• Title/Summary/Keyword: 요골동맥

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Harvesting of Radial Artery With Harmonic Scalpel (Harmonic Scalpel을 이용한 요골동맥의 적출)

  • 이현성;강정한;최성실;장병철
    • Journal of Chest Surgery
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    • v.34 no.6
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    • pp.499-501
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    • 2001
  • In the 1970s, the radial artery was proposed as a coronary artery bypass graft but then was abandoned due to graft occlusion secondary to spasm during harvesting. Development of new pharmacologic antispasmodic agents and minimal traumatic harvesting techniques has led to the revival of the use of the radial artery in coronary artery bypass procedures. Harmonic Scalpel(Ultracision Inc, Smithfield, Rl) offers the surgeon the ability to perform less traumatic, spasm free, and rapid radial artery harvesting.

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Analysis of Suitability of Radial Artery Graft as Bypass Conduit after Transradial Catheterization (관상동맥조영술에 사용된 요골동맥의 우회도관으로서의 적합성에 대한 분석)

  • 신윤철;이동석;지현근;김응중
    • Journal of Chest Surgery
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    • v.37 no.11
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    • pp.897-902
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    • 2004
  • Background: Although great concerns have been raised regarding the suitability of the use of the radial artery as a bypass conduit after transradial catheterization, there has been no studies that examined this issue in Korea. The purpose of this study was to compare clinical and angiographic results of radial artery grafting between patients with and without previous transradial catheterization. Material and Method: From January 2000 to February 2004, a total of 93 patients underwent coronary artery bypass grafting using the radial artery: 49 patients received preoperative transradial catheterization for coronary angiography (group I) and 44 patients did not (group II). These patients were retrospectively reviewed. Result: There was no significant difference in sex ratio, age, clinical diagnosis, risk factors, ejection fraction and early clinical outcomes between two groups. The graft patency rates in groups I and II were both 100% in the internal thoracic artery and in the radial artery, and 85% and 86% in the saphenous vein. respectively. The stenosis-free graft patency in groups I and II were 93% and 81% in the radial artery respectively but no statistical significance was shown. Conclusion: There was no significant difference in graft patency at postoperative coronary angiography between two groups. Radial artery graft after transradial catherization seems to be suitable for bypass conduit in short-term analysis.

Early Result of Coronary Artery Bypass Grafting Using the Radial Artery (요골동맥를 이용한 관상동맥우회술의 조기성적)

  • 박진홍;지현근;신윤철;김응중
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.734-740
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    • 2003
  • Increasing interest in the use of arterial conduits is based on the better patency of left internal thoracic artery (LITA) than that of saphenous vein (SV) graft and radial artery (RA) is emerging as one of them. We compared the early result of coronary artery bypass grafting (CABG) using UTA and RA (RA group) with CABG using UTA and SV only (SV group). Material and Method: We compared the early operative results of 45 cases in RA group with 45 cases in SV group selected from 165 cases who had CABG between January 2000 and December 2002. The two groups had similar profiles of age, sex, NYHA functional class, left ventricular ejection fraction and coronary angiographic anatomy. We analysed each group on the preoperative risk factors and operative results. Result: There were no statically signigicant difference between groups in operative mortality and each morbidities (stroke, IABP insertion, perioperative MI), respectively. However, the overall incidence of mortality and morbidities was lower in RA group compared to SV group (p < 0.05). RA group (2.93$\pm$0.62 days) had shorter duration of ICU stay than SV group (3.55$\pm$0.95 days) (p<0.001). The patency on postoperative coronary angiography at 7∼14 days after operation in RA group patients were 100% of LITA and RA and 94.9% of SV. Conclusion: We had better early operative results in RA group compared with SV group.

