• Journal of Chest Surgery
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• 제28권9호
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• pp.876-880
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• 1995

The optimal surgical approach to the patients with coronary artery disease combined with carotid artery stenosis is controversial. We report two cases of successful surgical management of the patients with combined obstructive coronary and carotid artery disease. The first case was a 69-year-old female who had unstable angina pectoris and a past medical history of left carotid endarterectomy. She was revealed to have triple vessel coronary disease and nearly total occlusion of right internal carotid artery. She was undergone staged right carotid endarterectomy 10 days before coronary bypass surgery. The second case, a 54-year-old male with a past medical history of left hemiparesis and dysarthria, was admitted due to unstable angina pectoris. He was revealed to have triple-vessel coronary disease and more than 90% stenosis of left internal carotid artery and 50% stenosis of right internal carotid artery. In the latter case, a combined coronary bypass surgery and left carotid endarterectomy was done. In both cases, postoperative neurologic complications were not observed.

• Imaging Science in Dentistry
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• 제39권3호
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• pp.157-161
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• 2009

Purpose : This study aimed to investigate the luminal stenosis of the internal carotid artery with calcification detected on panoramic radiographs. Materials and Methods : This study used fifty carotid arteries of 36 dental patients whose panoramic radiograph and computed tomography angiography (CTA) revealed the presence of carotid artery calcification. A neuroradiologist interpreted CTA to determine the degree of stenosis of the internal carotid arteries. The degree of stenosis was stratified in four stages; normal (no stenosis), mild stenosis (1-49%), moderate stenosis (50-69%) and severe stenosis (70-99%). Results : Among the fifty carotid arteries with calcification detected on both panoramic radiography and CTA, 20 carotid arteries (40%) were normal, 29 carotid arteries (18%) had mild stenosis, 1 carotid artery (2%) had moderate stenosis, and there was none with severe stenosis. Conclusion : Sixty percent of the carotid arteries with calcification detected on both panoramic radiography and CTA had internal luminal stenosis, and two percent had moderate stenosis. When carotid atheroma is detected on panoramic radiograph, it is possible that the dental patient has luminal stenosis of the internal carotid artery.

• 한국정보과학회논문지:소프트웨어및응용
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• 제30권9호
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• pp.821-828
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• 2003

본 논문은 경동맥(carotid artery)을 환영한 MRA(Magnetic Resonance Angiography) 영상을 이용하여 실제 내시경으로 접근이 불가능한 경동맥의 내부를 시각화(visualization)하기 위해 가상혈관경(virtual angioscopy)을 구현하였다 항해경로 결정을 위해 MRA의 단면 원천영상에서 총경동맥 (common carotid artery) 및 내경동맥(internal carotid artery)만을 분리하였고, 중앙축 변환(MAT Medial Axis Transformation)을 통해 구해진 좌표값을 가상 카메라의 운행 경로로 사용하였다. 원근투영 (perspective projection) 및 볼륨 데이타의 표면을 렌더링하기 위해 마칭큐브(marching rube) 알고리즘을 사용하였다 허혈성으로 인한 뇌혈관질환(cerebrovascular disease)은 뇌졸중(stroke)의 80% 정도를 차지하는데, 경동맥은 뇌에 혈액을 공급하는 주된 혈관으로 경동맥 협착증(carotid artery stenosis)은 뇌졸중의 직접적인 원인이 된다. 가상혈관경은 경동맥 내부의 협착 위치와 협착 정도를 정성적으로 파악 할 수 있으며 협착증의 진단과 교육에 사용될 수 있다.

• 한국정보과학회논문지:소프트웨어및응용
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• 제30권12호
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• pp.1247-1254
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• 2003

현재 경동맥 내막절제술 시행을 위한 경동맥 협착증의 정도 측정에는 디지털감산조영술(DSA), 회전조영술(rotational angiography), 컴퓨터단층조영술(CTA) 및 자기공명조영술(MRA)로부터 얻어진 경동맥의 투영 영상을 이용하여 북미, 유럽 표준 및 총경동맥 방법이 사용되고 있다. 본 논문에서는 기존의 기계적인 측경기를 이용하는 전형적인 경동맥 협착 측정 방법의 단점을 극복하고, 측정자간의 변화율을 최소화하기 위해 자기공명조영술의 단면 영상을 사용하고 컴퓨터화한 새로운 협착증 정도 측정 방법을 개발하였다. 영상 분할에 사용되는 방법중 가장 널리 사용되고 효율적인 명암값 임계치 방법을 사용하여 경동맥 및 동맥의 내강을 분할하였다. 또한, 각 증례의 측정된 총경동맥의 혈관두께를 사용하여 분할된 경동맥으로부터 혈관을 제거 하였고, 혈관이 제거된 경동맥을 혈류 영역과 플라그 영역으로 분할하였다. 각 단면 영상에서의 경동맥 협착증 정도 측정은 (분할된 플라그 영역/혈류영역 및 플라그를 합한 면적) * 100% 식으로 계산된다.

