• Title/Summary/Keyword: Vascular

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Pterional or Subfrontal Access for Proximal Vascular Control in Anterior Interhemispheric Approach for Ruptured Pericallosal Artery Aneurysms at Risk of Premature Rupture

  • Park, Jaechan
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.250-256
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    • 2017
  • Objective : Cases of a ruptured pericallosal artery aneurysm with a high risk of intraoperative premature rupture and technical difficulties for proximal vascular control require a technique for the early and safe establishment of proximal vascular control. Methods : A combined pterional or subfrontal approach exposes the bilateral A1 segments or the origin of the ipsilateral A2 segment of the anterior cerebral artery (ACA) for proximal vascular control. Proximal control far from the ruptured aneurysm facilitates tentative clipping of the rupture point of the aneurysm without a catastrophic premature rupture. The proximal control is then switched to the pericallosal artery just proximal to the aneurysm and its intermittent clipping facilitates complete aneurysm dissection and neck clipping. Results : Three such cases are reported : a ruptured pericallosal artery aneurysm with a contained leak of the contrast from the proximal side of the aneurysm, a low-lying ruptured pericallosal artery aneurysm with irregularities on its proximal wall, and a multilobulated ruptured pericallosal artery aneurysm with the parasagittal bridging veins hindering surgical access to the proximal parent artery. In each case, the proposed combined pterional-interhemispheric or subfrontal-interhemispheric approach was successfully performed to establish proximal vascular control far from the ruptured aneurysm and facilitated aneurysm clipping via the interhemispheric approach. Conclusion : When using an anterior interhemispheric approach for a ruptured pericallosal artery aneurysm with a high risk of premature rupture, a pterional or subfrontal approach can be combined to establish early proximal vascular control at the bilateral A1 segments or the origin of the A2 segment.

Diverse imaging characteristics of a mandibular intraosseous vascular lesion

  • Handa, Hina;Naidu, Giridhar S.;Dara, Balaji Gandhi Babu;Deshpande, Ashwini;Raghavendra, Raju
    • Imaging Science in Dentistry
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    • v.44 no.1
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    • pp.67-73
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    • 2014
  • Intraosseous vascular lesions of the maxillofacial region are rare, and the differential diagnosis of intraosseous vascular malformations from other jaw lesions can be challenging. In the present case, magnetic resonance imaging and three-dimensional computed tomographic angiography (CTA) was used for diagnosis, and the lesion was treated wih surgical excision. Diverse characteristics such as the "honeycomb" and "sunburst" radiographic appearances and the absence of major peripheral feeder vessels in the CTA were noted. Intraosseous vascular malformations have a varied radiographic appearance, and the nomenclature of these lesions is equally diverse, with several overlapping terms. Pathologists do not generally differentiate among intraosseous vascular lesions on the basis of histopathology, although these lesions may present with contrasting immunohistochemical and clinical behaviors requiring varied treatment strategies. This case report highlights the need for multiple imaging modalities to differentiate among vascular lesions, as well as to better understand the behaviors of these unique lesions.

A clinical study of peripheral vascular surgery using prosthetic or autogenous vein grafts -34 cases- (인조혈관 및 자가혈관을 이용한 말초혈관 수술 34예에 대한 임상적 고찰)

  • 이정렬
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.412-420
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    • 1986
  • From 1968 through September 1986, the authors have experienced 34 cases of peripheral arterial surgery using various vascular grafts. Almost all patients [32] were men, and age distribution was variable according to the disease entities. There were twenty eight cases of chronic occlusive peripheral vascular disease including ASO [21], Buerger`s disease [6], Aortoenteric fistula complicating infrarenal abdominal aortic aneurysm [1], four cases of vascular trauma, one case of acute arterial embolism [1] and one case of unknown etiology. The indications of operations for chronic vascular disease was intermittent claudication in 48%, rest pain in 45%, ischemic pregangrene or gangrene in 28%, and sensory change in 10% of patients. Types of operation used were arterial bypass in 28 cases [Aortobifemoral in 5, Aortoiliac in 3, Aortofemoral in 4, Aortoiliac with Aortofemoral in 1, Femorofemoral in 1, Femoropopliteal in 8, Femoroperoneal in 2, Axillofemoral in 3 cases of patients], graft interposition in four and patch angioplasty in three cases. Thirty four prosthetic vascular grafts including Dacron, Gore-Tex, Nylon and two autogenous saphenous vein graft and patch were used for vascular reconstruction in thirty four patients. Unfortunately recently performed one vein bypass was failed immediate postoperatively due to severity of disease and poor case selection. The authors experienced five post operative complications: wound infection [1], graft infection [1], bleeding [1], great saphenous neuralgia [1], pseudoaneurysm [1]. Twenty two of thirty four patients were followed up for more than one month and their cumulative patency rate was 81% [17/22] at 1 month and, 31% [7/22] at 5 month.

