• Journal of Korean Neurosurgical Society
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• v.63 no.6
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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.

• Journal of Chest Surgery
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• v.42 no.2
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• pp.279-281
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• 2009

A 38-year old man was admitted to our hospital due to a $5{\times}6cm$ sized pulsating mass in the right neck. He suffered from intermittent neck pain and hoarseness for two months due to the rapidly growing mass. The radiological examinations revealed an aneurysm of the right common carotid artery near the bifurcation, and it was compressing the internal and external carotid arteries. Endarterectomy of the right internal carotid artery, aneurysmectomy of the right common carotid artery and graft interposition were done, while the cerebral circulation was maintained by an internal shunt. Intraoperative injury to the nerve tissue around the aneurysm was avoided. He was discharged on the postoperative 7th day without any complications.

• Journal of Chest Surgery
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• v.30 no.6
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• pp.625-630
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• 1997

A 56 years old male patient adklitted to our neurology department because of repeated tingling sensation in right 3, 4, 5th. (infers and weakness on grasping, which were progressively developed re ently. At this time, he had also suffered from claudication in both lower extremities. Carotid angiogram showed that right internal carotid artery was obstructed completely, and both common, both external and left internal carotid arteries had significant stenosis, Concommitantly, aortogram suggested complete obstruction just below the renal arteries. We plamled staged operation for two separated arterial lesions. Both carotid endarterectomy was performed. and we used carotid shunt for left side during operation. Abdominal aortic lesion was operated 2 weeks later We obligately clamped aorta just below the celiac artery and infuse4 kidney perservation solution to pertect kidney during ischemia. Reversed Y bypass graft and kidney perservation was successful despite of 40 minute ischemia. Postoperative courts was uneventful and patient was discharged without any specific problem.

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.283-288
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• 2008

Purpose: The purpose of this study is to evaluate the transverse cervical artery of those who received preoperative radiotherapy or radical neck dissection and those who are unable to utilize the branch of external carotid artery system, which are most commonly used as recipient artery in head and neck reconstruction. Methods: 10 patients were selected as head and neck cancer candidates for study. 8 patients received radical neck dissection or modified radical neck dissection and 3 patients underwent preoperative radiotheraphy. In call cases, reconstruction using free flap was performed with transverse cervical artery as recipient artery and posterolateral cervical vein or transverse cervical vein as recipient vein. Results: Partial necrosis of flap due to wound infection was noted in one case and successful microsurgery was achieved in all other cases. The average pedicle length was 9.3 cm and all arteries underwent end to-end anastomosis. In 7 patients, posterolateral cervical vein was used as recipient artery and transverse cervical vein was utilized in 3 patients. Conclusion: In cases where recipient artery from external carotid system cannot be utilized due to preoperative radiotherapy or radical neck dissection, the transverse cervical artery can be an alternative option of choice. Due to diverse variations of transverse cervical vein as a recipient vein, the posterolateral cervical vein may be considered in such cases.

• Korean Journal of Digital Imaging in Medicine
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• v.14 no.1
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• pp.7-12
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• 2012

The purpose of this study was to examine usefulness of 3T equipment-based time-of-flight magnetic resonance angiography (3T-TOF MRA) by comparing standard technique (ST) with high resolution technique (HRT) in evaluation of cerebral blood vessel. The 3T-TOF MRA was performed for 31 patients who were suspected of having cerebrovascular disease from March to July 2010. For evaluation of cerebral blood vessel, classification was conducted randomly: group I that included vertebral artery and basilar artery, group II that ranged from 2.5cm before basin part of common carotid artery to basin part of internal and external carotid arteries and to genu part of internal carotid artery, group III that ranged from vertebral part of internal carotid artery to the first basin art of anterior and middle cerebral through education recognizes the importance of dose reduction and examine if their efforts and further reduce patient dose could achieve optimization of the medical exposure is considered.

