• 대한영상의학회지
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• 제85권1호
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• pp.235-239
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• 2024

장골동맥-장골정맥루는 드문 질환으로 일으키는 주요 요인으로는 선천성 이상 발생, 의인성, 외상 등이 있다. 그중에서도 May-Thurner 증후군과 동반된 장골동맥-장골정맥루에 대한 문헌은 매우 드물다. 이에 따라, 저자들은 80세 남성에서 발생한 May-Thurner 증후군과 동반된 장골동맥-장골정맥루의 증례를 보고하고자 한다. 컴퓨터단층촬영 및 혈관조영술을 통해 매우 넓은 범위의 장골동맥-장골정맥루를 확인하였고 이에 대해 다양한 크기의 색전용 코일 및 1400-2000 ㎛ 크기의 젤라틴 입자를 사용하여 색전술을 시행하였다. 색전술 이후, 추적을 위해 시행한 복부-골반 컴퓨터단층촬영에서 왼쪽 다리의 부종이 개선됨을 확인하였다.

• Journal of Chest Surgery
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• 제37권2호
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• pp.154-159
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• 2004

만성 신부전증 환자에서 장기간 원활한 혈액투석을 위해서는 충분한 혈류가 유지되는 동정맥루가 반드시 필요하다. 본원에서는 최초의 동정맥루조성술로서 손목보다 원위부인 anatomical snuffbox에서 동정맥루를 시행하고 있다. Snuffbox fistula의 개존율과 합병증, 동정맥루 폐쇄의 위험요인, 재수술의 종류 등을 알아보고자 본 연구를 시행하였다. 대상 및 방법: 1994년 6월부터 2001년 12월까지 146건의 snuffbox fistula를 시행하였다. 그중 추적관찰이 불가능한 6예를 제외한 140예를 대상으로 의무기록을 토대로 후향적 분석을 하였다. 환자의 평균 나이는 52$\pm$15세(17∼79세)였고 남 : 녀 비는 80 : 60이었다. 당뇨병이 동반된 경우는 47예, 고혈압을 동반한 경우는 101예였다. 술 전 혈액검사 상 creatinine과 potassium 수치는 각각 9.09$\pm$3.68 mg/dL (2.55∼20.09 mg/dL), 4.7$\pm$0.9 mmol/L (2.3∼8.1 mmol/L)였고 수술부위는 113예에서 좌측 손에 시행하였고 27예에서는 우측 손에 시행하였다. 결과: 수술 후 평균 추적기간은 41.8$\pm$31.0개월(0.2∼108.0개월)이었으며 추적기간 중 35명의 환자에서 동정맥루의 폐쇄가 발생하였고 이들의 평균 개존기간은 9.8$\pm$10.1개월(0.1∼40.4개월)이었다. 전체 환자의 1개월, 1년, 2년, 3년, 5년 개존율은 각각 92.8, 80.2, 73.8, 71.3, 69.6%로 확인되었다. 동정맥루의 폐쇄에 기여하는 위험요인으로는 우측 snuffbox fistula (p-value=0.045), 고령(p-value=0.048)으로 확인되었다. 수술 후 합병증에는 정맥벽의 비후로 인한 동정맥루폐쇄가 24건, 혈전증이 9건, 혈관문합부협착으로 인한 폐쇄가 3건, 정맥 고혈압이 2건 발생하였다 1차 수술 이후에 37명의 환자에서 최소한 1회 이상의 재수술이 시행되었으며 총 재수술건수는 86건이었다 결론: 본원에서 시행한 snuffbox fistula는 비교적 양호한 개존율과 낮은 합병증 발생률을 보였다. 따라서 혈액투석이 필요한 만성 신부전증 환자에서 1차 동정맥루조성술을 anatomical snuffbox에서 할 수 있다면 만성 신부전증 환자들에게 도움이 될 것으로 생각된다.

• Journal of Chest Surgery
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• 제15권1호
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• pp.112-117
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• 1982

Communications of coronary arteries with the cardiac cavities have first time been described by Krause in 1865 in a case of an accessory artery draining into the pulmonary artery and later Cayla in a case of a right coronary artery entering the right ventricle. The initial cases have been found accidentally at autopsies, however In recent years after the Introduction of angiography and coronary arteriography, the malformation Is diagnosed during life and is corrected surgically. These conditions are unusual entitles since the advent of angiography they are being diagnosed with increasing frequency. Three patients who had surgical correction of coronary-cardiac chamber fistula at our hospital are presented. In the first case and second case, coronary arteriovenous fistula was corrected horizontal mattress suture ligation with pladget under the cardiopulmonary bypass and third case was corrected double ligation with cardiopulmonary bypass standby. The postoperative courses were uneventful. They discharged without any fistula related complica-tions.

• 대한기관식도과학회지
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• 제8권1호
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• pp.57-60
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• 2002

Tracheoinnominate artery fistula is a rare but a catastrophic complication after tracheostomy or tracheal reconstruction. We experienced two cases of tracheoinnominate artery fistula after tracheal reconstruction and tracheostomy. The first patient was a 11 year old girl with cerebral arteriovenous malformation who maintained tracheostomy for 6 months before undergoing tracheal reconstruction. Three days after tracheal reconstruction, massive bleeding occurred through the intubation tube. She underwent emergency reoperation of repair the innominate artery with 5-0 Prolene and reconstruction of trachea. She died of bleeding 3 days after the reoperation. The second patient was a 68 year old man who underwent right upper lobectomy due to lung cancer. After operarion MRSA Pneumonia was developed and tracheostomy was performed 10 days after intubation. Twelve days after tracheostomy, massive bleeding occurred and emergency operation of ligation of innominate artery was performed. He died of sepsis 7 days after reoperation.