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A Interpretation of Vascular Dementia through Three Yin & Three Yang to Study on the Acupuncture Treatment (혈관성 치매의 육경적(六經的) 해석(解釋)및 침구(鍼灸) 치료(治療)의 방향(方向)에 관(關)한 소고(小考))

  • Lee, Bong-Hyo;Jeon, Won-Kyung;Han, Chang-Hyun
    • Korean Journal of Acupuncture
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    • v.28 no.4
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    • pp.169-175
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    • 2011
  • Objectives : The aim of this study is to find a desirable way for acupuncture treatment of Vascular Dementia. Methods : The author reviewed several literatures related with Vascular Dementia. Based on the literatures, the author interpreted the causes and symptoms of Vascular Dementia on viewpoint of three yin and three yang. In addition, research about desirable way for acupuncture treatment was carried out. Results and Conclusions : The cause of Vascular Dementia is thought to be the functional weakness of lesser yin, the heart meridian. Also, the related-factors represent functional excess of reverting yin and greater yin, as well show functional weakness of lesser yin. Accordingly, for the acupuncture treatment of Vascular Dementia, it is necessary to tonify lesser yin. On the other hand, the activation of lesser yang is thought to be helpful.

Berberine suppresses in vitro migration of human aortic smooth muscle cells through the inhibitions of MMP-2/9, u-PA, AP-1, and NF-κB

  • Liu, Su-Jian;Yin, Cai-Xia;Ding, Ming-Chao;Xia, Shao-You;Shen, Qin-Min;Wu, Ji-Dong
    • BMB Reports
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    • v.47 no.7
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    • pp.388-392
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    • 2014
  • Berberine, a type of isoquinoline alkaloid isolated from Chinese medicinal herbs, has been reported to have various pharmacological activities. Studies have demonstrated that berberine has beneficial effects on vascular remodeling and alleviates restenosis after vascular injury. However, its mechanism of action on vascular smooth muscle cell migration is not fully understood. We therefore investigated the effect of berberine on human aortic smooth muscle cell (HASMC) migration. Boyden chamber assay was performed to show that berberine inhibited HASMC migration dose-dependently. Real-time PCR and Western blotting analyses showed that levels of matrix metalloproteinase (MMP)-2, MMP-9, and urokinase-type plasminogen activator (u-PA) were reduced by berberine at both the mRNA and protein levels. Western blotting assay further confirmed that activities of c-Fos, c-Jun, and NF-${\kappa}B$ were significantly attenuated. These results suggest that berberine effectively inhibited HASMC migration, possibly by down-regulating MMP-2, MMP-9, and u-PA; and interrupting AP-1 and NF-${\kappa}B$ mediated signaling pathways.

Mechanical Dilation of the Recipient Vessel with the DeBakey Vascular Dilator in Lower Extremity Reconstruction: A Report of Two Cases

  • Min-Gi Seo;Tae-Gon Kim
    • Archives of Plastic Surgery
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    • v.50 no.3
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    • pp.311-314
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    • 2023
  • In lower extremity reconstruction, the recipient vessel often requires long-range mechanical dilation because of extensive vasospasm or plaque formation induced by concomitant atherosclerosis. While a forceps dilator can be used to manipulate and dilate vessels approximately 1 cm from their end, a DeBakey vascular dilator can dilate long-range vessels. The authors successfully performed free flap reconstruction of the lower extremity using the DeBakey vascular dilator. Of the two patients who underwent lower extremity reconstruction, one had extensive vasospasm, and the other had plaques in the recipient arteries. Irrigation with 4% lidocaine and dilation of the lumen with a forceps dilator were insufficient to restore the normal arterial blood flow. Instead, a DeBakey vascular dilator with a 1-mm diameter tip was gently inserted into the lumen. Then, to overcome vessel resistance, the dilator gently advanced approximately 10 cm to dilate the recipient artery. Normal arterial blood flow was gushed out after dilating the vessel lumen using a DeBakey vascular dilator. The vascular anastomosis was performed, and intravenous heparin 5000 IU was administered immediately after anastomosis. Prophylactic low-molecular-weight-heparin (Clexane, 1 mg/kg) was administered subcutaneously to both patients for 14 days. The reconstructed flap survived without necrosis in either patient.

