• Title/Summary/Keyword: 혈관 연축

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Low Cardiac Output Syndrome Caused by a Coronary Artery Spasm following CABG (관상동맥 우회술 직후에 발생한 자가 혈관의 연축에 의한 저심박출)

  • Kim, Young-Hak;Chung, Yoon-Sang;Kang, Jeong-Ho;Chung, Won-Sang;Shinn, Sung-Ho;Kim, Hyuck
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.633-636
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    • 2007
  • Coronary artery spasm immediately after the coronary artery bypass graft (CABG) surgery is rare but it can cause sudden and severe hypotension or a ventricular arrhythmia. We report a case of low cardiac output syndrome caused by a right coronary artery spasm following CABG that did not show any significant stenotic lesions on preoperative coronary angiography.

The Usefulness of the 3-D Overlapped Reconstruction MR Angiographic Technique in Patients with Hemifacial Spasm - A Preliminary Study (반얼굴 연축 환자에서 삼차원 중첩 자기공명 혈관 조영술 기법의 유용성-초기 보고)

  • Lee, Yoon-Mi;Park, Sun-Won;Pyun, Hae-Wook;Yoon, Myung-Kwan;Kim, Eun-Young;Suh, Chang-Hae;Lim, Myung-Kwan
    • Investigative Magnetic Resonance Imaging
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    • v.11 no.1
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    • pp.33-38
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    • 2007
  • Purpose : To investigate the applicability of the new three-dimensional overlapped reconstruction MR angiography (3-D ORMRA) technique in patients with hemifacial spasm and to compare the new 3-D reconstruction images with conventional MRA source images. Materials and Methods : The study group comprised 27 patients with surgically proven hemifacial spasm. In all patients, conventional MRA source images and 3-D fast imaging employing steady-state acquisition (FIESTA) images were obtained prospectively. After 3-D MR angiographic images were obtained, the 3-D MRA and FIESTA images were overlapped at the workstation by using GE A/W 4.2 add/sub software. We analyzed the relationship between the offending vessels and root exit zone of the facial nerve using both 3-D ORMRA images and conventional MRA source images. Results : In 25 of 27 patients, the offending vessel at the REZ of the facial nerve could be correctly identified on conventional MRA source images. In all patients, the presumed offending vessels depicted by the overlapped 3-D reconstruction MRA image corresponded well with the intraoperative findings. The 3-D reconstruction image showed more clear visualization of the spatial relationship between the offending vessels and the root exit zone of the facial nerve. Conclusion : The overlapped 3-D reconstruction MR angiography technique is very useful and informative in patients with hemifacial spasm, as compared with conventional MRA angiography technique.

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Case Analysis of Persistent Vasospasm after Cerebral Artery Aneurysm Rupture by Using Transcranial Color Coded Doppler Ultrasonography (경두개 색조 도플러 초음파검사를 이용한 대뇌동맥 파열 이후 지속적인 혈관 연축 증례 분석)

  • Ji, Myeong-Hoon;Seoung, Youl-Hun
    • Journal of radiological science and technology
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    • v.44 no.1
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    • pp.15-23
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    • 2021
  • In this case analysis, a patient was diagnosed with subarachnoid hemorrhage (SAH) in a 49-year-old female and showed persistent vasospasm after coil emboilzation in an aneurysm. The patient suffered from persistent vasospasm and performed angioplasty a total of 6 times. Transcranial color coded doppler (TCCD) was performed 12 times to monitor vasospasm. As a result, repetitive cerebral blood flow tests were low cost and safely performed without exposure to invasive radiation through the TCCD, and the repeatability and reproducibility of the test were confirmed with the capabilities of a trained professional radiological technologist.

