• Title/Summary/Keyword: 정맥형

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Transilluminated Powered Phlebectomy Using Arthroscopic Equipment in Varicose Vein of Lower Extremities (하지정맥류에서 관절경 장비를 이용한 광투시 전동형 정맥적출술)

  • 박형주;이철세;이길노;이석열
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.391-396
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    • 2003
  • Background: Recently transilluminated powered phlebectomy was introduced and used as a method of surgical treatment for varicose vein in lower extremities. The advantage of transilluminated powered phlebectomy are minimal scar and good cosmetic effect. However, the disadvantages of transilluminated powered phlebectomy is that a high priced Trivex system must be used which increases the patient's expenses. Therefore, we performed a transilluminated powered phlebectomy using an existing arthroscopic equipment instead of Trivex system and observed the effect of treatment and efficiency of the treatment. Material and Method: From March, 2000 to February, 2003, 78 patients (113 limbs) underwent transilluminated powered phlebectomy with an arthroscopic equipment. Patient's disease history, the number of operative scars and complications were reviewed. Result: The operation was performed in 133 limbs of the 78 patients (34 men, 44 women) and the age of patients were ranged from 16 to 72 years with mean age of 41.8 years. Operative time ranged from 20 to 65 minutes (average 48.7 minutes) per limb. The number of operative scar per limb from 2 to 7 (average 4.9). Postoperative complications are transient ecchymosis (78 cases) that desappeared spontaneously, edema persisting longer than 3 weeks (6 cases), remnant varicose vein (4 cases), skin perforation during operative procedure (2 cases), and contact dermatitis due to compression stocking (4 cases) The mean hospitalization day was 3.09 days. Subjective mean satisfaction degree of operation by the patients using a visual analogue scale was 92.6%. Conclusion: Our findings demonstrated that transilluminated powered phleectomy using arthroscopic equipment was possible and had good cosmetic results with acceptable complications.

Surgical Treatment of Varicose Vein - TIPP(Transilluminated Powered Phlebectomy) - (정맥류 환자의 수술적 치료 -광투시 전도형 정맥적출요법-)

  • 이교준;김해균;정은규;강두영
    • Journal of Chest Surgery
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    • v.35 no.2
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    • pp.144-148
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    • 2002
  • The present study was done to determine the efficacy and safety of varicose vein removal using a minimally invasive, powered vein-extracting device with cutaneous transillumination and tumescent anesthesia techniques and then compared this to a retrospective group of conventional phlebectomy operations. There were 133 limbs in 104 patients(72 women, 32 men) treated with the use of the vein extractor aided by transcutaneous illumination. The hydrodissection was performed with Trivex™ Irrigated illuminator(Smith & Nephe $w^{ R}$) system using normal saline after the 2~3mm sized skin incision. Varicose clusters were extracted by the use of TriveTM esector(Smith & Nephe $w^{ R}$) system under transillumination. After the varisoce vein extraction, the operation area was compressed with surgical pad for bleeding control. The complication rate was 3.84% The mean number of incisions was 3.24 and mean operative time per limb was 65.9 minutes. The mean hospitalization was 1.86 days. The varicose vein extraction using transilluminated powered phlebectomy(TIPP) is a safe, efficacious and cosmetically satisfactory method. The procedure decreases the operating time and the number of incisions required to remove varicose clusters. Further evaluation and long term follow up will be necessary to determine the recurrence rate and long termcomplications.to determine the recurrence rate and long termcomplications.

Clinical Review of Totally Implantable Venous Catheter (완전 거치형 정맥도관의 임상분석)

  • Kim, Jung-Tae;Oh, Tae-Yoon
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.691-695
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    • 2007
  • Background: The introduction of central venous catheters in 1979 has aided the administration of chemotherapy to oncologic patients. We analyzed the clinical reviews and complications of totally implantable venous catheters in an effort to achieve optimal management. Material and Method: We retrospectively studied 100 cases with totally implantable venous catheter at our hospital and we report the results. Result: 100 totally implantable venous catheters were placed in the right subclavian vein in 74 cases (74%), the left subclavian vein in 21 cases, the right jugular vein in 3 cases, the left jugular vein in 1 case and the right femoral vein in 1 case. The immediate complications were 5 cases in malposition of the catheter and 5 cases of arterial puncture. The late complications were 1 case of subclavian vein thrombosis, which was treated with anticoagulation, and 2 cases of pinch-of syndrome. There were no other early or late complications. Conclusion: The low rate of complications in this study confirms the safety and convenience of using totally implantable venous catheter in patients undergoing prolonged chemotherapy. Yet because Infection, thrombosis, and catheter fracture are the most common long term complications of totally implantable venous catheters, early diagnosis and management of these problems can prevent severe complications.