Detection of Radial Pulse Wave by Photoplethysmogram (광전용적맥파를 이용한 요골동맥 맥파 검출)

  • 정동근;김광년;연규선;최병철;서덕준
    • Journal of Life Science
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    • v.13 no.1
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    • pp.42-46
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    • 2003
  • Photoplethysmogram is widely used to measure heart rate and arterial blood oxygen saturation in human. This paper describes radial pulse waves recorded by photoplethysmogram with 940 nm wavelength infra red light. Radial pulse waves were varied according to the recording site. When recorded on the skin over radial artery, the radial pulse wave was inverted, comparing to the photoplethysmogram at fingertip. The mechanism of inverted pulse wave seemed to be caused by the change of the blood volume in the subcutaneous tissue between radial artery and the skin, which was reduced during systolic period and increased during diastolic period of the cardiac cycle. These results suggest that radial arterial wall may reflect infra red ray.

Coronary Artery Bypass Surgery with Radial Artery -Early Results (요골동맥을 이용한 관상동맥우회술 -조기성적)

  • 나찬영;이영탁;박국양;이해영;김욱성;박?현;홍민수;심재천;권오춘
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.275-281
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    • 1997
  • The radial artery as a graft for myocardial revascularization was introduced by Carpentier in the early 1970s. Mid-term results were unfortunately discoura ing, and the clinical experience with this graft was interrupted. At the end of the 1980s, these authors reproposed the same arterial conduit with more satisfying results, because of improved technique and pharmacological management of the graft. Between October 1994 and July 1995, 36 patients underwent myocardial revascularization with a radial artery graft in Seiong General Hospital. Left internal mammary artery was concomitantly used as a pedicled Vift in 34 patients. Fifteen patients (42%) had a complete arterial waft revascularization. A total of 12) distal anastomoses were performed (average 3.4 per patient), including 36 left internal mammary artery wafts (two sequential in 2 patients), and 23 saphenous vein grafts. The remaining 64 distal anastomoses were perFormed with radial artery grafts (mean 1.8 per patient). The radial arteries were anastomosed to the circumflex (n=38), diagonal (n= 18), right coronary(n=G), and left anterior descending coronary artery(n=2). The percent ge of radial artery graft anastomoses (64) to the total anastomoses(123) was 52%. The radial artery was used as a single graft in 10 patients, as a sequential graft in 25 patients, and two grafts in 1 patient. Twenty patients underwent associated procedures coronary endarterectomy (14), coronary artery patch angioplasty (4), mitral valve repair (1), and repair of ventricular septal rupture (1). One patient died of low cardiac output syndrome and the others had no perioperative myocardial infarction. There are no ischemic and functional complications in the arm or hand aftcr removal of the radial artery. Only 1 patient required reexploration of the am, for the hematoma evacuation, and 2 patients complained transient thumb dysesthesia of the side of the havested arm. This dysesthesia improved within one month. Postoperative angiovaphic controls were obtained in 11 patients(31%) postoperative 79 to 210 days (mean 126 days). The patency rate were as follows : left internal mammary artery (100%), saphcnous vein (100%), and radial artery(95%). We concluded that the radial artery is useful alternative graft, but long term clinical and angiographic studies are required to derterminc whether wider application is warranted.

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The Heart Rate Monitoring System using Inverted Photoplethysmography (반전 용적맥파 신호를 이용한 심박 모니터링 시스템)

  • Lee, Jun-Yeon
    • Journal of the Korea Society of Computer and Information
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    • v.17 no.3
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    • pp.105-111
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    • 2012
  • Photoplethysmogram is widely used to measure heart rate and arterial blood oxygen saturation in human. This paper describes implementation a photoplethysmography monitoring system that uses 780nm and 940nm length infrared light in radial artery. That system used combinations of 8 LEDs and 2 photoelectricities. When recorded on the skin over radial artery, the radial pulse wave was inverted. The mechanism of inverted pulse wave skin, which was reduced during systolic period and increase during diastolic period of the cardiac cycle. Through this system, we discovered optimal environments and combinations of sensors in both penetration type and reflection type. These results suggest that radial arterial wall way reflect infrared ray.

