• Title/Summary/Keyword: Carotid artery thrombosis

Search Result 27, Processing Time 0.02 seconds

Evaluation of Stent Apposition in the LVIS Blue Stent-Assisted Coiling of Distal Internal Carotid Artery Aneurysms : Correlation with Clinical and Angiographic Outcomes

  • Kwon, Min-Yong;Ko, Young San;Kwon, Sae Min;Kim, Chang-Hyun;Lee, Chang-Young
    • Journal of Korean Neurosurgical Society
    • /
    • v.65 no.6
    • /
    • pp.801-815
    • /
    • 2022
  • Objective : To evaluate the stent apposition of a low-profile visualized intraluminal support (LVIS) device in distal internal carotid artery (ICA) aneurysms, examine its correlation with clinical and angiographic outcomes, and determine the predictive factors of ischemic adverse events (IAEs) related to stent-assisted coiling. Methods : We retrospectively analyzed a prospectively maintained database of 183 patients between January 2017 and February 2020. The carotid siphon from the cavernous ICA to the ICA terminus was divided into posterior, anterior, and superior bends. The anterior bends were categorized into angled (V) and non-angled (C, U, and S) types depending on the morphology and measured angles. Complete stent apposition (CSA) and incomplete stent apposition (ISA) were evaluated using unsubtracted angiography and flat-panel detector computed tomography. Dual antiplatelet therapy with aspirin 200 mg and clopidogrel 75 mg was administered. Clopidogrel resistance was defined as fewer responders (≥10%, <40%) and non-responders (<10%) based on the percent inhibition (%INH) of the VerifyNow system. These were counteracted by a dose escalation to 150 mg for fewer responders or substitution with cilostazol 200 mg for non-responders. IAEs included intraoperative in-stent thrombosis, transient ischemic attack, cerebral infarction, and delayed in-stent stenosis. A multivariate logistic regression analysis was used to determine the predictive factors for ISA and IAEs. Results : There were 33 ISAs (18.0%) and 27 IAEs (14.8%). The anterior bend angle was narrower in ISA (-4.16°±25.18°) than in CSA (23.52°±23.13°) (p<0.001). The V- and S-types were independently correlated with the ISA (p<0.001). However, treatment outcomes, including IAEs (15.3% vs. 12.1%), aneurysmal complete occlusion (91.3% vs. 88.6%), and recanalization (none of them), did not differ between CSA and ISA (p>0.05). The %INH of 27 IAEs (13.78%±14.78%) was significantly lower than that of 156 non-IAEs (26.82%±20.23%) (p<0.001). Non-responders to clopidogrel were the only significant predictive factor for IAEs (p=0.001). Conclusion : The angled and tortuous anatomical peculiarity of the carotid siphon caused ISA of the LVIS device; however, it did not affect clinical and angiographic outcomes, while the non-responders to clopidogrel affected the IAEs related to stent-assisted coiling.

Experimental Study on Distally Based Free Flap Using Retrograde Arterial Flow (역행성 동맥 혈류를 이용한 원위 유리피판술의 실험적 연구)

  • Lee, Min-Goo;Minn, Kyung-Won
    • Archives of Reconstructive Microsurgery
    • /
    • v.7 no.1
    • /
    • pp.15-19
    • /
    • 1998
  • Microsurgical free-tissue transfer has allowed surgeons to salvage injured limbs but choosing appropriate healthy recipient vessels has proved to be a difficult problem. Retrograde flow flaps are established in island flaps. Retrograde flow anastomosis could prevent the possible kinking and twisting of the arterial anastomosis. By not interrupting the proximal blood flow to the fracture or soft tissue defect site, the compromise of fracture or wound healing might be prevented. We wished to estabilish an animal model in rat for a retrograde arterial flow based free flap. Nembutal-anesthetized male rats; weighing 250 to 300 gm, were used. The femoral artery and common carotid artery were exposed and divided. The systemic and retrograde arterial pressure were quantified by utilizing a parallel tubing system connected with peripheral arterial line. In this study, the retrograde flow was not pulsatile and the retrograde arterial pressure was 64-65mmHg, with a mean arterial pressure of 106-109mmHg. An epigastiic skin flap, measuring $3{\times}3cm$, was raised with its vascular pedicle. The epigastric free flap was transfered in the same rat from femoral vessels to carotid vessels in end to end fashion. We anastomosed the donor arteries to the distal parts of the divided recipient arteries and the donor veins to the proximal parts of the recipient veins. Twelve experiments were performed and the transplantations succeeded in 75 percent of them. In the remaining 25 percent, the experiments failed due to thrombosis at the site of anastpmosis, or other causes. This animal model represents an excellent example of retrograde arterial flow free flap transfer that is reliable.

