• Title/Summary/Keyword: dissecting

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Surgical Treatment of Chronic Constrictive Pericarditis -Report of 4 ases- (만성 교약성 심낭염의 외과적 치료 -4례 보고-)

  • 전희재
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.793-797
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    • 1994
  • Constrictive pericarditis is often accompanied with ~brothorax and deterioration of cardiac, hemodynamic functions. Surgical relief of fibrous peel causes remarkable improvement in pulmonary, cardiac, hemodynamic function, and subjective symptoms. We experienced 4 cases of constrictive pericarditis combined with bilateral ~brothorax after bilateral pleural effusion caused by tuberculosis and non-specific inflammation. Pleural decortication and pericardiectomy were done at the same time through anterolateral thoracotomy with sternal transection[3 patients] and median sternotomy incision[l patient]. Low cardiac output was the most common complication. With left anterolateral thoracotomy, we could prevent the hypotension from massive retraction for dissecting by median sternotomy, which was good for dissecting from anterior wall of left ventricle to posterior wall of left ventricle and surrounding phrenic nerve. It was enough to dissect the portion being through hard to dissect, right atrium, SVC and IVC.

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Spontaneous Anterior Cerebral Artery Dissection Presenting with Simultaneous Subarachnoid Hemorrhage and Cerebral Infarction in a Patient with Multiple Extracranial Arterial Dissections

  • Park, Yung Ki;Yi, Hyeong-Joong;Lee, Young Jun;Kim, Young-Seo
    • Journal of Korean Neurosurgical Society
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    • v.53 no.2
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    • pp.115-117
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    • 2013
  • Simultaneous subarachnoid hemorrhage and infarction is a quite rare presentation in a patient with a spontaneous dissecting aneurysm of the anterior cerebral artery. Identifying relevant radiographic features and serial angiographic surveillance as well as mode of clinical manifestation, either hemorrhage or infarction, could sufficiently determine appropriate treatment. Enlargement of ruptured aneurysm and progressing arterial stenosis around the aneurysm indicates impending risk of subsequent stroke. In this setting, prompt treatment with stent-assisted endovascular embolization can be a reliable alternative to direct surgery. When multiple arterial dissections are coexistent, management strategy often became complicated. However, satisfactory clinical results can be obtained by acknowledging responsible arterial site with careful radiographic inspection and antiplatelet medication.

Retrograde Cerebral Perfusion in the Surgical Treatment of Ascending Aortic Aneurysm -Report of 4 Cases- (역행성 뇌혈 관류를 이용한 상행대동맥류 수술 -4례 보고-)

  • 문승호
    • Journal of Chest Surgery
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    • v.28 no.8
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    • pp.788-791
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    • 1995
  • Dissecting aortic aneurysm of ascending aorta is a life threatening condition which requires prompt surgical correction. With deep hypothermic circulatory arrest and retrograde cerebral perfusion via superior vena cava, we could replaced ascending aorta in 4 cases safely. All of 4 cases; femoral artery, right auricle were used as cannulation site. The duration of circulatory arrest were 28, 30, 45, 60 minute in each cases and rectal temperature was 2$0^{\circ}C$ at that time. At the time of retrograde cerebral perfusion, we maintained central venous pressure under 25mmHg. We resected all of dissecting portion and replaced it with Hemashield graft. There were no deaths but two of four reoperated because of bleeding.

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Visceral Debranching Thoracic Endovascular Aneurysm Repair for Chronic Dissecting Thoracoabdominal Aortic Aneurysm

  • Cho, Kwang Jo;Park, Jong Yoon
    • Journal of Chest Surgery
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    • v.47 no.6
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    • pp.548-551
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    • 2014
  • Type II chronic dissecting thoracoabdominal aortic aneurysms are a surgically challenging disease. The conventional thoracoabdominal aortic aneurysm repair technique using cardiopulmonary bypass is a high-risk procedure. However, a recently developed endovascular technique may be an alternative treatment for the disease, but faces the obstacle of lesional restriction. This new technique uses a hybrid strategy to overcome the limits of endovascular thoracoabdominal aortic aneurysm repair. Herein, we report on a successful outcome after performing the hybrid visceral debranching procedure.

