• 제목/요약/키워드: Carotid Bifurcation

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An Anatomical Variant : Low-Lying Bifurcation of the Common Carotid Artery, and Its Surgical Implications in Anterior Cervical Discectomy

  • Gulsen, Salih;Caner, Hakan;Altinors, Nur
    • Journal of Korean Neurosurgical Society
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    • 제45권1호
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    • pp.32-34
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    • 2009
  • The common carotid artery generally bifurcates into the internal and external carotid arteries at the level of C3-4. Injury to the common carotid artery during anterior cervical discectomy is a complication that is very much feared but encountered rarely. Knowing the anatomic variations of the common carotid artery and using an operating microscope during the anterior cervical approach for cases with low-lying bifurcation of the common carotid artery would prevent injuries to this artery. We present a 42-year-old female who has successfully undergone anterior cervical discectomy at the level of C5-6 and C6-7. She had a low-lying bifurcation of the common carotid artery.

혈관 유연성을 고려한 경동맥 분기부 모델 혈류역학 해석 (NUMERICAL ANALYSIS OF BLOOD FLOW DYNAMICS AND WALL MECHANICS IN A COMPLIANT CAROTID BIFURCATION MODEL)

  • 투안;이상욱
    • 한국전산유체공학회:학술대회논문집
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    • 한국전산유체공학회 2011년 춘계학술대회논문집
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    • pp.500-503
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    • 2011
  • Blood flow simulations in an idealized carotid bifurcation model with considering wall compliance were carried out to investigate the effect of wall elasticity on the wall shear stress and wall solid stress. Canonical waveforms of flowrates and pressure in the carotid arteries were imposed for the boundary conditions. Comparing to rigid wall model, generally, we could find an increased recirculation region at the carotid bulb and an overall reduced wall shear stress. Also, there was appreciable change of flowrate and pressure waveform in longitudinal direction. Solid and wall shear stress concentration occurs at the bifurcation apex.

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혈관 유연성을 고려한 경동맥 분기부 모델 혈류역학 해석 (Numerical Study on Blood Flow Dynamics and Wall Mechanics in a Compliant Carotid Bifurcation Model)

  • 웬민투안;이상욱
    • 한국가시화정보학회지
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    • 제13권2호
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    • pp.28-32
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    • 2015
  • Blood flow simulations in an realistic carotid bifurcation model with considering wall compliance were carried out to investigate the effect of wall elasticity on the wall shear stress and wall solid stress. Canonical waveforms of flow rates and pressure in carotid arteries were imposed for boundary conditions. Compared to a rigid wall model, we found an increased recirculation region at the carotid bulb and an overall reduction of wall shear stress in a compliant model. Additionally, there was appreciable change of flow rate and pressure wave in longitudinal direction. Both solid and wall shear stress concentration occur at the bifurcation apex.

경동맥 혈류유동에서의 혈액의 비뉴우토니안 특성의 상대적 중요성 해석 (THE RELATIVE IMPORTANCE OF NON-NEWTONIAN CHARACTERISTICS OF BLOOD IN THE HEMODYNAMICS OF THE CAROTID BIFURCATION)

  • 이상욱
    • 한국전산유체공학회:학술대회논문집
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    • 한국전산유체공학회 2008년도 학술대회
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    • pp.181-185
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    • 2008
  • In this study, we attempted to quantify the relative importance of assumptions regarding blood rheology. Three patient-specific carotid bifurcation geometries and time-varying flow rates were obtained using magnetic resonance imaging. For each subject, CFD simulations were carried out assuming two different non-Newtonian rheology models Carreau and Ballyk models) and rescaled Newtonian viscosities based on characteristic shear rates to account for the shear-thinning property of blood. The sensitivity of WSS and oscillatory shear index (OSI) were contextualized with respect to the reproducibility of the reconstructed geometry and to assumptions regarding the inlet boundary conditions. We conclude that the assumption of Newtonian fluid is reasonable for studies aimed at quantifying the distribution of WSS-based extrema in an image-based CFD model of carotid bifurcation.

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경동맥 혈류유동에서의 혈액의 비뉴우토니안 특성의 상대적 중요성 해석 (THE RELATIVE IMPORTANCE OF NON-NEWTONIAN CHARACTERISTICS OF BLOOD IN THE HEMODYNAMICS OF THE CAROTID BIFURCATION)

  • 이상욱
    • 한국전산유체공학회:학술대회논문집
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    • 한국전산유체공학회 2008년 추계학술대회논문집
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    • pp.181-185
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    • 2008
  • In this study, we attempted to quantify the relative importance of assumptions regarding blood rheology. Three patient-specific carotid bifurcation geometries and time-varying flow rates were obtained using magnetic resonance imaging. For each subject, CFD simulations were carried out assuming two different non-Newtonian rheology models (Carreau and Ballyk models) and rescaled Newtonian viscosities based on characteristic shear rates to account for the shear-thinning property of blood. The sensitivity of WSS and oscillatory shear index (OSI) were contextualized with respect to the reproducibility of the reconstructed geometry and to assumptions regarding the inlet boundary conditions. We conclude that the assumption of Newtonian fluid is reasonable for studies aimed at quantifying the distribution of WSS-based extrema in an image-based CFD model of carotid bifurcation.

