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동시에 시행한 경동맥 내막절제술과 관상동맥 우회로 이식편 2예 : Two cases report
배자성,이성,윤상섭,최승혜,박종경,김승남,고용복,진웅,김치경 대한혈관외과학회 2002 Vascular Specialist International Vol.18 No.1
Combined carotid endarterectomy (CEA) and coronary artery bypass graft (CABG) has been traditionally advocated for patients in whom symptomatic disease has been elicited in both vascular territories. This rationale has related to the concern for an increased myocardial infarction rate following CEA with untreated coronary artery disease and conversely, the potential for stroke in patients receiving CABG with untreated carotid stenosis. Although significant cardiac and cerebral complication rates have been identified in these combined cases, justification for the procedure has stemmed from combined rates obtained which were lower than those encountered for either procedure performed in isolation. There has been a trend toward performance of combined CEA/CABG in patients with asymptomatic carotid stenosis. Release of the Asymptomatic Carotid Atherosclerosis Study (ACAS) in 1995 appears to have played a significant role in changing trend. Interpreting the ACAS data finding is problematic for the combined procedure. Yet controversy continues concerning the most appropriate management for patients with severe coronary artery disease who also have asymptomatic carotid stenosis. Recently we have successfully managed two cases of coronary artery disease and asymptomatic carotid stenosis patients by combined CEA and CABG without any surgical complication. We report these 2 cases and briefly review the literature.
하지심부정맥 혈전증에서 일시적 동맥정류를 동반한 Palma&Dale 술식의 임상 경험
고용복,유승진,윤상섭 대한혈관외과학회 1991 Vascular Specialist International Vol.7 No.1
In order to improve patency of low flow rate and low blood pressure in crossover venous bypass for unilateral iliac vein occlusion, additional arteriovenous fistula(A-V fistula) has been applied. But the use of the A-V fistula has not become universally accepted because 1) it may somewhat difficult to construct and 2) it can be very difficult to dissect and remove the fistula without damage to the involved artery and vein in the second operation for obliteration of A-V fistula. The fistula can be easilly obliterated later by tightening a string loop left in subcutaneous tissue when a nonabsorbable prolene loop was placed around the A-V fistula site. The authors had used successfully this techique in 11 patients with unilateral iliac vein occlusion and recommend it to improve to patency of venous reconstruction.