• Journal of Chest Surgery
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• 제21권1호
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• pp.143-147
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• 1988

Congenital coronary arteriovenous fistula is a communication of a coronary artery with one of the atria, ventricles, the coronary sinus, the superior vena cava, or the pulmonary artery. We had a successful surgical experience with 63 year-old-female patient who complained substernal chest pain on exertion for 8 years. On auscultation, a continuous murmur was heard at the left second to third intercostal space along the left sternal border. The right cardiac catheterization was revealed to 4% oxygen step up between right ventricle to main pulmonary artery, and Qp/Qs was 1.3:1. The selective coronary arteriography showed markedly tortuous dilated vessel which originated from left coronary artery draining into the main pulmonary artery. The operation performed to mid portion of tortuous and dilated fistula by multiple ligation with 3-0 Mersilene and suture ligation with pledgetted 3-0 Prolene on distal draining site, Postoperative course were uneventful without any symptoms and complications.

• Journal of Korean Neurosurgical Society
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• 제67권3호
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• pp.308-314
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• 2024

Vein of Galen aneurysmal malformation is one of important pediatric arteriovenous shunt diseases, especially among neonates and infants. Here, early history of the disease identification, basic pathoanatomy with a focus on the embryonic median prosencephalic vein, classification and differential diagnoses, and recent genetic studies are reviewed.

• 디지털융복합연구
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• 제18권2호
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• pp.447-453
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• 2020

본 연구는 동정맥루 및 혈관성형술 환자를 위한 정보제공프로그램을 개발하고 수술실 간호사가 제공하는 정보제공프로그램의 효과를 알아보기 위한 비동등성 대조군 전후설계를 이용하였다. 연구대상은 동정맥루나 혈관성형술을 위해 내원한 환자를 대상으로 실험군과 대조군 각각 40명을 편의표출 하였다. 정보제공프로그램은 수술당일, 수술 후 각각 1회기씩 총 2회기로 제공되며 수술에 대한 정보제공, 수술 후 통증관리, 투석혈관 관리, 응급상황 대처, 합병증 관리방법으로 구성되었다. 자료분석은 SPSS/WIN 21.0을 이용하여 사전 동질성 검증은 χ²-test 와 t-test, 실험군과 대조군간의 불안, 자기효능감에 대한 차이는 t-test를 이용하였다. 연구결과, 수술실 간호사의 정보제공프로그램을 제공 받은 실험군의 기질불안과 상태불안은 통계적으로 유의하게 감소하였고 자기효능감이 통계적으로 유의하게 증가하였다. 본 연구결과 수술실 간호사가 제공하는 정보제공프로그램이 동정맥루 및 혈관성형술 환자의 불안을 감소시키고 자기효능감을 증진시켜 말기 신질환자의 수술 후 자기 관리능력이 향상되어 투석로에 대한 합병증 예방과 자가간호 수준 향상에 기여할 것으로 사료된다.

• Journal of Chest Surgery
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• 제27권9호
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• pp.764-769
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• 1994

From november, 1985 to May, 1993, 222 arteriovenous fistulae were made in 201 patients with chronic renal failure. Among them, a total of 183 arteriovenous fistulae in 173 patients were reviewed to evaluate the factors influencing patency rate of the vascular access. The results were revealed as follows: There were 102 men and 71 women,aged 10 to 76 years [mean = 45.7 years]. Sixteen patients of them had previous shunts. The procedures included establishment of 214 radiocephalic or brachioocephalic fistulae, 203 side to end, 9 side to side, 2 end to end, 2 autologous saphenous vein grafts, 6 Gore-Tex grafts. There were 28 early shunt failures[12%] due to use of 23 inadequate veins and 5 thrombosis.There were 32 late complications[14%]; 19 thrombosis, 4 aneurysm, 4 venous hypertension, 3 steal syndrome, 2 infections. There were 32 diabetic patients [17 %]. No significant differences in graft patency were noted between diabetic and nondiabetic individuals. There were no significant difference in graft patency between male and female. Overall shunt patency in 183 cases with chronic renal failure was 96% at I month, 95% at 3 months, 93% at I year, 91% at 2 years, 84% at 3 years, 56% at 5years.This Study showed that early postoperative thrombosis and diabetic vasculopathy were most causes of the vascular access failure and suggested that prevention of thrombi and well control of diabetes mellitus were most important to enhance patency rates of the vascular access.