  • PDF

Antiplatelet and Antithrombotic Activities of Korean Red Ginseng

  • Yu, Ji-Yeon;Jin, Yong-Ri;Lee, Jung-Jin;Chung, Jin-Ho;Noh, Ji-Yoon;You, Soon-Hyang;Kim, Ki-Nam;Im, Ji-Hyun;Lee, Ju-Hyun;Seo, Ji-Min;Han, Hyeong-Jun;Lim, Yong;Park, Eun-Seok;Kim, Tack-Joong;Shin, Kyeong-Soeb;Wee, Jae-Joon;Park, Jong-Dae;Yun, Yeo-Pyo
    • Archives of Pharmacal Research
    • /
    • v.29 no.10
    • /
    • pp.898-903
    • /
    • 2006
  • The antiplatelet and antithrombotic activities of Korean Red Ginseng (KRG) were examined on rat carotid artery thrombosis in vivo, and platelet aggregation in vitro and ex vivo. Administration of KRG to rats not only prevented carotid artery thrombosis in vivo in a dose-dependent manner, but also significantly inhibited ADP- and collagen-induced platelet aggregation ex vivo, while failed to prolong coagulation times such as activated partial thromboplastin time (APTT) and prothrombin time (PT), indicating the antithrombotic effect of KRG might be due to its anti platelet aggregation rather than anticoagulation effect. In line with the above observations, KRG inhibited U46619-, arachidonic acid-, collagen- and thrombin-induced rabbit platelet aggregation in vitro in a concentration-dependent manner, with $IC_{50}$ values of $620{\pm}12$, $823{\pm}22$, $722{\pm}21$ and $650{\pm}14\;{\mu}g/mL$, respectively. Accordingly, KRG also inhibited various agonists-induced platelet serotonin secretions as it suppressed platelet aggregation. These results suggest that KRG has a potent antithrombotic effect in vivo, which may be due to antiplatelet rather than anticoagulation activity, and KRG intake may be beneficial to the individuals with high risks of thrombotic and cardiovascular diseases.

LB30057, an Orally Effective Direct Thrombin Inhibitor, Prevents Arterial and Venous Thrombosis in Rats and Dogs

  • Park, Hee-Dong;Kim, Hee-Jin;Oh, Yeong-Soo;Kim, In-Chull;Kim, Yong-Zu;Koh, Hyun-Chul;Shin, In-Chul;Lee, Yong-Hee;Lee, Chang-Ho
    • Archives of Pharmacal Research
    • /
    • v.26 no.3
    • /
    • pp.224-231
    • /
    • 2003
  • The anti-thrombotic effects of LB30057, a direct thrombin inhibitor, were evaluated with in vivo rat and dog thrombosis models. In rats, 1 mg/kg of LB30057 inhibited half of the clot formations in the inferior vena cava at 5 minutes after intravenous application. When measured at 2 hours after oral application, 100 mg/kg prevented approximately half of the clot formations in the inferior vena cava and 50 mg/kg prolonged the mean occlusion time from $15.6{\pm}1.3$ minutes to $47.2{\pm}8.3$ minutes in the carotid artery. In dogs, the formation of thrombus in the jugular vein was reduced to half at a dose range of 20-30 mg/kg at 6 hours after oral application. In addition, the LB30057 dosage required to reduce venous clot formation by approximately 80-90% in dogs was only about 10% of that required for the same reduction in rats. This is probably due to the variation in its time-dependent blood concentration profiles in each species; for example, the plasma half-life of LB71350 in dogs was longer than that in rats ($153.0{\pm}3.0$ vs. $129.7{\pm}12.7$ min at 30 mg/kg, i.v., respectively). AUG, $T_{max},{\;}G_{max}$, and BA in dogs were 59, 8.9, 9.17, and 13.3 times higher than those in rats at oral 30 mg/kg, respectively. Taken together, these results suggest that LB30057 administered orally is effective in the prevention of arterial and venous thrombosis in rats and dogs. It therefore represents a good lead compound for investigations to discover a new, orally available, therapeutic agent for treating thrombotic diseases.

