• The Academic Congress of Korean Shoulder and Elbow Society
• /
• 2008.03a
• /
• pp.175-175
• /
• 2008

We report a rare case of late-onset brachial artery occlusion caused by subclavian artery stenosis with excessive scar tissue after open reduction and plate fixation for clavicular fracture. When he referred to us, the right hand were pale and the radial and ulnar pulses at the wrist were absent. CT-angiogram showed compression of subclavian artery by excessive scar tissue beneath the fracture site and angiography revealed stenosis of subclavian artery with thrombus and complete obstruction of blood flow in the brachial artery with emboli. Therefore, we performed embolectomy. 2 years after operation, patient was essentially asymptomatic except mild pain after long standing elevation of arm. We recommend that minimal soft tissue dissection should be needed in the operative treatment of clavicular fracture, especially soft tissue beneath the clavicle should be protected maximally.

• Journal of Chest Surgery
• /
• v.42 no.2
• /
• pp.252-255
• /
• 2009

We performed a hybrid procedure for a 58-year-old man with coronary artery disease and a left subclavian artery stenosis. He underwent left subclavian artery stenting and off-pump coronary artery bypass surgery, including grafting the in situ left internal mammary artery to the left anterior descending coronary artery. The post-operative coronary angiogram and computed tomography showed good patency of the graft and stent. He discharged at postoperative 8 days and he has been followed up for six month with an excellent clinical condition.

• Korean Journal of Clinical Laboratory Science
• /
• v.50 no.3
• /
• pp.370-374
• /
• 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 Chest Surgery
• /
• v.26 no.3
• /
• pp.245-248
• /
• 1993

Recently we experienced a case of Takayasu`s arteritis involving the major aortic branches. A 30 year-old female patient admitted with the complaints of dizziness, visual disturbance, headache and tingling sensation of upper extremities. Aortogram revealed nearly complete obstruction of the origin site of both common carotid arteries and right vertebral artery, and irregular luminal narrowing of the origin site of innominate artery and left subclavian artery, but opacification of right subclavian artery and left vertebral artery. Successful surgical treatment was accomplished with a bypass from the ascending aorta to the left common carotid artery using a tube graft. The left subclavian artery and right axillary artery were revascularized distal to the stenosis with tube grafts that extended from the aortic graft. Postoperative complications were atelectasis, lymph leakage and left phrenic nerve palsy. She discharged uneventually at postoperative 22 days and most of symptoms were relieved.

• Proceedings of the KSMRM Conference
• /
• 2001.11a
• /
• pp.136-136
• /
• 2001

Purpose： Subclavian steal refers to the retrograde flow of blood in a vertebral artery that supplies t ipsilateral shoulder and arm caused by proximal subclavian artery stenosis or occlusion. T purpose of this exhibit is to demonstrate MR findings of subclavian steal on contrast-enhanc 3D (CE 3DMRA) and 2D TOF MR angiography. Method： Four patients(men 3 and women 1, age： 28-78years) with subclavian steal obtained both CE 3DMRA and digital subtraction angiography(DSA) including subclavian arterie Sequential imaging was undertaken during first pass after double dose of Gd-DTPA (0 mM/kg) Injected by a power injector. Coronal source images were obtained with coronal D-fast low angle shot sequence(TR/TE/flip angle=3.8/l.3/35, acquisition time= 10sec/one measurement). Precontrast imaging was subtracted from enhanced images and maximu intensity projection was done. 2D time-of-flight MR angiography(2D TOF) of the carot bifurcation was added in all cases with post-saturation. All studies were review retrospectively.

• Journal of Chest Surgery
• /
• v.28 no.3
• /
• pp.320-323
• /
• 1995

We report a case of recurred Takayasu,s arteritis.The patient was 28-year-old female underwent aorto-left common carotid and aorto-left subclavian bypass graft replacement 1 year ago.Unfortunately, she was readmitted because of newly developing angina and both eye claudication severe headache. Aorto-coronary angiogram showed complete obstruction of left common carotid artery ,stenosis of right carotid artery bifurcation and ostial stenosis of right coronary artery.Bilateral carotid arteries bypass graft with great saphenous vein and right coronary artery bypass graft with right internal mammary artery were done at same the time and she discharged after 21 days without any problem.

