• Title/Summary/Keyword: 대퇴동맥

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Comparison of Saphenous Vein and PTFE Grafts for Above the Knee Femoropopliteal Bypass Grafting (슬상부 대퇴동맥-슬와동맥 우회이식술에서 복재정맥과 PTFE 이식편의 비교)

  • Kim, Han-Yong;Kim, Jong-Seok;Kim, Myoung-Young;Hwang, Sang-Won;Yoo, Byung-Ha
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.127-132
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    • 2010
  • Background: Femoropopliteal artery bypss grafting is an effective form of treatment for infrainguinal artery occlusive disease in those patients who have either intermittent claudication or resting critical ischemia. The objective of this analysis was to evaluate the long-term patency of a femoropopliteal bypass graft that is classified as an above-the-knee saphenous vein graft or an above-the-knee PTFE (polytetrafluoroethylene) graft. Material and Method:From January 1998 to February 2005, 103 above-the-knee femoro-popliteal bypasses were performed on 87 patients. There were 74 male and 13 female patients with a mean age of $65.7{\pm}9.69$ (range: 31~82). The surgical indications were intermittent claudication in 65 cases (74.7%), foot ulceration in 2 cases (2.3%), foot necrosis in 10 ases (11.5%) and toe necrosis in 10 cases (11.5%). For the bypass graft, a reversed saphenous vein was used in 31 limbs and a polytetrafluoroethylene (PTFE) prosthesis was used in 72 limbs (6 mm: 27 limbs, 8 mm: 45 limbs). The perioperative risk factors were diabetes mellitus in 33 cases (37.9%), hypertension in 47 cases (54.0%), a history of ischemic heart disease in 13 cases (14.9%) and smoking in 72 cases (82.8%). Result:There were three perioperative deaths (3.4%) and seven late deaths (8.3%). Major leg amputation was necessary in 12 patients (13.8%) during the entire course of the study. The primary patency rate at 5 years for the vein grafts, the 8 mm-PTFE grafts and the 6 mm-PTFE grafts were 84.7%, 77.4% and 74.2%, respectively and the overall primary patency rate was 78.7%, and there were no significant statistical differences among the graft groups. By using multivariate analysis, the number of patent tibial arteries was determined to be a significant factor that influenced the primary graft patency rate (p<0.005), but risk factors such as diabetes mellitus, ischemic heart disease, smoking and age had no statistically significant affect on the primary graft patency rates. Conclusion: The great saphenous vein is considered the most durable conduit for infrainguinal revascularization, but the overall results of this study show that saphenous vein and PTFE grafts have comparable patency rates when used above the knee in patients with claudication or critical ischemia. The use of PTFE above the knee is a reasonable alternative for a femoro-poplitael bypass and it is associated with acceptable long term patency rates.

Patent Ductus Arteriosus Occlusion with an $Amplatz^{(R)}$ Canine Duct Occluder in a Dog (개에서 $Amplatz^{(R)}$ Canine Duct Occluder를 이용한 동맥관개존증의 폐쇄 증례)

  • Kang, Min-Hee;Kim, Seung-Gon;Hahn, Tae-Yeon;Park, Hyun-Ah;Min, Sa-Hee;Park, Ji-Hwan;Kim, Tae-Woo;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.498-501
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    • 2012
  • A 10-month-old intact male Maltese dog (body weight, 1.6 kg) presented with intermittent cough and abnormal heart sounds. The dog was diagnosed with a left-to-right patent ductus arteriosus (PDA) on the basis of the results of transthoracic echocardiography, color flow Doppler examination, and angiography. Transcatheter occlusion of the PDA was performed using the $Amplatz^{(R)}$ Canine Duct Occluder (ACDO) via the femoral artery. The device was placed under fluoroscopic guidance and successfully occluded the PDA. The continuous heart murmur disappeared immediately after the correction and no residual flow was detected. The dog was discharged the following day and regularly examined for complications and safety. This is the first report demonstrating the clinical application of ACDO for the transcatheter closure of PDA via the femoral artery in a small-breed dog in Korea.