A Case of Coronary Vasospasm in a Patient with Esophageal Cancer Receiving Chemotherapy with 5-fluorouracil (5-fluorouracil 사용 중인 식도암 환자에서 발생한 관상동맥연축)

  • Jin Wook Lee;Moo In Park;Seun Ja Park;Won Moon;Sung Eun Kim;Jae Hyun Kim;Kyoungwon Jung
    • Journal of Digestive Cancer Research
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    • v.5 no.1
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    • pp.58-61
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    • 2017
  • 5-Fluorouracil (5-FU) has been widely used in the treatment of various solid tumors. However, 5-FU cardiotoxicity is being reported with increasing frequency. The main symptom of cardiotoxicity is chest pain at rest with ischemic electrocardiographic changes. Up until now, the underlying mechanism has been suspected to be coronary artery spasm. However, this chest pain associated with 5-FU has several characteristics that are incompatible with coronary artery spasm; eg, inefficacy of calcium-channel blocker and a slow increase in cardiac enzyme levels. We experienced a case of 5-FU-induced cardiotoxicity which showed clinical findings consistent with acute myocardial infarction. Based on the clinical findings, coronary angiography, and no stenosis was noted. However, we concluded that the cardiotoxicity in this case was due to ischemia caused by coronary artery spasm. Because vasodilatator was effective and secondary attack was followed.

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Feature of cerebral infarction with tsutsugamushi disease (쯔쯔가무시병과 동반된 뇌경색의 특징)

  • Choi, Pahn Kyu;Kang, Hyun Goo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.10
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    • pp.178-184
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    • 2017
  • This study was performed on 16 patients diagnosed with tsutsugamushi disease and cerebral infarction from January 2007 to December 2015. An acute cerebral infarction was diagnosed by brain MRI and MRA. Tsutsugamushi disease was diagnosed using a polymerase chain reaction. To distinguish the difference between the generalized cerebral infarction and infarction with tsutsugamushi disease, the blood pressure and body temperature were measured uponadmission. In general, the blood pressure increases during an acute cerebral infarction. Interestingly, in this study, 12 patients showed a systolic blood pressure less than 130 mmHg uponadmission. The location of the cerebral infarction and whether single or multiple cerebral infarction were examined. Thirteen patients had a cerebral infarction in anterior circulation and 3 patients developed in posterior circulation. To evaluate the coagulation disorders, prothrombin time (PT), activated partial thromboplastin time (aPTT), D-dimer, fibrinogen, fibrin degradation product (FDP). D-dimer, which is generally known to increase in an acute cerebral infarction, showed a significant increase in the 13 patients. Fibrin degradation products (FDP) showed a significant increase in 15 patients. The pathophysiological mechanism of tsutsugamushi disease is known as vasculitis, which may result in an endothelial cell injury and proliferation of the endothelial wall, which may lead to a cerebral infarction accompanied by coagulopathy. Without endothelial cell damage and proliferation, a vasospasm caused by vasculitis may cause vasoconstriction and cerebral infarction.

Severe Mitral Regurgitation Due to Coronary Vasospasm, Confirmed by Ergonovine Echocardiography (에르고노빈 심초음파로 확진된 승모판 폐쇄부전을 유발한 혈관연축 1예)

  • Cha, Jung-Joon;Kyung, Chan Hee;Cho, Jang Ho;Kim, Yong Hoon;Kim, Haewon;Lee, Sung-Joo;Rim, Se-Joong;Choi, Eui-Young
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.120-123
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    • 2013
  • The common causes of organic mitral regurgitation (MR) include mitral valve prolapse (MVP) syndrome, rheumatic heart disease, and endocarditis. MR also occurs secondary to dilated cardiomyopathy and coronary artery disease. In acute severe MR, the hemodynamic overload often cannot be tolerated, and mitral valve repair or replacement must be performed immediately. We report herein a case of severe MR due to coronary vasospasm that was confirmed via ergonovine echocardiography in a 70-year-old man. He was scheduled to undergo mitral valve surgery, but it did not push through and he was put on medical therapy.

