• Journal of Chest Surgery
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• v.24 no.12
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• pp.1173-1184
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• 1991

This report is a review of 55 cases of peripheral arterial disease, who were treated at the department of thoracic and cardiovascular surgery, Masan Koryo General Hospital from January, 1986 to December, 1990. The result are summerized as follows ; 1. The incidence of peripheral arterial disease were as follows that : Arterial injury was in 21 cases(38.2%), arteriosclerosis oblitrans 18cases(32.7%), thromboembolism 9cases(16.4%), Buerger's disease was in 7cases(12.7%). 2. Overall male to female ratio was 6.8 : 1, the prevalent age was 3rd and 4th decade in arterial injury, 7th and 8th decade in atherosclerosis and thromboembolism and 5th and 6th decade in Buerger's disease. 3. The farmer was the first ranked occupation of these patients with chronic occlusive arterial disease, which was composed of 17 cases (68%). 4. 23 cases of patients with chronic occlusive disease has been smoking and most of them have been smoking over 10 years. 5. The clinical symptoms in acute and chronic arterial obstruction were pain, claudication, gangrene and coldness in order. 6. The duration of symptom of chronic arterial occlusive disease was less 1 years in 15 cases(60%). 7. The lower extremity were more affected than upper extremity in peripheral arterial disease. 8. The cause of arterial injury was traffic accident 9 cases(42.9%) stab wound 8 cases (38.1%), postangiography 2 cases(9.5%) and belt injury 1 case. 9. The etiologic factors of acute arterial occlusion was arterial fibrillation myocardial ischemia and postangiography in order. 10. Lumber sympathectomy in Buerger's disease, artificial bypass graft in atherosclerosis and thromboembolctomy in thromboembolism, end to end with vein graft in arterial injury were performed frequently. 11. Conclusively overall result was satis factory but 3 cases was below knee amputated after operation of chronic arterial occlusive disease.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.223-229
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• 2012

Purpose: The arterial base deficit and the serum lactate level are widely recognized indicators of injury severity, adequacy of resuscitation and outcome. The purpose of this study is to evaluate the usefulness of the arterial base deficit as an injury-severity indicator in multiple-trauma patients with head injuries. Methods: Data were retrospectively collected from trauma patients over 18 years of age who had been admitted at the emergency center between October 2005 and July 2006. The patients were divided into head-injury and non-head-injury groups. These patients were then sub-divided into minor ($$ISS{\leq_-}15$$)-injury and major ($$ISS{\geq_-}16$$)-injury groups according to their injury severity scores (ISS). We analyzed the differences in the base deficits and the serum lactate levels between the major- and the minor-injury sub-groups in both the head-injury and the non-head-injury groups. Results: In the non-head-injury group, we found statistically significant differences in the arterial base deficit between the major-injury and the minor-injury sub-groups($-6.86{\pm}2.40mmol/L$ vs. $-1.37{\pm}0.73mmol/L$, p=0.010). In the head-injury group, no significant differences were noted between the two sub-groups($-2.50{\pm}1.28mmol/L$ vs. $-1.51{\pm}0.74mmol/L$, p=0.897). Moreover, the differences in arterial base deficit between the major-injury and the minor-injury sub-groups were not significant both for either single-head-trauma or multiple-head-trauma patients (p=0.643 vs. p=0.832). Conclusion: We conclude that neither the arterial base deficit nor the serum lactate level can be used to predict injury severity in multiple-trauma patients with head injuries.

• Journal of Trauma and Injury
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• v.29 no.2
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• pp.37-42
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• 2016

Purpose: Arterial injury in children is a challenging problem for its special characteristics. It is rare even during warfare. This review described a personal experience in the management and outcome of acute pediatric arterial injuries of extremities. Methods: Thirty-six children below age of 13 years were studied during period from 2004 through 2014 in Iraq. Results: Male patients were 27 (75%) and female were 9 (25%). Seven to twelve years old was the most affected age group. The incidence of iatrogenic injuries was greater in infants and toddlers while penetrating injuries were the most common in older children. Upper limbs arteries were affected in 17 (47.2%) and lower limb in 19 (52.8%) patients. Hard signs were the commonest mode of presentation (83.3%). Lateral wall tear and complete transection were the most frequent types of arterial injury (36.1% and 27.8% respectively). The most frequent procedures performed were end-to-end anastomosis and lateral arteriorrhaphy. Surgical outcome was good. In 27 cases distal pulsations were regained. Seven cases had impalpable distal pulses but still viable limbs. Limb length discrepancy was detected in one case. One case was complicated with limb loss. No death was recorded. Conclusion: Arterial injuries in children are age related. The proper treatment of arterial injuries in children requires high index of suspicion, early operative intervention and continuous postoperative follow-up throughout years of active growth. Angiogram has a limited role as a diagnostic tool in acute arterial injuries.

• Journal of Trauma and Injury
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• v.22 no.1
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• pp.77-86
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• 2009