• Journal of Chest Surgery
• /
• v.35 no.9
• /
• pp.688-691
• /
• 2002

Takayasu's arteritis is a chronic inflammatory disease of unknown cause. It predominantly affects the aortic arch and its branches. Concomitant involvement of coronary and renal arteries is a rare entity. In this report, we described successful treatment of a patient with Takayasu's arteritis associated with coronary and renal arteries stenosis. A 23-year-old woman was presented with chest pain on exertion. Angiographic studies demonstrated left main coronary, bilateral renal, and left subclavian arteries stenosis. She underwent angioplasty and stenting of bilateral renal artery. After one week, coronary artery bypass grafting using greater saphenous veins and aorto-subclavian bypass with PTFE vascular graft were done simultaneously. She was discharged on the 13th postoperative day without any complications.

• Journal of Chest Surgery
• /
• v.27 no.5
• /
• pp.394-398
• /
• 1994

Takayasu`s arteritis is one of chronic inflammatory disease characteristically involving the aorta and it`s major branches. We experienced two surgical cases of Takayasu`s arteritis associated with the stenosis of the descending thoracic aorta. One case was 15 year-old girl and she was admitted because of dyspnea on exertion for 12 months. Aortogram showed the stenosis of the descending thoracic aorta from just below left subclavian artery to the 9th thoracic vetebra. The other case was 10 year-old girl and she was admitted because of URI and hypertension. Aortogram showed narrowing of right innominate artery, but developed collateral circulation, and the stenosis of the descending thoracic aorta near the 9th thoracic vertebra. In each case, bypass graft from the ascending aorta to the abdominal aorta just above the inferior mesenteric artery was performed with satisfactory result.

• Journal of Chest Surgery
• /
• v.26 no.8
• /
• pp.604-608
• /
• 1993

Coarctation of aorta is rather common congenital cardiovascular disease in the western contries, but it is known to be less than 2 % in Korea. From June 1986 to December 1992, seven patients of surgically treated coarctation of aorta who were less than 2 years old, were experienced at Department of Thoracic and Cardiovascular Surgery, Yeungnam University Hospital. The patients included six male and one female, with ages in the range of one month and 24 months. Four patients were preductal type and three juxtaductal. Associated cardiac anomalies were present in all patients and they were PDA[6 cases], ASD[3], VSD[2], bicuspid aortic valve[2], aortic stenosis[1], mitral regurgitation[1], and tricuspid regurgitation[1]. The operative procedures were four end to end anastomosis and three subclavian flap aortoplasty. Mean aortic cross clamping times were 37.3 minutes in patients with end to end anastomosis and 30.3 minutes in patients with subclavian flap aortoplasty. There were two operative deaths in patients who were treated with subclavian flap aortoplasty and pulmonary artery banding. One patient who had been treated with subclavian flap aortoplasty was complicated with postoperative mild paraplegia in lower limb. Pulmonary artery banding has been disappointing in our patients, and the data was suggestive that earlier total repair of complicated coarctation might improve survival.

• Korean Journal of Clinical Laboratory Science
• /
• v.49 no.3
• /
• pp.316-321
• /
• 2017

The occurrence of subclavian steal syndrome is possible in patients with either severe stenosis or occlusion in the left proximal subclavian or brachiocephalic arteries. Limited and insufficient blood flow in the vessel with a lesion induces blood supply from the opposite side via any of the connected vessels, which is called a subclavian steal phenomenon. The duplex sonography is useful for detecting this phenomenon. Some patients who experience this phenomenon complain of vertebrobasilar insufficiency, such as headache or numbness and weakness in the arm, and so on. Subclavian steal syndrome means subclavian steal phenomenon accompanied by these symptoms. We present a patient with focal severe stenosis of the brachiocephalic artery, manifested as blood flow reversal in the vertebral, and a "to-and-fro" waveform pattern in the external carotid, internal carotid, and common carotid arteries.