• Title/Summary/Keyword: Arterial

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Early mobilization and delayed arterial ligation (EMDAL) as a surgical technique for splenectomy and shunt surgery in portal hypertension

  • Harilal S L;Biju Pottakkat;Kalayarasan Raja;Senthil Gnanasekaran
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.1
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    • pp.48-52
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    • 2024
  • Backgrounds/Aims: Splenectomy is the most frequently performed procedure as definitive management or as part of shunt surgery or devascularization in portal hypertension. Splenectomy is technically challenging because of the frequent coexistence of multiple collateral varices, splenomegaly, poor liver function, and thrombocytopenia. Early arterial ligation and late mobilization (EALDEM) is the traditional method for splenectomy in portal hypertension. Early spleen mobilization offers good control of the hilum. We aim to compare the effect of the early mobilization and delayed arterial ligation (EMDAL) technique with that of the conventional splenectomy technique in patients with portal hypertension. Methods: During the study period from September 2011 to September 2022, 173 patients underwent surgical intervention for portal hypertension at our institution. Among these patients, 114 underwent the conventional method of splenectomy (early arterial ligation and late splenic mobilization) while 59 underwent splenectomy with the EMDAL technique. Demographics were compared between the two groups. Intraoperative and postoperative outcomes were analyzed using the Mann-Whitney test in each group. A minimum follow-up of 12 months was performed in each group. Results: Demographics and type of surgical procedure were comparable in the two surgical method groups. Median blood loss was higher in the conventional group than in the EMDAL method. The median duration of surgery was comparable in the two surgical procedures. Clavien-Dindo grade III/IV complications were reported more frequently in the conventional group. Conclusions: The splenic hilum can be controlled well and bleeding can be minimised with early mobilization and delayed arterial ligation.

Assessments of baroreflex sensitivity through the closed-loop feedback model between RR fluctuation and arterial blood pressure fluctuation (RR간격변동과 열합변동간의 폐루프 귀환 모델을 통한 압수용체반사감도의 평가)

  • 신건수;최석준;이명호
    • 제어로봇시스템학회:학술대회논문집
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    • 1997.10a
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    • pp.1643-1646
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    • 1997
  • In this study, the method is proposed, which enable us to noninvasively assess baroreflex sensitivity through the closed-loop feedback modle between RR flucturarion and arterial blood pressure fluctuation. The proposed indexes of baroreflex sensitivity, BRS$_{LF}$와 BRS$_{HF}$ are calculated by the modulus (or gain) of the transfer function between fluctuatuons in blood pressure and RR interval in the LF band HF band, where the coherence is more than 0.5 to evaluate the performance of the proposed method, it is applied to various cardiovascular variability signals obtained form subjects under the submaximal ecericse on bicycle ergometner. In result it is concluded that the proposed method can noninvasively assess the baroreflex sensitivity.ty.

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Analysis of multi-channel photoplethysmograph parameter by the changes of arterial characteries (동맥계 다채널 용적맥파 특징 파라미터 분석에 관한 연구)

  • Han, Soon-Chen;Kim, Hyoung-Jo;Kim, Hyoung-Tae;Kim, Jung-Kuk;Huh, Woong
    • Proceedings of the IEEK Conference
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    • 2003.07c
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    • pp.2745-2748
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    • 2003
  • In this paper, we implement the photoplethysmo-graphy system that have three channel pulse wave detects and one channel ECG amplifier. In order to detect the artery state, we measured the pulse waves at different positions, simultaneously. In general, arterial vascular system suffers the decrease of compliance, increase of resistance, and decrease of distensibility through aging. Therefore, we compared and analyzed variation of tile Pulse waves parameter both in time and frequency domains that is concerned with the changes of arterial characteries. And then evaluated the correlation coefficients between the parameters variation and the age group. As the result of experiment, we found that the Parameters have a significant correlation about aging.