• Korean Journal of Clinical Laboratory Science
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• v.53 no.1
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• pp.131-136
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• 2021

Duplex sonography is used widely in various medical fields because of its repeatability and low cost. In particular, the carotid duplex sonography is a useful non-invasive test for diagnosing cerebrovascular disease and predicting the prognosis. In clinical practice, it is very important to reduce the test time and improve accuracy. The patient's clinical information must be known in advance to perform carotid duplex sonography quickly and accurately. Despite this, there are often difficulties finding new cervical vascular diseases that are not mentioned in the clinical information. Therefore, knowing a variety of cases can lead to fast and accurate results. In this context, this paper reports three cases of cervical vascular disease discovered unexpectedly during carotid duplex sonography: CASE 1, internal carotid artery occlusion and cerebral arteries branched from the external carotid artery; CASE 2, internal jugular vein thrombosis; CASE 3, microembolism observed in the vertebral artery.

• The Journal of Korean Medicine
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• v.17 no.1 s.31
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• pp.345-360
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• 1996

Background and Purpose: To evaluate the blood flow velocity using doppler ultrasound of the carotid artery, vertebral artery, and basilar artery in stroke patients Material and Methods: To evaluate the blood flow, I measured the peak systolic velocity and mean velocity of the common carotid artery(CCA), internal carotid artery(ICA), external carotid artery (ECA). vertebral artery(VA), and basilar artery(BA) in 44 stroke patients and 15 healthy adults. To investigate the difference between ischemic stroke patients and normal healthy adults, I selected 44 ischemic stroke patients diagnosed by brain CT and brain MRI, and 15 healthy adults who did not have any symptoms of stroke, hypertension, heart disease, and diabetes melitus. Results: Peak velocity in normal adults was 50.6${\pm}$1.6cm/sec in the CCA, 67.2${\pm}$1.7cm/sec in the ICA, 62.5${\pm}$2.4cm/see in the ECA, 45.5${\pm}$1.9cm/sec VA. and 50.5${\pm}$3.5cm/sec in the BA. Mean velocity in normal adults was 26.9${\pm}$1.1cm/sec in the CCA, 43.7${\pm}$1.4cm/sec in the ICA, 26.7${\pm}$1.3cm/sec in the ECA. 31.6${\pm}$1.9cm/sec in the VA and 33.0${\pm}$2.6cm/sec in the BA. In this study, there was a significant increase in the velocity of ICA, ECA, and VA of ischemic stroke patients in comparison with normal healthy adults. And the blood flow velocity of this study in the CCA and ECA was different from other reported foreign values and the other known values in my country. Conclusion: There was a significant difference in the blood flow velocity between ischemic stroke patients and normal healthy adults. And the blood flow velocity of this study was different from other reported foreign values and the other known values in my country. Therefore, it needs more detailed studies about old aged Korean and ischemic stroke patients than previous studies.

• 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.

• The Journal of the Korean dental association
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• v.22 no.3 s.178
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• pp.213-222
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• 1984

• Journal of Korean Neurosurgical Society
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• v.37 no.3
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• pp.232-234
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• 2005

We report a rare case of a patient with meningeal solitary fibrous tumor. A 60-year-old woman presented with right leg monoparesis. Brain magnetic resonance imaging demonstrates a well enhancing huge mass, located in left parietal lobe. Cerebral angiography demonstrating increased vascularity in area of the tumor, which had feeder vessels extending from the internal carotid artery and external carotid artery. A presumptive diagnosis of meningioma or hemangiopericytoma was considered. At surgery, the consistency was firm and had destroyed the dura and skull. A gross total resection was performed. Immunohistochemically, tumor was strongly, and widely, positive for CD34 and vimentin. There was no staining for epithelial membrane antigen(EMA), S-100 protein, cytokeratin, and glial fibrillary acidic protein (GFAP). Differential diagnosis of intracranial solitary fibrous tumor includes fibroblastic meningioma, meningeal hemangiopericytoma, neurofibroma, and schwannoma.