Surgical Treatment of Thoracoabdominal Aortic Aneurysm (흉복부 대동맥류의 외과적 치료)

  • Ahn, Hyuk;Kim, Jun-Seok
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.177-184
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    • 1996
  • Between 1987 and 1994, 21 patients were treated surgically for aortic aneurysm involving the thoracoabdominal aorta. There were 11 males and 10 females, and their age ranged from 20 to 67 years old and mean age was 41.5 years. Many complained of back pain, chest pain or discomfort, and flank pain, but three patients were asymptomatic. 15 patients had chronic dissection (71.4%) and 6 had nondissecting fusiform or saccular aneurysm(28.5%), and of those 15 patients with chronic dissection, 6(28.5%) had atherosclerosis assniated with hypertension, 5 (23.8%) were Martian syndrome, and 2 (9.5%) were associated with pregnancy. The diameter of an aneurysm ranged from 6cm to 12cm, and their extent was classified as type I in 7(33.3%), type II in 8(38.1%), type III in 3(14.3%), and type IV in 3(14.3%) patients based on Crawford classification for TAA . Diseased aorta was replaced with artificial vascular graft in all but one patient. In whom the aortic tear site due to pseudoaneurysm was closed by primary suture. For the spinal cord protection during the operation, we used partial cardiopulmonary bypass (FV-FA or PA-FA bypass) in 12 patients (57.1%), Biopump (LA-FA bypass) in 4(19.0%), total circulartory arrest and CPB in 2 (9.5%), Gott's heparinized shunt in 1(4.7%), and simple aortic cross clamping in 2 (9.5%). The most common complication after the operation was hoarseness due to unilateral vocal cord palsy which onured in 5 patients (23.8%), and the next common complication was wound infection in 4 patients(19.0%), paraplegia in 2 patients (9.5%), chylothorax in 1 patient(4.7%). The hospital mortality rate was 9.5% (2deaths), and there was no late death. Our experience shows that the graft replacement of TAAA had reasonable rate of mortality, low rate of serious complication, and provided good post operative state of the pati nts, and since the thoracoabdominal aortic operation is not a high risky procedure anymore, we recommend a radical operation for the indicated patients.

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Comparative Pharmacokinetics of Platinum Coordination Complexes in Rats

  • Insook Jung;Lee, Juseon;Kim, Myungsoo;Changbae Jin;Younsoo Sohn;Park, Jongsei
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1996.04a
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    • pp.243-243
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    • 1996
  • 백금착물 항암제 후보물질로서 합성된 KBP31705-Cl27, KBP30603-901을 기존 화합물인 cisplatin 및 carboplatin과 pharmacokinetic profile을 비교 검토하였다. 웅성 Sprague-Dawley rat을 sodium pentobarbital 마취하에서 방광 및 대퇴동맥과 정맥에 polyethylene tubing을 사용하여 catheterization시켰다. Urine 배출이 안정화되었을 때 대퇴정맥내로 cisplatin과 KBP31705-Cl27은 2 mg/kg, carboplatin과 KBP 30603-901은 20mg/kg 용량으로 주사한 후 2, 4, 6, 8, 10, 15, 20, 30, 45, 60, 120 분에 대퇴동맥으로부터 혈액을 채취하였으며 urine은 약물투여 후 1시간 간격으로 4시간동안 채취하였다. Plasma와 urine중의 platinum농도는 inductively coupled plasma-mass spectrometer를 사용하여 측정하였고, pharmacokinetic parameters는 non-linear least square computer Program인 PCNONLIN을 이용하여 산출되었다. 혈중 platinum농도와 시간의 관계에서 KBP31705-Cl27은 cisplatin과 비교하여 alpha-phase에서 혈중 농도는 낮지만 비슷한 양상을 나타내었고, beta-phase에서는 비교적 느리게 소실됨을 보였다. Urine으로 4시간동안 배출된 platinum양은 각각 투여량의 52, 56%로서 두 약물에서 비슷하였다. 또한 KBP30603-901은 carboplatin과 비교하여 alpha-phase는 거의 비슷한 패턴을 나타내었으나, beta-phase는 훨씬 느리게 감소하여 반감기가 길다는 것을 보여 주었으며 또한 이것은 urine으로 4시간동안 배출된 platinum양이 KBP30603-901의 경우 투여량의 46%로서 carboplatin의 59%보다 적게 배출된다는 data와도 일관됨을 보여주었다. 이상의 결과로 볼 때 KBP30603-901이 다른 백금착물 항암제보다 체내에 머무르는 시간이 길어 혈중에서 보다 오랜 시간동안 머물러 높은 유효농도를 유지할 수 있을 것으로 사료된다.