• Journal of Chest Surgery
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• 제1권1호
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• pp.75-80
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• 1968

This is a case report of traumatic arterial injuries with false aneurysm & arterio-venous fistula treated surgically at National Medical Center. 3 cases were A-V fistula and 2 cases only false aneurysm. Physiological disturbance were produced by only arteriovenous fistula; In one case ulceration of mid. 1/3 tibia due to diminished arterial flow and in 2 cases left ventricular hypertrophy, in which cases Bramhan`s sign were positive. Removing out the fistulous lesions and aneurysm, all of the arterial continuities has been reconstructed by means of end to end anastomosis, Dacron graft and vein graft, veins were managed by ligations of both ends in two cases and end to end anostomosis in one case. Immediate post operative results were good, and two cases were followed for 10 months.

• Journal of Chest Surgery
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• 제21권4호
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• pp.716-720
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• 1988

Since Krause first described coronary arteriovenous fistula in 1865, there have been nearly 300 additional patients with this malformation reported in the literature. Increasing numbers of patients with this anomaly are being recognized each year resulting from the widespread use of cardiac catheterization and selective coronary arteriography in the evaluation of a variety of cardiac problems. A 9 month old male was admitted with the chief complaint of cardiac murmur and frequent URI and diagnosed as coronary A-V fistula at the distal portion of left anterior descending coronary artery to the apex of the right ventricle by cardiac catheterization and aortography. On the operative field, the left anterior descending coronary was markedly dilated about 1.5 cm in diameter from the aorta to the apex of the heart. The fistula opening was closed with 5-0 Prolene continuously under cardiopulmonary bypass and moderate hypothermia[28*C]. Postoperative course was uneventful and the patient was discharged without problem.

• Journal of Korean Neurosurgical Society
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• 제55권3호
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• pp.152-155
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• 2014

Dural ateriovenous fistula (DAVF) at the craniocervical junction is rare. We report a patient presenting with brainstem dysfunction as an uncommon onset. Brainstem lesion was suggested by magnetic resonance image study. Angiogram revealed a DAVF at a high cervical segment supplied by the meningeal branch of the right vertebral artery, with ascending and descending venous drainage. Complete obliteration of the fistula was achieved via transarterial Onyx embolization. Clinical cure was achieved in the follow-up period; meanwhile, imaging abnormalities of this case disappeared. Accordingly, we hypothesize that a brainstem lesion of this case was caused by craniocervical DAVF, which induced venous hypertension. Thus, venous drainage patterns should be paid attention to because they are important for diagnosis and theraputic strategy.

• 대한두개안면성형외과학회지
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• 제11권2호
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• pp.116-119
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• 2010

Purpose: Arteriovenous fistulas that involve the cavernous sinus often produce ophthalmologic symptoms and signs. Transvenous endovascular access is the method of choice for a carotid-cavernous sinus fistula. The superior ophthalmic vein is a safe and reasonable alternative route for the transvenous embolization of carotid-cavernous sinus fistula. We report a case of the embolization of a carotid-cavernous sinus fistula using the superior ophthalmic vein approach. Methods: A 58 year old female had conjunctival congestion, periocular pain and diplopia with a 2 month duration. Diagnostic orbital CT, brain MRI and cerebral angiography revealed a carotid-cavernous sinus fistula. The fistula occlusion was treated by coil embolization using the superior ophthalmic vein approach. Results: The initial presenting symptoms, conjunctival congestion, periocular pain and diplopia, decreased after surgery. Coil embolization via the superior ophthalmic vein approach was difficult because of the venous tortuosity and friability. During the follow up period, the patient was in a good condition without complications. Conclusion: Surgical exposure of the superior ophthalmic vein provides direct venous access to the cavernous sinus as well as an effective and safe treatment approach. The cooperation of the plastic surgeon and interventionist is a factor in successful treatment.

• 대한흉부심장혈관외과학회:학술대회논문집
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• 대한흉부외과학회 1993년도 제25차년차학술대회 및 총회
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• pp.29-29
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• 1993

• Maxillofacial Plastic and Reconstructive Surgery
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• 제11권1호
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• pp.226-230
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• 1989

As carotid-cavernous fistula is the major complication that can be occurred uncommonly after maxillofacial injuries, it is abnormal arteriovenous communication between cavernous sinus and internal carotid artery. Such an arteriovenous communication is most often the result of injuries, but need not be associated with bony fracture. It usually begins soon after an injury, but it may be delayed for as long as several months. It begins undramatically with eye pain, headache and slow protrusion of eye ball. A bruit may be heard above the eye with stethoscope. Close examination will reveal dilatation of superficial veins of the eyelid and forehead and periorbital edema. There will be complete or partial ophthalmoplesia of the affected eye. Compression of the common carotid artery on the ipsilateral side will reduce or obliterate the bruit. The lesion in the cavernous sinus is them demonstrable by angiography.