• Journal of Veterinary Clinics
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• v.28 no.5
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• pp.526-529
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• 2011

The brachiocephalic trunk (Bct) branches from the aortic arch (Aa) and consists, in ruminants, of the common trunk of the left subclavian artery (LSb), the bicarotid artery (Bc) or left and right common carotid artery (LCc and RCc), and the right subclavian artery (RSb). This pattern differs from the primitive mammalian Aa pattern due to the fact that the analogs of the LCc and LSb migrate cranially and merge with the common trunk of the RCc and RSb in the embryonic stage. A Bct having a septal remnant that consisted of the tunica media was observed in a female Korean water deer (Hydropotes inermis argyropus), which was deemed to have resulted from an incomplete merging of the vessel walls between a carnivoran-type Bct and an incomplete LSb. This is the first report of an abnormal Bct in a Korean water deer.

• Journal of Veterinary Science
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• v.25 no.2
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• pp.32.1-32.14
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• 2024

Background: Aortic arch (AA) branching patterns vary among different mammalian species. Most previous studies have focused on dogs, whereas those on raccoon dogs remain unexplored. Objectives: The objective of this study was to describe the AA branching pattern in raccoon dogs and compare their morphological features with those of other carnivores. Methods: We prepared silicone cast specimens from a total of 36 raccoon dog carcasses via retrograde injection through the abdominal aorta. The brachiocephalic trunk (BCT) branching patterns were classified based on the relationship between the left and right common carotid arteries. The subclavian artery (SB) branching pattern was examined based on the order of the four major branches: the vertebral artery (VT), costocervical trunk (CCT), superficial cervical artery (SC), and internal thoracic artery (IT). Results: In most cases (88.6%), the BCT branched off from the left common carotid artery and terminated in the right common carotid and right subclavian arteries. In the remaining cases (11.4%), the BCT formed a bicarotid trunk. The SB exhibited various branching patterns, with 26 observed types. Based on the branching order of the four major branches, we identified the main branching pattern, in which the VT branched first (98.6%), the CCT branched second (81.9%), the SC branched third (62.5%), and the IT branched fourth (52.8%). Conclusions: The AA branching pattern in raccoon dogs exhibited various branching patterns with both similarities and differences compared to other carnivores.

• Journal of Korean Neurosurgical Society
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• v.44 no.2
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• pp.78-83
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• 2008

Objective : To understand the anatomic characteristics of the aortic arch (AA) and its major branches to build a foundation toward performing endovascular surgery safely. Methods : A total of 25 formalin fixed Korean adult cadavers were used. The authors investigated : anatomical variations of the AA and its major branches; curvature of the AA; distance from the mid-vertebrae line to the origin of the major branches; distances from the origin of the major branches of AA to the origin of its distal branches; and the angle of the three major branches, the brachiocephalic trunk (BCT), the left common carotid artery (LCCA) and the left subclavian artery (LSCA) arising from AA. Results : The three major branches directly originated from AA in 21 (84%) of the cadavers. In two (8%) of remaining four cadavers. orifice of LCCA was slightly above the stem of BCT. In remaining two (8%) cadavers, the left vertebral artery (LVA) was directly originated from AA. Average angle of AA curvature to the coronal plane was 62.2 degrees. BCT originated 0.92 mm on the right of the mid-vertebrae line. LCCA and LSCA originated from 12.3 mm and 22.8 mm on the left of the mid-vertebrae line. Mean distance from the origin of the BCT to the origin of the RCCA was 32.5 mm. Mean distance from the origin of the LSCA to the origin of the LVA was 33.8 mm. Average angles at which the major branches arise from the AA were 65.3, 46.9 and 63.8 degrees. Conclusion : This study may provides a basic anatomical information to catheterize AA and its branches for safely performing endovascular surgery.

• Journal of Chest Surgery
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• v.55 no.6
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• pp.478-481
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• 2022

The innominate artery is an uncommon site for an aneurysm, and tracheal compression caused by an innominate artery aneurysm is a very rare occurrence. An innominate artery aneurysm can cause catastrophic complications, such as rupture or thromboembolism. The most common surgical approach for open repair is median sternotomy with cardiopulmonary bypass, but cerebral ischemic injury and thromboembolism can occur during surgery. We present the case of a male patient who had an isolated giant innominate artery aneurysm causing tracheal compression, which was successfully managed by surgical repair.

• Journal of Chest Surgery
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• v.36 no.1
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• pp.30-34
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• 2003

As classical acute aortic dissection, atherosclerotic penetrating ulcers and intramural hematoma have different pathophysiology and natural history, treatment strategy should be different and, therefore, accurate differential diagnosis is necessary. However, these three aortic diseases may be indistinguishable by clinical observation and even by various diagnostic modalities such as cardiac echocardiography, CT and MRI. The patients was a 71-year-old female with chief complaints of anterior chest pain, nausea and vomiting which occurred suddenly 3 days before admission. CT angiographic with 3 dimensional reconstruction shows intramural hematoma in ascending aorta, aortic arch, descending thoracic aorta and right brachiocephalic trunk, heompericardium, and blood in mediastinum and both pleural cavities. The CT angiographic finding of focal out-bulging in the ascending thoracic aorta was diagnosed as penetrating atherosclerotic ulcer. The patient underwent emergency operation under a preoperative diagnosis of penetrating atherosclerotic ulcer with a sign of aortic rupture. In the intraoperative findings, however, intimal tear was seen in the anterior portion of the ascending aorta about 1cm below the brachiocephalic trunk and falselumen appeared after hematoma was removed from the layer of tunica media. We report a case of type A aortic dissection which mimicked clinical and diagnostic features of penetrating atherosclerotic ulcer.

