• Journal of Chest Surgery
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• v.42 no.1
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• pp.107-110
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• 2009

Infection of the both native and prosthetic vessels in the groin is a very serious disease because of recurrent arterial rupture and sepsis, and both these complications can cause death. The successful treatment of groin infection, including infection of the femoral artery, requires extensive excision of the infected tissues and restoration of the circulation. We experienced a case of obturator bypass in a patient with an infected femoral artery pseudoaneurysm and accompanying sepsis, and this occurred after performing a transfemoral angiogram in an A-V fistula of the carotid artery, and the patient also displayed intracranial hemorrhage.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.653-656
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• 2009

The entrapment of the popliteal artery is a rare cause of ischemia of the lower extremities among young males. The development of local occlusive or aneurysmal changes of the popliteal artery is caused by abnormal anatomic relationships between vascular and musculo-tendinous structures in the popliteal fossa. An 18-year-old male visited our outpatient clinic with the chief complaint of claudication in his right calf. Three dimensional CT angiography showed an occlusion of the popliteal artery and less opacified arteries of the right leg. Intraoperatively, the popliteal artery was compressed by an accessory muscle band arising from the medial head of the gastrocnemius. After release of the muscle band, thrombectomy with endarterectomy was done. Three years after surgery, he is doing well without any problems.

• Journal of Chest Surgery
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• v.30 no.7
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• pp.724-728
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• 1997

We experienced a case of thoracic aortic aneurysm combined with coronary artery disease. A 68-year-old man complained of anginal pain in the left anterior chest and nonspecific pain in the posterior chest. The aneurysm was extending from left subclavian artery to the diaphragm and sign of impending rupture was noted in the chest CT. Coronary angiograms r vealed significant obstruction of left circumflex coronary artery(>95%) and left anterior descending artery(>50%). Exposure was obtained through the left posterolateral thoracotomy incision in the 4th intercostal space and then partial femoro-femoral cardiopulmonary bypass was established. After aortic cross clamping, the aneurysmal sac was opened and repaired with interposition of 26 mm Hemashield graft. Under the beating heart with femoro-femoral cardiopulmonary bypass, aorto-left circumflex coronary bypass with autogenous saphenous vein used as conduit was performed. Postoperatively multiple cerebral infarction ensued due to intraoperative hypovolemic shock and hypoxic brain damage during cardiopulmonary bypass. Currently, the patient's mental status is drowsy and in an improving state.

• Journal of the Korean Orthopaedic Association
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• v.56 no.5
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• pp.450-454
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• 2021

A 75-year-old male patient without any significant medical and habitual risk factors for acute atherosclerosis obliterans except for hypertension was diagnosed with coronavirus disease 2019 with dyspnea, coughing, and mild fever. After a week of hospitalization, he complained of right foot pain and numbness. The symptoms were aggravated during the next week, resulting in a complete toe color change and loss of dorsalis artery pulse. Enhanced 3-dimensional computed tomography angiography revealed thrombus formation in the right common iliac artery and a loss of blood flow below the popliteal artery on both sides. The patient underwent percutaneous balloon angioplasty with stent insertion followed by medical therapy for anticoagulation. The clinical symptoms immediately were improved after the intervention, but the great toe necrosis was not recovered. Finally, amputation of the great toe was performed.

• Investigative Magnetic Resonance Imaging
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• v.14 no.1
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• pp.47-55
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• 2010

Purpose : To evaluate the geometry of carotid artery by assessing the images of contrast-enhanced MR angiography (CE-MRA) and interrelationships between the geometry of carotid artery and clinical factors. Materials and Methods : 216 consecutive patients who performed supraaortic CE-MRA with fast spoiled gradient-echo imaging were included. Their medical records were reviewed for variable information including risk factors predictive of generalized atherosclerotic disease (age, hypertension (HTN), diabetes mellitus, hyperlipidema, and smoking), sex, body weight, height, and body mass index (BMI). We reviewed the CE-MRA with carotid origin (3 types), carotid artery tortuosity, angle of internal carotid artery bifurcation, the type of aortic arch branching, and the presence of the coiling of carotid artery. Results : Multinomial logistic regression analysis showed that significantly contributed clinical backgrounds for carotid origin were the age and the BMI. With an increase of age at 1, the probability that the type of carotid origin become from type 1 to type 2 was 0.9 times (p=0.004) in right carotid artery (RCA), 0.9 times (p = 0.031) in left carotid artery (LCA), 0.9 times that are likely to be type3 from type 2 (p<0.001) in RCA and 0.9 times in LCA (p=0.009). Increase in BMI at 1 increased odds of becoming type 2 as 1.1 times (p = 0.067) in RCA, 1.1 times (p=0.009) in LCA and increased chance of becoming type 3 as 1.2 times (p = 0.001) in RCA, 1.2 times (p=0.003) in LCA. Mean value of right and left carotid tortuosity were $240.9{\pm}69.0^{\circ}$and $154.4{\pm}55.0^{\circ}$, respectively. Conclusion : The BMI, age, sex and presence of HTN affects the geometry of carotid arteries, the site of origin and tortuosity of carotid artery specifically.

