• Journal of Chest Surgery
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• v.39 no.8 s.265
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• pp.626-632
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• 2006

Background: Pulmonary hypertension caused by chronic pulmonary embolism is underrecognized and carries a poor prognosis. Medical therapy is generally unsatisfactory and palliative. With the improvement of operative technique and postoperative management, pulmonary endarterectomy has been the treatment of choice for this condition. Material and Method: Between January 2001 and December 2005, eleven patients were received pulmonary endarterectomy. All patients had chronic dyspnea and exercise intolerance. Diagnosis was made with cardiac echocardiography, lung perfusion scan and computed tomography. Before the operation, Greenfield vena cava filter were placed in all patient except one. Deep hypothermic circulatory arrest was used for the distal-most portion of the endarterectomy procedure. More than moderate degree of tricuspid reguirgitation was repaired during operation. Result: There was no early and late death. Right ventricular systolic pressure was reduced significantly after operation from $91{\pm}21$ mmHg to $40{\pm}17$ mmHg on echocardiography (p=0.001). NYHA class and tricuspid reguirgitaion were improved postoperatively. Although mild reperfusion injury in three case and postoperative delirium in one case were observed, all of them recovered without complication. Conclusion: Pulmonary thromboendarterctomy offers to patient an acceptable morbidity rate and anticipation of clinical improvement. This method is safe and effective operation for pulmonary hypertension caused by chronic pulmonary thromboembolism.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1107-1112
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• 2000

Recently various operative procedures including microsurgery or endovascular surgery have been increasing for the management of ischemic cerebrovascular diseases. Carotid endarterectomy(CEA), extracranial-intracranial(EC-IC) arterial bypass, embolectomy, decompressive craniectomy, arterial transposition, intravascular thrombolysis, and percutaneous transarterial angioplasty and stenting (PTAS) are available surgical modalities for ischemic stroke. This article focuses the complications and perioperative management of patients treated with CEA and carotid PTAS among various surgical managements for ischemic stroke.

• Journal of Korean Neurosurgical Society
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• v.56 no.5
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• pp.441-443
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• 2014

Cerebral hyperperfusion syndrome (CHS) is increasingly recognized as an uncommon, but serious, complication subsequent to carotid artery stenting (CAS) and carotid endarterectomy (CEA). The onset of CHS generally occurs within two weeks of CEA and CAS, and a delay in the onset of CHS of over one week after CAS is quite rare. We describe a patient who developed CHS three weeks after CAS with status epilepticus.

• Journal of Korean Neurosurgical Society
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• v.41 no.5
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• pp.327-329
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• 2007

A 44-year-old woman presented with recurrent, transient episodes of left-side hemiparesis. She had received a radiation dose of 6120 cGy to her cervical region for parotid gland carcinoma 13 years previously. Cerebral angiography revealed a long, irregular tight stenosis involving the right extracranial internal carotid artery [ICA] and common carotid artery [CCA], measuring approximately 90% at the most severe narrowing according to North American Symptomatic Carotid Endarterectomy Trial criteria. Endovascular stent placement resulted in restoration of the carotid lumen to about 80% of its original diameter. She showed no further ischemic events during the follow-up period of 48 months. Our clinical and angiographic findings suggest that carotid stenting is considered a safe and effective treatment option in patients with radiation-induced carotid stenosis.

• Journal of Korean Neurosurgical Society
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• v.52 no.6
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• pp.551-554
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• 2012

Alternative to carotid endarterectomy, carotid artery stenting (CAS) can be performed for symptomatic severe stenosis of internal carotid artery, especially for high-risk patients. Among several complications after CAS, subacute in-stent thrombosis is rare but important, because patient's condition can deteriorate rapidly. Subacute in-stent thrombosis with carotid artery occlusion can be managed by superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. We report two cases of STA-MCA anastomosis for internal carotid artery occlusion by subacute in-stent thrombosis after CAS.

• The Journal of the Korean life insurance medical association
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• v.30 no.1
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• pp.21-23
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• 2011

Chronic thromboembolic pulmonary hypertension(CTEPH) is known as class IV pulmonary hypertension. Unlike other subtype of pulmonary hypertension, surgical treatment such as pulmonary endarterectomy is well known therapeutic strategy. Also there's oral disease-modifying drug which is developed lately. According to recent article, the prognosis of CTEPH is markedly improved. If prognosis of certain disease is improved, insurance rating should be altered. Whether rating change is necessary or not, mortality analysis of CTEPH was performed from recently published source article, Estimated extra-risks are MR of 525% and EDR of 37‰. In conclusion, the extra-risks of CTEPH are still very high.

• Journal of Korean Neurosurgical Society
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• v.52 no.5
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• pp.476-479
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• 2012

Cerebral hyperperfusion syndrome (CHS) is a rare, serious complication of carotid revascularization either after carotid endarterectomy or carotid stent placement. Although extensive effort has been devoted to reducing the incidence of CHS, little is known about the prevention. Postprocedural hypertension is very rare due to autoregulation of carotid baroreceptors but may occur if presented with autonomic dysfunction. We present two cases of CHS after cerebral revascularization that presented autonomic dysfunction.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.414-421
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• 1988

Concerning the operative technique for the relief of discrete subvalvular aortic stenosis, emphasis by some authors has been placed on the superiority of blunt dissection in the enucleation of the entire, obstructing structure such as membranous or fibrous ring stenosis compared with the conventional resection by sharp dissection technique. Here report a case operated applying the technique of blunt dissection, analogous to endarterectomy, which resulted in good clinical improvement. The technique is such that the tissue causing obstruction is peeled off the ventricular septum along the plane of cleavage using a dissector, starting under the commissure between right and left coronary cusps. As for the origin of stenosis this case imply a possibility of different mechanism of etiology evidenced by that the tissue removed consisted of elastic fibers only.

• 대한핵의학회:학술대회논문집
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• 1998.11a
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• pp.36.2-36.2
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• 1998

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.20 no.4
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• pp.231-234
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• 2018

A persistent proatlantal artery (PA) is rare. We report a type 1 persistent PA originating from the right external carotid artery (ECA). A 78-year-old woman presented with dizziness. Computed tomographic (CT) angiography showed a persistent PA originating from the right ECA. This persistent PA did not pass through the atlas transverse foramen. The extracranial segment of this artery in the atlas transverse process level had a more lateral position than a normal left vertebral artery. CT angiography well demonstrated the relationship with bony structures and the course of this persistent PA. This anomalous artery in our patient presented as an incidental finding. Surgeon should recognize a persistent PA when performing carotid endarterectomy or ligation of the ECA for avoidance of complication.