• Journal of Chest Surgery
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• v.35 no.4
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• pp.283-289
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• 2002

Backgrouds: It is almost universally accepted that occlusive vascular diseases are best managed by anatomical reconstruction. However, the mortality and the morbidity have limited this operation for patients with high operation risks. In these patients, palliative operations such as extra-anatomic bypass and lumbar sympathectomy, are accepted as useful treatment. Material and Method: A retrospective study was conducted in 38 patients who underwent palliative operations for occlusive vascular disease at Korea University Guro Hospital between 1996 and 2000. Mean age of the patients was 60.37 $\pm$ 17.65 years, and preoperative diagnoses were atherosclerosis in 32 patients, Buerger's disease in 4 patients, Raynaud's syndrome in 1 patient and SVC syndrome in 1 patient. Result: Extra-anatomic bypass(40procedures), lumbar sympathectomy(17), thromboembolectomy(7) and femoral artery graft interposition(1) were performed. Six patients were required reoperation due to graft flow failure or fistula. Three year primary patency rate of entire operations was 78.29 $\pm$ 8.81%, and the correlation between type of operation and patency rate was not statistically significant. Conclusion: Palliative operations for occlusive vascular disease are useful treatment in limited patients with high operation risks or limited life expectancy.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.787-792
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• 2004

Even though there well developments in various treatment techniques for acute limb ischemia, this disease is both life threatening and limb threatening. We investigated early and mid-term results of operation for acute limb ischemia with symptoms, the combined diseases, location of occlusion, complication in our patients. Material and Method: A retrospective review was conducted in 54 patients (43 men, 11 women, mean age 67.2 years) presenting with acute limb ischemia due to arterial thrombosis or embolism between Jan. 1996 and Dec. 2003, initially underwent thromboembolectomy. Result: In 33 patients (61.1%) the timeinterval from the onset of symptom to admission was within 24 hours. Causes of acute limb ischemia were embolic occlusion (27.8%), native arterial thrombosis (66.7%), and bypass graft thrombosis (5.6%). The distribution of arterial occlusion location was at 8 aortoiliac (14.8%) and 43 distal to femoral (79.6%) and brachial (5.6%). Clinical categories were grade I in 64.8%, IIa in 24.1%, IIb in 7.4%, and III in 3.7%, All the patients were received embolectomy. Underlying diseases were heart disease (72.2%), hypertension (33.3%), cerebrovascular accident (16.7%) and diabetes (18.5%). History of smoking was noted in 96,3% of the cases. Mortality rate was 5.6％ and overall amputation rate was 9.3% (5/54). The 1-year limb salvage rate was 93.62%. Postoperative complications were 1 wound infection, 1 G1 bleeding, 3 acute renal failure, and 1 compartment syndromes. The functional outcomes of the salvaged limb according to the recommended scale for gauging changes in clinical status, revised version in 1997 were +3 in 68.5%, +2 in 9.3%, +1 in 7.4%, -1 in 5.6%, -2 in 3.7%, and -3 in 5.6%. Conclusion: This study revealed 5.6% mortality and the amputation rate was 9.3%. We have retrospectively shown good results from early diagnosis & early operation. To improve outcome, early diagnosis and understand the underlying diseases, prompt treatment and operation would be appreciated.