• Journal of Chest Surgery
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• 제54권6호
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• pp.513-516
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• 2021

An 87-year-old man presented with a saccular aneurysm at the proximal descending thoracic aorta. As computed tomography revealed a shaggy aorta, we planned hybrid thoracic endovascular aortic repair (TEVAR) with embolic protection devices (EPDs) in both internal carotid arteries to prevent a cerebrovascular accident. We inserted an Emboshield NAV⁶ Embolic Protection System (Abbott Vascular, Abbott Park, IL, USA) into both internal carotid arteries before performing the TEVAR procedure. The patient was discharged from the hospital on postoperative day 4 without any neurological complications.

• 대한영상의학회지
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• 제82권2호
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• pp.447-454
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• 2021

저자들은 대퇴-대퇴동맥 우회 인조혈관 폐색 환자에서 AngioJet Rheolytic Thrombectomy System (이하 AngioJet)과 색전보호기구를 이용하여 성공적으로 혈전제거술을 시행한 1예를 보고하고자 한다. 하지 혈관 전산화단층촬영에서 좌측에서 우측으로의 대퇴-대퇴 우회 인조혈관 폐색 소견을 보였다. AngioJet을 이용한 흐름 용해 혈전제거술과 풍선 혈관성형술을 시행하여 우측 하지 혈류를 재개통 시켰으며, 시술 중 우측 표재성 대퇴동맥에 색전보호기구를 거치시켜 효과적으로 원위부 색전을 예방할 수 있었다.

• 대한영상의학회지
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• 제81권3호
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• pp.739-745
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• 2020

경동맥 혈관성형술 및 스텐트삽입술과 관련된 주요 합병증은 시술 도중 발생하는 원위부 뇌색전증으로 이를 방지하기 위해 색전예방장치가 개발되었다. 그러나 취약한 죽상경화반을 가진 환자의 경우 색전예방장치를 사용한 경동맥 혈관성형술 및 스텐트삽입술 후 뇌 색전증의 위험은 논란의 여지가 있으며, 색전예방장치의 사용에도 불구하고 무증상 또는 증상이 있는 뇌졸중이 발생한다. 저자들은 지방이 풍부한 괴사성 핵과 경화반 내 출혈이 있는 취약한 죽상경화반의 원위 필터형 색전예방장치를 이용한 내경동맥의 스텐트 시술 후 발생한 다량의 뇌 미세혈전의 증례를 보고하고자 한다.

• Journal of Korean Neurosurgical Society
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• 제54권2호
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• pp.93-99
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• 2013

Objective : Neurologic complications during carotid artery stenting (CAS) are usually associated with distal embolic event. These embolic incident during CAS are highly associated with the carotid plaque instability. The current study was undertaken to identify the angiographic characteristics of carotid plaque vulnerability, which was represented as filling defect in the cerebral protection filters during CAS. Methods : A total of 107 patients underwent CAS with use of a distal protection filter. Angiographic carotid plaque surface morphology was classified as smooth, irregular, and ulcerated. To determine predictable factors of filling defect in the protection filters, 11 variables were retrospectively analyzed which might influence filling defect in the protection filters during CAS. Results : Filling defects during CAS were presented in the 33 cerebral protection filters. In multivariate analysis, angiographic ulceration [odds ratio (OR), 6.60; 95% confidence interval (CI) : 2.24, 19.4; p=0.001], higher stenosis degree (OR, 1.06; 95% CI : 1.00, 1.12; p=0.039), and coexistent thrombus (OR, 7.58; 95% CI : 1.69, 34.05; p=0.08) were highly associated with filling defect in the cerebral protection devices during CAS. Among several variables, angiographic surface ulceration was the only significant factor associated with flow stagnation during CAS (OR, 4.11; 95% CI : 1.33, 12.72; p=0.014). Conclusion : Plaque surface morphology on carotid angiography can be a highly sensitive marker of plaque instability during CAS. The independent risk factors for filling defect in the filter devices during CAS were plaque ulceration, stenosis degree, and coexistent thrombus.