A study on the Prevention of Deep Vein Thrombosis and Skin Response of Patients after Intracranial Surgery : By Boots and Calf Intermittent Pneumatic Compression Device (뇌수술 환자의 심부정맥혈전증 예방과 피부반응에 미치는 실험연구 : 부츠형과 무릎형의 간헐적 공기 압박기 적용에 따라)

  • Cho, Moo-Yong;Kim, Boon-Han;Kim, Ki-Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.5
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    • pp.203-212
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    • 2016
  • This study examined the prevention of deep vein thrombosis and skin response after the application of boots or calf intermittent pneumatic compression (IPC) devices in immobile patients with intracranial surgery. The subjects of this study included 60 patients in a surgical intensive care unit after receiving intracranial surgery from May to November in 2015. The blood flow velocity was measured daily to assess the deep vein thrombosis for 7 days, and the skin response of the legs was observed regularly. As a result, the boots IPC group showed an increased blood flow velocity over time compared to the calf IPC group. A significant statistical difference was observed in both the boots IPC group and calf IPC group over time (Right side; F=64.41, p<.001, Left side; F=58.21, p<.001). The dorsum circumference over time and the correlations between two groups (Right side; F=9.13, p <.001, left side; F=9.29, p<.001) also showed a significant difference. In addition, the boots IPC group showed no skin complications. In conclusion, the boots type IPC is a more effective method for preventing deep vein thrombosis for immobile patients with intracranial surgery.

Comparative Study of Conventional Phlebectomy and Transiliuminated Powered Phlebectomy in Varicose Veins (하지 정맥류의 고식적 수술 방법과 광투시 전동형 정맥제거술의 비교연구)

  • Lee Choong Won;Chung sung Woon
    • Journal of Chest Surgery
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    • v.38 no.6 s.251
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    • pp.415-420
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    • 2005
  • Recently the cases of varicose veins are increasing because the patients with latent disease have come to realize that they want a positive treatment. Accordingly, the purpose of this study is to compare and analyze two methods the conventional phlebectomy (CP) and transiliuminated powered phlebectomy (TIPP). Material and Method: From March 200f to December 2004, 114 patients (167 legs) with varicose vein were operated in Pusan National University Hospital. A retrospective review was performed on the clinical records. We analyzed age, sex, duration of illness, chief complaints, duplex doppler findings, number of skin incisions, operative time, length of hospitalization, complications, and remnant lesions. Result: Operative time was significantly shorter in the TIPP group than CP group (for one leg $108.4\pm27.6\;min\;vs\;83_4\pm24.4\;min,\;for\;both\;legs\;184.7\pm28.4\;min\;vs\; 137.8\pm24.4\;min)$. There was signifcant statistical difference in average number of skin incisions per leg between the CP group and the TIPP group $(5.9\pm2.2\;vs\;4.2\pm1.6)$. Mean duration of hospitalization was Significantly shorter in the TIPP group than CP group $(4.4\pm1.0\;days\;vs\;5.8\pm1.9\;days)$. Complications were pain $(15.9\%)$, remnant lesion $(9.5\%)$, and ecchymosis $(4.8\%)$ in the CP group and ecchymosis $(19.6\%),\;pain\;(7.8\%),\;and\;remnant\;lesion\;(7.8\%)$ in TIPP group. Sclerotherapy or reopertaion was done for the patients who had remnant lesions. Conclusion: Transilluminated powered phlebectomy in varicose vein could reduce operative time and number of skin incisions, and almost completely removed the multiple lesions. Although there were postoperative complications such as ecclymosis, they were absorbed within 2 months and patients were satisfied. Therefore, TIPP is a more effective operative technique than conventional phlebectomy in varicose veins.

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.

