• The Korean Journal of Pain
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• v.8 no.1
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• pp.55-59
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• 1995

Stellate ganglion block (SGB) is applicated frequently to increase the blood flow and to reduce the pain in head, neck and upper extremity. The effects of SGB are able to be estimated by clinical signs and symptoms of Horner's syndrome, skin warmth, anhydrosis, etc. The effects are also estimated by sympathetic function and the blood flow. Blood flow velocities and pulsatility indices of common carotid,d axillary, brachial and radial artery were measured by Doppler flowmeter after SGB with 1% lidocaine at C6 level. Blood velocities of all arteries were increased and pulsatility indices of all arteries were decreased. This results suggest that SGB increase the blood flow of head and upper extremity and Doppler flowmeter is a good indicator of the effects of SGB.

• Journal of Chest Surgery
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• v.14 no.1
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• pp.67-70
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• 1981

Aneurysms of the extracranial carotid artery are rare. This is a case report of the rapidly expanding false carotid aneurysm at left common carotid artery, which was repaired surgically with internal shunt This 20 year old male patient had a large pulsatile mass on left lateral aspect of neck at the time of admission. About 1 month before admission, he had received a trauma on left neck by glass piece and noted massive blood loss. And its skin of lesion was sutured simply at local clinic and well healed. 10 days before the admission, he had the sudden onset of the adult thumb sized and pulsatile mass and the mass had been enlarged more and more to the adult first-sized one. The cervical film showed a egg-sized and soft tissue mass. There was systolic bruit on the mass. The diagnosis was confirmed with the angiogram of left carotid artery and this showed the man`s thumb tip-sized extravasation at the point 2 Cm below the bifurcation of Internal and external carotid arteries. The emergency operation was performed by the internal shunt with carotid artery. The aneurysm was enclosed with the adventitia and carotid sheath, and the intima and media were Intact and had the opening of 0.5 cm in diameter. The opening was sutured by the one-hand mattress suture method and firmed with the Aron Alpha-A "Sankyo." The postoperative course was uneventful and the patient was discharged with good general condition.

• 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.

• Journal of Korean Neurosurgical Society
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• v.44 no.3
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• pp.159-162
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• 2008

Stenting is a useful alternative treatment modality in carotid artery stenosis patients who are too high-risk to undergo carotid endarterectomy (CEA). We report a case of contralateral cerebral infarction after stenting for extracranial carotid stenosis. A 78-year-old woman was admitted to the hospital with left-sided weakness. Based on magnetic resonance imaging (MRI) of the brain and conventional angiography, she was diagnosed with an acute watershed infarct of the right hemisphere secondary to severe carotid stenosis. Stenting was performed for treatment of the right carotid artery stenosis after a one-week cerebral angiogram was completed. Thirty minutes after stent placement, the patient exhibited a generalized seizure. Four hours later, brain MRI revealed left hemispheric cerebral infarction. Complex aorta-like arch elongation, tortuosity, calcification, and acute angulation at the origin of the supra-aortic arteries may increase the risk of procedural complications. In our case, we suggest that difficult carotid artery catheterization, with aggressive maneuvering during stenting, likely injured the tortuous, atherosclerotic aortic arch, and led to infarction of the contralateral cerebral hemisphere by thromboemboli formed on the wall of the atherosclerotic aorta.

• Journal of the Korean Society of Radiology
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• v.3 no.4
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• pp.5-12
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• 2009

Arterial blood from the heart chonggyeong passed directly to the cerebral arteries and the blood circulation is important, especially in arteries that prevent blood flow there are several variables. Among the variables the average flow velocity, pulse index, and blood flow resistance and which variables, double maekbakjisuna systolic and diastolic blood flow resistance index at the maximum rate and blood pressure associated with this because they are important variables, The change of variables such as speed noehyeolryu There are observations about the non-invasive ultrasound measurements using Doppler noehyeolryu uses. Up to 20 men in the exercise of noeroganeun hyeolryuin chonggyeong arteries to increase blood flow rates can be found.

• The Journal of Korean Medicine
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• v.39 no.1
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• pp.86-94
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• 2018

Objectives: This study is aimed to examine the effect of Geopungchunghyul-dan on circumferential strain of carotid artery in outpatients of Kyung Hee University hospital of Korean Medicine. Methods: Retrospective chart review is used from June 2016 to August 2017 for outpatients of Kyung Hee University hospital of Korean Medicine. 14 patients taking Geopungchunghyul-dan over 1 month were speculated. Data of circumferential strain and intima-media thickness was taken from carotid ultrasonography and processed by Wilcoxon signed-rank test. Results: Geopungchunghyul-dan lowered circumferential strain of both carotid arteries after 1 month of administration (p<0.05). Intima-media thickness of both carotid arteries did not changed significantly. Conclusions: Geopungchunghyul-dan may ameliorate arterial stiffness.

