• 제목/요약/키워드: Carotid artery common

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재발한 부갑상선암 수술 중 발생한 총경동맥 파열의 성공적인 인터벤션 치료: 증례 보고 (Successful Interventional Management of Common Carotid Artery Rupture during Recurrent Parathyroid Cancer Surgery: A Case Report)

  • 황예린;노승연;권세환;오주형
    • 대한영상의학회지
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    • 제83권5호
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    • pp.1128-1133
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    • 2022
  • 부갑상선암 수술 중 발생하는 총경동맥 파열은 매우 드물고 생명을 위협하는 질환이다. 저자들은 재발한 부갑상선암을 가진 59세 남자 환자에서 파열된 총경동맥을 응급 피복형 스텐트 삽입을 통해 성공적으로 치료한 증례를 보고한다. 수술 도중 환자의 우측 총경동맥은 갑자기 파열되었고 수술적 대처에도 활력징후가 급속하게 악화되었으나 스텐트 삽입 후 호전되었고 합병증 없이 퇴원하였다.

Modified Suturing Techniques in Carotid Endarterectomy for Reducing the Cerebral Ischemic Time

  • Joo, Sung-Pil;Cho, Yong-Hwan;Lee, Yong-Jun;Kim, You-Sub;Kim, Tae-Sun
    • Journal of Korean Neurosurgical Society
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    • 제63권6호
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    • pp.834-840
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    • 2020
  • Objective : Carotid endarterectomy (CEA) is an effective surgical procedure for treating symptomatic or asymptomatic patients with carotid stenosis. Many neurosurgeons use a shunt to reduce perioperative ischemic complications. However, the use of shunting is still controversial, and the shunt procedure can cause several complications. In our institution, we used two types of modified arteriotomy suture techniques instead of using a shunt. Methods : In technique 1, to prevent ischemic complications, we sutured a third of the arteriotomy site from both ends after removing the plaque. Afterward, the unsutured middle third was isolated from the arterial lumen by placing a curved Satinsky clamp. And then, we opened all the clamped carotid arteries before finishing the suture. In technique 2, we sutured the arteriotomy site at the common carotid artery (CCA). We then placed a curved Satinsky clamp crossing from the sutured site to the carotid bifurcation, isolating the unsutured site at the internal carotid artery (ICA). After placing the Satinsky clamp, the CCA and external carotid artery (ECA) were opened to allow blood flow from CCA to ECA. By opening the ECA, ECA collateral flow via ECA-ICA anastomoses could help to reduce cerebral ischemia. Results : The modified suture methods can reduce the cerebral ischemia directly (technique 1) or via using collaterals (technique 2). The modified arteriotomy suture techniques are simple, safe, and applicable to almost all cases of CEA. Conclusion : Two modified arteriotomy suture techniques could reduce perioperative ischemic complications by reducing the cerebral ischemic time.

뇌경색 환자의 경동맥 초음파 검사와 한방 중풍 변증과의 관련성 연구 (Study on the Relationship between Carotid Intima-Media Thickness and Korean Standard of Pattern Identification in Ischemic Stroke Patients)

  • 김경민
    • 대한중풍순환신경학회지
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    • 제15권1호
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    • pp.29-38
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    • 2014
  • ■ Objectives The purpose of this study was to investigate the correlation of The Korean Standard Pattern Identification for Stroke and Intima-Media Thickness of common carotid artery(CCA-IMT). ■ Methods 100 subjects with acute ischemic stroke were recruited from the patients admitted to DongEui Medical Center from the June 2011 to January 2014. We assessed 100 patient's Common Carotid Intima Media Thickness data by B Mode ultrasonography. We investigated pattern identification of all subjects based on Korean Standard Pattern Identification for Stroke-III. then, We analyzed their characteristics, risk factor, blood test result, life style. ■ Results We analyzed indicators of Korean Standard Pattern Identification for Stroke-III by Common Carotid Intima Media Thickness difference. As a result, pale complexion, look powerless, drowsiness like to lie, heat vexation and aversion to heat were significantly higher in the CCAIMT ≧ 1.0mm group then in the CCA-IMT < 1.0mm group. ■ Conclusion According to the analysis, the Relationship between Carotid Intima-Media Thickness and The Korean Standard Pattern Identification for Stroke in Ischemic Stroke Patients were founded. To acquire more concrete conclusion on this theme, we need more research.

