• Archives of Reconstructive Microsurgery
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• v.16 no.1
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• pp.48-51
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• 2007

There could be several methods for trochanteric reconstruction including local flap, pedicled perforator flaps, free flap, etc. We performed greater trochanteric reconstruction with lumbar artery perforator free flap in some aberrant method. So we report this experience with review of literatures. A 42-year-old man visited our hospital with a large soft tissue defect in his left greater trochanteric area by traffic accident. The patient had wide skin and soft tissue defect combined with open femur fracture. During one month period of admission, he underwent femur open reduction and wound debridement four times. After that we planned thoracodorsal perforator free flap reconstruction. The flap was outlined as large as $20{\times}15\;cm$ and elevated in a suprafascial plane from the lateral border. During intramuscular perforator dissection, we found that two 1.5 mm diametered perforator vessels coursed inferomedially toward second lumbar region. Finally the flap became lumbar artery perforator flap based on second lumbar artery perforator as a main pedicle. After flap transfer, the perforator vessels were connected with inferior gluteal artery and vein microsurgically. The operation was successful without uneventful course. We found no significant postoperative complication and donor site morbidity during six months follow up periods. Lumbar artery perforator flap could be an alternative procedure for thoracodorsal perforator flap in some patients with anatomic variant features.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.719-724
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• 2011

Purpose: Previous studies of the facial artery have shown significant anatomical variability in this region. The vascular anatomy of the region is considered unreliable in predicting the ideal pedicle. Preoperative imaging has been suggested as a means of improving preoperative awareness, with Doppler ultrasound as useful tools. Multi-detector row angiographic computed tomography (angio CT) is a significant improvement, providing noninvasive operator-independent details of the vascular anatomy. This tool was used to perform an $in$ $vivo$ anatomical study of the facial artery, demonstrating the usefulness of facial angio CT in planning the facial reconstruction. Methods: Eleven consecutive patients underwent facial angio CT of the facial vasculature with the anatomical details of the facial artery assessed. Results: Facial angio CT could demonstrate the size and course of the facial vasculature, particularly the facial artery. Conclusion: The vascular anatomy of the facial artery is highly variable, and thus there is a role for preoperative imaging. Facial angio CT can demonstrate cases where there is an aberrant or non-preferred anatomy, or select the method of a facial reconstruction.

• Journal of Chest Surgery
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• v.48 no.2
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• pp.139-141
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• 2015

The aetiology, incidence and management of type II endoleaks in standard infrarenal endovascular aortic aneurysm repair is well described. Far less data is available for thoracic stent grafting. We present a rare and interesting case of a type II endoleak post thoracic aortic stenting and highlight the aberrant anatomy that can cause this phenomenon in such cases.

• Journal of Chest Surgery
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• v.15 no.1
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• pp.27-34
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• 1982

Pulmonary sequestration Is an unusual congenital malformation characterized by the presence of nonfunctioning lung tissue which usually has no communication with the normal bronchial tree and which receives its blood supply from an anomalous systemic artery instead of a pulmonary arterial branch. Two forms of pulmonary sequestration occur: Intralobar sequestration, in which the abnormal pulmonary tissue is incorporated within the normal lung and shares a common covering of visceral pleura, and extralobar sequestration, in which the abnormal pulmonary tissue is separated from the normal lung and has its own pleural investment. Since 1970, five cases of pulmonary sequestration were operated at the Department of Thoracic and Cardiovascular Surgery, College of Medicine, Seoul National University. 1. Among five cues, one was male and the others were female. 2. All were intralobar type and involved left lower lobe. 3. There was no operative mortality following left lower lobectomy and ligation of the aberrant artery.

