. 2010; 16(3): 95-99 | |||
Sallanan trombüs ve ileri derecede aort darlığı bulunan aktif pnömonili olguda lokal anestezi altında acil karotis endarterektomisiSibel Güler1, Taylan Köşker21Siirt Devlet Hastanesi Nöroloji Kliniği, Siirt2Siirt Devlet Hastanesi Kalp Damar Cerrahisi Kliniği, Siirt 81 yaşında sol vertebral arter proksimalinde %80 üzerinde semptomatik stenoz ve sallanan trombüs saptanan lokal anestezi altında karotis endarderektomi uygulanan kadın hasta sunuldu. Olguda ayrıca ciddi aort darlığı saptandı. Ciddi ve sallanan trombüsün eşlik ettiği semptomatik karotid darlığında, karotid arterlerde bulunan stenozlar sanıldığından çok daha kısa sürede tam tıkanmaya dönüştüğünden ilk olarak karotid operasyonu uygulandı. Postoperatif izlemde prognoz da belirgin düzelme gözlendi. Olguda lokal anestezi uygulanmasını zorunlu hale getiren ileri derece aort Emergency carotid endarterectomy performed under local anesthesia in an active pneumonia case with loose thrombus and high-grade aortic stenosisSibel Güler1, Taylan Köşker21Siirt Public Hospital Neurology Clinic, Siirt2Siirt Public Hospital Cardiovascular Surgery Clinic, Siirt An 81-year-old female patient in whom symptomatic stenosis over 80% and loose thrombus were detected in the proximal left vertebral artery and who underwent carotid endarterectomy under local anesthesia was presented. Severe aortic stenosis was also found in the case patient. Since the stenoses present in the carotid arteries transform into full stenosis more frequently than presumed in symptomatic carotid stenosis accompanied by severe and loose thrombus, carotid operation was performed initially. During the postoperative follow-up, a marked improvement was observed in the prognosis. The most important features in this case are the presence of transient ischemic stroke episodes and loose thrombus that increase the risk of endarterectomy, and active pneumonia together with high-grade aortic stenosis making performance of local anesthesia mandatory. This case is of interest due to being a rare case in the literature, where emergency karotid endarterectomy was performed. Keywords: Rocking thrombus, carotid endarterectomy, local anesthesia, active pneumonia, awake patient.Sibel Güler, Taylan Köşker. Emergency carotid endarterectomy performed under local anesthesia in an active pneumonia case with loose thrombus and high-grade aortic stenosis. . 2010; 16(3): 95-99 Sorumlu Yazar: Sibel Güler, Türkiye |
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