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Takayasu 씨 동맥염 - 치험 1례 (Takayasu`s Arteritis: A case Report)

  • 송진천
    • Journal of Chest Surgery
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    • 제23권2호
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    • pp.402-406
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    • 1990
  • Recently we have experienced a case of Takayasu’s arteritis involving both common carotid artery, left subclavian artery, left renal artery, and the right pulmonary artery. The patients was 27 year-old female and she was admitted because of neck pain, dizziness and palpitation. Renal artery angioplasty with Griintzig balloon catheter was performed with successful result. And then bypass graft surgery using bifurcated Gore- Text graft was performed with satisfactory result.

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급성산-염기 균형장해때의 국소 혈류량 변화 (Local blood flow in acute respiratory and metabolic acid-base distrubances in dog)

  • 김삼현;이영균;김우겸
    • Journal of Chest Surgery
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    • 제17권1호
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    • pp.101-109
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    • 1984
  • The influences of acute respiratory and metabolic acid-base disturbances on the carotid, renal and coronary blood flow were measured in dogs. Respiratory acidosis was induced by artificial respiration with 8% CO2 -02 gas mixture and respiratory alkalosis was induced by hyperventilation under the control of respirator. Metabolic acidosis and metabolic alkalosis were induced by intravenous infusion of 0.3N hydrochloric acid and 0.6M sodium bicarbonate solution. To observe the effect of hyperkalemia, isotonic potassium chloride solution was infused. CVI electromagnetic flowmeter probes were placed on the left common carotid artery, left renal artery and left circumflex coronary artery. Each flow was recorded on polygraph. 1. The carotid blood flow showed rapid showed rapid and marked increase in acute respiratory acidosis. Even in the cases when arterial blood pressure was lowered during the state of respiratory acidosis, carotid blood flow increased. By the infusion of hydrochloric acid, carotid blood flow increased slowly and returned to the previous label after discontinuation of the infusion. Carotid blood flow also increased by the infusion of large amount of sodium bicarbonate, but it might be the combined effect of expansion of extracellular fluid and compensatory elevation of carbon dioxide tension. 2.The renal blood flow remained unchanged during the acute acid-base disturbances, suggesting effective autoregulation. Renal blood flow, however, increased very slowly when the infusion of potassium chloride continued for a long period. 3.Although less marked than the carotid blood flow, the coronary blood flow increased in the acute respiratory and metabolic acidosis. In asphyxiated condition, coronary blood flow increased most markedly and this might be the combined effect of hypoxia, hypercapnea, and lowering of pH. In summary, the carotid blowflow showed more marked change in the acute respiratory and metabolic acidosis than the renal and coronary blood flow. Respiratory and metabolic components of acid-base disturbances may influence the local blood flow concomitantly, there being more differences in the individual responses, but respiratory component manifested more rapid and marked effect than metabolic component.

