• Journal of Chest Surgery
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• v.50 no.2
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• pp.133-136
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• 2017

A 27-year-old female patient was referred due to an edematous left lower extremity. Both saphenous veins had been ablated with an endovenous laser procedure used to treat varicose veins. Venography revealed that the left common femoral vein had been divided and that thrombosis was present at the site of division. No veins were available around the thighs. The patient was treated using a staged procedure. During the first stage, a ringed polytetrafluoroethylene graft was used to repair the common femoral vein, and an arteriovenous fistula was constructed from the femoral artery to the graft using a short segment of cephalic vein to increase graft patency. The edema was relieved postoperatively and the graft was patent. During the second stage, which was performed 6 months later, the fistula was occluded by coil embolization. The staged procedure described herein provides an alternative for venous reconstruction when autologous vein is unavailable.

• Journal of Chest Surgery
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• v.36 no.5
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• pp.371-374
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• 2003

Atherosclerosis has more than 60% of the causes of arterial occlusive diseases. The abdominal aorta and lower extremity arteries are the most common sites of occlusion. We have treated surgically 2 cases who had intermittent claudication and were diagnosed as simultaneous aortobifemoral and bilateral femoropopliteal obstruction by angiography, but had ineffective results from medical treatment or angioplasty. Simultaneously aortobifemoral bypass using Hemashield Y graft and bilateral femoropopliteal bypass using autologous greater saphenous vein were done. After operations, the symptom disappeared and there were no specific post-operative complications except abdominal wound dehiscence. In postoperative angiography, we had obtained good patency of bypass graft. We are following up patients through the out patient department without recurrence up to 16 months.

• Journal of Chest Surgery
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• v.35 no.3
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• pp.239-243
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• 2002

In this case, a 39 year-old man was admitted with Budd-Chiari syndrome associated with complete superior vena cava(SVC) obstruction causing general edema and hepatic failure. Conservative medical therapy was failed. And after the radiologist failed to invasive procedure of balloon dilatation, we attempted the inferior vena cava to right atrium bypass graft. Operation was done through median sternotomy and extended vertical oblique abdominal incision. A 24 mm Dacron tube was placed from the inferior vena cava just below the left renal vein to the right atrium without using the cardiopulmonary bypass pump. The patient's postoperative course was uneventful without signs of bleeding or any other complications. We used anticoagulants at the postoperative first day. At the postoperative 26th day, we performed abdominal Doppler sonography and we confirmed that the graft patency was good. The patient was discharged with SVC obstructive symptoms but we noticed relief of SVC obstructive symptoms in the course of follow-up.

• Journal of Chest Surgery
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• v.45 no.4
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• pp.257-259
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• 2012

Descending thoracic aorta to femoral artery bypass has been used as a remedial operation after aortic or axillofemoral graft failure or graft infection and other intra-abdominal pathologies not amenable to standard aortofemoral revascularization. It can avoid abdomen approach and has been known as a durable procedure with excellent long-term patency. We reported descending thoracic aorta to femoral artery bypass grafting for primary revascularization in a 55-year-old male with hostile abdominal conditions.

• Archives of Plastic Surgery
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• v.49 no.1
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• pp.80-85
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• 2022

The instep flap and medialis pedis flap are both originate based on the medial plantar artery. The medialis pedis flap is based from the deep branch and the instep flap is based from the superficial branch. To increase the axial rotation, it is acceptable to ligate the lateral plantar artery. However, this can partially affect the blood supply of the plantar metatarsal arch. We restored the blood flow with a vein graft between the posterior tibial artery and the ligated stump. From 2012 to 2020, 12 cases of heel reconstruction, including seven instep flaps and five medialis pedis flaps, were performed with ligation of the lateral plantar artery. The stump of the lateral plantar artery was restored with a vein graft and between the posterior tibial artery and the ligated stump. Patients were followed for 18 months. Long-term results showed the vascular restoration of the lateral plantar artery remained patent demonstrated by doppler ultrasonography. Restoring blood flow to the lateral plantar artery maintains good blood supply to the toes. If the patient in the future develops a chronic degenerative disease, with microvascular complications, bypass surgery can still be performed because of the patency of both branches.

• Journal of Chest Surgery
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• v.39 no.10 s.267
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• pp.759-764
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• 2006

Background: We analyzed post-operative angiography performed in symptomatic patients to evaluate the patency rates and the roles of grafts. Material and Method: We reviewed 52 (15%) coronary angiograms performed for recurrent angina after prior coronary artery bypass surgery from January 1995 to June 2005. A total of 345 patients underwent coronary artery bypass surgery during this period. There were 41 men and 11 women and the mean age was $64.07{\pm}15.58$ years. The median period from operation to re-angiogram was 68.5 months (range, 1 to 126 months). The numbers of grafts and peripheral anastomoses were 42 and 43 for internal thoracic artery (ITA), 14 and 20 for radial artery (RA), and 49 and 89 for saphenous vein. The mean number of anastomosis was 2.9 per patient, Result: The patency rates of ITA, RA and saphenous vein graft (SVG) were 37/43 (86%), 17/20 (85%) and 34/89 (38.2%). The patency rate of arterial grafts was significantly higher than that of SVG (p< 0.001) and the patency rate of the RA was comparable to that of ITA (p=0.942). The patency rate of sequential SVGs was higher than that of single SVG (40.3% vs 31.8%, p=0.478) and the patency rate of proximal segments in sequential anastomosis was higher than that in single anastomsis (55.6% vs 31.8%, p=0.097), but statistically not significant. Conclusion: Arterial grafts have markedly superior patency rates than SVGs, so consideration should be given to the vigorous use of arterial grafts. The patency rate of the RA was comparable to that of ITA.

