• Title/Summary/Keyword: Peripheral artery disease

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Early Manifestation of Supravalvular Aortic and Pulmonary Artery Stenosis in a Patient with Williams Syndrome

  • Lee, Jong Uk;Jang, Woo Sung;Lee, Young Ok;Cho, Joon Yong
    • Journal of Chest Surgery
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    • v.49 no.2
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    • pp.115-118
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    • 2016
  • Williams syndrome (WS) is a developmental disorder characterized by vascular abnormalities such as thickening of the vascular media layer in medium- and large-sized arteries. Supravalvular aortic stenosis (SVAS) and peripheral pulmonary artery stenosis (PPAS) are common vascular abnormalities in WS. The natural course of SVAS and PPAS is variable, and the timing of surgery or intervention is determined according to the progression of vascular stenosis. In our patient, SVAS and PPAS showed rapid concurrent progression within two weeks after birth. We report the early manifestation of SVAS and PPAS in the neonatal period and describe the surgical treatment for stenosis relief.

Peripheral Arterial Bypass using Interpositional Vein Graft in the Hypothenar Hammer Syndrome: A Case Report (소지구 망치증후군에서 정맥이식을 이용한 동맥우회술: 증례 보고)

  • Kim, Jeong Hong;Eun, Seok Chan;Heo, Chan Yeong;Baek, Rong Min;Minn, Kyung Won
    • Archives of Plastic Surgery
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    • v.36 no.1
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    • pp.89-92
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    • 2009
  • Purpose: The clinical syndrome of unilateral finger ischemia, caused by digital artery occlusions from embolization from the palmar ulnar artery associated with repetitive striking of the palm, has been called the hypothenar hammer syndrome (HHS). We report the case of a man with this unique disease probably caused by manual work. Methods: A 52 - year - old male left - hand dominant manual worker complained of pain and coldness in the left 4,5th finger. On physical examination, there was a tip necrosis and the result of Allen's test was mildly positive(sluggish filling of hand from the ulnar artery). Arteriograms confirmed occlusion of the distal ulnar artery without direct perfusion of the superficial palmar arch and distal digital artery. Surgical bypass with reverse autologous vein grafting was performed between ulnar artery and superficial palmar arch, common digital artery. Results: He had an uneventful postoperative course and has remained asymptomatic for 18 months since discharge. Patency has been confirmed by color doppler with resolution of cold intolerance and successful digital preservation. Conclusion: We introduce very unique pattern of vascular ischemic disease and recommend the arterial bypass with vein interpositional grafting.

Off-Pump Coronary Artery Bypass Grafting (심폐바이패스없이 시행하는 관상동맥우회술)

  • Kim, Ki-Bong;Lim, Hong-Gook;Huh, Jae-Hak;Ahn, Hyuk;Ham, Byung-Moon
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.38-44
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    • 2000
  • Background: We analyzed the result of the "Off-Pump" Coronary Artery Bypass grafting (OPCAB) performed to minimize inflammatory responses to cardiopulmonary bypass and myocardial ischemia during the aortic cross-clamp period. Material and Method : The preoperative diagnosis operative procedure mortality complication and postoperative course of the 50 patients who underwent OPCAB between January 1998 and September 1998 were analyzed. There were 34 males and 16 females with mean age of 60$\pm$9 years. Preoperative clinical diagnoses were unstable angina in 31(62%) stable angina in 16(32%) and clinical diagnoses were unstable angina in 31(62%) stable angina in 16(32%) and postinfarction angina in 3(6%) patients. Preoperative angiographic diagnoses were three-vessel disease in 25(50%) two-vessel disease in 5(10%) one-vessel disease in 7(14%) and left main disease in 13(26%) patients. There were elective operation in 37 cases and urgent operation in 13 cases. Result: The mean number of grafts was 3.2$\pm$1.2 per patient. Grafts used were unilateral internal thoracic artery in 43 greater saphenous vein in 37 radial artery in 7 bilateral internal thoracic arteries in 4 and right gastroepiploic artery in 2 cases Forty sequential anastomoses were performed in 18 cases. Vessels accessed were left anterior descending artery in 48 diagonal branch in 41 obtuse marginal branch in 30 right coronary artery in 24 posterior descending artery in 9 ramus intermedius in 5 and posterolateral branch in 5 anastomoses. Predischarge coronary angiography performed in 44 patients demonstrated the patency rate of 89.5%(128/143) Operative mortality was 2%(1/150) Postoperative complications were arrhythmia in 5 graft occlusion that needed reoperation in 4. perioperative myocardial infarction in 2 femoral artery thromboembolism developed after the application of IABP in 1 postoperative transient delirium in 1 peripheral compression neuropathy in 1 case. Sixteen patients(32%) were extubated at the operating room and the other patients were extubated at the mean 13$\pm$20 hours after the operation. Mean duration of stay in intensive care unit was 49$\pm$46 hours. Thirteen patients(26%) required blood transfusions perioperatively and the amount of perioperative blood transfusion was mean 0.70$\pm$1.36 pack/patient. Conclusion: OPCAB is suggested to be the ideal technique with less postoperative complication less hospitalization time and less cost.less cost.