• Journal of Chest Surgery
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• v.42 no.3
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• pp.375-379
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• 2009

Difficulty in exposing anastomotic sites is a frequently encountered problem during surgical repair of a distal aortic arch aneurysm via median sternotomy or lateral thoracotomy. Endovascular repair has th limitation that it usually requires surgical rerouting of some of the brachiocephalic branches in order to get sufficient length for proximal fixation of the stent-graft. To take advantage of each approach, we fixed the distal end of the prosthetic graft by means of a pre-mounted metallic stent instead of performing conventional surgical anastomosis during the repair of distal arch aneurysms with using median sternotomy and hypothermic circulatory arrest. We report here on our experience with such 3 patients.

• Journal of Chest Surgery
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• v.40 no.12
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• pp.871-873
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• 2007

A rupture of an innominate artery caused by blunt trauma is relatively rare because this artery is short and protected by the chest bony cage. This report describes a 25-year-old man who suffered a traffic accident, that resulted in an innominate artery rupture, which was detected by a chest computed tomogram and angiogram. This patient underwent urgent surgery through a right clavicular incision and median sternotomy without a cardiopulmonary bypass due to multiple injuries. An approximately 3 cm sized injury was found from the innominate artery to the proximal right subclavian artery and the origin of the common carotid artery. The injured lesion was repaired with a saphenous vein patch. After surgery, he was discharged from hospital without complications.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.3
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• pp.370-374
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• 2018

Subclavian steal syndrome is a type of obstructive artery disease caused by severe stenosis and occlusion of a left proximal subclavian artery or brachiocephalic trunk. The resulting vertebro-basilar insufficiency symptoms are due to retrograde blood flow from the contralateral vertebral and basilar arteries into the low-pressure ipsilateral upper extremity vessels. For that reason, patients usually experience dizziness or arm ischemic symptoms. Neurointervention is an effective treatment for ischemic stroke, including the subclavian artery stenosis. This paper reports a patient with subclavian steal syndrome who had a vertebral artery Doppler waveform change in duplex sonography and a 12 mmHg difference in interarm systolic blood pressure. A stenotic lesion of the subclavian artery was treated effectively by inserting a precise stent. The follow up examination showed that the vertebral artery Doppler waveform change disappeared and recovered and that the 12 mmHg difference in interarm systolic blood pressure decreased to 5 mmHg after treatment.

• Journal of the Korean Society for Precision Engineering
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• v.24 no.10
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• pp.123-130
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• 2007

Hypoplastic left heart syndrome is currently the most lethal cardiac malformation of the newborn infant. Survival following a Norwood operation depends on the balance between systemic and pulmonary blood flow, which is highly dependent on the fluid dynamics through the interposition shunt between the two circulations. The purpose of this study is an optimization of the systemic-to-pulmonary artery shunt. In this study, We used computational fluid dynamic(CFD) models to determine the velocity profile in a systemic-to-pulmonary artery shunt and suggested a simplified method of calculating the blood flow in the shunt based on Ultrasound systems. We analyzed the flow characteristic variations and oscillatory shear index(OSI) due to the anastomosis angle and shunt diameter changing. Four different CFD models were constructed with the shunt sizes ranging from 3 to 3.5mm. The angle between the brachiocephalic trunk(BCT) and the shunt were $30^{\circ}$ and $45^{\circ}$, respectively. When the diameter is 3.0 mm, the oscillatory shear index decreased by 1.2% at $30^{\circ}$ as opposed to at $45^{\circ}$. When the diameter is 3.5 mm, it increased by 18% more at $30^{\circ}$ as opposed to at $45^{\circ}$. When the joint angle is $30^{\circ}$ and the diameter is 3.0 mm, the oscillatory shear index decreased by 4.1% in comparison with the 3.5 mm diameter. When the angle is $45^{\circ}$ and the diameter is 3.0 mm, the index increased by 14.6% in comparison with the 3.5 mm diameter.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.6
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• pp.636-640
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• 2018

Objective: Central venous catheter (CVC) misplacement can result in incorrect readings of the central venous pressure, vascular erosion, and intravascular thrombosis. Several studies have examined the correlation between the guidewire J-tip direction and misplacement rate. This study examined whether the guidewire J-tip direction (cephalad vs. caudad) affects the misplacement rate in right subclavian venous catheterization. Methods: This prospective randomized controlled study was conducted between February 2016 and February 2017. The subjects were divided into two groups (cephalad group vs. caudad group) and the misplacement rate was compared according to guidewire J-tip direction in each group. Results: Of 100 patients, the cephalad and caudad groups contained 50 patients each. The age, sex, and operator experience were similar in the two groups. In the cephalad group, misplacement of CVC insertion into the ipsilateral internal jugular vein occurred in two cases. In the caudad group, misplacement of CVC insertion into the contralateral subclavian vein occurred in one case, with loop formation in the brachiocephalic trunk in one case. Guidewire J-tip direction showed no significant correlation with CVC misplacement. Conclusion: The guidewire J-tip direction does not influence the rate of misplacement.