{"id":3380,"date":"2023-02-12T08:26:46","date_gmt":"2023-02-12T08:26:46","guid":{"rendered":"https:\/\/www.karotidnahirurgija.com\/?page_id=3380"},"modified":"2023-02-23T17:05:29","modified_gmt":"2023-02-23T17:05:29","slug":"10-4-embolektomija","status":"publish","type":"page","link":"https:\/\/www.karotidnahirurgija.com\/?page_id=3380","title":{"rendered":"10.3.1. Embolektomija"},"content":{"rendered":"

\"\"<\/a><\/p>\n

<\/p>\n

OP\u0160TI PRINCIPI REKONSTRUKCIJA SUPRAAORTALNIH GRANA<\/h1>\n

<\/a><\/h1>\n

\n

\n

10.3. KLEMOVANJE SUPRAAORTALNIH GRANA<\/p>\n

<\/h3>\n<\/div>\n
\n

\n

10.3. 1. Embolektomija<\/p>\n

<\/h3>\n<\/div>\n<\/p>\n
\n

Okluzivna<\/span> <\/span>bolest<\/span> <\/span>supraaortalnih<\/span> <\/span>grana<\/span> <\/span>se<\/span> <\/span>mo\u017ee<\/span> <\/span>hirur\u0161ki<\/span> <\/span>korigovati<\/span> <\/span>zahvatima<\/span> <\/span>po<\/span> <\/span>tipu:<\/span><\/h3>\n
    \n
  • Embolektomija<\/b><\/span>,<\/span><\/li>\n
  • Trombendarterektomija<\/b><\/span>,<\/span><\/li>\n
  • By<\/b><\/span> <\/b><\/span>pass<\/b><\/span> <\/b><\/span>procedura<\/span> <\/span>(anatomski<\/span> <\/span>ili<\/span> <\/span>ekstraanatomski)<\/span> i<\/span><\/li>\n
  • Transpozicije<\/strong><\/span> <\/span><\/strong>supraaortalnih<\/span> <\/span>grana.<\/span><\/li>\n<\/ul>\n<\/div>\n
    \n

    Embolektomija<\/h2>\n

    Embolektomija<\/b><\/span> balon<\/span> <\/span>kateterom<\/span> <\/span>(Fogarty)<\/span> <\/span>mogu\u0107a<\/span> <\/span>je<\/span> <\/span>kroz<\/span> <\/span>malu<\/span> <\/span>popre\u010dnu<\/span> <\/span>arteriotomiju.<\/span> <\/span>Prednjim<\/span> <\/span>cervikalnim<\/span> <\/span>pristupom,<\/span> <\/span>preko<\/span> <\/span>karotidne<\/span> <\/span>bifurkacije<\/span> <\/span>mo\u017eemo<\/span> <\/span>na\u010diniti<\/span> <\/span>embolektomiju<\/span> <\/span>unutra\u0161nje<\/span> <\/span>i<\/span> <\/span>spolja\u0161nje<\/span> <\/span>karotidne<\/span> <\/span>arterije<\/span> <\/span>distalno,<\/span> <\/span>a<\/span> <\/span>zajedni\u010dke<\/span> <\/span>karotidne<\/span> <\/span>arterije,<\/span> <\/span>pa<\/span> <\/span>i<\/span> <\/span>brahiocefali\u010dnog<\/span> <\/span>trunkusa<\/span> <\/span>proksimalno.<\/span> <\/span>Presudan<\/span> <\/span>je<\/span> <\/span>zna\u010daj<\/span> <\/span>vremenskog<\/span> <\/span>faktora<\/span> <\/span>u<\/span> <\/span>slu\u010daju<\/span> <\/span>embolizacije<\/span> <\/span>karotidnih<\/span> <\/span>arterija.<\/span> <\/span>Embolektomija<\/span> <\/span>unutra\u0161nje<\/span> <\/span>karotidne<\/span> <\/span>arterije<\/span> <\/span>ima<\/span> <\/span>smisla<\/span> <\/span>samo<\/span> <\/span>ako<\/span> <\/span>od<\/span> <\/span>po\u010detka<\/span> <\/span>cerebralne<\/span> <\/span>ishemije<\/span> <\/span>nije<\/span> <\/span>pro\u0161lo<\/span> <\/span>vi\u0161e<\/span> <\/span>od<\/span> <\/span>4<\/span> <\/span>sata,<\/span> <\/span>ako<\/span> <\/span>pacijent<\/span> <\/span>nije<\/span> <\/span>gubio<\/span> <\/span>svest<\/span> <\/span>(bez<\/span> <\/span>lezije<\/span> <\/span>mo\u017edanog<\/span> <\/span>stabla)<\/span> <\/span>i<\/span> <\/span>ako<\/span> <\/span>je<\/span> <\/span>CT<\/span> <\/span>nalaz<\/span> <\/span>na<\/span> <\/span>mozgu<\/span> <\/span>uredan.<\/span><\/span><\/p>\n<\/div>\n