• Journal of Chest Surgery
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• v.32 no.1
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• pp.84-87
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• 1999

The bronchopulmonary sequestration is a term used to describe an area of embryonic lung tissue supplied by an anomalous systemic artery. Two forms are recognised -extralobar and intralobar- with different clinical presentations. We have experienced a case of aspergillosis within an intralobar sequestration. The patient was 32 year-old female and had no specific complaints. The lung mass containing cystic lesion was found incidentally and confirmed to be intralobar sequestration on the operative field which showed aberrant artery in the inferior pulmonary ligament. The right lower lobectomy was done

• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.380-384
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• 2015

Systemic arterial supply from the descending thoracic aorta to the basal segment of the left lower lobe without a pulmonary arterial supply is a rare congenital anomaly within the spectrum of sequestration lung disease. The most common pattern of anomalous systemic artery to the lung arises from the descending thoracic aorta and feeds the basal segments of the left lower lobe. We report an extremely rare case of a 29-year-old woman who underwent a successful left upper lobectomy for the treatment of recurrent massive hemoptysis from anomalous bronchial arterial supply to the lingular segment of left upper lobe.

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.132-136
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• 1998

Nonrecurrence of the inferior laryngeal nerve always results from a vascular anomaly during embryonic development of the aortic arches. The nonrecurrent inferior laryngeal nerve is important clinically for two reasons, it is vulnerable during thyroid surgery and it is associated with difficulty in swallowing. It can be suspected preoperatively from signs associated with the vascular anomaly : dysphagea, thoracic x-ray images showing evidence of retroesophageal subclavian artery, or situs inversus viscerum. If such signs are noted, a barium swallow test and chest computed tomography are justified. We experienced a case of Rt. nonrecurrent inferior laryngeal nerve, which is diagnosed thyroid papillary carcinoma.

• Tuberculosis and Respiratory Diseases
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• v.48 no.4
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• pp.550-555
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• 2000

The bronchopulmonary sequestration is a region of the lung parenchyma that has an incomplete or no connection with the airways and is supplied by an aberrant artery arising from the aorta or one of its branches. The anatomy of the supplying artery is very important during operation. A case of pulmonary sequestration supplied with the left gastric artery is presented. The patient was 61 years old male and had hemoptysis. The chest CT showed cystic bronchiectasis in the left lower lung with few air-fluid level. Also, in aortogram, arterial supply was The aortogram also showed arterial supply coming from the left gastric artery of abdominal aorta branches. Left lower lobectomy and abnormal arterial ligation were performed.

• Tuberculosis and Respiratory Diseases
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• v.68 no.6
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• pp.358-362
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• 2010

Intralobar pulmonary sequestration is a rare congenital lung anomaly. It is defined as a portion of nonfunctioning lung parenchyma that receives its blood supply from an anomalous systemic artery. Patients often present with chronic or recurrent pneumonia. A chest radiograph may show a cystic lesion with air-fluid levels in the lung base. A high index of suspicion is needed for a diagnosis. Surgical removal of a symptomatic intralobar pulmonary sequestration is generally the treatment of choice. Identifying the aberrant artery is a difficult problem when resecting a pulmonary sequestration. The thoracic and abdominal aortas are the most common origins for the abnormal blood supply. However, arterial supply from the celiac artery is quite rare. We present a case of intralobar pulmonary sequestration with the blood supply originating from the celiac artery.

• Journal of Korean Neurosurgical Society
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• v.51 no.3
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• pp.177-181
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• 2012

We present a case of an athetoid cerebral palsy with quadriparesis caused by kyphotic deformity of the cervical spine, severe spinal stenosis at the cervicomedullary junction, and atlantoaxial instability. The patient improved after the first surgery, which included a C1 total laminectomy and C-arm guided righ side unilateral C1-2 transarticular screw fixation. C1-2 fixation was not performed on the other side because of an aberrant and dominant vertebral artery (VA). Eight months after the first operation, the patient required revision surgery for persistent neck pain and screw malposition. We used intraoperative VA angiography with simultaneous fluoroscopy for precise image guidance during bilateral C1-2 transarticular screw fixation. Intraoperative VA angiography allowed the accurate insertion of screws, and can therefore be used to avoid VA injury during C1-2 transarticular screw fixation in comorbid patients with atlantoaxial deformities.