• Journal of Chest Surgery
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• v.42 no.1
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• pp.53-58
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• 2009

Background: The goal of this study was to compare the patency and complications of femoropopliteal bypass with superficial femoral artery stenting for patients with atherosclerotic superficial femoral artery occlusive disease. Material and Method: Between July 2005 and July 2008, we reviewed 29 femoropopliteal bypass procedures (24 patients) with prosthetic grafts (the bypass group) and 19 superficial femoral artery stentings (15 patients) with nitinol stent (the stent group). There were 35 male patients (89.7%) and the mean age of the patients was 69.2 years (range: 48~84). The number of patients who had DM, hypertension and a smoking history was 25 patients (64.1%), 17 patients (43.6%) and 30 patients (76.9%), respectively. 23 (59.0%) patients had skin ulceration or tissue gangrene at admission. Result: There were 27 cases (93.0%) of TASC C&D lesion in the bypass group and 16 cases (84.2%) of TASC A&B lesion in the stent group. There were significant differences for the indications for a procedure between the two groups (p<0.01). The primary patency rates at 6 months, 12 months and 24 months were 91.9%, 79.7% and 79.7% for the bypass group and 93.3%, 86.2% and 86.2% for the stent group, respectively. There were no statistical difference between the two groups (p=0.48). Conclusion: There were no significant differences in the outcome between two groups. TASC C&D lesion and failed intervention therapy should be treated with femoropopliteal bypass surgery, and TASC A&B lesion and the high-risk patients should be treated with femoral artery stent insertion.

• Journal of the Korean Society of Radiology
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• v.84 no.5
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• pp.1185-1190
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• 2023

Pseudoaneurysms are among the most serious complications of percutaneous balloon angioplasty. Although pseudoaneurysm rupture rarely happens, when it does, the result can be fatal; thus, early detection and management are crucial. In this report, we disclose the case of a 34-year-old male with end-stage renal disease who presented with a huge symptomatic pseudoaneurysm of the left popliteal artery, following percutaneous balloon angioplasty three months prior. The pseudoaneurysm was successfully excluded using interventional treatment. The patient recovered well, and the follow-up was uneventful, with excellent patency of the covered stent.

• Journal of Chest Surgery
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• v.36 no.5
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• pp.367-370
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• 2003

A 62-year-old male was admitted to our hospital complaining of coldness in both legs and discolorization in the right toes. On angiogram, obstruction of right external iliac artery and left common iliac artery was shown. The patient underwent extended extraanatomic arterial reconstruction due to poor general conditions. From right subclavian artery to right popliteal artery, artery bypass was done with 8 mm PTFE and 6 mm PTFE Suprapubic crossover bypass was done with another 8 mm PTFE from 8 mm PTFE in right inguinal area that was anastomosed with right subclavian artery and left common femoral artery The patient was discharged from hospital and OPD follow up was done. Right leg pain and discolorization of entire toes disappeared and were normalized. We report a case of extended extraanatomic arterial reconstruction: subclavian artery-popliteo-crossover-femoral-PEFE-bypass.

• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.527-540
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• 2021

Peripheral arterial occlusive disease (PAOD) of the femoropopliteal artery is commonly caused by atherosclerosis. It can present with varying clinical symptoms depending on the degree of disease, ranging from intermittent claudication to critical limb ischemia and tissue loss. Therefore, appropriate and timely treatment is required to improve symptoms and salvage the affected limbs. Interventional approaches for femoropopliteal arterial disease commonly include percutaneous transluminal angioplasty, atherectomy, and stent placement. Over the years, endovascular recanalization has been widely performed for treating PAOD due to continuous developments in its techniques and availability of dedicated devices with the inherent advantage of being minimal invasive. In this review, we introduce various types of endovascular treatment methods, discuss the results of clinical research from existing literature, and illustrate the treatment procedures using representative images.