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The Necessity for Coronary Angiography in Atherosclerotic Arterial Obstruction in the Lower Extremities and the Clinical Features of Accompanied Coronary Arterial Diseases (죽상동맥경화성 하지동맥폐쇄증에서 관상동맥조영술의 필요성 및 동반되는 관상동맥 질환의 양상)

  • Lee Jae-Wook;Yeom Wook;Park Young-Woo;Shin Hwa-Kyun;Won Yong-Soon
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.619-625
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    • 2006
  • Background: Peripheral arterial disease is frequently accompanied with systemic arteriosclerosis and more than half of the cause of deaths is due to the development of coronary arterial disease. Moreover, it is known that the most frequent cause of death after a bypass surgery of chronic arterial obstruction is heart related complications. Especially in patients with atherosclerotic arterial obstruction in the lower extremities who had no history of heart disease or had no presenting symptoms of ischemic heart disease showed a high rate of postoperative mortality and for this reason we suggest preoperative evaluation in these patients to evaluate whether or not coronary arterial disease is accompanied. Material and Method: Since Feb. 2001 to Oct. 2004, we analyzed 52 patients who were operated on for atherosclerotic arterial obstruction in the lower extremities, with the exception of patients with a past history of heart disease or symptoms of ischemic heart disease. They underwent on the same day a coronary and femoral angiography for evaluation of accompanying coronary arterial disease. Of among these patients, we compared those who received bypass surgery of the arteries of the peripheral extremities alone to those who underwent combined coronary artery bypass surgery. Result: 63% of the reported cases of atherosclerotic arterial obstruction in the lower extremities were accompanied with coronary arterial disease. Old age, hypertension, diabetes mellitus, smoking, and hypercholesterolemia are known risk factors for arteriosclerosis and of these, only old age and hypertension had statistically significance in patients with severe atherosclerotic arterial obstruction in the lower extremities accompanied with coronary arterial disease. Diabetes, smoking, and hypercholesterolemia showed no statistical significance in this group. With the increase in severity of the range and the degree of atherosclerotic arterial obstruction, coronary arterial disease is frequently accompanied and its severity also increased. Patients who received both peripheral artery and coronary artery bypass surgery showed no difference in the period of hospitalization and ICU stay period compared with patients who received bypass surgery of the arteries of the lower extremities alone. Conclusion: Patients with atherosclerotic arterial obstruction in the lower extremities without symptoms of ischem to evaluate coronary arterial disease for active treatment, especially in the patients with old age, hypertension and high AVD scores.

A Case of Spontaneous Hemothorax Associated with Von Recklinghausen's Disease (Von Recklinghausen 병에 동반된 자발성 혈흉 1예)

  • Kang, Mi-Jeong;Chung, Lee-Young;Kim, Su-Jin;Kang, Jung-Hun;Jeong, Gyeong-Won;Park, Dong-Jun;Lee, Jong-Deog;Hwang, Young-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.4
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    • pp.538-542
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    • 1999
  • Spontaneous hemothorax may be developed as a complication of von Recklinghausen's disease. It is rare but fatal. A 60 year old man with von Recklinghausen's disease was admitted to our hospital because of left chest and shoulder pain. Radiograph of chest showed a massive left pleural effusion. Thoracentesis revealed gross blood. The peripheral angiography was done to determine the source of bleeding and its finding showed intercostal artery aneurysm in left 7th rib. No active bleeding from the aneurysm was seen. The source of the hemothorax was believed to be hemorrhage from rupture of intercostal artery aneurysm. He was inserted chest tube and treated embolization of intercostal artery aneurysm.