In Situ Intersegmental Anastomosis within a Single Artery for Treatment of an Aneurysm at the Posterior Inferior Cerebellar Artery : Closing Omega Bypass

  • Lee, Sung Ho;Choi, Seok Keun
    • Journal of Korean Neurosurgical Society
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    • v.58 no.5
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    • pp.467-470
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    • 2015
  • A 74-year-old patient was diagnosed with a subarachnoid hemorrhage suspected from a dissecting aneurysm located at the lateral medullary segment of the posterior inferior cerebellar artery (PICA). Because perforators to the medulla arose both proximal and distal to the dissecting segment, revascularization for distal flow was essential. However, several previously reported methods for anastomosis, such as an occipital artery-PICA bypass or resection with PICA end-to-end anastomosis could not be used. Ultimately, we performed an in situ side-to-side anastomosis of the proximal loop of the PICA with distal caudal loops within a single artery, as a "closing omega," followed by trapping of the dissected segment. The aneurysm was obliterated successfully, with intact patency of the revascularized PICA.

Distal Middle Cerebral Artery M4 Aneurysm Surgery Using Navigation-CT Angiography

  • Lee, Seung-Hwan;Bang, Jae-Seung
    • Journal of Korean Neurosurgical Society
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    • v.42 no.6
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    • pp.478-480
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    • 2007
  • Unruptured non-traumatic dissecting aneurysm in the M4 segment of the middle cerebral artery (MCA) accompanied by complete occlusion of the ipsilateral internal cerebral artery (ICA) has never been reported. A 41-year-old man presented with an infarction manifesting as left-sided weakness and dysarthria. Magnetic resonance angiography revealed a subacute stage infarction in the right MCA territory and complete occlusion of the right ICA. Angiography demonstrated aneurysmal dilatation of the M4 segment of the right MCA. Surgery was performed to prevent hemorrhage from the aneurysm. The aneurysm was proximally clipped guided by Navigation-CT angiography and flow to the distal MCA was restored by superficial temporal artery-middle cerebral artery (STA-MCA) anastornosis. We report this rare case with literature review.

Ultrasound-Guided Minimally Invasive Procedure Using Thread (실을 이용한 초음파 유도하 최소침습시술)

  • Park, Hae-Yeon;Kim, Jae Min
    • Clinical Pain
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    • v.20 no.2
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    • pp.70-73
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    • 2021
  • A minimally invasive procedure refers to a procedure that minimizes tissue damage due to incision. By limiting the size of the incision, it can be expected to reduce the time taken for wound healing, reduce pain, and reduce the risk of infection. Recently, studies have been attempted to dissect the structures of the neuromusculoskeletal system using ultrasound-guided minimally invasive technique. Among those, dissecting thread may be utilized in several musculoskeletal diseases, including carpal tunnel syndrome, cubital tunnel syndrome, trigger finger, and selective crural fasciectomy. In this brief review, the use of dissecting thread in treating neuromusculoskeletal diseases are described.

Treatment of Internal Carotid Artery Dissections with Endovascular Stent Placement: Report of Two Cases

  • Deok Hee Lee;Seung Ho Hur;Hyeon Gak Kim;Seung Mun Jung;Dae Sik Ryu;Man Soo Park
    • Korean Journal of Radiology
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    • v.2 no.1
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    • pp.52-56
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    • 2001
  • Extracranial carotid artery dissection may manifest as arterial stenosis or occlusion, or as dissecting aneurysm formation. Anticoagulation and/or antiplatelet therapy is the first-line treatment, but because it is effective and less invasive than other procedures, endovascular treatment of carotid artery dissection has recently attracted interest. We encountered two consecutive cases of trauma-related extracranial internal carotid artery dissection, one in the suprabulbar portion and one in the subpetrosal portion. We managed the patient with suprabulbar dissection using a self-expandable metallic stent and managed the patient with subpetrosal dissection using a balloon-expandable metallic stent. In both patients the dissecting aneurysm disappeared, and at follow-up improved luminal patency was observed.

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