• Title/Summary/Keyword: 혈관 손상

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Treatment of Traumatic Vascular Injury (외상성 혈관 손상의 치료)

  • 장인석;최준영;김종우;이정은;이상호
    • Journal of Chest Surgery
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    • v.36 no.8
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    • pp.590-594
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    • 2003
  • Vascular injury has been increased with popular outside activities. However there are only a few studies for vascular trauma. We intended to find out the relationships between the vascular trauma and its prognosis. Material and Method: Forty-four patients were diagnosed and operated on for vascular injury in the Gyeongsang National University Hospital from 1992. to 1999. We reviewed their chart and analysed their data retrospectively. We studied to causes, treatments, and prognoses of traumatic vascular injury. Result: The transfer time between accident place and emergency department was mean 3,5 hour, and the operation preparing time was 8.8 hours. Five cases required amputation of extremity. All amputation cases were combined with communited bony fractures. Thirty-eight cases had combined other injuries, and almost combined injuries were muscular and neurological damages, Conclusion: The optimal treatment plan for vascular trauma was prompt diagnosis and quick management. It may decrease amputation rate and post-traumatic complications. Therefore we must be carefully evaluated the multiple traumatic patients for early diagnosis of vascular injury and operate quickly in emergency status.

Endovascular Treatment for Vascular Injuries of the Extremities (사지 혈관 손상의 인터벤션 치료)

  • Tae Won Choi;Yohan Kwon;Jinoo Kim;Je Hwan Won
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.846-854
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    • 2023
  • Vascular injuries of the extremities are associated with a high mortality rate. Conventionally, open surgery is the treatment of choice for peripheral vascular injuries. However, rapid development of devices and techniques in recent years has significantly increased the utilization and clinical application of endovascular treatment. Endovascular options for peripheral vascular injuries include stent-graft placement and embolization. The surgical approach is difficult in cases of axillo-subclavian or iliac artery injuries, and stent-graft placement is a widely accepted alternative to open surgery. Embolization can be considered for arterial injuries associated with active bleeding, pseudoaneurysms, and arteriovenous fistula and in patients in whom embolization can be safely performed without a risk of ischemic complications in the extremities. Endovascular treatment is a minimally invasive procedure and is useful as a simultaneous diagnostic and therapeutic approach, which serve as advantages of this technique that is widely utilized for vascular injuries of the extremities.

Endovascular Treatment for Head and Neck Trauma (두경부 외상의 인터벤션)

  • Jae Won Han;Jae Il Lee;Lee Hwangbo
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.792-808
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    • 2023
  • Trauma to the head and neck region can have serious consequences for vital organs such as the brain, and injuries to blood vessels can cause permanent neurological damage or even death. Thus, prompt treatment of head and neck vessels is crucial. Although the level of evidence is moderate, an increasing amount of research indicates that endovascular treatments can be a viable alternative to traditional surgery or medical management. Embolization or reconstructive endovascular procedures can significantly improve patient outcomes. This article provides an overview of various endovascular options available for specific clinical scenarios, along with examples of cases in which they were employed.

Penetrating Vascular Trauma to Zone One of the Neck - A report of two cases - (경부 1구역의 관통상에 의한 혈관 손상의 치험 - 2예 보고 -)

  • Kim, Sang-Ik;Kim, Byung-Hun
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.128-132
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    • 2008
  • Penetrating vascular trauma to zone one of the neck is potentially life-threatening. Trauma in this anatomical location is difficult to access and manage because the neck is a small anatomic area with the anatomical proximity of vital structures. An accurate diagnosis and aggressive surgical intervention are critical to the successful outcome of penetrating zone one vascular trauma in the neck. Here we report two cases with review of the medical literature.

Treatment for Maior Vascular Injuries of Lower Lumbar Disc Surgery -2 Cases Report (요추 추간판 제거술중 발생한 대혈관 손상 수술 치험 -2례 보고-)

  • Kim, Seung-U;Hwang, Yun-Ho
    • Journal of Chest Surgery
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    • v.30 no.6
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    • pp.621-624
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    • 1997
  • Conventional surgery for lower lumbar disc herniation is a common practice and its vascular complications have been reported rarely. If the hypotension is severe or prolonged postoperatively, one should suspect vascular injury and perform urgent laparotomy. We experienced two cases of major vascular injuries following semi-laminectomy and discectomy.