Effect of Bee Venom Therapy in a Rat Femoral Artery Model induced Vasospasm (봉독약침(蜂毒藥鍼)이 백서(白鼠) 대퇴동맥(大腿動脈)의 혈관연축(血管攣縮)에 미치는 영향(影響))

  • Kim, Jae-soo;Kim, Hyung-hwan;Choi, Ho-young;Kim, Chang-hwan
    • Journal of Acupuncture Research
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    • v.20 no.1
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    • pp.35-50
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    • 2003
  • In order to study the effect of Bee venom(BV) on the subarachnoid hemorrhage animal model, the autologous whole blood was applied to the vicinity of the sprague dawley rat right femoral artery. Following periarterial application of autologous whole blood(PAB) and intraperitoneal injection of BV(1:5,000 nd 1:500), the vasomotor responses to BV(from 1:500,000 to 1:500) were identified and the histological changes, neovascularized blood vessel were observed. We have shown that alterations in vasomotor and histological findings are elicited following application of periarterial blood and i.p. injection of BV(1:5,000 and 1:500) induced heavy vasospasm and neovascularization on the subarachnoid hemorrhage like model form peripheral artery.

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Role of Catheter Imaging with $^{99m}Tc$-Macroaggregated Albumin in Intraarterial Chemotherapy (동맥내 항암제투여에 있어 $^{99m}Tc$-Macroaggregated Albumin 도관스캔의 역할)

  • Kim, Byung-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.1
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    • pp.18-21
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    • 1993
  • 이상에서 $^{99m}Tc$-MAA 도관스캔을 고찰하여 보면 다음과 같이 요약할 수 있다. 1) $^{99m}Tc$-MAA 도관스캔은 반복 시행할 수 있고, 그 방법이 간단하나 도관의 위치를 알아내는데 매우 정확하다. 2) 방사선학적 방법인 혈관조영술은 조영제 주입시 실제 항암제를 주입하는 속도보다 매우 빠르게 주입하므로써 야기될 수 있는 동맥의 연축(spasm), 층류 등의 원인에 의하여 항암제를 주입할 때와 다른 양상을 보여 암종의 헐류분포나 주변의 다른동맥으로 항암제가 주입 되는지의 여부를 정확히 알 수 없는 반면, $^{99m}Tc$-MAA 도관스캔은 항암제 주입속도와 동일하게 주입하므로써 보다 정확하게 암종의 혈류분포나 부작용을 예측할 수 있다. 3) 골반내 종양의 경우와 같이 도관을 양측의 동맥에 삽입하여야 하는 경우에는 암종에 대한 각 동맥으로부터의 혈류분포를 비교하여 항암제의 투여량을 변화시키므로써 치료효과의 상승과부작용의 감소를 꾀할 수 있다. 나아가서 둔부동맥으로의 혈류가 많은 경우에는 둔부동맥을 색전화하여 부작용을 극소화할 수도 있다. 4) 여러 종류의 종양, 특히 간종양의 경우에는 폐의 방사능섭취를 측정하여 종양내 동정맥단락을 정량화 할 수 있어 치료후 그 변화를 관찰하여 치료효과를 추측할 수도 있다.

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Improved Heat Lamp for Preventing Arterial Spasm after Microvascular Surgery (미세혈관 수술 후 혈관 연축의 예방을 위한 개선된 온열전등)

  • Ahn, Sung-Min;Hwang, So-Min;Hu, Eun-Suk;Park, Jung-Mi;Park, Kyung-A;Oh, Jin-A
    • Archives of Reconstructive Microsurgery
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    • v.17 no.2
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    • pp.120-125
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    • 2008
  • Purpose: Heat therapy by heat lamp after microvascular surgery is being used for preventing blood vessels's contraction and blood-flow's disturbance. As usually, incandescent lamp has been used. But there have been several problems and need for improvement in the existing heat lamp treatment. So we would like to introduce improved heat lamp to keep an appropriate temperature and intensity of illumination. Methods: The existing heat lamps are the ones of general light stands covered with newspaper, having 60 watt light bulb of incandescence and lampshade made of aluminum. We have tried to improve shortcomings of the existing heat lamps by enlarging the size of aluminum lampshade and attaching a curtain that can block heat and light. We conducted a comparative study between the existing and improved heat lamps. Under the assumption that there are several affected parts, we have also measured the distance from heat lamp to patients' eye region and then intensity of illumination. Result: The target temperature of surface was realized in 11 minutes with the maximum temperature reaching at 36.6 degrees C in 28 minutes at the existing heat lamp while the target temperature reached in 7 minutes with the maximum temperature reaching at 39.0 degrees C in 17 minutes at the improved heat lamp. The existing and improved heat lamp showed 38 lx and 0.1 lx of intensity of lumination, respectively. Conclusion: Using improved heat lamps, we can keep an appropriate temperature and we think we can make contribution to patients' treatment by making them and their neighbors able to sleep with minimized disturbance thanks to low intensity of illumination secured by blocking light.