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Transcarotid Coil Embolization in a Yorkshire Terrier Puppy with Patent Ductus Arteriosus Using a JR Coronary Catheter and Free Push Deployment System (동맥관 개존증에 걸린 요크셔테러어종 자견에서 경동맥 경로와 JR Coronary Catheter/Free Push Deployment System을 이용한 색전코일을 이용한 치료증례)

  • Choi, Bum-Sul;Choi, Ran;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.28 no.2
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    • pp.240-243
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    • 2011
  • Several vascular accesses can be used for catheter guided coil embolization for occluding patent ductus arteriosus (PDA). Although trans-femoral approach is most commonly used in dogs, it is often unable to insert angiocatheter for inserting the coil delivery system, especially small puppies weighing less than 2 kg of body weight. Therefore this case study developed trans-carotid method for puppy using JR coronary catheter and free push delivery system. Using this new method, we successfully treated a puppy with PDA weighing 1.25 of body weight.

Surgical Treatment of Femoral & Popliteal Arteries Thrombosis Caused by Collagen Material Closure Device - A case report - (콜라겐제제 봉합제 사용으로 인한 우측 대퇴동맥, 우측 슬와동맥 혈전증의 수술적 치료)

  • Jo, Tae-Jun;Chee,, Hyun-Keun
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.396-399
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    • 2005
  • Manual or mechanical compression followed by 4 to 8 hours of bed rest is still the standard technique for accessing site management of the femoral arterial puncture site. But these methods are often uncomfortable and delay hospital discharge. Recently, a number of new devices to achieve hemostasis have been developed. These devices uses collagen to facilitate local hemostasis. But many complications associated with the use these devices have been reported internationally. We present a case of successful treatment of Rt. femoral and Rt. popliteal arteries thrombosis caused by Angioseal.

Acute Abdominal Aortic Occlusion after Open Heart Surgery - A case report - (개심술 후에 발생한 급성 복부 대동맥 차단 -1예 보고-)

  • Han, Won-Kyung;Cho, Joon-Yong;Lee, Jong-Tae
    • Journal of Chest Surgery
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    • v.38 no.10 s.255
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    • pp.710-713
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    • 2005
  • Acute abdominal Aortic occlusion is rare but it is a vascular emergency with high mortality and morbidity. There­fore, delay in diagnosis can have severe impact on the prognosis. A 60-year-old women complained of paresthesia, paralysis, and severe pain in bilateral lower extremities on 13th day after open heart surgery for mitral stenosis, atrial fibrillation, coronary arterial stenosis, tricuspid regurgitation, and atrial septal defect. Her skin was mottled and cool from the umbilicus to the feet, and there were no palpable pulses in the lower exteremities. We diagnosed an acute abdominal aortic occlusion using the Multi-Detector Row Spiral Computed Tomography and successfully treated the problem with emergent thrombo-embolectomy and Aortobifemoral bypass.