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Surgical treatment for knee dislocation with popliteal artery injury after endovascular intervention for arterial injury - A case report - (슬와 동맥 손상을 동반한 슬관절 탈구에서 혈관내 중재술 후 시행한 수술적 치료 - 증례 보고 -)

  • Ahn, Ji Hyun;Kim, Sang Kil
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.113-116
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    • 2011
  • Although uncommonly encountered, knee dislocation is frequently associated with popliteal artery injury. It has been reported that all detected arterial injuries warrant intervention and open surgical management is the standard of treatment. We report here on a case of endovascular intervention for popliteal artery injury in knee dislocation, and then this was treated with ligament surgery with arthroscopic and open procedure.

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The Role of Oxygen Free Radicals from Endothelial Cells in Endotoxin-induced Endothelial Cell Cytotoxity (내독소에 의한 혈관 내피세포 손상에서 혈관 내피세포로부터 유리된 산소기의 역할에 관한 연구)

  • Choi, Hyung-Seok;Jeong, Ki-Ho;Yoo, Chul-Gyu;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.319-327
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    • 1994
  • Background: The pathogenetic mechanism of adult respiratory distress syndrome(ARDS) is not clearly defined yet, but it is well known that increased pulmonary capillary permeabilty is characteristic feature of ARDS. The increased alveolar-capillary permeability is usually preceded by damage of pulmonary artery endothelial cells. The released enzymes and oxygen free radicals from the activated neutrophils seem to play a predominant role in endothelial cell cytotoxicity. The activated neutrophils, however, probably are not the sole contributing factor in this type of damage because many cases of ARDS have been reported in severe neutropenia. Bacterial endotoxin perse and/or oxygen free radicals released from endothelial cells are suggested to be possible factors that contribute to the development of ARDS. The purpose of this study is to investigate the direct cytotoxicity of endotoxin and the role of oxygen free radicals released from the endothelial cells in endotoxin-induced endothelial cell cytotoxicity. Methods: First, to investigate whether endotoxin is cytotoxic to HUVE by itself, various doses of endotoxin were added to culture medium and cytotoxicity was measured. Second, to evaluate the possible role of oxygen free radical in endotoxin-induced HUVE cytotoxicity, various antioxidants were added on the endotoxin-induced HUVE cytotoxicity and cytotoxicity was measured. Third, to verify the release of oxygen free radicals from HUVE, the concentrations of hydrogen peroxide in the endotoxin-treated culture supernatant were measured. Finally, to observe the cytotoxic effect of hydrogen peroxide, HUVE cytotoxicity in the presence of various doses of hydrogen peroxide was measured. The fourth generations of subcultured HUVE from primary culture were used. The cell cytotoxicity was quantified by the chromium-51 release assay. Results: 1) Endotoxin alone showed HUVE cytotoxicity in a dose-dependent fashion. 2) Endotoxin-induced HUVE cytotoxicity was significantly attenuated by the pretreatment of catalase and DMTU. 3) Hydrogen peroxide was released from HUVE after endotoxin treatment in a dose-dependent fashion. 4) Exogenous hydrogen peroxide also showed HUVE cytotoxicity in a dose-dependent fashion. Conclusion: These results suggest that endotoxin alone can directly injure HUVE, and, oxygen-free radicals released from HUVE in response to endotoxin may also participate in the endotoxin-induced HUVE cytotoxicity.

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Clinical Study of Vascular Injuries (혈관 손상의 임상적 고찰)