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Correlation between Angiographic Vasospasm and Clinical Vasospasm following Aneurysmal Subarachnoid Hemorrhage (뇌동맥류 파열에 의한 뇌지주막하 출혈후 혈관 조영상 혈관연축과 임상적 혈관연축의 상관관계)

  • Suh, Dong-Sang;Kim, Bum-Tae;Im, Soo-Bin;Cho, Sung-Jin;Shin, Won-Han;Choi, Soon-Kwan;Byun, Bark-Jang
    • Journal of Korean Neurosurgical Society
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    • v.29 no.12
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    • pp.1563-1569
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    • 2000
  • Objective : Delayed ischemic neurologic deficit(DIND) is one of the major complications following aneurysmal subarachnoid hemorrhage(SAH). However, the correlation between angiographic vasospasm(AV) and DIND after SAH is not precisely known. The authors investigated the timing, incidence, characteristics of DIND, and analyzed correlation between AV and DIND. Patients and Methods : A series of 126 patients with SAH and performed cerebral angiography which, confirmed anterior circulation aneurysm, admitted to between January 1996 to December 1998, were studied retrospectively. A comparative analysis between group 1(G1) in which AV patients presented with DIND, and group 2(G2) patients did not DIND, were done. AV was graded according to location, distribution and degree. Location of vasospasm was classified as basal type(BT), distal type(DT). BT was involved horizontally and include the bilateral carotid systems, proximal middle cerebral artery(MCA) and proximal anterior cerebral artery(ACA). DT was involved vertically and include the MCA branches as they become vertically or posteriorly oriented and the ACA distal to the anterior communicating artery. BT and DT all defined ether as localized type(LT) or combined type(CT). Distribution of vasospasm was classified as type I, type II and type III. Type I represents the involvement of bilateral carotid systems and bilateral anterior cerebral artery, type II was designed as one carotid system without involving anterior cerebral artery, and type III when only some portions of the anterior cerebral artery were involved, bilaterally. Degree of vasospasm was classified as mild(less than 25%), moderate(between 25-50%), severe(greater than 50%), and those were determined by comparing the caliber of the artery in vasospasm to that of the nearest area of apparently normal vessel. Results : The incidence of AV & DIND was 57/126(45.2%), 29/126(23.0%), and timing of DIND was 9 days(${\pm}4.1$) after initial hemorrhage. As for the location, BT was seen in 12 cases(40.0%), DT 11 cases(36.7%) and CT 7 cases (23.3%), respectively. Where as G1, BT was seen 5 cases(18.5%), DT 5 cases(18.5%) and CT 17 cases(63.0%), respectively in G2. CT AV was more correlated with DIND than LT AV(p<0.05). For distribution, type I was seen in 16 cases(59.2%), type II 4 cases(14.8%), type III 7 cases(25.9%) in G1 where as type I was seen in 7 cases(23.3%), type II 10 cases(33.3%), type III 13(43.3%) in G2. Type I AV was well correlated with DIND unlike to type II or type III(p<0.05). As for the degree, mild was seen in 4 cases(14.8%), moderate 14 cases(51.9%), severe 9 cases (33.3%) in G1, and mild 16 cases(18.5%), moderate 11 cases(36.7%) and severe 3 cases(10.0%) in G2. Moderate to severe type AV was well correlated with DIND(p<0.05). Conclusion : These results indicate that it may be possible to predict DIND according to careful analysis of location, distribution, degree of AV in patients with aneurysmal SAH.

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