Journal of Chest Surgery

  • 제40권8호
  • /
  • Pages.582-586
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  • 2007
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  • 2765-1606(pISSN)
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  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
권호 표지

신혈관성 고혈압 및 장골동맥 폐쇄에 대한 수술

Surgical Treatment for Renovascular Hypertension and Iliac Artery Occlusion

  • 류경민 (단국대학교 의과대학 흉부외과학교실) ;
  • 류재욱 (단국대학교 의과대학 흉부외과학교실) ;
  • 박성식 (단국대학교 의과대학 흉부외과학교실) ;
  • 강태수 (단국대학교 의과대학 내과학교실) ;
  • 김석곤 (단국대학교 의과대학 마취통증의학교실) ;
  • 서필원 (단국대학교 의과대학 흉부외과학교실)
  • Ryu, Kyoung-Min (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Dankook University) ;
  • Ryu, Jae-Wook (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Dankook University) ;
  • Park, Seong-Sik (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Dankook University) ;
  • Kang, Tae-Soo (Department of Internal Medicine, College of Medicine, Dankook University) ;
  • Kim, Seok-Kon (Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University) ;
  • Seo, Pil-Won (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Dankook University)
  • 발행 : 2007.08.05
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초록

48세 남자 환자가 조절되지 않는 고혈압 및 좌측 하지통증을 주소로 내원하였다. 컴퓨터 단층 혈관조영술에서 동맥경화에 의한 양쪽 신장동맥 폐쇄와 좌측 총장골동맥 폐쇄가 관찰되었으며, 2개월간의 내과적 치료로도 호전되지 않아 수술을 시행하였다. 수술은 8 mm 인공도관을 이용하여 대동맥-양측 신동맥간 우회수술 및 대동맥-좌측 대퇴동맥간 우회수술을 시행하였다. 수술 후 10개월간 1종류의 항고혈압제(안지오텐신 수용체 억제제)와 항응고제만 사용하면서 정상적인 혈압을 유지하고 있다. 수술을 통한 신혈관성 고혈압의 치료는 중재적 시술기법 및 약물치료의 발달 및 최근 감소하는 경향이나, 광범위한 동맥경화가 동반된 경우에는 수술치료가 필요하다. 본 증례는 광범위한 동맥경화에 의한 신혈관성 고혈압 및 좌측장골동맥 폐쇄 환자에 대한 수술치료로 좋은 결과를 얻었기에 보고하는 바이다.

A 48-year old male patient visited our hospital with uncontrolled hypertension and pair of the left leg. CT angiography shows atherosclerotic occlusion of both renal artery orifices and the left common iliac artery. Despite of medical treatment for 2 months, the clinical condition of the patient worsened. We performed the surgical revascularization with both renal arteries and aorto-left femoral artery bypass with using an 8 mm artificial vascular graft. He lived well without hypertension with using only angiotensin receptor blocker and an anticoagulant for 10 postoperative months. Using surgical revascularization for renovascular hypertension has decreased due to the development of intervention technology and medication, but this surgery is indicated in cases of renovascular hypertension with extensive atherosclerotic lesions. We report here on a case of surgical revacularization for medically Intractable atherosclerotic renovascular hypertension together with left common iliac artery occlusion.

키워드

참고문헌

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