  • Chung, Sung-Woon;Kim, Young-Kyu
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.480-484
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    • 2007
  • Background: Major vascular injuries can jeopardize a patient's life or imperil limb survival. We performed this study to establish an optimal management plan for vascular injuries. Material and Method: We retrospectively reviewed 26 cases of vascular injury that were treated at Pusan National University Hospital from May, 1999 to September, 2004. The age and sex distribution, the locations and causes of vascular injury, the diagnostic tools, the degree of injuries, clinical manifestations, the treatment modality and complications were reviewed. Result: The mean age was 39.5 years (range: $12{\sim}86$) and the male to female ratio was 22 : 4. The injuries were in 6 descending thoracic aortas, 4 femoral arteries, 4 popliteal veins and so on. The causes of injury were iatrogenic in 8 cases, traffic accident in 7, stab injury in 6 and industrial accident in 5. The most commonly used diagnostic tools were CT and angiography. The degrees of arterial injury were pseudoaneurysm in 10 cases, partial severance in 5, complete severance in 3 and thrombosis in 3. The degrees of venous injury were partial severance in 6 cases, complete severance in 2 and arteriovenous fistula in 2. The clinical manifestations were absence of pulse in 8 cases, coldness in 7, chest pain in 6, swelling in 5, bleeding in 5 and so on. The most frequently used type of revascularization was graft interposition in 11 cases. Two arteriovenous fistulae were repaired by endovascular procedure. There was one case of mortality due to multi-organ failure after hemorrhagic shock, There were three major amputations, and two of them were due to delayed diagnosis and treatment. Conclusion: A system for the early diagnosis and treatment is essential for improving limb salvage and patient mortality. As a consequence of the widespread application of endovascular procedures, the incidence of iatrogenic injuries has recently increased. Educating physicians is important for the prevention of iatrogenic injury. Easy communication and cooperation for earlier involvement of a vascular surgeon is also an important factor.

Development of a Rabbit Iliac Arterial Stenosis Model Using a Controlled Cholesterol Diet and Pullover Balloon Injury (콜레스테롤 식이 및 내막 손상을 통한 토끼 장골동맥 협착 전임상 모델 개발)

  • Hooney D. Min;Chong-ho Lee;Jae Hwan Lee;Kun Yung Kim;Chang Jin Yoon;Minuk Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.372-380
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    • 2024
  • Purpose This study aimed to develop a rabbit iliac stenosis model and evaluate the effects of different mechanical injury techniques on the degree of arterial stenosis. Materials and Methods Eighteen rabbits were divided into three groups: cholesterol-fed with pullover balloon injury (group A; n = 6), cholesterol-fed with localized balloon dilatation (group B; n = 6), and chow-diet with pullover balloon injury (group C; n = 6). After baseline angiography, the left iliac arteries of all rabbits were injured with a 3 × 10 mm noncompliant balloon using either a wide pullover technique (groups A and C) or a localized balloon dilatation technique (group B). A nine-week follow-up angiography was performed, and the angiographic late lumen loss and percentage of stenosis were compared. Results Group A exhibited the most severe late lumen loss (A vs. B, 0.67 ± 0.13 vs. 0.04 ± 0.13 mm, p < 0.0001; A vs. C, 0.67 ± 0.13 vs. 0.26 ± 0.29 mm, p < 0.05; stenosis percentage 32.02% ± 6.54%). In contrast, group B showed a minimal percentage of stenosis (1.75% ± 6.55%). Conclusion Pullover-balloon injury can lead to significant iliac artery stenosis in rabbits with controlled hypercholesterolemia. This model may be useful for elucidating the pathogenesis of atherosclerosis and for evaluating the efficacy of novel therapeutic interventions.

임신중독증

  • KOREA ASSOCIATION OF HEALTH PROMOTION
    • 건강소식
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    • v.31 no.10 s.347
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    • pp.30-31
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    • 2007
  • 임신중독증에 대한 원인은 아직 확실히 밝혀지지 않았다. 유전적∙인종적인 요인이 많이 작용한다는 설도 있고 칼슘이 부족하여 일어난다는 설도 있다. 또는 태반 조직에 대한 면역 작용 때문이라는 설도 있다. 근본적인 원인이 무엇이든 결과적으로 임신중독증이 생기는 의학적 이유는 혈관 수축으로 인한 것으로 말초혈관 수축에 의해 고혈압이 발생하고 신장혈관 수축에 의한 신장 손상으로 단백뇨가 생기고 이차적으로 그것이 원인이 되어 부종이 생기는 것이다. 임신중독증에 대한 원인은 아직 확실히 밝혀지지 않았다. 유전적∙인종적인 요인이 많이 작용한다는 설도 있고 칼슘이 부족하여 일어난다는 설도 있다. 또는 태반 조직에 대한 면역 작용 때문이라는 설도 있다. 근본적인 원인이 무엇이든 결과적으로 임신중독증이 생기는 의학적 이유는 혈관 수축으로 인한 것으로 말초혈관 수축에 의해 고혈압이 발생하고 신장혈관 수축에 의한 신장 손상으로 단백뇨가 생기고 이차적으로 그것이 원인이 되어 부종이 생기는 것이다.

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