• The Korean Journal of Pain
• /
• v.8 no.1
• /
• pp.55-59
• /
• 1995

Stellate ganglion block (SGB) is applicated frequently to increase the blood flow and to reduce the pain in head, neck and upper extremity. The effects of SGB are able to be estimated by clinical signs and symptoms of Horner's syndrome, skin warmth, anhydrosis, etc. The effects are also estimated by sympathetic function and the blood flow. Blood flow velocities and pulsatility indices of common carotid,d axillary, brachial and radial artery were measured by Doppler flowmeter after SGB with 1% lidocaine at C6 level. Blood velocities of all arteries were increased and pulsatility indices of all arteries were decreased. This results suggest that SGB increase the blood flow of head and upper extremity and Doppler flowmeter is a good indicator of the effects of SGB.

• Journal of Multimedia Information System
• /
• v.9 no.2
• /
• pp.161-170
• /
• 2022

Under General anesthesia with isoflurane, we insert a chicken's esophageal catheter into the near the left atrium. 1MHz radio wave was added to electrocardiogram electrodes of the esophagus, and the change of impedance (phase) was obtained by amplitude synchronous detection technique. At the same time, a thin tube is surgically inserted into the axillary artery to continuously measure blood pressure. The correlation between impedance (phase) and blood pressure was obtained. Both showed a very high correlation (R²=0.9665). It was also observed the waveform flowing from the left atrium into the left ventricle. When an individual infected with the avian influenza virus develops, the cytokine storms lead to hypotension earlier than the test for antigen-antibody reaction. In order to detect this, in the future, this impedance technique will be useful for screening individuals infected with avian influenza virus by measuring the blood pressure of chickens in cages in a non-contact manner using microwaves.

• Archives of Plastic Surgery
• /
• v.35 no.4
• /
• pp.487-490
• /
• 2008

Purpose: The latissimus dorsi flap and the serratus anterior flap have been used as combined flaps to reconstruct extensive defects. Because these two muscles are usually supplied by the subscapular-thoracodorsal vessels, the two flaps can be based on vascular pedicle that is long and anatomically reliable. In this case, we reported that serratus anterior possessed an anomalous arterial supply totally independent from the subscapular pedicle while raising combined latissimus dorsi and serratus anterior flap. Methods: A 35-year-old male with extensive soft tissue defect in the left perineum and thigh visited. Muscle defects of the medial thigh were observed, and femoral nerve and vessels were exposed. Combined latissimus dorsi and serratus anterior free flap was raised to reconstruct defect. On raising flaps, artery supplying the serratus anterior muscle originated from the axillary artery directly, was lying on the undersurface of the serratus anterior muscle. Results: Because two flap pedicles had no communication and latissimus dorsi muscle was large enough to cover soft tissue defect, we transferred only latissimus dorsi free flap with 1 : 3 meshed skin graft. Patient had limb salvage and satisfactory functional outcome. Conclusion: There are many variations of arterial pedicles of flaps. However, most of these variations remain within known anatomical consistence, thus is an indicator in planning the dissection of the vessels. According to documents, arterial pedicle to the serratus muscle not originated from the thoracodorsal artery is rarely reported, and in most of these cases, the arteries are originated from the subscapular artery. Thus pedicle directly originated from the axillary artery to serratus muscle is a very rare variation in its vascular anatomy.

• Anatomy & Biological Anthropology
• /
• v.31 no.4
• /
• pp.167-170
• /
• 2018

Axillary arch is relatively common variation of muscle in the axilla. There were several attentions on axillary arch due to its anatomical and surgical importance. During educational dissection, a variant muscle was found in right arm of 68-year-old female cadaver. The variation of muscle originated from the lateral edge of the latissimus dorsi muscle as muscular form. And then, it crossed the axillary artery and median nerve as tendinous form. Finally it became wide as muscular form and inserted into the pectoralis major. We reported this variant muscle and discussed its clinical significances.

• Journal of Chest Surgery
• /
• v.40 no.1 s.270
• /
• pp.25-31
• /
• 2007

Background: Cerebral protection is one of the most important procedures during aortic arch surgery. We can minimize neurological complications through short period of total circulatory arrest and resuming of brain perfusion. We evaluated 11 patients who underwent arch replacement using antegrade brain perfusion via right axillary artery. Material and Method: Between July 2004 and July 2006, 11 patients (male 9, female 2) underwent aortic arch replacement with antegrade brain perfusion via right axillary artery. Preoperative diagnosis was listed; 5 type A aortic dissections (5/11, 45.5%), 5 aortic aneurysms (5/11, 45,5%) and 1 type A IMH (intramural hematoma, 1/11, 9%). The mean age at the time of operation was $60.3{\pm}12.8$ years. For antegrade brain perfusion, we performed right axillary artery cannulation in all patients. Retrograde brain perfusion was used briefly during total circulatory arrest. Result: The mean total circulatory arrest time was $31.1{\pm}16.9$ minutes and the mean retrograde brain perfusion time was $21{\pm}17.8$ minutes. Mean antegrade brain perfusion time was $77.9{\pm}17.5\;(43{\sim}101)$ minutes. We had neither operative mortality nor permanent neurological complications. Conclusion: By means of antegrade brain perfusion via right axillary artery, that could lead to decrease circulatory arrest time and minimize damages to severely atheromatous arch vessels, we can expect to reduce neurological complications after aortic arch replacement. Further investigation with iarge patient populations will be required.