• Journal of Chest Surgery
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• 제35권5호
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• pp.369-374
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• 2002

배경: 혈액 투석을 위한 투석로의 확보는 신부전증 환자의 치료에 필수적인 요소이지만, 여러 요소에 의해 투석로의 확보가 점점 어려워지고 있어서 인조 혈관의 사용 빈도가 증가하고 있는 추세이다. 저자들은 동정맥루 조성술을 시행받은 환자를 대상으로 자가 혈관 및 인조 혈관의 개통률의 차이와 인조 혈관의 종류에 따른 개통률의 차이, 동반 질환이 동정맥루 개존에 미치는 영향 및 이와 연관하여 재수술이 필요했던 경우 등을 분석하고자 하였다. 대상 및 방법: 1996년 1월부터 2000년 12월가지 고려대학교 구로병원 흥부외과에서 혈액투석을 위해 동정맥루 조성술을 시행한 186명의 환자를 대상으로 후향적으로 분석하였다. 대상 환자의 남녀 비는 99 : 87로 남자가 다소 많았고, 평균 연령은 54.37$\pm$12.89세이었으며, 대상 환자에서 시행한 전체 수술은 292건, 이 중 자가 혈관과 인조 혈관을 이용한 동정맥루 조성술이 각각 156과 116건이었다. 결과: 동정맥루의 1년 및 5년 개통률은 자가 혈관의 경우 각각 92.78$\pm$2.35%, 39.03$\pm$9.08%이었고, 인조 혈관의 경우는 각각 96.09$\pm$2.22%, 16.45$\pm$10.15%이었으나 두 군 사이의 통계적 유의성은 없었다. 신부전증과 동반된 질환 중 가장 많은 빈도를 보인 고혈압과 당뇨, 그리고 두 가지를 모두 가지고 있던 환자의 동정맥루 평균 개통 기간은 각각 52.99$\pm$2.05개월, 52.70$\pm$4.24개월, 53.49$\pm$2.33개월로 이러한 질환을 가지지 않는 환자의 평균개통 기간인 48.12$\pm$2.05개월과 비교해 각 군 사이의 통계적 유의성은 없었고, 수술에 사용된 여러 종류의 인조 혈관들의 1년 및 3년 개통률 사이의 비교에서도 서로 간의 통계적 유의성은 없었다. 수술 후 합병증 및 재수술이 필요했던 이유는 주로 혈전이나 혈류 감소, 동맥류 형성 및 인조 혈관 감염 등이었고, 재수술이나 3차 수술 후의 개통률도 첫수술과 비교하여 통계적 유의성은 없었다. 절론 자가 혈관에 비해 인조 혈관을 이용한 동정맥루의 개통률도 우수하였으나, 사용된 인조 철관의 종류에 따른 개통률의 차이를 비교하기 위해서는 인조 혈관에 따른 더 많은 증례가 축적되어야 할 것이다. 한편 동반 질환은 동정맥루 개통률에 영향을 미치지 않았다.

• International Journal of Internet, Broadcasting and Communication
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• 제12권4호
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• pp.188-195
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• 2020

Purpose: This study aimed to review the recent scientific literature regarding nursing care of arteriovenous fistula (AVF) for the patients with Chronic Renal Failure (CRF) undergoing hemodialysis. Methods: An integrative review was conducted and articles were searched from Cochrane library, Medline, PubMed, Science direct and CINAHL databases by using the terms "nursing", 'Chronic Renal Failure', 'Haemodialysis', renal failure', 'or 'AV Fistula' nursing care', 'self-care'. The inclusion criteria were articles published in English in the year of 2015-2020 with availability of free full text. Reviewed data were carefully analyzed and charted regard to the nursing care of the patient with AVF. Results: 12 articles papers met the inclusion criteria. Three themes were derived from the data: (a) Intervention (b). Patient and nurse education (c) KPA Assessment of (Knowledge, Practice and Attitude) Conclusions: This review indicates the challenges that nursing care of AVF patients undergoing hemodialysis. The identified themes can be used in the development of more effective educational- programs. Future studies should focus on the development and evaluation of educational programs that include these selected themes.

• 대한영상의학회지
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• 제84권1호
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• pp.226-239
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• 2023

목적 뇌동정맥루(arteriovenous fistula; 이하 AVF), 뇌동정맥기형(arteriovenous malformation; 이하 AVM), 경동맥해면정맥동루(carotid-cavernous sinus fistula; 이하 CCF) 등 뇌동정맥단락을 진단하는 데 있어서, T2 강조영상(T2-weighted imaging; 이하 T2WI)과 자화율 강조영상(susceptibility-weighted imaging; 이하 SWI)의 민감도를 비교하고, 단일 에코(single-echo) SWI(이하 s-SWI)와 다중 에코(multi-echo) SWI (이하 m-SWI)의 전반적인 영상 질을 비교하고자 하였다. 대상과 방법 2016년부터 2021년까지 뇌혈관조영술로 입증된 뇌동정맥단락을 조사하였다. 뇌동정맥단락에 대한 T2WI와 SWI의 민감도를 McNemar's Test를 이용하여 비교하였다. s-SWI와 m-SWI의 영상 질을 나쁨, 보통, 좋음으로 분류하고 Fisher's exact test를 이용하여 그 비율을 비교하였다. 결과 총 24명의 환자(중위 연령: 61세, 여성: 12명, 남성: 12명)가 연구에 포함되었다. 그중 4명은 s-SWI와 m-SWI 두 가지의 SWI로, 나머지 20명은 이 중 한 가지의 SWI로 검사하였다. 10명은 AVF, 11명은 AVM, 3명은 CCF로 진단되었고, 이와 같은 뇌동정맥단락에 대해, SWI는 T2WI 보다 유의하게 높은 민감도를 보였다(82.1% vs. 53.6%, p = 0.013). m-SWI는 s-SWI 보다 좋은 영상 질의 비율이 유의하게 높았다(83.3% vs. 25.0%, p = 0.009). 결론 SWI는 T2WI 보다 뇌동정맥단락을 더 민감하게 진단해 낼 수 있었으며, m-SWI는 s-SWI보다 혈관질환을 평가하는데 더 좋은 영상 질을 보였다.