• Journal of Veterinary Clinics
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• v.26 no.6
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• pp.637-640
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• 2009

A 13-year-old female 30 kg Korean Jin-do dog was presented with severe defects due to vasculitis and perivascular dermatitis at the left antebrachium area. A left superficial brachial axial pattern flap was elevated to cover the defect and the wound was covered. However, one week post surgery, the flap was survived about 1/3 of total flap length. Remaining two thirds defects were performed by the free skin mesh graft as an additional method. After ten days, the entire wound was achieved completely. Skin flaps carry own blood supply in other hands, the flap method is dependent upon continuation of adequate circulation until vascularization takes place. Because they are much thicker than other grafts, this is a slower process and the flap method is vulnerable to problems with kinking or tension of the base. According to this case, a practician has to consider length of flap and thickness in order to vascular perfusion when superficial brachial axial pattern flap is performed in a dog.

• 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.

• Journal of Chest Surgery
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• v.35 no.11
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• pp.779-784
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• 2002

Recently, the number of coronary artery bypass surgery(CABG) is increasing according to the increasing incidence of coronary artery disease. However, CABG is not a definite corrective surgery; therefore, in some patients, redo-CABG may be required. We retrospectively reviewed our redo-CABG experiences to help future redo-CABG. Material and Method: From January 1991 to April 2001, 14 cases of redo-CABG were performed in Yonsei Cardiovascular Center(M:F＝12:2) and mean age was 61,7 $\pm$ 7.1(47-72) years. Mean time from 1st. CABG to redo-CABG was 121.9 $\pm$ 50.5(6.1-179.6) months. Thirteen cases were conventional on-pump CABG and one case was off-pump CABG. In two patients, mitral valve re-replacement and mitral valve repair were performed each. All redo-CABG were performed through mid-sternotomy. During redo-CABG, left internal mammary artery and saphenous vein grafts were used in 6 patients, left internal mammary artery and left radial artery grafts were used in 2 patients, left internal mammary artery and gastroepiploic artery were used in one patient and only greater saphenous veins were used in 5 cases(In one case, cephalic vein was also used). The number of mean distal anastomosis was 2.1 $\pm$ 0.9(1-4). Result: There were no operative death and no perioperative myocardial infarctions and cerebrovascular accidents or other heart related complications. Mean follow up duration was 40.1 $\pm$ 38.6(1.1-118.5) months. During follow up period, angina was re-developed in one patient 13 months after operation. Two patients died of end-stage renal failure 14.8 months and 116.3 months after redo-CABG, respectively. During follow up period, coronary angiography was performed in 3 patients, and all grafts were patent. At last follow up, mean Canadian class was 1.3. Kaplan-Meier survival at 9 years was 90.0 $\pm$ 9.5% and event free survival at 9 years was 71.4 $\pm$ 6.9%. Conclusion: After redo-CABG, all patients improved their angina symptom and daily activity. And long-term survival after redo-CABG was excellent. Therefore, if patients have indications for redo-CABG, thenredo-CABG must be strongly recommended and performed.

• Journal of Chest Surgery
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• v.38 no.3 s.248
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• pp.191-196
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• 2005

We analysed the characteristics of anastomotic sites after coronary artery bypass grafting (CABG) using coronary angiographies (CAGs) performed at one and five years postoperatively in the same patient population. Material and Method: Among the 219 patients who underwent isolated CABGs between January 1995 and December 1997, follow-up coronary angiograms were performed in 149 ($75.3\%$) patients at one year and in 115 ($58.1\%$) patients at five years postoperatively. FitzGibbon grading system was used to evaluate the anastomotic sites. Result: The patency rates of arterial grafts at one- and five-year were $96.5\%$ (192/199) and $93.1\%$ (134/144), which were higher than those of saphenous vein grafts (SVGs) ($82.9\%$ (224/270) and $77.5\%$ (141/182), respectively) (p=0.01). Although there were significant decreases in the patency rates between one- and five-year CAGs of both arterial and venous grafts, the proportion of FitzGibbon grade B among the SVGs was increased from $5.2\%$ (one-year) to $8.2\%$ (five-year), suggesting the progression of vein graft disease (p < 0.01). Conclusion: The patency rate of the arterial graft was higher than that of SVG in both one- and five-year CAGs. The attrition rate of saphenous vein graft was higher than arterial grafts.

• Journal of the Korean Society of Radiology
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• v.12 no.7
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• pp.845-852
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• 2018

This study aimed to investigate the difference of X-ray exposure by comparing and analyzing absorbed dose according to changes in the number of frames in coronary angiography, also depending whether the zoom mode is FOV enlargement or Zoom Live. Moreover, for appropriate frame selection measures for examination, including the effect of frame change on the image quality, were sought by measuring the noise strength expressed by the standard deviation (SD), the signal to noise ratio (SNR) and contrast to noise ratio (CNR). The study was conducted with an anthropomorphic phantom on an angio-system. The linear relationship between the frame rate and the radiation dose was evident. On the contrary, the indices of image quality (SD, SNR, and CNR) were almost constant irrespective of the number of frames. The difference depending on the zoom mode was not statistically significant for DAP, air kerma, and SD (p > 0.05). However, SNR and CNR were statistically different between FOV enlargement and Zoom Live. In conclusion, since the image quality was not degraded significantly with the decreasing frame rate from 30, 15, to 7.5 f/s and the radiation dose evidently decreases in almost exactly linear proportion to the decreasing frame rate, the number of frames per second needs to be maintained as low as reasonably achievable. As for the dependence on the zooming mode, the Live Zoom mode showed statistically significant improvement in the image quality indices of SNR and CNR and it justifies active use of the Live Zoom mode which enables real-time image enlargment without additional radiation dose.