• Title/Summary/Keyword: 동정맥루

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Vein Crossover Bypass Surgery for a Chronic Femoral Vein Ligation -A case report- (만성 대퇴정맥 결찰술 후 정맥 Crossover 우회로 조성술 -1예 보고-)

  • Hong, Joon-Hwa;Cho, Dai-Yun;Choe, Ju-Won;Sohn, Dong-Suep
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.534-537
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    • 2010
  • A twenty six year old man was admitted to our clinic for bleeding from a venous ulcer of the left leg. His left femoral vein had been ligated for bleeding control after a traffic accident that happened when he was 5 years old. He had a varicose vein, stasis dermatitis, and a venous ulcer on his left leg. To shunt left femoral venous return to the right femoral vein, we did a crossover bypass with arteriovenous fistula using the right greater saphenous vein. To get good patency of the arteriovenous fistula, the bypass graft was closed 6 weeks after the initial operation. He maintained his left leg circumference relatively well for 6 months after the operation. We report the case of a patient who had a vein crossover bypass for a chronic femoral vein ligation.

Comparison of the Degree of Pain According to Nursing Intervention Method during Arteriovenous Fistula Needle Insertion for Patients on Hemodialysis (혈액투석 환자의 동정맥루 천자 시 간호중재요법에 따른 통증정도 비교)

  • Yu, Young Mi;Moon, Sung Mi;Kim, Jin Youn;Bae, Hyun Ju;Ha, Hye Rim
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.2
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    • pp.286-296
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    • 2011
  • Purpose: This research was done to compare the pain relief effects of various nursing interventions, such as cold therapy, attention diversion and 10% Lidocaine spray during arteriovenous fistula needling for patients on hemodialysis, and also to identify and develop more effective nursing interventions for pain relief in these patients. Methods: This research was conducted from October 1, 2010 to January 31, 2011 with 8 hemodialysis patients, who were on regular dialysis (3 times a week) at K University Hospital in Seoul and had an arteriovenous fistula within the past 3 months. Each patient received the three nursing interventions (cold therapy, attention diversion and 10% Lidocaine spray therapy) prior to the arteriovenous fistula needling and applied in turn with the series being repeated 4 times. After each intervention, physiologic indexes, subjective and objective pain were measured at the time of needling. ANOVA was used with SPSS/WIN 12.0 to analyze pain scores and comparison of physiologic indexes (BP, pulse). Results: No significant differences were found for subjective pain (p=.574), objective pain (p=.562) and total pain (p=.506) among the 3 interventions. Systolic blood pressure (p=.689), diastolic blood pressure (p=.969) and pulse (p=.980) also showed no significant difference among the 3 interventions. Conclusion: These 3 interventions are all possible for pain relief during arteriovenous fistula needling for these patients. However, the only interventions that nurses can do independently are cold therapy and attention diversion so we recommend that these nursing interventions be used.

Change of Pulmonary Artery Hemodynamics and Pulmonary Vascular Resistance in Experimental Pulmonary Embolism (실험적 급성 폐색전증에서 폐동맥혈역학 및 폐혈관저항의 변화)