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박막니티놀 생체재료의 혈액적합성 및 소형혈관계 스텐트 연구

  • Cheon, Yeong-Jae
    • Journal of the KSME
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    • v.52 no.12
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    • pp.41-48
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    • 2012
  • 생명을 위협하는 주요한 소형혈관 치료를 위한 의료기기의 생체재료로서 박막니티놀이 최근 소개되었고, 다양한 실험실 실험(in vitro)과 생체실험(in vivo)을 통하여 혈액적합성과 소형혈관치료 디바이스로서의 가능성에 대한 연구가 이루어졌다. 이 글에서는 박막니티놀의 특성, 제조방법 그리고 이 재료를 이용한 디바이스인 뇌동맥류 유량 조절 스텐트(cerebral aneurysm flow-diverting stent)와 말초동맥질환 스텐트 그라프트(peripheral artery disease stent graft)에 대하여 설명을 하였다.

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Crossed Renal Ectopia and Aorto-Occlusive Disease: A Management Strategy

  • Ng, Eugene;Campbell, Ian;Choong, Andrew MTL;Dunglison, Nigel;Aziz, Maged
    • Journal of Chest Surgery
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    • v.48 no.5
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    • pp.371-374
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    • 2015
  • We present a rare case of a patient with aortoiliac occlusive disease on the background of type A crossed renal ectopia, for whom open surgical intervention was required. Aortic exposure in patients with concomitant crossed renal ectopia can present technical challenges to the vascular surgeon. The knowledge of variations in the ectopic renal blood supply is of paramount importance when performing surgery to treat this condition and affects the choice of surgical exposure. We present and discuss the operative details of our patient and outline an approach to this subset of patients.

Popliteal Artery Entrapment Syndrome: A Case with Bilateral Different Types

  • Lee, Eun Joo;Jung, Jae Seung;Lee, Kanghoon;Lee, Seung Hun;Son, Ho Sung;Sun, Kyung
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.302-305
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    • 2014
  • Popliteal artery entrapment syndrome (PAES) is a non-artherosclerotic cause of claudication and acute ischemia of the legs in young athletic individuals. It is classified in terms of the abnormal anatomical relationship between the popliteal artery and surrounding structures. All types of PAES have the same pathophysiology. Repetitive arterial compression by surrounding structures causes progressive vascular injury. Bilateral PAES is reported in about 30% of cases. Bilateral PAES is usually of the same type in each artery; exceptions are rare. We report a case of a young athletic patient who suffered bilateral PAES of two different types.

Acute Toxicity of pCK-VEGF in Rata and Mice (Vasular Endothelial Growth Factor 165 (VEGF165) 발현 벡터 (pCK-VEGF)의 랫드와 마우스에서의 급성독성)

  • 김선영;이영주;조홍찬;박은진;안병옥;김덕경
    • Toxicological Research
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    • v.16 no.1
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    • pp.67-71
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    • 2000
  • It has been demonstrated that the injection of naked DNA expressing vascular endothelial growth factor 165(VEGFl165) to the affected area can provide significant therapeutic effects on peripherol artery occlusive diseases. Success with this type of gene therapy highly depends on the quality of the vector delivering the therapeutic gene, especially in terms of the level and duration of gene expression in the localized area. We have recently developed a vector expressing VEGF165(pCK-VEGF) for the treatment of peripheral artery occulsive diseases and demonstrated high level expression of VEGF165 in mouse skeletal muscle. This study was designed to assess the acute toxicity of intramuscularly injected pCK-VEGF in BALB/c mice and Sprague-Dawely rats. There was no evidence of any changes in clinical signs, body weights, or gross pathological signs. We estimate LD50 values of pCK-VEGF higher than 50mg/kg in mice and 20 mg/kg in rats by intramuscular injection.

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