Effects of Antioxidant and Blood Flow Improvement of Grape Leaf Extract and Resveratrol from Vitis romaneti (남항(Vitis romaneti) 유래 포도잎 추출물과 Resveratrol의 항산화 및 혈행개선 효과)

  • Kang, Hyun Ju;Kim, Hyeon Soo;Jeon, In Hwa;Mok, Ji Ye;Han, Kyeong Soo;Jang, Seon Il
    • Journal of the Korean Society of Food Science and Nutrition
    • /
    • v.42 no.11
    • /
    • pp.1736-1743
    • /
    • 2013
  • The purpose of this study is to investigate the effects of 80% ethanol grape leaf extract (VGLE) and resveratrol (VGLR) from Vitis romaneti on antioxidant of red blood cells (RBC) of rat and efficacy of blood flow improvement in a rat model of topical ferric chloride ($FeCl_3$)-induced carotid artery damage. RBC oxidative hemolysis and plasma lipid peroxidation induced by the aqueous peroxyl radical generator 2,2'-azobis(2-amidinopropane) dihydrochloride were significantly suppressed by VGLE or VGLR in a dose-dependent manner. The $FeCl_3$ treatment seriously damaged the carotid artery: the walls of the artery and blood flow. However, VGLE or VGLR administration has ameliorated the blood flow and suppressed thrombus in blood vessels. These results suggest that VGLE or VGLR ameliorates the oxidative stress of RBC and thrombosis against blood vessel damage.

The Effects of ChondroT on Thrombus in FeCl3-induced Rats (ChondroT 투여가 FeCl3로 유발된 혈전에 미치는 영향)

  • Kim, Ji Hoon;Kim, Sun Gil;Kim, Joo Il;Yoon, Chang Suk;Choi, Ji Min;Na, Chang Su;Kim, Seon Jong
    • Journal of Korean Medicine Rehabilitation
    • /
    • v.30 no.3
    • /
    • pp.45-56
    • /
    • 2020
  • Objectives This study was designed to investigate the effects of ChondroT on thrombus in FeCl3-induced rats. Methods We exposed FeCl3 to rat's carotid artery to induce thrombus. Specimens were divided in 5 groups; Intact, Control, ASA10 (aspirin 10 mg/kg), CT100 (ChondroT 100 mg/kg), and CT200 (ChondroT 200 mg/kg), each n=6. We investigated thromboxane, platelet activating factor (PAF), histological change, lipid metabolism, transaminase, leukocyte, erythrocyte and thrombocyte level. Results In ASA10, CT200 groups, there was significants decrease in both thromboxane level and total cholesterol level, compared to control group and there were significant histological changes of blood vessel, compared to control group. In CT200 group, there was significant decrease in PAF level, compared to control group (p<0.05). In ASA10, CT200 groups, triglycerides level tended to decrease, compared to control group. Conclusions Based on these results, it could be suggested that ChondroT was effective on thrombus in FeCl3-induced rats, and further study is needed to conduct a rigorous clinical research.

Development of Biocompatible Vascular Graft -Endothelialization of Small Vascular Graft- (생체적합성 인조혈관의 개발 -혈관내피화 인조혈관-)

  • 김형묵;이윤신
    • Journal of Chest Surgery
    • /
    • v.29 no.4
    • /
    • pp.373-380
    • /
    • 1996
  • Prevention of thromboembolism is the most important task in the development of bioconpatible small caliber artificial vascular graft. In normal vessels, vascular endothelial cells maintain homeosatsis by secreting numerous factors. The aim of this study is to develope a method which Improves biocompatibility of small caliver polyurethane graft using endothelial cell culture technique, and ev luate the efTectiveness of extracelluar matrix for endothelization which was produced by cultured fibroblast. Methods ; Multiporous polyurethane tube of 3 mm diameter, 0.3 mm thickness was manufactured for vascular graft. Three mongrel dogs were intubated and internal jugular veins removed. Extracelluar matrix produced by cultured flbrobast which was obtained from dog's internal jugular vein were coated to the polyurethane graft. Then, endothelial cells extracted from Jugular vein were cultured and fixed on the extracelluar matrix layer of vascular graft. Endothelial cell coated vascular grafts were implanted to the carotid arteries of experimental dogs as interposed autograft. Implanted grafts were removed after 3 and 6 weeks. As a control, PTFE graft was interposed on carotid artery. These experiments demonstrated that extracelluar matrix produced by fibroblast can afford a base for endothelial cell linings of polyurethane graft. Although thrombosis were developed on autografted en othelial cell coated graft, 33% opening was noticed, and showed less adhesion to adjacent tissue layer. These findings suggest that fiboblast produced extracelluar matrix which can be used for edothelial cell lining vascular graft, and by improving the cultured endothelial cell function, there will be a new modality for reducing thrombosis on small vascular graft.

  • PDF