  • Chung, Hee-Soon;Lee, Jae-Ho;Kim, Cheol-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.913-922
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    • 1995
  • Background: When we define the pressure of pulmonary vasculature in which a recruitment of blood flow occurs as $P_I$ and the proportion of change in pulmonary artery to that in cardiac output as IR and then we compare PI and IR with pulmonary vascular resistance, we would find some problems in pulmonary vascular resistance. In other words, it is the theory that, IR should be increased mainly in pulmonary embolism in which decreases the cross sectional area of pulmonary vasculature. But there are many contradictory reports resulted from various researches and the fact is known widely that any difference exists between PVR and PI, IR. For this reason, the purpose of this study is to observe how PI and IR change at the time of the outbreak and during treatment of the pulmonary embolism, and to find out the meaning of these new indicators and the difference from the pulmonary vascular resistance used generally when we subdivide the pulmonary vascular resistance into PI and IR. Method: After making AV fistula in experimental dog, we controlled cardiac output at the intervals of 15 minute in case of three kinds(all AV fistula are obstructed, only one of fistula is open and all of fistula is open), and after evoking massive pulmonary embolism with radioactive autologous blood clots, we measured the mean pulmonary artery pressure, and calculated PI and IR. We observed the pattern of change in PI and IR, without giving the control group any specific treatment and with injecting intravenously rtPA in the Group 1 and Group 2 at the dose of 1mg per kg, for 15 minutes fot the former and 3 hours for the latter. Result: 1) Pulmonary vascular resistance showed a change similar to that of pulmonary artery pressure and in all three group, PVR increased significantly, but group 1 and group 2 showed tendency that PVR keeps on decreasing after treatment, and the rate of decrease in group 1 is more rapid than group 2 significantly. 2) Both intersection(PI) and degree(IR) are proved statistically significant, in view of the straight line relationship between cardiac output and pulmonary artery pressure, calculated by minimal regression method. 3) PI changed similarly to pulmonary vascular resistance, while in the IR which is theoretically more similar to PVR, there was no significant difference or change after rtPA infusion. Conclusion: In the pulmonary embolism, Both change in IR which means real resistance of pulmonary vasculature and PI which was developed due to secondary vasoconstriction by pulmonary embolism are reflected same time.

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Bare-Metal Stent in Dysfunctional Hemodialysis Access: An Assessment of Circuit Patency according to Access Type and Stent Location (혈액투석 접근로 기능부전에서의 비피복형 스텐트: 접근로 종류와 스텐트 위치에 따른 개통률 평가)

  • Kyungmin Lee;Je Hwan Won;Yohan Kwon;Su Hyung Lee;Jun Bae Bang;Jinoo Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.197-211
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    • 2023
  • Purpose To evaluate the circuit patency after nitinol bare-metal stent (BMS) placement according to the type of access and location of the stent in dysfunctional hemodialysis access. Materials and Methods Between January 2017 and December 2019, 159 patients (mean age, 64.1 ± 13.2 years) underwent nitinol BMS placement for dysfunctional access. The location of stents was as follows: 18 brachiocephalic vein, 51 cephalic arch, 40 upper arm vein, 10 juxta-anastomotic vein, 7 arteriovenous (AV) anastomosis, and 33 graft-vein (GV) anastomosis. Circuit patency was evaluated by the Kaplan-Meier method, and cox regression model. Results A total of 159 stents were successfully deployed in 103 AV fistula (AVF) and 56 AV graft (AVG). AVG showed lower primary and secondary patency at 12-months compared with AVF (primary patency; 25.0% vs. 44.7%; p = 0.005, secondary patency; 76.8% vs. 92.2%; p = 0.014). Cox regression model demonstrated poorer primary patency at 12 months after stenting in the cephalic arch and GV anastomosis compared with the other sites. Conclusion AVF showed better primary and secondary circuit patency at 12 months following the placement of BMS compared with AVG. Stents in the cephalic arch and GV anastomosis were associated with poorer primary patency at 12 months compared to those in other locations.

Coronary Arteriovenous Fistula Associated with Valvular Heart Disease (심장판막증이 동반된 관상동정맥루 -수술치험 1례-)

  • 임승현
    • Journal of Chest Surgery
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    • v.27 no.7
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    • pp.624-627
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    • 1994
  • Congenital coronary arteriovenous fistula is a rare cardiac defect that causes coronary arterial flow to drain into the right cardiac chambers, the pulmonary artery, the coronary sinus, or the left cardiac chambers. The most frequently involved vessel is the right coronary artery. We experienced a case that had a coronary arteriovenous fistula associated with valvular heart disease. With the cardiopulmonary bypass done under hypothermia, mitral valve replacement was accomplished and the fistulas of both proximal and distal portions of the right coronary artery were closed with 3-0 prolene. Postoperative course was uneventful.

