Ateroskleroz dışı karotis arter hastalıkları
Küçük Resim Yok
Tarih
1998
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Ekstrakranial karotid arterin en sik görülen hastalığı aterosklerotik damar değişikliklerine bağlı lezyonlardır. Diğer hastalıkları nadiren görülür. Bu çalışmada Ege Üniversitesi Tıp Fakültesi Kalp ve Damar Cerrahisi Anabilim Dalı'nda 1990-1997 yılları arasında tespit edilen 6 ateroskleroz dışı karotis arter hastalığı ele alınarak değerlendirilmiştir. Bu olguların 4'ünde karotid cisim tümörü ve 1'inde bilateral karotis arter anevrizması tespit edilmiştir. Karotis cisim tümörü saptanan olguların 2'sinde tümör soyularak çıkartılmış ve arter serbestleştirilmiştir. Diğer 2'sinde ise tümörün eksizyonu sonrası ana ve internal karotid arter arasına safen veni interpozisyonu yapılarak eksternal karotid arter bağlanmıştır. Bilateral karotis arter anevrizması olan hasta ise 1 ay ara ile 2 kez opere edilerek, bir tarafa rezeksiyon ve ucuca anastamoz, diğer tarafa rezeksiyon sonrası safen veni interpozisyonu uygulanmıştır. Operasyon sırasında tüm olgularda EEG monitorizasyonu ile beyin aktivitesi izlenmiş ve hiçbir hastada şant kullanılması gerekmemiştir. Olgularda mortalite ve kalıcı nörolojik hasar yoktur. Üç hastada geçici yutma güçlüğü ve 1 hastada geçici ses kısıklığı ve yutma güçlüğü gelişmiştir. Oldukça seyrek görülen karotid cisim tümörleri ve anevrizmasının tedavisinde cerrahinin tek seçenek olduğunu düşünmekteyiz ve bu hastalarda cerrahi günümüzde düşük bir mortalitée ve morbidite yüzdesi ile yapılabilmektedir.
The most frequent extracranial carotid artery disease is atherosclerotic stenosis. Other diseases are very rare. In this study, 6 patients with carotid artery disease other than atherosclerosis, diagnosed between 1990 and 1997 were evaluated and reported. Carotid body tumors were detected in 4 of these patients and bilateral carotid artery aneurysm in 1. In 2 of patients with carotid body tumors, the mass was excised by peeling and artery was liberated. In other 2 patients with carotid body tumors, saphenous vein interposition was performed between common and internal carotid artery, and external carotid artery was ligated subsequent to tumor excision. In 1 patient with bilateral carotid artery aneurysm, resection and end to end anastomosis for one side, and saphenous vein interposition subsequent to excision of aneurysm for other side were performed in 2 sequential operations within 1 month interval. No shunting was needed in any patient to whom continuous EEG monitorization was applied to observe brain activities. There was no mortality. As complications, reversible dysphagia in 3 patients and both dysphagia and hoarseness in one patient were encountered. Surgical therapy is still the first choice for treatment of carotid body tumors and aneurysms that encountered very rarely, and has very low mortality and morbidity rates, today.
The most frequent extracranial carotid artery disease is atherosclerotic stenosis. Other diseases are very rare. In this study, 6 patients with carotid artery disease other than atherosclerosis, diagnosed between 1990 and 1997 were evaluated and reported. Carotid body tumors were detected in 4 of these patients and bilateral carotid artery aneurysm in 1. In 2 of patients with carotid body tumors, the mass was excised by peeling and artery was liberated. In other 2 patients with carotid body tumors, saphenous vein interposition was performed between common and internal carotid artery, and external carotid artery was ligated subsequent to tumor excision. In 1 patient with bilateral carotid artery aneurysm, resection and end to end anastomosis for one side, and saphenous vein interposition subsequent to excision of aneurysm for other side were performed in 2 sequential operations within 1 month interval. No shunting was needed in any patient to whom continuous EEG monitorization was applied to observe brain activities. There was no mortality. As complications, reversible dysphagia in 3 patients and both dysphagia and hoarseness in one patient were encountered. Surgical therapy is still the first choice for treatment of carotid body tumors and aneurysms that encountered very rarely, and has very low mortality and morbidity rates, today.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Damar Cerrahi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
7
Sayı
3
