• Title/Summary/Keyword: 색전 제거술

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Open Embolectomy of an Acute Pulmonary Artery Embolism after Pulmonary Lobectomy (폐엽절제술 후 생긴 급성폐동맥색전증에서 수술을 통한 색전 제거술)

  • Kim, Jae-Jun;Kim, Hwan-Wook;Wang, Young-Pil;Park, Jae-Kil
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.433-436
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    • 2010
  • Acute massive pulmonary artery embolism after pulmonary resection is very rare, but has a high mortality rate. This is one of the most severe complications after pulmonary resection. Acute pulmonary artery embolism developed suddenly in a patient who underwent lobectomy and was recovering without complications. Because the patient’s condition was aggravated after conservative treatment, we did emergency open embolectomy which was successful. Hence, we report this case with a literature review.

Embolectomy of Arteries of Extremities -Clinical analysis of 26 cases (사지동맥의 색전제거술 -26례의 분석-)

  • 강종렬;구본일
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.172-178
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    • 1997
  • We present a etrospective analysis of arterial embolectomies performed at the Inje University Seoul Paik Hospital. During the period of March 1987 Feburary 1996 twenty-six patients underwent embolectomies, eighteen patients were male and eight patients were female, mean age of patients was 56.8 years. Rest pain was the chief complaint in 24 patients, the remaining two patients complained of long term history of claudication after recovery of acute symtoms. But only 10 patients had sensBrylmotor symtoms. Heart was the most common source of embolization and frequent predisposing factor of embolism was ischemic heart disease in 8 cases and valvular heart disease in 11 cases. The sites of embolization were upper extremities artery in 6 cases, saddle embolism in 2 cases, lower extremities artery in 18 cases and the most common site of embolism was femoral artery in 1 1 cases. Preoperative angiography was taken in the diagnosis and planning of the embolectomy in 1) patients while in the other patient p eoperative angiography was not taken. Only two cases were operated within the golden period of 6 hours and other cases were operated in more than 6 hours after embolization. In all patients, the Fogarty embolectomy catheter was used without bypass surgery via bachial ateriotomy in the embolism of upper extremities artery, bilateral groin approaches in the saddle embolism and transfemoral approach in the embolism of lower extremities artery. However 3 patients were re-operated via transpopliteal approach in the distal poplitiotibial embolism. Eighteen patients received perioperative anticoagulation therapy by heparin or fraxiparine and wafarin was used in 17 patients at the time of discharge and the indication of anticogulation was patients of valvular heat disease andfor atrial fibrillation, peripheral artery atherosclerosis and recurrent embolism. Postoperative results of the embolectomy were as follows: fouteen pateints had excellent results, five cases had symtom improvement after re-operation, B. K. amputation in 1 case who had severe atherosclerosis of lower extremities, recurrent embolism in 1 case and death in 2 cases the cause of death were acute renal failure and cerebral artery embolism, respectively. The complications of the embolectomy were reperfusion syndrome, pseudoaneurysm and intimal dissection in one case each. Conclusively the problems of embolism is delayed diagnosis and increasing number of old aged patient who had suffered from ischemic heart diease. Preoperative angiography was not always needed for embol ectomy. Selective anticoagulation therapy can decrease incidence of re-embolism. In the distal poplitiotibial embolism, embolectomy of tibial artery was difficult.

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Transcatheter Removal of Bone Cement Embolism in the Right Atrium after Percutaneous Vertebroplasty: The Embolus Broke in Half and Migrated to the Right Pulmonary Artery Intraoperatively (경피적 척추성형 후 발생한 우심방 내 골 시멘트 색전의 도관경유제거술: 시술 중 두 동강나 우폐동맥으로 이동한 색전)

  • Sunhyang Lee;Jae Woo Yeon;Jin-Tae Kwon;Hyuk Jung Kim;Suk Ki Jang
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.1011-1017
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    • 2021
  • Bone cement embolism often occurs during percutaneous vertebroplasty. Bone cement pulmonary arterial embolism generally requires no treatment because of the small size and asymptomatic manifestation. Intracardiac bone cement embolisms are rare but associated with a risk of severe complications. Intracardiac bone cement embolisms are mainly removed through open heart surgery. To the best of our knowledge, only three cases of intracardiac bone cement embolisms removed with interventions have been reported. Here, we report another case of successful transcatheter retrieval of a 6-cm-long cement embolism in the right atrium after percutaneous vertebroplasty. The embolus broke in half and migrated to the right pulmonary artery intraoperatively. Using two snares and a filter retrieval device, we advanced from opposite directions. Further, we gently grasped and pulled the fragments of the right pulmonary artery and aligned them in a linear fashion directly into the sheath for uneventful removal.

Choriocarcinorma in the Pulmonary Artery Diagnosed and Treated by Emergency Pulmonary Embolectomy (응급 페동맥 색전 제거술로 진단 및 치유된 폐동맥내 융모막 암종)

  • 조봉균;김종인;이해영;박성달;김송명;김영옥
    • Journal of Chest Surgery
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    • v.36 no.7
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    • pp.531-534
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    • 2003
  • A 43-year-old woman who had had an invasive mole 5 years previously required emergent pulmonary embolectomy under cardiopulmonary bypass. Curative resection was impossible because the tumor invaded the right main pulmonary artery and left lower pulmonary artery. The pathologic diagnosis made by the tumor emboli specimens was choriocarcinoma. The patient received post-operative chemotherapy over a 6-month period and had complete remission. Although rare, choriocarcinoma should be considered in the differential diagnosis of fertile women presented with pulmonary embolism.