Angiographic Results of Radial Artery Grafts that are Used for Myocardial Revascularization (관상동맥 우회술 후 혈관조영술을 이용한 요골동맥의 개통률 분석)

  • Yie, Kil-Soo;Oh, Sam-Sae;Kim, Jae-Hyun;Shinn, Sung-Ho;Kim, Soo-Cheol;Seo, Hong-Joo;Na, Chan-Young
    • Journal of Chest Surgery
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    • v.40 no.8
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    • pp.546-551
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    • 2007
  • Background: The radial artery is gaining widespread acceptance as complementary arterial conduits for surgical myocardial revascularization, but there have been limited reports about its angiographic patency compared with that of internal thoracic artery or saphenous vein. We tried to evaluate angiographic patency of radial artery graft and to compare that of radial artery and other gratis with retrospective manner. Material and Method: From January 2001 to Jure 2006, totally 132 patients (male 92, female 40) who underwent coronary artery bypass graft using radial artery were re-admitted to our hospital for follow up angiographic examination. Mean age was 58.2+8.87 and mean follow up duration was 32 month ($2{\sim}110$ month). Off pump and on pump bypass surgery were performed 74 and 58 patients respectively. Along with radial artery, left internal thoracic arteries were used in 57 cases, concomitant left internal thoracic artery and saphenous veins were used in 47 cases and bilateral internal thoracic arteries were used in 20 cases. Result: Totally 412 distal anastomosis were performed and 376 anastomosis remained patent (91.2%). Left internal thoracic artery showed the most excellent patency in all of the conduits (98.5%). Radial artery graft patency was 90.8% (169/186). There was no statistical difference of the patency by conduit between on-pump and off-pump group. But radial artery showed more higher patency rate (98/110, 89%) in the severe stenotic lesion that preoperatively revealed more than 90% stenosis than in the lesser severe (<90%) stenotic lesion (60/76, 78%)(p < 0.005). Radial artery conduit represented the worst result when it was grafted in the right coronary system. But when it was positioned in the left heart especially diagonal or obtuse marginal area, patency was comparable with left internal thoracic artery. Conclusion: Radial artery graft showed good midterm patency when it was used in the severe stenotic lesion more than 90% and left coronary system. But great notice should be taken when it is grafted in the right coronary system or less severe stenotic lesion.

Endoscopic Radial Artery Harvest: Techniques & Results (내시경을 이용한 요골동맥 수확법의 수술 방법과 결과)

  • Jeong, Young-Kyun;Lee, Jong-Tae;Cho, Jun-Yong;Kim, Kyu-Tae;Chang, Bong-Hyun
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.35-41
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    • 2006
  • Background: The radial arteries are being used more often for coronary artery bypass grafting, We tried to the endoscopic radial artery harvest to reduce the cosmetic problems and neurologic complications of the conventional open harvesting and report the techniques and early results. Material and Method: The 86 patients underwent coronary artery bypass grafting between May 2003 and April 2005 had their nondominant radial artery endoscopically removed through a 2 cm incision at the wrist. The radial pedicle was dissected and was divided at antecubial area through a 5 mm counterincision. Result: The 23 patients complained of neuralgias on territory of superficial raidal none but no one complained of neuralgias on territory of lateral antebrachial cutaneous none. There was no functional impairment of the hand. There was no wound complication except a localized hematoma. All patients were contacted by telephone after postoperative 7.9$\pm$3.6 months. The 4 patients still complained of neuralgia. All the patients were satisfied with the aesthetics of the wounds. The multidetectional tomography was done on the 66 patients for the estimation of early patency of radial artery. There were 2 cases of stenosis and a case of occlusion. Conclusion: Endoscopic radial artery harvest had no functional impairment of the hand, lesser rate of neurologic complications and outstanding aesthetics. The results of early patency of the radial artery was similar to conventional methods. Therefore, we think that endoscopic radial artery harvest is the optimal procedure.

