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- 주제어 : Microemboli (검색결과 3 건)
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윤성원,김호균,도진국,김영환 대한영상의학회 2011 대한영상의학회지 Vol.65 No.6
Carotid stump, the blind remnant of an occluded internal carotid artery, can be a potential source of microemboli, and warrants its exclusion from the vascular lumen to prevent the recurrence of a microembolism. In a 69-year-old male with a symptomatic carotid stump and acute angle between left common carotid artery and aortic arch, a 7-Fr. shuttle sheath was scarcely placed into the left carotid artery but the 7-mm-diameter stent-graft-loading balloon could not be inserted into the 7-Fr. shuttle sheath. With the mounting a stent graft over a 5-mm balloon, the balloon-expandable stent graft was unfolded. The self-expandable stent was placed over the stent graft, and an 8-mm balloon was subsequently expanded. Self-expanding stenting can be useful for troubleshooting in a case of device incompatibility coming from the different calibers of the external and common carotid arteries for the successful exclusion of a symptomatic carotid stump. 목동맥 그루터기는 속목동맥이 막히고 남은 자루모양의 구조로 미세색전의 잠재적인 근본 원인이 될 수 있다. 따라서 재발하는 미세색전증을 예방하기 위해 이를 혈관내벽으로부터 차단할 필요가 있다. 유증상 목동맥 그루터기를 가진 69세 남자에서 왼쪽 일반목동맥과 대동맥궁 사이의 각도가 예각을 이루어, 7 프렌치 왕복덮개를 왼쪽 목동맥에 간신히 설치하였으나 7 mm 직경의 인조혈관 스텐트를 얹은 풍선도관이 7 프렌치 왕복덮개 내로 들어가지 못하였다. 5 mm 풍선도관 위에 인조혈관 스텐트를 얹은 다음, 풍선팽창성 인조혈관 스텐트를 설치하였다. 순차적으로 인조혈관 스텐트 위에 자가팽창성 스텐트를 설치하고, 8 mm 풍선을 확장시켰다. 유증상 목동맥 그루터기를 차단하고자 할 때, 바깥목동맥과 일반목동맥의 직경 차이로부터 비롯된 기구의 부적합성이 문제가 될 수 있으며, 이때 부가적인 자가팽창성 스텐트 설치로 이 문제를 해결한 경험을 보고하고자 한다.
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Risk Factors for Developing Large Emboli Following Carotid Artery Stenting
Kwon, Sae Min,Cheong, Jin Hwan,Lee, Sang Kook,Park, Dong Woo,Kim, Jae Min,Kim, Choong Hyun The Korean Neurosurgical Society 2013 Journal of Korean neurosurgical society Vol.53 No.3
Objective : The introduction and development of the embolic protecting device (EPD) has resulted in a decreased rate of stroke after carotid artery stenting (CAS). The authors performed a retrospective study to investigate the risk factors for developing large emboli after CAS which can lead to ischemic events. Methods : A total of 35 consecutive patients who underwent CAS between January 2009 and March 2012 were included in this study. Patients were divided into two groups including those with small emboli (group A; grade 1, 2) and those with large emboli (group B; grade 3, 4). The size and number of emboli were assigned one of four grades (1=no clots, 2=1 or 2 small clots, 3=more than 3 small clots, 4=large clots) by microscopic observation of the EPD after CAS. We compared demographic characteristics, medical history, and angiographic findings of each group. Results : Thirty-five patients underwent CAS, and technical success was achieved in all cases. Twenty-three patients were included in group A and 12 patients in group B. Our results demonstrated that advanced age [odds ratio (OR) 1.24; 95% confidence interval (CI) 1.01-1.52; p=0.044] and smoking (OR 42.06; CI 2.828-625.65, p=0.006) were independent risk factors for developing large emboli after CAS. Conclusion : In patients with carotid artery stenosis treated with CAS, advanced age and smoking increased the number and size of emboli. Although use of an EPD is controversial, it may be useful in CAS in patients with risk factors for large emboli in order to reduce the risk of ischemic events.
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