primary reason of stroke. The virtual angioscopy is highly recommended as a diagnosis tool with which the specific Place of stenosis can be identified and the degree of stenosis can be measured qualitatively. Also, the virtual angioscopy can be used as an education and training tool for endoscopist and radiologist.

• Journal of Chest Surgery
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• v.26 no.11
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• pp.833-837
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• 1993

In an effort to reduce the stroke rate of patients after coronary artery bypass, many authors have studied the prevalence of the extracranial carotid disease and its role in determining neurologic morbidity and mortality rates. From April 1992 to August 1993, Seventy-five patients undergoing coronary artery bypass were preoperatively evaluated for presence of carotid and femoral stenosis by Duplex sono. Among them, fourteen patients was positive by Duplex sono and overall prevalence of carotid or femoral stenosis was 18.7%. And significant carotid stenosis [ > 60% ] had proved to be in 3 patients [ 4.0% ].Prophylatic bilateral carotid endarterectomy was performed in one patient, at 5 months prior to and , 1 week prior to coronary artery bypass respectively. Their mean age was 57.6 years [ ranged from 40 to 70 years] and were composed of 10 males and 4 females. There was no postoperative morbidiry and mortality related to neurologic complications. Our data, although small, suggest that preoperative carotid screening is helpful to determine patients at high risk of stroke, and significant simultaneous carotid and coronary atherosclerosis should be corrected in selected patients by staged operations when feasible.

• Journal of the Korean Society of Radiology
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• v.12 no.7
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• pp.853-859
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• 2018

This study aims to investigate the correlation between the occurrence of colon polyps and carotid IMT by age. This study checked the correlation between the occurrence of colon polyps and carotid IMT, grouping patients who had a colonoscopy and carotid ultrasonography simultaneously by age based on cross-tabulation. As a result of the analysis, by age, the older the patients with metabolic syndrome, the higher the correlation between the occurrence of colon polyps and carotid IMT became. Also, when carotid IMT was more than 1.1mm, the incidence of polyps was high. In conclusion, there was a high correlation of the occurrence rate of colon polyps with carotid ultrasonography and colonoscopy, and the older the patient and the thicker the carotid IMT, the higher the correlation became.

• Journal of Korea Association of Health Promotion
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• v.4 no.1
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• pp.12-27
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• 2006

"본 논문은 대한내과학회지 2006년 제70권 제3호에 실렸던 논문으로 대한내과학회 편집위원회의 승인을 득하고 본 협회지에 게재함. Background : Diabetes mellitus is a major independent risk factor for atherosclerosis. In recent years non-invasive high resolution B-mode ultrasound methods have been developed to measure the intima-media thickness(IMT) of the carotid artery as an indicator for early atherosclerosis. Itis known that obesity plays a role in the development of type 2 diabetes and cardiovascular disease, and it has also been reported that not only the amount but also the distribution of body fat is important. This study investigated the relationship between obesity and the development of carotid atherosclerosis in type 2 diabetic patients. Methods: Carotid IMT was measured by ultrasound B-mode imaging in 144 patients with type 2diabetes mellitus. All subjects underwent assessment for the degree and distribution of obesity, the presence of coronary artery disease risk factors, and the presence of diabetic complications. Resuts: Carotid IMT was increased in the abdominal obese group defined by waist circurference. However, there was no significant difference in carotid TMT between the non-obese group and obese group as defined by body mass index, waist to hip ratio, and total body fat percent measured by bio electrical impedance analysis. There were positive correlations between carotid IMT and age, duration of diabetes, systolic blood pressure, and waist circumference. Multiple linear regression analysis revealed the variable that interacted independently with carotid IMT was age in type 2 diabetic patients. Carotid IMT was significantly increased in type 2 diabetic patients with macrovascular complications and microvascvlar complications .Conclusion: This study suggested that abdominal obesity rather than general obesity was associated with carotid atherosclerosis reflected by increment of carotid IMT in type 2 diabetic subjects.

• Journal of Preventive Medicine and Public Health
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• v.42 no.1
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• pp.29-34
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• 2009

Objectives : This study was performed to evaluate the relationship between C-reactive protein(CRP) and carotid intima-media thickness(carotid IMT) in a population of middle-aged Koreans. Methods : A total of 1,054 men and 1,595 women(aged 40-70 years) from Kanghwa County, Korea, were chosen for the present study between 2006 and 2007. We measured high-sensitivity CRP and other major cardiovascular risk factors including anthropometrics, blood pressure, blood chemistry, and carotid ultrasonography. Health related questionnaires were also completed by each study participant. Carotid IMT value was determined by the maximal IMT at each common carotid artery. The relationship between CRP level and carotid IMT was assessed using multiple linear and logistic regression models after adjustment for age, body mass index, menopause(women), systolic blood pressure, total/HDL cholesterol ratio, triglyceride level, fasting glucose, smoking, and alcohol consumption. Results : Mean carotid IMT values from the lowest to highest quartile of CRP were 0.828, 0.873, 0.898, and 0.926 mm for women(p for trend<0.001), and 0.929, 0.938, 0.949, and 0.979 mm for men(p for trend=0.032), respectively. After adjustment for major cardiovascular risk factors, the relationship between CRP and carotid IMT was significant in women(p for trend=0.017), but not in men(p for trend=0.798). Similarly, adjusted odds ratio of increased IMT, defined as the sex-specific top quartile, for the highest versus lowest CRP quartiles was 1.55(95% CI=1.06-2.26) in women, but only 1.05(95% CI=0.69-1.62) in men. Conclusions : CRP and carotid IMT levels appear to be directly related in women, but not in men.