Early Result of Proximal Anastomosis Methods of Radial Artery in Coronary Artery Bypass Surgery (관상동맥우회술 시 요골동맥의 근위부 문합방법에 따른 조기결과)

  • Park Jong Un;Shin Yoon Cheol;Kim Eung-Jung;Chee Hyun Keun
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.91-98
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    • 2006
  • Background: There are many different opinions regarding the proximal anastomotic sites of radial artery in coronary artery bypass surgery. Therefore, we compared the clinical and angiographic findings according to anastomosis of radial artery to develop a guideline. Material and Method: From January 2003 to December 2004, 48 patients who underwent coronary artery bypass surgery using radial artery in Kangdong Sacred Heart Hospital were studied for clinical and coronary angiographic findings and were divided into group I for radial artery that anastomsed to aorta independently and group II that anastomosed to left internal mammary artery. Result: Patients in group I were 33 (men 26, women 7; mean age 61.93$\pm$6.56) and group II were 15 (men 13, women 2; mean age 59.53$\pm$6.02) and there was no difference in preoperative characteristics. Patients in group I had longer cardiopulmonary bypass time (169.36$\pm$40.28 versus 139.40$\pm$20.45, p=0.026) and patients in group II had more sequential grafts with RA per patients (5/33 versus 11/15, p < 0.05). Patients in group I used more vein graft for distal anatstomosis (47/117 ($40\%$) versus 9/48 ($18\%$), p=0.011) and there was no difference in perioperative outcome and overall survival. Mean follow-up time was 15.87$\pm$7.33 (1 to 28) months in patients of the group I and 21.40$\pm$2.85 (17 to 25) months in group II. Postoperative coronary angiography was performed 17/33 ($51.5\%$) in group I and 14/15 ($93.3\%$) in group II. Early perfect patency rate was not statistically different in left anterior descending artery (15/17 ($88.2\%$) versus 2/14 ($85.7\%$), p=1.00) and radial artery (17/20 ($85\%$) versus 30/30 ($100\%$), p=0.058). Late mortality was 1/33 ($3.0\%$) in group I and 1/15 ($6.7\%$) in group II. Conclusion: There was no difference in terms of clinical and postoperative angiographic findings except in cardiopulmonary bypass time, the number of sequential grafts with the RA per patients and the number of the used vein graft.

Pulsatility Index of Blood Echogenicity of the Human Radial and Common Carotid Arteries: Relation with Age and Stroke (인체 요골동맥과 경동맥의 혈액에코박동지수: 나이 및 뇌졸중과의 관계)

  • Bok, Tae-Hoon;Kong, Qi;Nam, Kweon-Ho;Choi, Jay Chol;Paeng, Dong-Guk
    • Journal of the Korean Society for Nondestructive Testing
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    • v.32 no.5
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    • pp.494-501
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    • 2012
  • In the present paper, the ultrasound blood images were measured at both the human radial artery(RA) and common carotid artery(CCA), depending on the age, and the pulsatility index of blood echogenicity(PIBE) was analyzed. In addition, the ultrasound blood images were measured at both RA and CCA of both the stroke patients and the control group, and PIBE was compared. PIBE of RA for the young group was similar with that for the old group ($0.13{\pm}0.11$ and $0.16{\pm}0.03$). PIBE of CCA for the young group, however, was larger than that for the old group ($0.70{\pm}0.21$ and $0.32{\pm}0.01$), and was more variable depending on the subject. Similarly, the fibrinogen concentrations of the patients ($336{\pm}61$ and $340{\pm}126mg/dl$) were more than that of the control group ($264{\pm}38$ and $257{\pm}43mg/dl$), for both RA and CCA. The results indicate the possibility of the ultrasonic test on the correlation between erythrocyte aggregation and stroke, and it is expected that the in-vivo EA measurement would be clinically useful.