• Investigative Magnetic Resonance Imaging
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• v.22 no.2
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• pp.94-101
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• 2018

Purpose: To determine the value of the appearance of the high signal intensity halo sign for detecting carotid intraplaque hemorrhage (IPH) on maximum intensity projection (MIP) of time-of-flight (TOF) MR angiography (MRA), based on high signal intensity on magnetization-prepared rapid acquisition with gradient-echo (MPRAGE) sequencing. Materials and Methods: A total of 78 carotid arteries in 65 patients with magnetization-prepared rapid acquisition gradient-echo (MPRAGE) positive on carotid plaque MR imaging were included in this study. High-resolution MR imaging was performed on a 3.0-T scanner prior to carotid endarterectomy or carotid artery stenting. Fast spin-echo T1- and T2-weighted axial imaging, TOF, and MPRAGE sequences were obtained. Carotid plaques with high signal intensity on MPRAGE > 200% that of adjacent muscle on at least two consecutive slices were defined as showing IPH. Halo sign of high signal intensity around the carotid artery was found on MIP from TOF MRA. Continuous and categorical variables were compared among groups using the Mann-Whitney test and Fisher's exact tests. Results: Of these 78 carotid arteries, 53 appeared as a halo sign on the TOF MRA. The total IPH volume of patients with a positive halo sign was significantly higher than that of patients without a halo sign ($75.0{\pm}86.8$ vs. $16.3{\pm}18.2$, P = 0.001). The maximum IPH axial wall area in patients with a positive halo sign was significantly higher than that of patients without a halo sign ($11.3{\pm}9.9$ vs. $3.7{\pm}3.6$, P = 0.000). Conclusion: High signal intensity halo of IPH on MIP of TOF MRA is associated with total volume and maximal axial wall area of IPH.

• Journal of Yeungnam Medical Science
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• v.21 no.2
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• pp.143-150
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• 2004

A thromboembolic stroke is believed to be precipitated by a rupture of vulnerable atheromatous plaques. Until recently the assessment of a further risk of stroke in high-risk patients in whom atherosclerosis has presented with a transient ischaemic attack (TIA), has been confined to a quantitative assessment of the luminal patency of the internal carotid artery. These traditional stratification parameters are no longer believed to be the most accurate predictors of a thrombo-embolism. This is because the process of vessel wall remodeling can maintain a luminal patency, and consequently, quite large friable plaques may remain unidentified. Accordingly, there is a need for an improved risk assessment. The fibrous cap of a vulnerable plaque is thinner, and an intraplaque hemorrhage and inflammation can occur during the development of atherosclerotic plaque. Several imaging methods for identifying vulnerable plaques have been developed. Recently, high resolution magnetic resonance (MR) imaging has emerged as an accurate non-invasive tool that can characterize the carotid plaque components in vivo. A High resolution carotid magnetic resonance is capable of distinguishing an intact, thick fibrous cap from a thin and ruptured cap in carotid plaque. In addition, a plaque MR can identify the active inflammation and detect a hemorrhage. High resolution carotid MR imaging is a valuable noninvasive method for quantifying the plaque components and identifying vulnerable plaque.

• Advances in Traditional Medicine
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• v.2 no.2
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• pp.87-93
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• 2002

The present study was aimed to examine the role of endothelium in the relaxant effect of hawthorn fruit extract of Crataegus pinnatifida in four different types of rat arteries, posterior cerebral communicating artery, right descending coronary artery, common carotid artery, and aorta. In $9,11-dideoxy-11{\alpha}$, $9{\alpha}-epoxy-methanoprostaglandin$ $F_{2{\alpha}}$ (U46619)-preconstricted arterial rings except for aorta, the extract produced endothelium-independent relaxations with similar potency. This relaxation was unaffected by pretreatment with $100\;{\mu}M\;N^G-nitro-L-arginine$ methylester (L-NAME, the nitric oxide synthase inhibitor), $3\;{\mu}M$ 1H-[l,2,4]oxadiazolo$[4,2-{\alpha}]$quinoxalin-1-one (ODQ, the guanylate cyclase inhibitor), or $10\;{\mu}M$ indomethacin (the cyclooxygenase inhibitor). Putative $K^+$ channel blockers (charybdotoxin plus apamin or glibenclamide) did not affect the extract-induced relaxation in cerebral or coronary artery rings. In contrast, in rat aortic rings the extract produced significantly smaller relaxant response in endothelium-denuded rings than that in endothelium-intact rings. Pretreatment with L-NAME or ODQ abolished the extractinduced endothelium-dependent aortic relaxation, whilst indomethacin $(3\;{\mu}M)$ had no effect. The present results indicate that hawthorn fruit extract possesses a vasorelaxing effect in cerebral, coronary and carotid arteries and this effect is independent of the presence of a functional endothelium. However, the extract-induced endothelium-dependent relaxation in rat aorta was mediated through endothelial nitric oxide and cyclic GMP-dependent mechanisms, suggesting that active components in the extract may act on endothelium to stimulate release of nitric oxide in large conduit arteries of the rats.

• Journal of Chest Surgery
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• v.29 no.1
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• pp.103-106
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• 1996

Aneurysms of the extracranial carotid arteries are relativeley rare in comparison with the total arterial system, but can cause death or a cerebrovascular accident. The treatment of choice is resection of the aneurysm and restoration of arterial continuity. This report describes two cases of extracranial internal carotid arterial aneurysm, which were saccular type. In both cases, the operations were performed under general anesthesia without shunt. The patients were recovered without any neurological sequelae.