• Journal of Chest Surgery
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• v.24 no.1
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• pp.106-112
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• 1991

A 37-year old man was admitted due to the left subauricular mass of 6 month duration which was 3 x 4cm sized, pulsatile and slowly growing He was suffered from the intermittent left facial and auricular pain radiating to the occipital area. The carotid angiography revealed 3x4cm sized saccular aneurysm of the left internal carotid artery just above the carotid bifurcation, extending to the mandibular angle level. He was planned to be operated under the direct clamp of internal carotid artery or shunting procedure. But, the back pressure of the internal carotid was 35mmHg, which suggested adequate cerebral collateral. Thereby, aneurysmectomy and restoration of cerebral blood flow with saphenous vein graft was done under the direct clamp of internal carotid artery for 25 minutes. Although mild transient neurologic sequelae such as mydriasis, tongue deviation for 10 days, he recovered completely without any complication. The aneurysmal sac had no thrombus and pathologic finding was compatible with congenital origin.

• Journal of Chest Surgery
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• v.39 no.11 s.268
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• pp.815-821
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• 2006

Background: Carotid endarterectomy is an effective treatment modality in patients with severe carotid artery stenosis, but it may result in serious postoperative complications, We analyzed the results of the carotid endarterectomy performed in our institution to reduce the complications related to the card endarterectomy. Material and Method: We analyzed retrospectively the medical records of 74 patients(76 cases) who underwent carotid endarterectomy for carotid artery stenosis by a single surgeon from February 1996 to July 2004. Result: There were 64 men and 10 women. The mean age of the patients was 63.6 years old. Carotid endarterectomy only was performed in 63 cases, carotid endarterectomy with patch angioplasty in 8 cases, and carotid endarterectomy with segmental resection of internal carotid artery and end to end anastomosis in 5 cases. Intra-arterial shunt was used in 29 cases. The mean back pressures of internal carotid arteries checked after clamping common carotid arteries and external carotid arteries were $23.48{\pm}10.04$ mmHg in 25 cases with changes in electroencephalography(group A) and $47.16{\pm}16.04$ mmHg in 51 cases without changes in electroencephalography(group B). There was no statistical difference in the mean back pressure of internal carotid arteries between two groups(p=0.095), but the back pressures of internal carotid arteries of all patients with changes in electroencephalography were under 40 mmHg. When there was no ischemic change of electroencephalography after clamping common carotid artery and external carotid artery, we did not make use of intra-arterial shunt regardless of the back pressure of internal carotid artery. Operative complications were transient hypoglossal nerve palsy in four cases, cerebral hemorrhage occurred at previous cerebral infarction site in two cases, mild cerebral infarction in one case, hematoma due to anastomosis site bleeding in one case, and upper airway obstruction due to laryngeal edema probably caused by excessive retraction during operation in two cases. One patient expired due to cerebral hemorrhage occurring at previous cerebral infarction site. Conclusion: Carotid endarterectomy is a safe operative procedure showing low operative mortality. We suggest that intra-arterial shunt usage should be decided according to the ischemic change of electroercephalography regardless of the back pressure of internal carotid artery. Excessive retraction during operation should be avoided to prevent upper alway obstruction due to laryngeal edema and if upper airway obstruction is suspected, prompt management is essential.

• Journal of Chest Surgery
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• v.14 no.1
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• pp.67-70
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• 1981

Aneurysms of the extracranial carotid artery are rare. This is a case report of the rapidly expanding false carotid aneurysm at left common carotid artery, which was repaired surgically with internal shunt This 20 year old male patient had a large pulsatile mass on left lateral aspect of neck at the time of admission. About 1 month before admission, he had received a trauma on left neck by glass piece and noted massive blood loss. And its skin of lesion was sutured simply at local clinic and well healed. 10 days before the admission, he had the sudden onset of the adult thumb sized and pulsatile mass and the mass had been enlarged more and more to the adult first-sized one. The cervical film showed a egg-sized and soft tissue mass. There was systolic bruit on the mass. The diagnosis was confirmed with the angiogram of left carotid artery and this showed the man`s thumb tip-sized extravasation at the point 2 Cm below the bifurcation of Internal and external carotid arteries. The emergency operation was performed by the internal shunt with carotid artery. The aneurysm was enclosed with the adventitia and carotid sheath, and the intima and media were Intact and had the opening of 0.5 cm in diameter. The opening was sutured by the one-hand mattress suture method and firmed with the Aron Alpha-A "Sankyo." The postoperative course was uneventful and the patient was discharged with good general condition.

• Korean Journal of Head & Neck Oncology
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• v.5 no.1
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• pp.5-13
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• 1989

Carotid body paraganglioma is uncommon, with appoximately 900 reports of it in the world literature, and with only 7 documented cases in the Korean literature. The classic carotid body paraganglioma develops in the bifurcation of common carotid artery and involves both the internal and external carotid arteries at it expands. The diagnosis may almost always be established preoperatively by selective angiography which shows a widening of the carotid bifurcation with a well defined vascular mass. Differential consideration of a single, lateral cervical mass in this location include branchial cleft cyst, neurogenic tumor, metastatic thyroid cancer, carotid body aneurysm and salivary gland tumor. Surgical therapy is the preferred method of treatment as these tumors are regarded as radioresistant. Because of their high vascularity and anatomical location, surgical removal of these tumors reguires a considerable degree of caution and a high degree of surgical expertise. With improved diagnostic and surgical technique, the morbidity and mortality has been reduced lately. This report details the management of 3 patients with carotid body paraganglioma who underwent safe resection by subadventitial dissection or using an internal vascular shunt.