    \n

    Poslednja<\/span> <\/span>faza<\/span> <\/span>le\u010denja<\/span> <\/span>kardio-embolizma<\/span> <\/span>je<\/span> <\/span>eliminacija<\/span> <\/span>emboligenog<\/span> <\/span>\u017eari\u0161ta.<\/span> <\/span>Najbolje<\/span> <\/span>je<\/span> <\/span>ako<\/span> <\/span>se<\/span> <\/span>pacijent<\/span> <\/span>rehabilituje<\/span> <\/span>nekoliko<\/span> <\/span>nedelja.<\/span> <\/span>U<\/span> <\/span>me\u0111uvremenu<\/span> <\/span>treba<\/span> <\/span>dijagnosti\u010dki<\/span> <\/span>veri<\/span>fi<\/span>kovati<\/span> <\/span>emboligeno<\/span> <\/span>\u017eari\u0161te<\/span> <\/span>i<\/span> <\/span>nastaviti<\/span> <\/span>sa<\/span> <\/span>antikoagulantnom<\/span> <\/span>terapijom.<\/span> <\/span>Tek<\/span> <\/span>potom<\/span> <\/span>se<\/span> <\/span>otklanjanje<\/span> <\/span>emboligeno<\/span> <\/span>\u017eari\u0161te<\/span> <\/span>(tromb<\/span> <\/span>u<\/span> <\/span>pretkomori,<\/span> <\/span>mitralna<\/span> <\/span>mana,<\/span> <\/span>arterijska<\/span> <\/span>aneurizma<\/span> <\/span>itd.)<\/span><\/p>\n<\/div>\n

    \"\"<\/p>\n

    \n

    Tehnika trombo-embolektomije Fogarty balon-kateterom: <\/em><\/p>\n

    (A) Plasiranje balon-katetera iznad tromba, <\/em><\/p>\n

    (B) Naduvavanje Fogarty balona na vrhu katetera, <\/em><\/p>\n

    (C) Izvla\u010denje trombo- embolijske mase iz arterije.<\/em><\/p>\n<\/div>\n


    \n<\/p>\n","protected":false},"excerpt":{"rendered":"

    OP\u0160TI PRINCIPI REKONSTRUKCIJA SUPRAAORTALNIH GRANA 10.3. KLEMOVANJE SUPRAAORTALNIH GRANA 10.3. 1. Embolektomija Okluzivna bolest supraaortalnih grana se mo\u017ee hirur\u0161ki korigovati zahvatima po tipu: Embolektomija, Trombendarterektomija, By pass procedura (anatomski ili ekstraanatomski) i Transpozicije supraaortalnih grana. Embolektomija Embolektomija balon kateterom (Fogarty) mogu\u0107a je kroz malu popre\u010dnu arteriotomiju. Prednjim cervikalnim pristupom, preko karotidne bifurkacije mo\u017eemo na\u010diniti embolektomiju […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-3380","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"\n10.3.1. Embolektomija - KAROTIDNA HIRURGIJA<\/title>\n<meta name=\"description\" content=\"Embolektomija balon kateterom (Fogarty) mogu\u0107a je kroz malu popre\u010dnu arteriotomiju. Prednjim cervikalnim pristupom, preko karotidne bifurkacije mo\u017eemo na\u010diniti embolektomiju unutra\u0161nje i spolja\u0161nje karotidne arterije distalno, a zajedni\u010dke karotidne arterije, pa i brahiocefali\u010dnog trunkusa proksimalno.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.karotidnahirurgija.com\/?page_id=3380\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"10.3.1. Embolektomija - KAROTIDNA HIRURGIJA\" \/>\n<meta property=\"og:description\" content=\"Embolektomija balon kateterom (Fogarty) mogu\u0107a je kroz malu popre\u010dnu arteriotomiju. Prednjim cervikalnim pristupom, preko karotidne bifurkacije mo\u017eemo na\u010diniti embolektomiju unutra\u0161nje i spolja\u0161nje karotidne arterije distalno, a zajedni\u010dke karotidne arterije, pa i brahiocefali\u010dnog trunkusa proksimalno.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.karotidnahirurgija.com\/?page_id=3380\" \/>\n<meta property=\"og:site_name\" content=\"KAROTIDNA HIRURGIJA\" \/>\n<meta property=\"article:modified_time\" content=\"2023-02-23T17:05:29+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.karotidnahirurgija.com\\\/?page_id=3380\",\"url\":\"https:\\\/\\\/www.karotidnahirurgija.com\\\/?page_id=3380\",\"name\":\"10.3.1. 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