A Study on the Mobilization of Calcium by Ginseng Alcohol Extract in Rabbit Vascular Smooth Muscle (가토 대동맥 평활근에서 인삼 알콜 추출물에 의한 Calcium 동원에 관한 연구)

  • Kim, Yong-Bae;Lee, Young-Ho;Kang, Bok-Soon;Kang, Doo-Hee
    • The Korean Journal of Physiology
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    • v.24 no.1
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    • pp.77-90
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    • 1990
  • There have been conflicting reports concerning the effect of Panax ginseng on the contractility of vascular smooth muscle, i.e., Panax ginseng extract has been reported to cause relaxation, contraction or to have no effect on the tension of vascular smooth muscle. A further investigation of $Ca^{++}$ stores which supply $Ca^{++}$ for contraction of vascular smooth muscle is needed to understand the underlying mechanisms of this conflicting effect of ginseng alcohol extract (GAE). The present study was intended to examine the sources of calcium mobilized for contraction of vascular smooth muscle by GAE. Aortic ring preparations were made from the rabbit thoracic aorta and endothelial cells were removed from the ring. The contractility of the aortic ring was measured under various experimental conditions and $Ca^{++}$ flux across the membrane of aortic ring and the sarcoplasmic reticulum and mitochondria were measured with a calcium selective electrode. The result were summarized as follows; 1) At low concentration of extracellular $Ca^{++}$, GAE increased the contractility of vascular smooth muscle in dose-dependent fashion except high concentration $Ca^{++}$ (1 mM). 2) In the presence of ryanodine, GAE still increased contractility of vascular smooth muscle as much as control group, but in the presence of caffeine, GAE increased it significantly. i.e. Their effects seemed to be additive. 3) In the presence of verapamil+lanthanum, and verapamil+lanthanum+ryanodine, the contractility of the vascular smooth muscle was decreased, but a dose dependent increase in vascular tension was still demonstrated by GAE although total tension was low. 4) GAE increased $Ca^{++}$ efflux from vascular smooth muscle cells, but have no effect on $Ca^{++}$ influx. 5) GAE increased $Ca^{++}$ efflux from sarcoplasmic reticulum and mitochondria vesicles. From the above results, it may be concluded that GAE increased the release of $Ca^{++}$ from sarcoplasmic reticulum, mitochondria or other intracellular $Ca^{++}$ stores of vascular smooth muscle, but it does not increase $Ca^{++}$ influx across the plasma membrane.

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Complete Vascular Ring Caused by Kommerell's Diverticulum and Right Aortic Arch with Mirror Image Branching

  • Ryu, Jae-Wook
    • Journal of Chest Surgery
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    • v.45 no.5
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    • pp.338-341
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    • 2012
  • Vascular ring, caused by Kommerell's diverticulum and ligamentum arteriosum, in a patient with right aortic arch and mirror image branching is extremely rare. A 10-month-old boy with coughing and stridor was diagnosed as having tracheo-esophageal stenosis, which is caused by a vascular ring with Kommerell's diverticulum, ligamentum arteriosum, right aortic arch, and mirror image branching. Kommerell's diverticulum was successfully resected via a left thoracotomy. The patient has been free from tracheo-esophageal stenosis for a year after the surgery.

Congenital Intracranial Vascular Malformations in Children : Radiological Overview

  • Jung-Eun Cheon;Ji Hye Kim
    • Journal of Korean Neurosurgical Society
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    • v.67 no.3
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    • pp.270-279
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    • 2024
  • Prompt medical attention is crucial for congenital intracranial vascular malformations in children and newborns due to potential severe outcomes. Imaging is pivotal for accurate identification, given the diverse risks and treatment strategies. This article aims to enhance the identification and understanding of congenital intracranial vascular abnormalities including arteriovenous malformation, arteriovenous fistula, cavernous malformation, capillary telangiectasia, developmental venous anomaly, and sinus pericranii in pediatric patients.