Pulmonary Thromboendarterectomy Under Total Circulatory Arrest (완전순환정지를 이용한 폐동맥색전증의 수술 치험 1례)

  • Kim, Chang-Young;Kang, Chang-Hyeun;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.684-687
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    • 2002
  • Besides lung transplantation, pulmonary thromboembolectomy is the only effective therapeutic option for chronic thromboembolic pulmonary hypertension. It is however associated with a considerably high hospital mortality between 6.6 to 23%. Proper patient selection is critical when considering a patient for pulmonary thromboembolectomy. And It cannot be overemphasised that the key to the success of the operation is complete endarterectomy of the entire pulmonary arterial tree. We report that pulmonary thromboendarterectomy under total circulatory arrest was an effective and safe method in the surgical correction of the chronic thrornboernbolic pulmonary hypertension and enabled complete removal of superimposed peripheral organized thrombi in a good operative field.

Thromboendarterectomy for Chronic Pulmonary Embolism under Cardiopulmonary bypass - Report of a Cases - (만성 폐전색증의 폐동맥 색전제거및 내막 절제술;치험 2례)

  • Lee, Jong-Guk;Yun, Chi-Sun;Kim, Eun-Gi
    • Journal of Chest Surgery
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    • v.24 no.12
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    • pp.1201-1208
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    • 1991
  • Two successful pulmonary thromboendartectomies were performed. In the first case, it was performed under cardiopulmonary bypass with moderate hypothermia and ventricular fibrillation In the second case, it was done under deep hypothermia and intermittent circulatory arrest. The patients are recovered uneventfully without complication and discharged from the hospital on warfarin. Their symptoms were improved and the follow-up pulmonary perfusion scans revealed no evidence of residual pulmonary embolus in both cases.

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Pulmonary Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension in a Patient with Antiphospholipid Syndrome and Systemic Lupus Erythematosus (항인지질 증후군과 전신성 홍반성 루푸스 환자에게 발생된 만성 폐혈전색전성 폐동맥 고혈압에 대해 시행한 혈전내막제거술)

  • Kang, Pil-Je;Kim, Jeong-Won;Lee, Jae-Won
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.867-870
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    • 2007
  • Antiphospholipid syndrome (APS) is defined as venous and/or arterial thromboses, recurrent fetal losses, thrombocytopenia in combination with repeatedly positive tests for the lupus anticoagulant (LAC), and anticardiolipin antibodies (aCL). The pulmonary manifestation is APS are relatively rare. We report a rare case of antiphopholipid syndrome with systemic lupus erythematosus in a patient who presented with pulmonary hypertension secondary to a chronic pulmonary thromboembolism. A bilateral thromboendarterectomy was performed satisfactorily and the incision was extended to the left intrapleural pulmonary artery.

Fibrocalcific Embolism of Right Coronary Artery Combined with Aortic Valvular Stenosis (대동맥판협착증에 동반된 우관상동맥의 석회성 색전증)

  • 장성욱;박정옥;김영권;이명용;류재욱;박성식;서필원;김삼현
    • Journal of Chest Surgery
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    • v.36 no.11
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    • pp.858-861
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    • 2003
  • The main cause of ischemic heart disease combined with aortic valve disease is the systemic atherosclerotic process. Coronary artery embolism by a particle from the calcified aortic valvular tissue is very rare. A 73-year-old female patient was admitted due to chest tightness of recent onset. Two dimensional echocardiogram showed severe calcific aortic valve stenosis. Preoperative coronary angiogram exhibited a stenotic lesion at the distal right coronary artery, which seemed to be embolic in origin. The coronary embolus was removed through the coronary arteriotomy and then the arteriotomy site was repaired by onlay patch angioplasty technique. Aortic valve was replaced by a bioprosthetic valve. The embolus was reported as a fibrocalcified particle of diseased valve.

Surgical Resection of Renal Cell Carcinoma Extended to the Inferior Vena Cava Using Pump Driven Veno-venous Bypass (정맥-정맥간 우회술을 이용하여 하대정맥까지 확장된 콩팥세포암종의 수술적 치료 1예)

  • Park Han Gyu;Choi Chang Woo;Lee Jae Wook;Her Keun;Shin Hwa Kyun;Won Yong Soon
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.72-75
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    • 2006
  • In a 40 year-old man who has complained of epigastric pain and dyspnea for 10 days including melena for 1 month, abdominal ultrasonography and computerized tomography revealed a large, solid mass in the right kidney and thrombus of inferior vena cava (IVC) that extended to the cavoatrial junction. Renal cell carcinoma was performed by percutaneous needle biopsy. IVC thromboembolectomy was performed using centrifugal pump driven venovenous bypass without cardiac arrest and cardiopulmonary bypass (CPB).