• 대한두경부종양학회지
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• 제20권2호
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• pp.177-180
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• 2004

Objectives: To completely excise a malignant tumor which invades carotid artery walls, the resection and reconstruction of the carotid artery is essentially required. In most of the cases, interposition graft using a saphenous vein has been performed, however the vessel caliber discrepancy between a common carotid artery and the saphenous vein can result in a problem on surgical technique. We have introduced and evaluated a new titanium hemoclip tailing method to overcome vessel caliber discrepancy in interposition saphenous vein graft for carotid artery resection in the treatment of head and neck cancers. Method: After carotid artery resection, the calibers of the proximal common carotid artery and the vein were compared, and an orifice of the common carotid artery was gradually reduced to a little larger than or the same size as the orifice of the vein by using the titanium hemostatic clip. Subsequently, the common carotid artery was connected to the vein through anastomosis. The same method was also applied to the distal anastomosis site. There after, the vessels were connected through the anastomosis, and a circulation was restored by releasing a vascular clamp. Then, a titanium hemostatic clip-applied redundant portion on the outside of carotid artery was sutured by the blanket edge suture method, using 6-0 Prolene. Results: We have experienced this method in two patients with recurrent squamous cell carcinoma and neuroblostoma, respectively. The interposition saphenous vein graft of these patients was found to maintain good patency on the follow up angiography after one year, and they had no specific vascular complication, such as atherosclerosis. Conclusion: This method made it possible to simply perform the interposition saphenous vein graft (ISVG) within a short time and, therefore, was very useful for shortening the duration to block circulation.

• Journal of Chest Surgery
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• 제14권1호
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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.

• Journal of Trauma and Injury
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• 제29권4호
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• pp.172-175
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• 2016

Penetrated injury of common carotid artery (CCA) is rare and extremely lethal. Carotid artery injury tends to bleed actively and potentially occlude the trachea. It can cause fatal neurological complications. An accurate diagnosis and adequate treatment are very needed to the successful outcome of the penetrating vascular injury in zone 1, 2, and 3 of the neck. Open surgical treatment is more invasive and complicated than endovascular treatment. We experienced a case with penetrating injury in neck zone 2. Here, we report the case successfully treated with endovascular stent graft technique.

• Imaging Science in Dentistry
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• 제36권3호
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• pp.151-155
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• 2006

Purpose : Stroke is one of the leading causes of death in Korea. Atherosclerotic disease in the carotid artery bifurcation is the most common cause of stroke. The carotid artery calcification is easily appreciated by CT (Computed tomography). CT is often taken in a dental hospital for the diagnosis of inflammation, injury, cyst or tumor on maxillofacial region. However, there was no report of carotid artery calcification on CT in dental patients. This study was to determine the prevalence of carotid artery calcification on CT in dental patients. Materials and Methods : The presence of carotid artery calcification was evaluated by an experienced radiologist on CT scans of 287 patients (166 males, 121 females, average age 42, range 6 to 86 years) and the medical history of the patient and the interpretation of CT were reviewed. Results : Carotid artery calcification was detected on CT scans of 57 patients (19.8%; 35 males, 22 females). All the male patients with carotid artery calcification were older than 50, and all the female patients with carotid artery calcification were older than 60. Among the 57 patients, 10 had Diabetes mellitus, 20 had cardiovascular disease, 3 had history of stroke and 3 underwent radiation therapy for head and neck cancer. Carotid artery calcification was not included in the interpretation of CT of dental patients except one patient. Conclusion : The prevalence of carotid artery calcification on CT of dental patients was about 20% in this study. Carotid artery calcification should be included in the interpretation of CT of dental patients.