• Journal of the Korean Society of Radiology
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• v.85 no.4
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• pp.746-753
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• 2024

Purpose This study aims to evaluate the incidence and management of venous ruptures after percutaneous transluminal angioplasty (PTA) for dysfunctional arteriovenous (AV) access. Materials and Methods From January 1998 to December 2015, 13506 PTA, mechanical thrombectomy, and thrombolysis procedures were performed in 6732 patients. The venous rupture rate following PTA was obtained, and access circuit primary patency (ACPP) was compared according to the etiology (PTA, thrombotic occlusion, and treatment type) of the venous rupture present. Results Venous rupture developed in 604 of the 13506 procedures. Venous ruptures were more frequent in female, AV graft cases, and in cases accompanied by thrombosis. Balloon tamponade was performed in 604 rupture cases, and stents were deployed in 119 cases where contrast extravasation and flow stasis persisted. ACPP was significantly better in the non-ruptured AV access circuits than in the ruptured group. However, AV access type and thrombosis was not associated with primary patency. In ruptured cases, ACPP is 8.4 months for prolonged balloon tamponade and 11.2 months for bare-metal stent insertion, showing statistically significant difference. Conclusion Balloon tamponade and bare-metal stent placement are effective treatment for PTA-induced venous ruptures. In particular, stent placement showed a similar ACPP to that of non-ruptured AV access circuits.

• Journal of Chest Surgery
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• v.16 no.2
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• pp.170-174
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• 1983

Aortic arch syndrome is an unusual disease entity characterized by the narrowing or obliteration of major branches of the arch of the aorta regardless of etiology. We have experienced 2 cases. One of them was 22 years old office girl with 3 months history of headache, intermittent syncope and weakness and claudication on left arm especially during her physical exercise. On physical examination, pulseless on left antecubital and radial artery and blood pressure on left arm was inable to check and coldness with weakness were noted on the same side. Aortic angiography reealed 34% narrowing of left subclavian artery as that of right. But both common carotid artery and both axillary arterial patency were relatively good. Through right supraclavicular and left axillary incision, bypass graft with Gore-tex prosthesis (I.D. 6mm, Length 25 cm) was implanted from right subclavian artery on 2cm distal to origin of right common carotid arery to left axillary artery distal to axillary fossa. End to side anastomosis with preservation of left subclavian artery was done. Postoperative state was stable with blood pressure of 110/70 mmHg on left arm and palpable antecubital and radial pulsation. Another one was 41 year old male patient with 8 months history of pain and numbness on right upper arm and shoulder. On admission, right arm blood pressure was 110/80 mmHg, left arm was 160/110 mmHg, but other physical findings had no abnormalities. Angiography revealed segmental narrowing of right axillary artery on the beginning with 2 cm in length. Operative treatment with right wupraclavicular and right axillary incision, bypass graft with great saphenous vein (Length; 15 cm) from right subclavian artery between scalenus anticus and medius to axillary artery at distal end of axillary fossa was done. The authors report two cases of Aortic arch syndrome treated with bypass graft using Autograft or Gore-tex with good result.

• Journal of Chest Surgery
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• v.28 no.11
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• pp.983-988
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• 1995

From January 1983 to December 1994, 48 cyanotic patients were underwent a subclavian artery-pulmonary artery shunt using polytetrafluoroethylene[PTFE for the purpose of improvement of reduced pulmonary blood flow. The diameters of the PTFE used were 4mm[4 cases , 5mm[36 cases , and 6mm[8 cases sizes. The effectiveness of modified Blalock-Taussig shunts was evaluated clinically and angiographically. There were 5 early deaths and 2 late deaths. There were 3 early shunt failures and 5 late shunt failures. The overall graft patency rate was 83.3%. Postoperative hemoglobin was reduced significantly[p = 0.0011 in comparison of the preoperative and postoperative hemoglobin, SaO2, PaO2, and cardiothoracic ratio.

• Journal of Chest Surgery
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• v.18 no.2
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• pp.314-319
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• 1985

Nineteen patients with various types of cyanotic congenital heart disease underwent systemic-pulmonary artery shunts with a microporous polytetrafluoroethylene [PTFE] graft between September, 1983, and April, 1985. Age ranged from 3 months to 18 years, and seven of them were less than 12 months old. There were seventeen Great Ormond Street type of modified Blalock-Taussig shunts, and two central polytetrafluoroethylene shunt [ascending aorta-right pulmonary artery]. There was one postoperative death [1/19=5.3%] in a 10 Kg child born with pulmonary atresia and ventricular septal defect associated with patent ductus arteriosus. He had another anomaly of imperforated anus. Relief from cyanosis was achieved in other eighteen patients with variable degree. Eighteen survivors have been followed up from 1 month to 19 months. Clinical status, auscultation, oxygen partial pressure of arterial blood, and hemoglobin have been used to establish shunt patency in all survivors. By above criteria, all survivors have good patent shunt.