• Journal of Chest Surgery
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• 제28권3호
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• pp.324-327
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• 1995

Extracranial carotid artery disease is rare and closely related to cardiovascular morbidity and mortality.We experienced one case of surgical treatment of left common carotid artery stenosis using internal shunt.The patient was 54-year-old female presented as headache and dizziness for about 2 years.On Doppler ultrasound, an atheromatous plaque was noted along the posteromedial wall of left common carotid artery resulting in luminal narrowing in about 75s of cross section area.The atheroma was resected through carotid endarterectomy, measured about 5.2cm in length. Postoperative course was uneventful and she was discharged in good condition.

• Journal of Chest Surgery
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• 제28권3호
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• pp.320-323
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• 1995

We report a case of recurred Takayasu,s arteritis.The patient was 28-year-old female underwent aorto-left common carotid and aorto-left subclavian bypass graft replacement 1 year ago.Unfortunately, she was readmitted because of newly developing angina and both eye claudication severe headache. Aorto-coronary angiogram showed complete obstruction of left common carotid artery ,stenosis of right carotid artery bifurcation and ostial stenosis of right coronary artery.Bilateral carotid arteries bypass graft with great saphenous vein and right coronary artery bypass graft with right internal mammary artery were done at same the time and she discharged after 21 days without any problem.

• Journal of Korean Neurosurgical Society
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• 제45권6호
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• pp.350-354
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• 2009

Objective : The purpose of this study was to analyze the clinical outcome of 75 consecutive patients with cervical carotid artery stenosis and who were treated by carotid artery stenting (CAS) only. Methods : From February 2003 to June 2008, there were 78 stents placed in 75 symptomatic patients (mean age : 67.3 years); 69 patients had carotid stenosis ${\geq}70%$, and 6 patients had asymptomatic stenosis ${\geq}80%$. No carotid endarterectomy (CEA) was performed during the same period. The patients were clinically followed-up for a mean of 20.1 months. Results : The procedures were technically successful in all cases. Three (3.8%) patients had procedure-related complications. During the 30-day postprocedural period, there were no restenosis or major stroke. Minor stroke was noticed in 3 (3.8%) patients and 1 (1.3%) of the 75 patients suddenly expired 2 days after discharge. There were no new neurological symptoms that developed during the clinical follow-up period. The results of our series were not inferior to those the previously published in CAS studies, and in fact they were better. Conclusion : Our results suggest that CAS may be safe and useful for the treatment of cervical carotid artery stenosis when it is used as the first line treatment in those institutions that lack enough experience with CEA.

• Journal of Korean Neurosurgical Society
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• 제44권3호
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• pp.159-162
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• 2008

Stenting is a useful alternative treatment modality in carotid artery stenosis patients who are too high-risk to undergo carotid endarterectomy (CEA). We report a case of contralateral cerebral infarction after stenting for extracranial carotid stenosis. A 78-year-old woman was admitted to the hospital with left-sided weakness. Based on magnetic resonance imaging (MRI) of the brain and conventional angiography, she was diagnosed with an acute watershed infarct of the right hemisphere secondary to severe carotid stenosis. Stenting was performed for treatment of the right carotid artery stenosis after a one-week cerebral angiogram was completed. Thirty minutes after stent placement, the patient exhibited a generalized seizure. Four hours later, brain MRI revealed left hemispheric cerebral infarction. Complex aorta-like arch elongation, tortuosity, calcification, and acute angulation at the origin of the supra-aortic arteries may increase the risk of procedural complications. In our case, we suggest that difficult carotid artery catheterization, with aggressive maneuvering during stenting, likely injured the tortuous, atherosclerotic aortic arch, and led to infarction of the contralateral cerebral hemisphere by thromboemboli formed on the wall of the atherosclerotic aorta.

• Journal of Korean Neurosurgical Society
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• 제54권3호
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• pp.239-242
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• 2013

Spontaneous bilateral cerebellar infarction in the territory of the superior cerebellar arteries is extremely rare. Occasionally there have been reports of bilateral cerebellar infarction due to vertebrobasilar atherosclerotic occlusion or stenosis, whereas no report of bilateral cerebellar infarction due to complicated hemodynamic changes. In this report, we present a patient with bilateral cerebral infarctions related to stenoses of bilateral internal carotid arteries, in whom vertebrobasilar system was supplied by multiple collaterals from both posterior communicating arteries and right external carotid artery. We performed stent-angioplasty of bilateral internal cerebral arterial stenosis, and then acute infarction developed on bilateral superior cerebellar artery territories. The authors assumed that the infarction occurred due to hemodynamic change between internal carotid artery and external carotid artery after stent-angioplasty for stenosis of right internal carotid artery.

• Journal of Chest Surgery
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• 제26권11호
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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.