• Journal of Korea Society of Digital Industry and Information Management
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• v.19 no.4
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• pp.97-115
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• 2023

In South Korea, chronic kidney disease(CKD) impacts around 4.6 million adults, leading to a high reliance on hemodialysis. For effective dialysis, vascular access is crucial, with decisions about vascular surgeries often made during dialysis sessions. Anticipating these needs could improve dialysis quality and patient comfort. This study investigates the use of Artificial Intelligence(AI) to predict the timing of surgeries for dialysis vessels, an area not extensively researched. We've developed an AI algorithm using predictive maintenance methods, transitioning from machine learning to a more advanced deep learning approach with Long Short-Term Memory(LSTM) models. The algorithm processes variables such as venous pressure, blood flow, and patient age, demonstrating high effectiveness with metrics exceeding 0.91. By shortening the data collection intervals, a more refined model can be obtained. Implementing this AI in clinical practice could notably enhance patient experience and the quality of medical services in dialysis, marking a significant advancement in the treatment of CKD.

• Journal of Chest Surgery
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• v.44 no.1
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• pp.25-31
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• 2011

Background: Mature autogenous arteriovenous fistulas have better long term patency and require fewer secondary interventions compared to arteriovenous prosthetic graft. Our Study evaluated vascular patency rates and incidence of interventions in autogenous arteriovenous fistulas and grafts. Material and Methods: A total of 166 vascular access operations were performed in 153 patients between December 2002 and November 2009. Thirty seven caeses were excluded due to primary access failure and loss of follow-up. One group of 92 autogenous arterioveous fistulas and the other group of 37 arteriovenous prosthetic grafts were evaluated retrospectively. Primary and secondary patency rates were estimated using the Kaplan-Meier method. Results: The primary patency rate (84%, 67%, 51% vs. 51%, 22%, 9% at 1, 3, 5 year; p=0.0000) and secondary patency rate (96%, 88%, 68% vs. 88%, 65%, 16% at 1, 3, 5 year; p=0.0009) were better in autogenous fistula group than prosthetic graft group. Interventions to maintain secondary patency were required in 23% of the autogenous fistula group (average 0.06 procedures/patient/year) and 65% of prosthetic graft group (average 0.21 procedures/patient/year). So the autogenous fistula group had fewer intervention rate than prosthetic graft group (p=0.01) The risk factor of primary patency was diabetus combined with ischemic heart disease and the secondary patency's risk factor was age. Conclusion: Autogenous arteriovenous fistulas showed better performance compared to prosthetic grafts in terms of primary & secondary patency and incidence of interventions.

• Bulletin of the Korean Chemical Society
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• v.35 no.5
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• pp.1333-1336
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• 2014

Expanded polytetrafluoroethylene (ePTFE) grafts have been used as vascular access for many patients suffering from end stage renal disease. However, the vascular graft can cause significant clinical problems such as stenosis or thrombosis. For this reason, many studies have been performed to make drug eluting graft, but initial burst is major problem in almost drug eluting systems. Therefore we used biodegradable polymer to reduce initial burst and make sustained drug delivery. The ePTFE grafts were dipped into a paclitaxel-dissolved solution and then PLGA-dissolved solution was passed through the lumen of ePTFE. We analyzed whether the dose of paclitaxel is enough and the loading amount of PLGA on ePTFE graft increases according to the coating solution's concentration. Scanning electron microscope (SEM) images of various concentration of PLGA showed that the porous surface of graft was more packed with PLGA by tetrahydrofuran solution dissolved PLGA. In addition, in vitro release profiles of Ptx-PLGA graft demonstrated that early burst was gradually decreased as increasing the concentration of PLGA. These results suggest that PLGA coating of Ptx loaded graft can retard drug release, it is useful tool to control drug release of medical devices.

• Journal of Chest Surgery
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• v.53 no.6
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• pp.408-410
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• 2020

Iatrogenic vascular injuries may occur during venipuncture, arterial cannulation, or catheterization procedures. Brachial arteriovenous fistula (AVF) resulting from antecubital vascular access is rare and develops slowly. We report the case of an 18-year-old man who had developed iatrogenic brachial AVF. He had a history of several venipunctures in the left arm at the age of 10 months. Doppler ultrasonography and computed tomographic angiography were used to establish a diagnosis of brachial AVF, and surgical correction of the AVF was performed. As our case indicates, delayed surgery can be considered as a treatment option and may be associated with a decreased risk of vascular complications in the management of iatrogenic brachial AVF in infants.

• Journal of Trauma and Injury
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• v.37 no.3
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• pp.182-191
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• 2024

Purpose: Vascular injuries require immediate surgical treatment with standard vascular techniques. We aimed to identify pitfalls in vascular surgery for trauma team optimization and to suggest recommendations for trauma and vascular surgeons. Methods: We reviewed 28 victims and analyzed the patterns of injuries, methods of repair, and outcomes. Results: Ten patients had torso injuries, among whom three thoracic aorta injuries were repaired with thoracic endovascular aortic repair, one left hepatic artery pseudoaneurysm with embolization, and two inferior vena cava with venorrhaphy, three iliac arteries with patch angioplasty or embolization, and three common femoral arteries with bypass surgery or arterioplasty. Four patients had upper extremity injuries, among whom one brachial artery and vein was repaired with bypass surgery after temporary intravascular shunt perfusion, two radial arteries were repaired with anastomoses, and one ulnar artery was repaired with ligation. One radial artery under tension was occluded. Fourteen patients had lower extremity injuries, among whom one superficial femoral artery and vein was repaired with bypass and concomitant ligation of the deep femoral artery and vein, three superficial femoral arteries were repaired with bypass (two concomitant femoral veins with bypass or anastomosis), one deep femoral artery with embolization, two popliteal arteries with bypass or anastomosis, four infrapopliteal transected arteries, one arteriovenous fistula with ligation, and one pseudoaneurysm with bypass. However, one superficial femoral artery and all femoral veins were occluded. One leg replantation failed. Conclusions: There are potential complications of vascular access during resuscitative endovascular balloon occlusion of the aorta procedures. Vascular repair should be performed without tension or spasm. Preservation of the harvested vein in papaverine solution and blood while using a temporary intravascular shunt is a method of eliminating spasms.