• Journal of Korean Neurosurgical Society
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• 제44권6호
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• pp.364-369
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• 2008

Objective : The aim of this study was to evaluate the efficacy of endovascular therapy as a primary treatment for spinal dural arteriovenous fistula (DAVF). Methods : The authors reviewed 18 patients with spinal DAVFs for whom endovascular therapy was considered as an initial treatment at a single institute between 1993 and 2006. NBCA embolization was considered the primary treatment of choice, with surgery reserved for patients in whom endovascular treatment failed. Results : Surgery was performed as the primary treatment in one patient because the anterior spinal artery originated from the same arterial pedicle as the artery feeding the fistula. Embolization was used as the primary treatment modality in 17 patients. with an initial success rate of 82.4%. Two patients with incomplete embolization had to undergo surgery. One patient underwent multiple embolizations, which failed to completely occlude the fistula but relieved the patient's symptoms. Spinal DAVF recurred in two patients (one collateral development and one recanalization) during the follow-up period. The collateral development was obliterated by repeated embolization, but the patient with recanalization refused further treatment. The overall clinical status improved in 15 patients (83.3%) during the follow-up period. Conclusion : Endovascular therapy can be successfully used as a primary treatment for the majority of patients with spinal DAVFs. Although it is difficult to perform in some patients, endovascular embolization should be the primary treatment of choice for spinal DAVF.

• Journal of Trauma and Injury
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• 제28권4호
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• pp.262-265
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• 2015

An arteriovenous fistula (AVF) from the renal artery following a penetrating abdominal trauma is not common. We report the case of a 19-year-old male who presented with a knife stab wound in the right upper quadrant. Due to unstable vital signs and to the protrusion of the mesentery through the stab wound, providing definite evidence of peritoneal violation, an emergent exploratory laparotomy was carried out. There were injuries at the proximal transverse mesocolon and the second portion of the duodenum, with bile leakage. There was also a mild amount of retroperitoneal hematoma near the right kidney, without signs of expansion or pulsation. The mesocolon and the duodenum were repaired. After the operation, abdominal computerized tomography (CT) was performed, which revealed contrast from the right renal artery shunting directly into the vena cava. Transcatheter arterial embolization with a coil and vascular plug was performed, and the fistula was repaired. The patient recovered completely and was discharged without complication. For further and thorough evaluation of an abdominal trauma, especially one involving the retroperitoneum, a CT scan is recommended, when possible, either prior to surgery or after surgery when the patient is stabile. Furthermore, a lateral retroperitoneal hematoma and an AVF after a penetrating trauma may not always require exploration. Sometimes, it may be safely treated non-operatively or with embolization.

• Journal of Korean Neurosurgical Society
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• 제44권2호
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• pp.101-104
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• 2008

Intracranial pial arteriovenous fistula (AVF) is a rare cerebrovascular lesion that has only recently been recognized as a distinct pathological entity. A 41-year-old woman (Patient 1) presented with the sudden development of an altered mental state. Brain CT showed an acute subdural hematoma. A red sylvian vein was found intraoperatively. A pial AVF was revealed on postoperative angiography, and surgical disconnection of the AVF was performed. A 10-year-old boy (Patient 2) presented with a 10-day history of paraparesis and urinary incontinence. Brain, spinal MRI and angiography revealed an intracranial pial AVF and a spinal perimedullary AVF. Endovascular embolization was performed for both lesions. The AVFs were completely obliterated in both patients. On follow-up, patient 1 reported having no difficulty in performing activities of daily living. Patient 2 is currently able to walk without assistance and voids into a diaper. Intracranial pial AVF is a rare disease entity that can be treated with surgical disconnection or endovascular embolization. It is important for the appropriate treatment strategy to be selected on the basis of patient-specific and lesion-specific factors in order to achieve good outcomes.