Purpose: The appropriate management of traumatic truncal arterial injury is often difficult to determine, particularly if the injury is associated with severe additional truncal lesions. The timing of repair is controversial when patients arrive alive at the hospital. Also, there is an argument about surgery versus stent-graft repair. This study's objective was to evaluate the appropriate method and the timing for treatment in cases of truncal abdominal injury associated with other abdominal lesions. Methods: The medical records at Ajou University Medical Center were reviewed for an 8-year period from January 1, 2001, to December 31, 2008. Twelve consecutive patients, who were diagnosed as having had a traumatic truncal arterial injury, were enrolled in our study. Patients who were dead before arriving at the hospital or were not associated with abdominal organ injury, were excluded. All patients involved were managed by using the ATLS (Advanced Trauma Life Support) guideline. Data on injury site, the timing and treatment method of repair, the overall complications, and the survival rate were collected and analyzed. Results: Every case showed a severe injury of more than 15 point on the ISS (injury severity score) scale. The male-to-female ratio was 9:3, and patients were 41 years old on the average. Sites of associated organ injury were the lung, spleen, bowel, liver, pelvic bone, kidney, heart, vertebra, pancreas, and diaphragm ordered from high frequency to lower frequency. There were 11 cases of surgery, and one case of conservative treatment. Two of the patients died after surgery for truncal organ injury: one from excessive bleeding after surgery and the other from multiple organ failure. Arterial injuries were diagnosed by using computed tomography in every case and 9 patients were treated by using an angiographic stent-graft repair. There were 3 patients whose vessels were normal on admission. Several weeks later, they were diagnosed as having a truncal arterial injury. Conclusion: In stable rupture of the truncal artery, initial conservative management is safe and allows management of the major associated lesions. Stent grafting of the truncal artery is a valuable therapeutic alternative to surgical repair, especially in patients considered to be a high risk for a conventional thoracotomy.

• Journal of Chest Surgery
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• v.7 no.1
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• pp.109-116
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• 1974

Eleven cases of peripheral arterial injuries treated at Korea University Woo Sok Hospital during these 3 years and 3 months from Feb. 1971Eleven cases of peripheral arterial injuries treated at Korea University Woo Sok Hospital during these 3 years and 3 months from Feb. 1971 to May 1974 were reviewed. Common causes of injuries were stab wound, automobile accidents and iatrogenic injuries during operation. Of the 11 arterial injuries 3 were femoral artery which` was the commonest in frequency and the next was 2 cases of brachial artery. The most frequent type of injury was transection. Laceration, contusion and spasm was also recognized. The need to operate immediately following an injury was emphasized. Operative procedures were end to end anastomosis and saphenous vein graft in 5 and 2 cases, respectively. Other cases were undergone multiple suture ligature due to staphyllococcal infection, insertion of polyethylene catheter, and lateral suture after thromboendarterectomy. Fractures and extensive soft tissue damage associated with arterial injuries with widespread destruction of the collateral circulation aggravated the situation and complicated the amputation of lower extremity in 4 cases. The factors influencing the amputation were time lag, presence of associated injuries and complications.[KTCS 1974;1:109-116] Common causes of injuries were stab wound, automobile accidents and iatrogenic injuries during operation. Of the 11 arterial injuries 3 were femoral artery which` was the commonest in frequency and the next was 2 cases of brachial artery. The most frequent type of injury was transection. Laceration, contusion and spasm was also recognized. The need to operate immediately following an injury was emphasized. Operative procedures were end to end anastomosis and saphenous vein graft in 5 and 2 cases, respectively. Other cases were undergone multiple suture ligature due to staphyllococcal infection, insertion of polyethylene catheter, and lateral suture after thromboendarterectomy. Fractures and extensive soft tissue damage associated with arterial injuries with widespread destruction of the collateral circulation aggravated the situation and complicated the amputation of lower extremity in 4 cases. The factors influencing the amputation were time lag, presence of associated injuries and complications.

• Journal of Trauma and Injury
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• v.28 no.4
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• pp.292-294
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• 2015

Central venous catheterization is one of the most important procedures for initial resuscitation of hemodynamically unstable patients including multiple trauma patients. Inadvertent arterial placement of the large caliber central venous catheter can results in resuscitation failure as well as unnecessary invasive treatment. Here, we report an arterial puncture during central venous catheterization which may lead to inadvertent arterial catheterization. We recommend that arterial catheterization should be evaluated before dilator insertion during Seldinger's method. Ultrasound can help in preventing the inadvertent arterial catheterization of central venous catheter.

• 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.

• Journal of Society of Preventive Korean Medicine
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• v.12 no.3
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• pp.67-80
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• 2008

The pathobiologic process of arterial stenosis following balloon angioplasty continues to be an enigmatic problem in clinical settings. This study investigates the ability of demethoxycurcumin, a curcuminoid isolated from Radix Curcumae, to attenuate balloon injury-induced neointima(NI) formation in the rat carotid artery. It was found that demethoxycurcumin induced inducible heme oxygenase(HO-1) expression and inhibited dose-dependently cellular proliferation in rat vascular smooth muscle cells. Perivascular application of demethoxycurcumin immediately following injury significantly reduced NI area and NI thickness 2 weeks post-injury. Interestingly, treatment with tin-protoporphyrin IX, a HO inhibitor, reversed the effects of demethoxycurcumin on NI formation. These results implicate demethoxycurcumin as a potent new therapeutic agent that is capable of reducing post-angioplasty arterial stenosis through induction of the HO-1 expression.

• Journal of Trauma and Injury
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• v.37 no.2
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• pp.158-160
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• 2024

Arterial thoracic outlet syndrome (TOS) resulting from thoracic trauma is an exceedingly rare condition, typically caused by a fracture of the first rib or clavicle. In this report, the author presents a case of traumatic arterial TOS precipitated by multiple left rib fractures, notably excluding the first rib, following a fall from a 2-m high stepladder. The patient was treated successfully with first rib resection via a transaxillary approach, and the postoperative course was uneventful. The literature includes no known reports of traumatic arterial TOS in patients with multiple fractures that spare the first rib, making this the first documented case of its kind. In this instance, the patient sustained fractures to the fourth and fifth ribs. The TOS was likely not a direct result of the multiple rib fractures, which were located some distance from the thoracic outlet. Rather, it is hypothesized that the trauma from these fractures caused a soft tissue injury within the thoracic outlet, which ultimately led to the development of TOS.

• 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.