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Influencing Factors of Nutritional Status among Liver Cancer Patients Receiving Transcatheter Arterial Chemoembolization(TACE) (간동맥 화학색전술을 받은 간암환자의 영양상태에 미치는 영향요인)

  • Sohn, Young-Sil;Kang, In-Soon
    • The Korean Journal of Health Service Management
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    • v.11 no.1
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    • pp.159-169
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    • 2017
  • Objectives : The purpose of this descriptive observational study was to identify the factors influencing the nutritional status of patients with liver cancer receiving transarterial chemoembolization(TACE) Methods : A total of 100 participants were enrolled in this study. Data were collected and descriptive statistics and logistic regression were performed. Results : Among participants, 41.0% had a risk of malnutrition and 59.0% had a normal nutritional status. Statistically significant differences between the normal and risk groups were found for the following factors: occupation; economical status; regular exercise; underlying disease; adverse events right after TACE; current adverse events; duration after TACE; depression; and self-care performance. Underlying disease(OR=5.134, p=.005) and self-care performance(OR=0.931, p=.032) had statistically associated with nutritional status. Conclusions : The findings suggest that underlying disease and self-care performance influence the nutritional status among liver cancer patients receiving transcatheter arterial chemoembolization(TACE).

The Evaluation of Carotid Artery Stenosis Using Spiral CT. (Spiral CT를 이용한 경동맥 질환의 평가)

  • Yoon, Hee-Suk;Hwang, Yun-Chean;Shin, Hyun-Kil;Beak, Cheon-Ki;Yoon, Suck-Min
    • Journal of radiological science and technology
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    • v.19 no.2
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    • pp.45-49
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    • 1996
  • To determine the utility of spiral computed tomography(CT) in the evaluation of carotid artery stenosis, spiral CT images of 10 patients were compared with both ones of conventional angiography and magnetic resonance(MR) angiography. The severeness of stenosis was determined for each Internal carotid artery on the basis of arterial narrowness : mild stenosis : 40 % or less, moderate stenosis = $40{\sim}70%$, severe stenosis = greater than 70 % of arterial narrowness. The short examination and clear depiction of the arterial lumen In areas of complex or low flow make CT angiography attractive alternative to MR angiography. Spiral CT angiography shows normal and abnormal carotid anatomy well when compared with conventional anglography.

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Development of Intravascular Micro Active Endoscope(I) -Analysis of Lubrication Characteristics of Small Arteries with Micro Catheter Insertion- (혈관 삽입형 초소형 작동형 내시경의 개발(I) - 도뇨관 삽입시 혈관 내부의 윤활 특성 분석 -)

  • 장준근;김중경
    • Tribology and Lubricants
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    • v.15 no.3
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    • pp.272-277
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    • 1999
  • The objective of this investigation is to examine the influence of the micro catheters, which mimic the intravascular micro active endoscopes, on local pressure changes and flow rate in an arterial branch model similar to the femoral artery of human. The effects of branch to main lumen flow rate ratios and the locations of a catheter tip were found to be significant on the local pressure changes. Relatively large pressure drops and an increase in shear stress due to the obstruction effects may induce an endothelial cell damage and a change in arterial wall permeability, which have been reported to be the primary cause of the initiation of the atherosclerosis and other major vascular diseases.

clinical analysis of vascular trauma (혈관손상의 임상적 고찰)

  • 성숙환
    • Journal of Chest Surgery
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    • v.19 no.2
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    • pp.288-294
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    • 1986
  • During the period from Mar. 1983 to Feb. 1986, 22 patients with vascular trauma were treated at Capital Armed General Hospital. 1] 11 patients had arterial injury alone, 6 patients had venous injury alone, and 5 patients had both arterial and venous injuries. 2] The mechanism of injury in these 22 patients was 7 penetrating non-gun shot wounds, 5 blast fragments injuries, 4 iatrogenic injuries, 4 blunt injuries, 2 gun shot wounds. 3] The method of 16 arterial repair was 5 autogenous saphenous vein graft, 8 synthetic vascular graft, 1 end to end anastomosis, 2 lateral suture. Midterm patency of 16 repairs was 100% within 1 months. 4] The method of 11 venous repair was 1 autogenous saphenous vein graft, 2 onlay vein patch, 2 ligation, 1 lateral suture. The thrombotic obstructions occurred in 4 repairs [36.4%], but they were resolved somewhat with heparinization. 5] Uncommon cases of false aneurysm of internal carotid artery and laceration of retrohepatic inferior vena cava were summarized.