• 대한방사선기술학회지:방사선기술과학
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• 제36권1호
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• pp.25-30
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• 2013

경동맥 내중막 두께의 증가는 죽상경화증의 조기 표지자이며 관상동맥 질환과 뇌혈관 질환의 강력한 예측자이다. 이 연구의 목적은 성인에서 총경동맥 내중막 두께와 심혈관질환 위험인자들 사이의 연관성을 알아보고자 하였다. 총 134명을 대상으로 초음파를 이용하여 총경동맥 내중막 두께를 측정하였으며, 신체계측과 혈액검사를 시행하여 다음과 같은 결과를 얻었다. 연구결과 남성의 내중막 두께가 여성에 비해 더 두꺼운 것으로 나타났으며, 연령이 증가함에 따라 내중막 두께도 유의하게 증가하는 것으로 나타났다. 혈중지질 중 총 콜레스테롤과 동맥경화지수가 내중막 두께와 유의한 양의 상관관계가 있는 것으로 나타났다. 이상의 결과를 정리하면 성인에서 심혈관질환 위험인자는 총경동맥 내중막 두께 증가와 연관성이 있는 것으로 나타났다.

• Journal of Chest Surgery
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• 제3권2호
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• pp.127-132
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• 1970

A patient was 29 year old house wife who was admitted to the Yonsei University Medical Center on 6 th of Nov., in 1970, with chief complaints of complete loss of bilateral visual acuity, generalized weakness, frequent palpitations, claudication of masseter muscles and intermittent fainting. These symptoms were developed 5 years prior to admission. Physical finding on admission revealed complete loss of bilateral visual acuity, absence of both radial and carotid pulse, but there was good femoral and popliteal pulse. She couldn't open her mouth as she desired and had weakness of mastication. Radiological findings of plane chest PA were not significant. Aortogram(Cineangiogram) showed non-visualization of both carotid and subclavian arteries. It showed only innominate and interal mammary artery preoperatively. The operative findings were as follows: There were complete obliterative changes in both common carotid and subclavian arteries, and periarteritis in the innominate artery. Tube Dacron Prosthesis Bypass with V-arm between innominate artery and both common carotid arteries was performed after thromboendarterectomy. Histopathological finding of the thromboend arterectomy specimen was compatible with pulseless disease, which showed marked fibrous thickening of intima and a diffuse inflammatory cell infiltration of the whole layers. Her postopererative course was uneventful. Follow up aortogram(Cineangiogram) was taken on 11th postoperative day, which revealed both common carotid arteries patent. Her preoperative Subjective symtoms disappeared remarkably, such as her visual acuity improved much, fainting and vertigo disappeared completely and she can go to bath room without difficulty and help. Another patient was 34 year old house wife who was admitted on August, 1964 with chief complaints of frequent fainting and progresive visual loss. She was operated only thromboendarterectomy of both common carotid arteries. Postoperative course was smooth and subjective symptoms were disappeared.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제26권2호
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• pp.130-140
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• 2024

Objective: To assess whether local anesthetic infiltration could minimize the carotid baroreceptor reflex (CBR) which has an incidence after carotid artery stenting (CAS) that varies from 29% to 51%. Methods: This retrospective single-center study included 51 patients (mean age, 70.47 years) who underwent CAS for carotid stenosis. The groups included patients who underwent CAS for asymptomatic ischemic stroke (n=41) or symptomatic disease (n=10). Preprocedural percutaneous lidocaine injections (PPLIs) were administered to 70.6% and 5.9% of patients who underwent elective CAS and emergency CAS, respectively. Results: Among patients who received PPLIs, the mean degree of stenosis was 80.5% (95% confidence interval [CI]: ±10.74, 51-98%). The mean distance from the common carotid artery bifurcation to the most stenotic lesion (CSD) was 8.3 mm (95% CI: ±0.97, 6.3-10.2 mm); the mean angle between the internal carotid artery and common carotid artery (CCA) trunk (IAG) was 65.6° (95% CI: ±2.39, 61-70°). Among patients who did not receive PPLIs, the mean degree of stenosis was 84.0% (95% CI: ±8.96, 70-99%). The mean CSD was 5.9 mm (95% CI: ±1.83, 1.9-9.9 mm); the mean IAG was 60.4° (95% CI: ±4.41, 51-70°). The procedure time was longer in the PPLI group than in the no PPLI group (28.19 [n=39] vs. 18.88 [n=12] days) (P=0.057); the length of intensive care unit stay was shorter in the PPLI group (20.01 [n=36] vs. 28.10 [n=5] days) (P=0.132). Conclusions: Targeted PPLI administration to the carotid bulb decreased aberrant heart rates and blood pressure changes induced by carotid stent deployment and balloon inflation. As CBR sensitivity increases with decreasing distance to the stenotic lesion from the CCA bifurcation, PPLIs may help stabilize patients during procedures for stenotic lesions closer to the CCA.