• Vascular Specialist International
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• v.34 no.4
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• pp.88-93
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• 2018

Purpose: This study aimed to compare surgical revisions and balloon angioplasty after surgical thrombectomy on thrombosed dialysis access as a first event. Materials and Methods: Records of patients undergoing creation of arteriovenous grafts (AVGs) at the Gachon University Gil Medical Center between March 2008 and February 2016 were reviewed. Among them, patients who underwent treatment on first-time thrombotic occlusion after AVG creation were identified. Outcomes were primary, primary-assisted, and secondary patency. The patency was generated using the Kaplan-Meier method, and patency rates were compared by log-rank test. Results: A total of 59 de novo interventions (n=26, hybrid interventions; n=33, surgical revisions) for occlusive AVGs were identified. The estimated 1-year primary patency rates were 47% and 30% in the surgery and hybrid groups, respectively. The estimated primary patency rates were not different between the two groups (log-rank test, P=0.73). The Kaplan-Meier estimates of 6 and 12 months for primary-assisted patency rates were 68% and 57% in the surgery group and 56% and 56% in the hybrid group. The Kaplan-Meier estimates of 12 and 24 months secondary patency rates were 90% and 71% in the surgery group and 79% and 62% in the hybrid group. There were no differences in the estimated primary-assisted and secondary patency rates between the two groups. Conclusion: Our results showed no significant difference between the two groups in terms of primary patency (P=0.73), primary-assisted patency (P=0.85), and secondary patency (P=0.78). However, percutaneous transluminal angioplasty can give more therapeutic options for both surgeons and patients.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.128-132
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• 2008

Penetrating vascular trauma to zone one of the neck is potentially life-threatening. Trauma in this anatomical location is difficult to access and manage because the neck is a small anatomic area with the anatomical proximity of vital structures. An accurate diagnosis and aggressive surgical intervention are critical to the successful outcome of penetrating zone one vascular trauma in the neck. Here we report two cases with review of the medical literature.

• Journal of Medicine and Life Science
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• v.20 no.3
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• pp.115-125
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• 2023

Arteriovenous fistula flow dysfunction is the leading cause of vascular access thrombosis and loss in patients undergoing hemodialysis. However, data regarding the influence of access flow rate measurements on the long-term outcomes of access are limited. This study aims to identify accesses at a high risk of thrombosis and loss among patients undergoing hemodialysis by measuring the access flow rate and exploring an optimal threshold value for predicting future access thrombosis. We enrolled 220 patients with arteriovenous fistula undergoing hemodialysis. The primary outcome was the occurrence of access thrombosis. Access flow rates were measured monthly using the ultrasound dilution method and were averaged using all measurements from patients with patent access. In patients experienced access thrombosis, those immediately before the thrombosis were selected. Using these data, we calculated the access flow rate threshold for thrombosis occurrence by analyzing the receiver operating characteristic curve, and the patients were divided into two groups according to whether access flow rates were higher or lower than 400 mL/min. During a median follow-up period of 3.1 years, 4,510 access flows were measured (median measurements per patient, 33 times; interquartile range, 11-54). A total of 65 access thromboses and 19 abandonments were observed. Access thrombosis and loss were higher in the lowflow group than in the high-flow group. This study revealed that low access flow rates are strongly associated with access thrombosis occurrence and subsequent loss of arteriovenous fistulas in patients undergoing hemodialysis.

• Journal of Environmental Science International
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• v.19 no.4
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• pp.459-481
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• 2010

This study was carried out to investigate the vascular flora of Mt. Munsu. The vascular plants collected in 13 times(from Mar. to Oct. 2009) were identified as 511 taxa in total, including 113 families, 332 genera, 445 species, 5 subspecies, 46 varieties, 5 forms. Among them, 6 taxa of the Korea Forest Service-designated rare & endangered plants and the Korean endemic plants were identified as 2 taxa. Based on the list of approved for delivering overseas of plants, 6 taxa were recorded in the investigated area. The Ministry of Environment-designated plants, which should be protected by the wildlife protection law, were identified as 2 taxa and 39 taxa of specially designated plants by the Ministry of Environment. The naturalized plants were identified as 53 taxa, and their naturalization ratio and urban index were found to be 10,3%, and 18.5% respectively. There existed many kinds of plants resources having conservational value like Ranunculus trichophyllus var. kadzusensis, Jeffersonia dubia etc, in this area, but there remains a fear of nature destruction's acceleration due to indiscriminate human development and access of a lot of visitors, so it is judged that there should be a management plan, such as a limit on the number of visitors or rest-year-system for restoration of nature.

• Journal of Chest Surgery
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• v.29 no.9
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• pp.1028-1030
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• 1996

Arteriovenous fistula Is the most widely used mean of vascular access for long-term hemodialysis in patients with end-stage renal disease. Lymphangioma associated with arteriovenous fistula is very rare, seemed to be developed from Iymphatic fluid accumulation. Lymphangioma is benign neoplasm, arises de hobo or secondary to surge y or irradiation, and affects almost any part of the body served by the Lwphasic system. Treatment of choise for Iymphangioma Is surgical excision. We repo$\ulcorner$t a case of procedure using Gore-Tex graft between left brachial artery and cephalic vein for vascular access of hemodialysis in 59 year old female, with successful surgical removal.