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

  • 김병철;편승환
    • Journal of Chest Surgery
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    • 제30권6호
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    • pp.625-630
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    • 1997
  • 56세 남자 환자가 신경과에 내원하였는데, 그는 최근에 심해지는 우측 세번째에서 다섯번째 수지의 반복 적인 저린 통증과 파악력의 약화를 주소로 하였다. 이와 함께 보행시 하지 동통을 호소하였다. 경동맥 조영술상 우내경동맥이 완전히 막혀 있었고 좌우총경동맥과 외경동맥, 좌내 경동맥은 심각한 협착이 있었다. 함께 시행한 대동맥 조영술상 신동맥이하는 완전한 폐색을 보였고 양측 대퇴 동맥은 지연 조영 을 보였다. 두개의 동맥 병변에 대해 단계별로 수술 계획을 세웠다. 양측 경동맥 병변은 경동맥 내막절제술을 시행 하였다. 이 때 좌측은·경동맥 션트를 사용하였다. 복부대동맥 병변은 2주후에 시행되었으며 복강동맥하방의 대동맥을 결찰하고 허혈시 신장을 보존하기위 해 신보존액을 주입하였다. 역 Y 회로 이식술과 신보존을 시행하여 린분간의 허혈동안에도 성공적으로 시술되었으며 별다른 문제없이 술 후 보름만에 퇴원하였다.

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당귀가 백서의 뇌손상 및 심혈관계에 미치는 영향 (An Experimental Study on Brain Damage and Cardiovascular System Effects of Angelicae Gigantis Radix Extract)

  • 김용진;황치원
    • 대한한의학회지
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    • 제21권4호
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    • pp.37-46
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    • 2000
  • Objective : The purpose of this study was to investigate the effects of Angelicae Gigantis Radix on brain damage and the cardiovascular system. Method : By administration Angelicae Gigantis Radix, we compared treated groups with not treated groups, in view of five points as follows $\circled1$ the intervascular eNOS, $\circled2$ the blood pressure of SHR, $\circled3$ the transcription of the Kir6.2, $\circled4$ the survival time of the rats when common carotid artery was ligated, and $\circled5$ antiplatelet aggregation. Result : In this experiment, Angelicae Gigantis Radix treated group showed significant produced in the intervascular eNOS and decreased the blood pressure of SHR, increased the transcription of the Kir6.2 and SUR significantly in all Treated groups, prolonged the survival time of the rats when common carotid artery, showed the effects on antiplatelet aggregation. Conclusion : According to the above results, Angelicae Gigantis Radix can protect the brain damage and have cardiovascular system effect.

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대동맥궁 증후군의 수술치료 -2례 보고- (Srugical treatment of aortic arch syndrome -Two cases report-)

  • 채성수
    • Journal of Chest Surgery
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    • 제16권2호
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    • pp.170-174
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    • 1983
  • Aortic arch syndrome is an unusual disease entity characterized by the narrowing or obliteration of major branches of the arch of the aorta regardless of etiology. We have experienced 2 cases. One of them was 22 years old office girl with 3 months history of headache, intermittent syncope and weakness and claudication on left arm especially during her physical exercise. On physical examination, pulseless on left antecubital and radial artery and blood pressure on left arm was inable to check and coldness with weakness were noted on the same side. Aortic angiography reealed 34% narrowing of left subclavian artery as that of right. But both common carotid artery and both axillary arterial patency were relatively good. Through right supraclavicular and left axillary incision, bypass graft with Gore-tex prosthesis (I.D. 6mm, Length 25 cm) was implanted from right subclavian artery on 2cm distal to origin of right common carotid arery to left axillary artery distal to axillary fossa. End to side anastomosis with preservation of left subclavian artery was done. Postoperative state was stable with blood pressure of 110/70 mmHg on left arm and palpable antecubital and radial pulsation. Another one was 41 year old male patient with 8 months history of pain and numbness on right upper arm and shoulder. On admission, right arm blood pressure was 110/80 mmHg, left arm was 160/110 mmHg, but other physical findings had no abnormalities. Angiography revealed segmental narrowing of right axillary artery on the beginning with 2 cm in length. Operative treatment with right wupraclavicular and right axillary incision, bypass graft with great saphenous vein (Length; 15 cm) from right subclavian artery between scalenus anticus and medius to axillary artery at distal end of axillary fossa was done. The authors report two cases of Aortic arch syndrome treated with bypass graft using Autograft or Gore-tex with good result.

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