• 대한임상전기생리학회지
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• 제1권2호
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• pp.1-9
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• 2003

The purpose of this study was to analyze the effect given to the variable details which disturb the flow of blood in brain artery disease through Aerobic exercises. It chose the subjects of study : 5 persons in an exercise group and 5 persons in a non-exercise group. Peak brain blood velocity, mean velocity, and resistance & artery stricture ratio were measured with TCD, measure machine for brain artery blood flow. The conclusion of the study was as follows: 1. At pre-test of an exercises group and a non-exercise group, PBV, MBV, BRI, ASI of a non-exercise group were showed much lower in the variation of left common carotid artery(LCCA). 2. At post-test of an aerobic exercises group and a non-exercise group, PBV, MBV, BRI, ASI of a non-exercise group were showed just a little decrease ratio but were not significant different in the variation of left common carotid artery(LCCA). Viewing on the base of these result, continuing exercises promote the functional improvement of the heart blood system and were showed the positive variation of artery stricture ratio according to brain blood flow velocity, the pulse and resistance or blood velocity. Therefore programs for prescriptions through aerobic exercises must be developed in many ways.

• Anatomy and Cell Biology
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• 제51권4호
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• pp.302-304
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• 2018

Prior knowledge of arterial supply to the head and neck is of substantial importance for well-planned surgeries involving the concerned region. We are reporting an unusual and rare variation in the branching pattern of external carotid artery in a 60-year-old female cadaver. A common trunk known as thyrolinguofacial trunk, originating from the anterior surface of the external carotid artery (right and left) giving of superior thyroid artery and a linguofacial trunk during a routine neck dissection. The linguofacial trunk then divided into a lingual and a facial artery. Vascular abnormalities are usually detected either on the dissection table or by the radiologists during imaging or accidently during surgeries leading to serious consequences.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제25권1호
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• pp.1-12
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• 2023

Objective: Although chronic carotid artery occlusion seems to be associated with significant risk of ischemic stroke, revascularization techniques are neither well established nor widespread. In contrast, extracranial-intracranial bypass is common despite the lack of evidence regarding neurological improvement or prevention of ischemic events. The aim of current review is to evaluate the effectiveness of various methods of recanalization of chronic carotid artery occlusion. Methods: Comprehensive literature search through PubMed, Scopus, Cochrane and Web of Science databases performed. Various parameters were assessed among patients underwent surgical, endovascular and hybrid recanalization for chronic carotid artery occlusion. Results: 40 publications from 2005 to 2021 with total of more than 1300 cases of revascularization of chronic carotid artery occlusion have been reviewed. Further parameters were assessed among patients underwent surgical, endovascular and hybrid recanalization for chronic carotid artery occlusion: mean age, male to female ratio, mean duration of occlusion before treatment, rate of successful recanalization, frequency of restenosis and reocclusion, prevalence of ischemic stroke postoperatively, neurological or other symptoms improvement and complications. Based on proposed through reviewed literature indications for revascularization and predictive factors of various recanalizing procedures, an algorithm for clinical decision making have been formulated. Conclusions: Although treatment of chronic carotid artery occlusion remains challenging, current literature suggests revascularization as single option for verified neurological improvement and prevention of ischemic events. Surgical and endovascular procedures should be taken into account when treating patients with symptomatic chronic carotid artery occlusion.