• Journal of Chest Surgery
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• v.39 no.6 s.263
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• pp.456-461
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• 2006

Background: Distal anastomosis using artificial vascular graft is difficult when luminal size mismatch occurred owing to severe occlusion of popliteal artery and its branches. So we reconstructed blood flow to ischemic lower limb by using autologous greater saphenous vein in situ graft (GSVISG) as vascular graft material. Material and Method: From July 2000 to July 2005, 26 patients treated using GSVISG. We analyzed clinical results retrospectively by chart review. Result: There was no in hospital or early postoperative death and 6 late deaths occurred during follow up period. Postoperative complications were 5 cases of early graft obstruction, 2 cases of wound dehiscence, 1 case of graft aneurysmal change, 1 case of seroma formation at inguinal wound and 1 case of graft injury during valvulotomy. Overall patency rate during follow up period was 69.3%. Conclusion: Greater saphenous vein in situ graft is acceptable vascular graft for arterial occlusive disease of lower extremity.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.3 no.2
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• pp.69-73
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• 2010

Osteochondroma arising around the knee joint may sometimes be associated with vascular complication. Angiography is widely used to demonstrate the vascular complication, but it is invasive. Recently MR angiography is recommended as a non-invasive alternative, but it is very costly. We report a twenty-year-old man with popliteal arterial compression caused by osteochondroma who was diagnosed and assessed the surgical result by Doppler ultrasonography. And we also provide the usefulness of Doppler ultrasonography.

• 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.

• Journal of Chest Surgery
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• v.29 no.8
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• pp.889-896
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• 1996

Aggressive revascularization of the ischemic lower extremities in atherosclerotic occlusive diseases or acute embolic arterial occusion due to cardiac valvular disease by thromboembolectomy or an arterial by- pass operation has been advocated by some authors. To evaluate clinical pattern and operative outcome of the ischemic lower extremity, surgical experience in 101 patients who were admitted to Dong-A Univer- sity Hospital between March 1990 and August 1995 was analyzed. The patients were 92 males and 9 females ranging fro 25 to 87 years of age. The underlying causes of arterial occlusive disease were atherosclerotic obliterances in 54 case, Buerger's disease in 20 cases, thromboembolism in 24 cases, vascular trauma in 3 cases and pseudoaneurysm in 3 cases. - The major arterial occlusive sites of atherosclerotic obliterance were femoral artery in 30 cases, iliac artery in 23 cases, popliteal artery in 10 cases, distal aorta in 6 cases and the major arterial occlusive sites of Buerger's disease were posterior tibial artery in 14 cases, anterior tibial artery in 8 cases, popliteal artery in 5 cases. The operative procedures of arterial occlusive disease were bypass graft operation in 61 cases, thromboembolectomy in 21 cases, sympathectomy in 20 cases. Arterial bypass operations with autogenous or artificial vascular prosthesis were done in 61 cases which Included femoro-popliteal bypass in 21 cases, femoro-femoral bypass in 15 cases, axillo-bifemoral bypass in 7 cases, aorto-bifemoral with inverted Y-gr ft In 3 cases, femoro-profundafemoral bypass in 3 cases, popliteo-tibial bypass in 2 cases, aorto-iliad bypass in 1 case Over all postoperative patency rates were 83.6 oyo at 1 year, 75.5% at 3 years and limb salvage rate was 86.8 oyo . Six patients died in the hospital following vascular surgery for ischemic lower extremities, although the causes of death were not directly related to the vascular reconstructive operative proccedures. The leading causes of death were in the order of multiple organ failure, acute renal failure, and sepsis.

• 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.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.120-123
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• 2008

A 60-year-old man with a history of gunshot vascular injury on the right inguinal area, and this happened in the military service 40 years ago, was admitted to our hospital with claudication and dyspnea on exertion. The patient was diagnosed with a chronic traumatic femoral arteriovenous fistula. The patient underwent a successful operation for arteriovenous fistula closure with bovine pericardium and for femoropopliteal bypass with using a right greater saphenous vein graft. The patient is well at 14 months after the operation.