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Postlaminectomy Arteriovenous Fistula -Report of a case- (요추궁 절제술후 발생한 동정맥루 -1례 보고-)

  • 이정호
    • Journal of Chest Surgery
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    • v.13 no.2
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    • pp.130-133
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    • 1980
  • Since the first report of an operation for prolapsed intervertebral disk by Mixter and Barr[1934], many thousands of operations have been successfully performed without incident. Linton and White in 1945 reported the vascular complication, but perforation of large vessels is rare complication of operation for prolapsed disk. A medical student, aged 22 years, was performed to a disk operation [L4-5, Rt. on May 1977.] From postoperative 10th day, palpitation, generalized edema and substernal pain were noted, and 2 months later, wide pulse pressure [70-80 mmHg], continuous bruit and thrill on the Rt. low abdomen were followed. Aortography revealed arteriovenous fistula between just proximal to abdominal aortic bifurcation and inferior vena cava. So, fistulectomy [Resection of proximal 2 cm of C.I.A., Rt, including fistula opening and end to end anastomosis] was performed on July, 77. During follow up study, remained fistula between Rt. internal lilac artery and lilac vein was found 2 months later. Re-operation [Double ligation of the Rt. internal lilac artery] was don on January 1978. Postop. results were excellent, except impossible to ejaculation.

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Acquired Pulmonary Arteriovenous Fistula -A Case Report- (후천성 폐 동정맥루 -1례 보고-)

  • 김남혁
    • Journal of Chest Surgery
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    • v.28 no.5
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    • pp.495-498
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    • 1995
  • Pulmonary arteriovenous fistula can be either congenital or acquired. The vast majority are congenital, and about 60% have been associated with hereditary hemorrhagic telangiectasia [Rendu-Osler-Weber disease . Secondary or acquired pulmonary arteriovenous fistula occurs with trauma, schistosomiasis, long-standing hepatic cirrhosis, metastatic carcinoma, and actinomycosis. Pulmonary hemorrhage secondary to acquired pulmonary arteriovenous fistula is a rare event associated with mortality. We have experienced 64 year-old female patient with the hemoptysis secondary to acquired pulmonary arteriovenous fistula due to the infection of pulmonary parasite. The chest PA and CT scan was showed calcified nodule to the distal portion of lateral segmental bronchus of RML. The bronchial angiogram was demonstrated slightly hypertrophied bronchial artery supplying RML bronchus and the presence of hypervascularization around the calcified nodule, rapid A-V shunting is noted by fluoroscopy. The patient was successfully treated by the right middle lobectomy.

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Numerical Study on Blood Flow Characteristics in a Arteriovenous Graft with Delivered dose During Hemodialysis (혈액 투석 시 주사침에서의 투석량에 따른 인조혈관 내부 유동 특성에 관한 수치해석 연구)

  • Kim, J.Y.;Ro, K.C.;Ryou, H.S.
    • 한국전산유체공학회:학술대회논문집
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    • 2011.05a
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    • pp.469-476
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    • 2011
  • Hemodialysis is essential for patients with end stage renal failure. It is important to improve the patency rate and to minimize occurrence of the stenosis. Also, the blood flow to the artificial kidney can affect the blood flow characteristics though arteriovenous graft. Thus, the delivered dose are important factors for analyzing hemodynamic characteristics during hemodialysis access. In this study, the numerical analysis was performed for the effect of the delivered dose during hemodialysis access on the blood flow through the graft. As a result, The adverse pressure gradient occurred in case of a larger delivered dose through a catheter than standard dose and the flow instability increased. Also the circulation flow appeared largely at anastomotic site of the vein when the delivered dose was exceeded about half blood flow of inlet blood flow.

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NUMERICAL ANALYSIS ON THE BLOOD FLOW CHARACTERISTIC IN THE ARTERIOVENOUS GRAFT FOR DIFFERENT INJECTION METHOD OF BLOOD (혈액 투석시 충혈방법에 따른 인조혈관 내 유동 특성에 관한 수치해석 연구)

  • Kim, J.T.;Sung, K.H.;Ryou, H.S.
    • Journal of computational fluids engineering
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    • v.18 no.3
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    • pp.14-19
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    • 2013
  • Renal failure patients have to operate arteriovenous graft for hemodialysis. Blood flow characteristics influence the patency rate of arteriovenous graft. Numerical investigation is performed with the arteriovenous graft according to injection of blood. As a result, when the injection is not applied to venous graft, the low wall shear stress region appears at venous anastomosis. It may cause intimal hyperplasia at venous anastomosis.