Computed tomographic evaluation of experimental hydronephrosis treated with transarterial embolization of renal artery in Beagle dogs (신장동맥 색전술을 실시한 실험적 수신증의 전산화 단층촬영)

  • Chang, Dongwoo;Yoon, Junghee
    • Korean Journal of Veterinary Research
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    • v.41 no.3
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    • pp.421-427
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    • 2001
  • This study was performed to evaluate the embolized kidney and contralateral normal kidney using computed tomography (CT) and enhanced computed tomography. Experimental hydronephrosis was induced by ligation of unilateral ureter in Beagle dogs. Renal artery embolization was performed using selective catheterization in the hydronephrotic kidney of seven dogs and EKG, $SpO_2$, body temperature, pulse, and repiratory rate were within normal ranges during procedures. Iohexol-ethanol solution was used as embolic material. There were no dogs expired after TAE-Ra and no side effects associated with regurgitation of iohexol-ehtanol solution. Revascularization of renal artery was not found in angiography in dogs treated by TAE-RA at immediately after TAE-RA and 14 days after TAE-RA. CT showed dilation of urinary collection system and ventral displacement of spleen at 14 days after TAE-RA in one dog not treated by TAE-RA and experimental group treated by TAE-Ra. CT two month after TAE-RA showed the shrunken embolized kidney in experimental group. Transverse CT with contrast enhancement demonstrated the increase of signal intensity at thinned renal cortex in control group not treated by TAE-Ra at 30 days and 60 days, however, there was no increase of signal intensity at shrunken embolized kidney at 60 days after TAE-RA. CT was useful modality for evaluation of the morphology and the size of embolized kidney and contralateral normal kidney. Enhanced CT was availabel for the detection of revascularization of renal artery after TAE-RA in dogs with hydronephrosis. It is conclued that CT is useful modality for the monitoring of the revascularization of the renal artery after TAE-RA.

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Femoral Vein Thrombosis Associated with Distal Femoral Osteochondroma - A Case Report - (원위 대퇴골 골연골종으로 인한 대퇴 정맥 혈전증 - 증례 보고 -)

  • Oh, Joo-Han;Kim, Jae-Yoon;Gong, Hyun-Sik;Kim, Woo-Sung;Shin, Sang-Ik
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.83-88
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    • 2006
  • Osteochondroma is a hyperplasic bony lesion caused by subperiosteal displacement of physeal cartilages, and the most common benign bone tumor. Osteochondromas rarely cause vascular complications, but when encountered, acute ischemia, phlebitis, and arterial puncture are the most common. They are caused by the mass effect or by the sharp end of the tumor. Deep vein thrombosis may be caused by impaired venous blood flow or a hypercoagulable blood state, but sometimes no predisposing cause can be found. We experienced a patient with deep vein thrombosis caused by the mass effect of an asymptomatic osteochondroma, and treated him successfully by excising the osteochondroma and performing a saphenous vein graft after resecting obstructed vein.

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Transarterial Coil Embolization in Two Maltese Dogs with Patent Ductus Arteriosus Using a Mini Cobra-tip Angiocatheter (말티스 견에서 시술된 미니코브라 카테터와 코일을 이용한 동맥관 개존증의 치료 2 증례)

  • Han, Dong-Hyun;An, Hyo-Jin;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.27 no.6
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    • pp.740-745
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    • 2010
  • Patent ductus arteiosus (PDA) is the persistent opening of ductus arterious located between pulmonary artery and descending aorta after birth. Although PDA can be occluded by surgical ligation, interventional closure of PDA using various devices is being rapidly replaced to surgical ligation, because of its non-invasive nature of treatment and minimal post-care after treatment. Main problem encountering in interventional treatment in toy breed dogs is vascular inaccessibility due to small size of artery. Although transvenous approach using jugular veins has been developed, this technique requires experienced skill to locate occlude devices into PDA and has high risk of accidental dislodgement of occluding devices (i.e. embolization coils or vascular plugs). Therefore, in this study, we developed a modified technique for coil embolization using mini-angiocatheter with trans-femoral approach in toy breed dogs (< 3.0 kg of body weight). With this modified method, we were successfully treated two toy breed (Maltese) dogs with the left to right shunted PDA.