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A cadaveric study on variations in branching pattern of external carotid artery

  • Devadas, Deepa;Pillay, Minnie;Sukumaran, Tintu Thottiyil
    • Anatomy and Cell Biology
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    • 제51권4호
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    • pp.225-231
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    • 2018
  • Variations in the vascular anatomy of the carotid triangle have been reported in current scientific literature. The carotid arteries, being the major feeding arteries of the head and neck deserve special importance and protection from iatrogenic injury during radiological evaluations and surgical interventions. The present study was carried out over a period of 4 years from 2012-2016 to assess the variant anatomy of external carotid artery. The external carotid artery and its branches were dissected bilaterally in 40 formalin embalmed cadavers. The external carotid artery was traced from its origin to termination and variations in the branching pattern as well as the level of the carotid bifurcation were observed and analysed. A higher carotid bifurcation was observed in 25% cases. The linguofacial trunk was the commonest variation noted in the branching pattern seen in 20% cases. A single case of unilateral thyrolinguofacial trunk was also observed. The external carotid artery gave rise to accessory branches in 7.5% cases namely the superior laryngeal, accessory ascending pharyngeal and masseteric branches. A slender branch to the internal jugular vein was also observed in one case. These findings may provide further insight into the understanding of the vascular anatomy of the carotid triangle to the curious student, the discerning radiologist and the vigilant surgeon to avert complications and help improve overall treatment outcome.

경동맥체 부신경절종 (Management of Carotid Body Paraganglioma: Review of the literature with report of three cases)

  • 박정수;김준식;홍원표;최은창;김동익
    • 대한두경부종양학회지
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    • 제5권1호
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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.

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경동맥 분지관내 정상유동에 대한 컴퓨터 시뮬레이션과 MRA 관찰 (Computer Simulation and MRA Observation for Steady Flow in the Carotid Arterial Bifurcation)

  • 서상호;조민태;유상신;정태섭
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1996년도 춘계학술대회
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    • pp.73-76
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    • 1996
  • Computer simulation and magnetic resonance angiograms(MRAs) are used to understand for flow patterns in the carotid arterial bifurcation. Steady momentum equation is solved by the finite volume method. A Phantom of the carotid artery made of bioacrylic material is used for MRA observation. Flow Patterns are observed by using MRA for flow in the phantom of an automatic closed-type circulatory system filled with sugar 4 w% solution. For numerical analysis the idealized geometric shape of the carotid artery is constructed to portray the phantom. Results of numerical analysis are compared with those of MRA. The flow patterns of the phantom on MRA are almost identical to those of the computer simulation.

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환자 특정 경동맥 분기부 모델 혈류유동에 대한 입구부 이차곡률의 영향 (Influence of Inlet Secondary Curvature on Hemodynamics in Subject-Specific Model of Carotid Bifurcations)

  • 이상욱
    • 비파괴검사학회지
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    • 제31권5호
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    • pp.479-486
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    • 2011
  • 의료영상을 기반으로 한 경동맥 분기부 혈류유동장 전산유체역학 해석의 수행에 있어 입구부 경계 조건 도출을 위한 환자 특정 시간 변동 상세 유속 분포를 얻는 것은 일반적으로 쉽지 않다. 그러므로 대부분의 경우 계측된 혈류량을 바탕으로 이상적인 축대칭 완전발달 유속 분포를 적용하게 된다. 그러나 MRI로 직접 계측한 총경동맥 혈류 유속분포를 적용한 기존의 연구에서 입구부 유속분포 경계 조건이 경동맥 분기부 혈류 유동장 해석 결과에 중요한 영향을 미친다는 것을 보였으며, 특히 계측된 혈류 유속분포가 전형적인 Dean type 유동과 다른 독특한 형태를 가진다는 것을 보고하였다. 본 연구에서는 이러한 독특한 형태의 유속 분포가 경동맥 입구부 형상의 이차곡률에 의해 생성됨을 보이고, 직접 경동맥 분기부 유동장 CFD 해석의 경계 조건으로 적용하여 이의 영향을 조사하였다. 이를 통하여 충분한 길이의 실제 경동맥 입구부 형상을 적용 할 경우, 입구부 경계 조건의 영향이 의료영상으로 부터 혈관 형상을 도출하는 과정에서 불가피하게 유기되는 영상 처리 오차에 의한 영향에 비해 상대적으로 크지 않음을 알 수 있었다.

경동맥체 부신경절종 -수술치험 2례- (carotid Body Paragangrioma -Two cases report-)

  • 박영훈;김욱진
    • Journal of Chest Surgery
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    • 제29권9호
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    • pp.1023-1027
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    • 1996
  • 경동맥체 종양(carotid body tumor)은 총경동맥 분지부에 위치한 경동맥체 즉 화학 수용기에서 발생하는 종양으로서 그 발생빈도가 드물다. 이 경동맥 체의 기능은 혈액내 화학조성에 의해 호흡,혈압, 맥박수의 반사조절이 이루어지는 것으로 알려져 있다. 조직학적으로 대부분 주세포(chiefcell)로 구성되어 있고 대부분 피막에 쌓여 있으며 분엽성, 압축성으로 서서히 자라나중에 경부혈관을 둘러싸 압박하게되며 그 이외 다른 혈관이나 신경을 누르게 된다. 경동맥체의 치료방법은 수술적 절제, 방사선 조사, 색 전술등이 알려져 있으며 이중 외과적 절제가 대표적인 치료 방법으로 알려져 있다. 하지만 외과적 절제가 쉽지 않고수술중비교적 높은 이병율과뇌혈류 부전으로 인한 반측마비등의 후유증을 유발할 수 있기 때문에 고도의 주의를 요한다. 저자들은 경동맥 체종양으로 진단받고 절제수술을 받은 2례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

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