• Journal of Korean Neurosurgical Society
• /
• v.52 no.6
• /
• pp.547-550
• /
• 2012

Tracheoinnominate artery fistula is a critical complication of tracheostomy. The most important factors influencing patient outcome are prompt diagnosis, immediate control of bleeding with a patent airway, and emergency operation with or without interruption of the innominate artery. Here, we report a case of tracheoinnominate artery fistula in a 40-year-old woman with cerebrovascular accident who was successfully managed with an aorta-axillary artery bypass.

• Journal of Chest Surgery
• /
• v.26 no.12
• /
• pp.926-933
• /
• 1993

We experienced 20 patients with Takayasu`s disease who required 22 surgical procedures for critical arterial stenoses, aneurym of descending thoracic aorta, and aortic regurgitation from 1986 to 1993.Five patients had type I arteritis, seven patients had type II , seven patients had type III, and one patients had type IV.15 patients were female and 5 patients were male.Patients` ages ranged from 17 to 47 years and mean age was 29.1 years. The surgical procedures were as follows;autotransplantations of kidney[3], aortic valve replacements[2], ascending aorta-bilateral internal carotid artery bypasses[2], unilateral renal artery bypasses[2], bilateral renal artery bypasses[3], replacement of descending thoracic aorta[1], ascending aorta-abdominal aorta bypass[1], ascending aorta-right internal carotid artery bypass[1], ascending aorta-right internal carotid artery and left subclavian artery bypass[1], left common carotid artery-left-subclavian artery bypass[1], pulmonary artery angioplasty[1], left femoro-bilateral axillary bypass[1] and others[2]. There was no hospital death.Mean duration of follow-up was 42.7 months[ranged from 3 to 96 months].There was one late death and late mortality rate is 5.9%.Two patients was underwent second vascular procedures, one after 5 years and the other after 5 months.The other patients have done well after surgery.

• Archives of Reconstructive Microsurgery
• /
• v.11 no.2
• /
• pp.135-140
• /
• 2002

It has been known that latissimus dorsi(LD) myocutaneous flap based on thoracodorsal artery is one of most useful method for microreconstructive surgery and the thoracodorsal artery of this flap has constant vascular anatomy. The retrospective study for anatomy of the thoracodorsal arterial system was performed at operative cases. The aim of this study was to document the anatomical variation of this pedicle clinically. 167 LD flaps were carried out from 1983 to 2002 in our clinic. We found unusual 7(4.2%) cases compared to standard textbooks of anatomy. One case was no vascular supply to LD muscle. In 2(1.2%) cases thoracodorsal artery was a typical branch of the subscapular artery but didn't branch to LD muscle, passed to lower serratus anterior muscle, and at this point, supplied vessel to LD muscle and it's vascular diameter was about 1mm diameter. The thoracodorsal artery arose from the axillary artery in 1.8% of cases(3 cases). One case had less than 1mm vascular diameter but a branch of subscapluar artery. It should be emphasized that we must elevate the latissimus dorsi flap after accurate cognition for the anatomy of thoracodorsal artery because the thoracodorsal arterial system is almost reliable but not uniform in rare cases.

• Archives of Plastic Surgery
• /
• v.49 no.6
• /
• pp.755-759
• /
• 2022

Brachial artery aneurysms are rare diseases that may be caused by infection or trauma. We report a case of a 71-year-old man who presented with a mass in his right antecubital fossa that increased in size slowly over time. Three years ago, the patient underwent ascending and total-arch replacement with artificial vessel graft to treat aortic root and ascending aorta aneurysm. Preoperative physical examination of right upper extremity showed a nonpulsatile mass with normal pulse of axillary, brachial, and radial arteries. The mass was removed and brachial artery reconstruction was done initially using saphenous vein graft. Two months later, the patient revisited with recurrent pseudoaneurysm, involving the bifurcation point of brachial artery. Aneurysm was totally resected and the brachial artery was reconstructed by interposition graft using a bifurcated GORE-TEX artificial vessel graft. The patient healed without complication and no recurrence was observed. Artificial vessel graft is an available option for reconstruction, and revascularization of vessel defect after excision of brachial artery aneurysm may involve bifurcation point.

• Journal of Chest Surgery
• /
• v.11 no.4
• /
• pp.378-384
• /
• 1978

Injuries to the major vessels in the thoracic inlet require early recognition and expedient operative approach. Delayed diagnosis difficulties encountered in the operative exposure of the region are the major factors limiting successful management. This report is a review of 13 patients with vascular injuries to the neck base who were managed at Busan National University Hospital from March 1975 to September 1978 about 3 years and 6 months. The important clinical problems are delineated with emphasis on the technical aspects of operative management. 1] Among 13 cases, 8 cases were male 5 cases were female. 2] Of 28 vascular injuries, subclavian axillary vascular injuries were 22 [78%]. Stab wound was the cause in 70% of these patients. 3] Without extension 7 cases[53.8%] were managed successfully with supraclavicular, and axillary incision. Posterolateral thoracotomy one of extending 4 cases, 2 cases were used right musculoskeletal flap for management of proximal part of the subclavian artery and innominate vessel, 2 cases were used left supraclavicular incision with anterolateral thoracotomy for management of left proximal subclavian artery. One Expired. 4] Repair of vascular injury was accomplished by lateral suture of debridement and end-to end anastomosis in 17[74%]. Autogenous vein was used one for interposition graft. Ligation was required 2 arterial, 6 venous injuries. Of 8 cases which were pulseless preoperatively, 5 cases were able to palpable distal pulse. 5] Post operative complications occurred 50%. Complication of vasular repair was rare. The majority was neurologic deficit (33.3%).