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Bypass Surgery in Arterial Thoracic Outlet Syndrome

  • Bae, Miju;Lee, Chung Won;Chung, Sung Woon;Choi, Jinseok;Kim, Min Su
    • Journal of Chest Surgery
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    • v.48 no.2
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    • pp.146-150
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    • 2015
  • Arterial thoracic outlet syndrome (TOS) causes ischemic symptoms; it is the rarest type, occurring in 5% of all TOS cases. This paper is a case report of a 38-year-old male patient diagnosed with arterial TOS, displaying symptoms of acute critical limb ischemia caused by thromboembolism. Brachial artery of the patient has been diffusely damaged by repeated occurrence of thromboembolism. It was thought to be not enough only decompression of subclavian artery to relieve the symptoms of hand ischemia; therefore, bypass surgery using reversed great saphenous vein was performed.

In Situ Saphenous Vein Arterial Bypass - A case report - (자연위치의 복재정맥을 이용한 하지동맥 우회술 1례 보)

  • Lee, Hong-Seop;Park, Guk-Yang;Kim, Chang-Ho
    • Journal of Chest Surgery
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    • v.20 no.1
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    • pp.187-190
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    • 1987
  • The Saphenous vein is still the graft of choice for bypass of small calibered peripheral arteries, and many recent studies revealed that the "In Situ" technique had higher rate of long term patency than the conventional "reversed" one. A 71-year-old male who had atherosclerotic obstruction in the superficial femoral and popliteal trifurcation underwent In Situ saphenous vein arterial bypass. The saphenous vein is exposed by a long medial skin incision over the course of the vein. All branches of vein are ligated. A olive-tipped metal needle is introduced into the vein from above and everts the valves. The patient has been followed for 2 months after operation. The graft remained pulsatile and the gangrenous areas on the toe proceeded to heal. We think In situ vein bypass offers an excellent and safe method of revascularization of the arterial occlusion below the knee although it is technically demanding and the time consuming. time consuming.

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Three cases report of arterial bypass graft using polytetrafluoroethylene vascular prosthesis (Polytetrafluoroethylene 인조혈관을 이용한 동맥재건술: 3례 보)

  • 이철세
    • Journal of Chest Surgery
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    • v.17 no.4
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    • pp.691-697
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    • 1984
  • After the real birth of vascular surgery occurred with the introduction of the first practical arterial prosthesis about 50 years ago, a variety of potential vascular graft had been tested and rejected. Polytetrafluoroethylene [Teflon, PTFE] was first used as a vascular prosthesis in 1957. Thereafter this pros-thesis was first used clinically in 1972 and has subsequently been widely applied as a small and medium sized vessel replacement because it is easy to use and readily available. There are numerous reports of good results about Polytetrafluoroethylene graft. We experienced the three cases of arterial bypass graft using polytetrafluoroethylene vascular pros-thesis. First, 21 years old female patient had suffered from Takayasus disease which affected the left subclavian artery and right subclavian-left axillary extra anatomical bypass graft as done. Second, 64 years old male patient had suffered from Leriche syndrome for 12 years and the left axillofemoral and femorofemoral extra anatomical bypass graft was done. Third, 34 years old male patient had suffered from recurrent Buergers disease which affected the left popliteal artery and the isolated popliteal artery segment bypass graft was done. Relatively satisfactory result was obtained in early post-operative period in all three cases.

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