Fracture of an Implantable Central Catheter Due to Pinch Off Syndrome (Pinch off 증후군에 의한 피하매몰형 중심정맥도관의 절단)

  • Yun, Ju-Sik;Oh, Sang-Gi;Song, Sang-Yun
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.504-507
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    • 2008
  • Implantable central venous catheters (Chemoport) are increasingly being used for vascular access, parenteral nutrition and administering chemotherapeutic agents. As with most invasive procedures, central venous catheterization is associated with numerous potential complications such as infection, thoromboembolism and occlusion. A rare but serous complication is the catheter fracture. We present here three cases of catheter fracture as a consequence of Pinch off syndrome, and we include a review of the relevant literature.

A Study on the Comparison of Detected Vein Images by NIR LED Quantity of Vein Detector (정맥검출기의 NIR LED 수량에 따른 검출된 정맥 이미지 비교에 관한 연구)

  • Jae-Hyun, Jo;Jin-Hyoung, Jeong;Seung-Hun, Kim;Sang-Sik, Lee
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.15 no.6
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    • pp.485-491
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    • 2022
  • Intravenous injection is the most frequent invasive treatment for inpatients and is widely used for parenteral nutrition administration and blood products, and more than 1 billion procedures are used for peripheral catheter insertion, blood collection, and other IV therapy per year. Intravenous injection is one of the difficult procedures to be performed only by trained nurses with intravenous injection training, and failure can lead to thrombosis and hematoma or nerve damage to the vein. Accordingly, studies on auxiliary equipment capable of visualizing the vein structure of the back of the hand or arm are being published to reduce errors during intravenous injection. This study is a study on the performance difference according to the number of LEDs irradiating the 850nm wavelength band on a vein detector that visualizes the vein during intravenous injection. Four LED PCBs were produced by attaching NIR filters to CCD and CMOS camera lenses irradiated on the skin to acquire images, sharpen the acquired images using image processing algorithms, and project the sharpened images onto the skin. After that, each PCB was attached to the front end of the vein detector to detect the vein image and create a performance comparison questionnaire based on the vein image obtained for performance evaluation. The survey was conducted on 20 nurses working at K Hospital.

Bypass of Superior Vena Cava with Spiral Vein Graft (Spiral Vein Graft를 이용한 상대정맥 우회로 조성술-치험 1례-)

  • Hwang, Su-Hui;Kim, Byeong-Jun;Jeong, Seong-Un
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.344-347
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    • 1997
  • A 49-year-old female patient who had obstruction of superior vents cave(SVC) with SVC syndrome was successfully managed by bypass operation of superior vents cava with spiral vein graft. A composite spiral vein graft was placed between the right innominate vein and the right atrium to bypass the occluded SVC. The graft was constructed from the patient's own saphenous vein, which was split longitudinally and wrapped around a stent in spiral fashion and the edges of the vein were sutured together to form a large autogenous conduit. The patient was relieved o SVC obstructive symtoms and signs and discharged 21 days postoperatively without any complication.

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A Study on the Implementation and Development of Image Processing Algorithms for Vibes Detection Equipment (정맥 검출 장비 구현 및 영상처리 알고리즘 개발에 대한 연구)

  • Jin-Hyoung, Jeong;Jae-Hyun, Jo;Jee-Hun, Jang;Sang-Sik, Lee
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.15 no.6
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    • pp.463-470
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    • 2022
  • Intravenous injection is widely used for patient treatment, including injection drugs, fluids, parenteral nutrition, and blood products, and is the most frequently performed invasive treatment for inpatients, including blood collection, peripheral catheter insertion, and other IV therapy, and more than 1 billion cases per year. Intravenous injection is one of the difficult procedures performed only by experienced nurses who have been trained in intravenous injection, and failure can lead to thrombosis and hematoma or nerve damage to the vein. Nurses who frequently perform intravenous injections may also make mistakes because it is not easy to detect veins due to factors such as obesity, skin color, and age. Accordingly, studies on auxiliary equipment capable of visualizing the venous structure of the back of the hand or arm have been published to reduce mistakes during intravenous injection. This paper is about the development of venous detection equipment that visualizes venous structure during intravenous injection, and the optimal combination was selected by comparing the brightness of acquired images according to the combination of near-infrared (NIR) LED and Filter with different wavelength bands. In addition, an image processing algorithm was derived to threshehold and making blood vessel part to green through grayscale conversion, histogram equilzation, and sharpening filters for clarity of vein images obtained through the implemented venous detection experimental module.