• Journal of Chest Surgery
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• 제22권5호
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• pp.823-828
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• 1989

Aortoenteric fistula is an uncommon important complication of aortic reconstruction with a prosthetic graft. The complication often is difficult to diagnose and is associated with poor prognosis. Aortoenteric fistula could be divided into true aortoenteric fistula and paraprosthetic-enteric fistula. In case of true aortoenteric fistula, an actual communication between the gastrointestinal tract and the aortic lumen is present. So, massive gastrointestinal hemorrhage is the presenting manifestation. In paraprosthetic-enteric fistula, characterized by communication between the gastrointestinal tract and the external surface of synthetic vascular prosthesis without actual fistularization into the vascular lumen, the predominant clinical manifestation were sepsis, fever and anemia. We experienced one case of paraprosthetic-enteric fistula in a 16 years old male after abdominal aortic reconstruction with a prosthetic graft. The interval from the operation to onset of symptoms was 40 months. The initial clinical manifestation was sepsis, fever and anemia without massive gastrointestinal hemorrhage. Surgical treatment consists of complete excision of infected graft, two layers closure of jejunal wall defect and pledgets suture of aortic stump with surrounding health tissue. Anatomic revascularization was not able to be done: because of extensive retroperitoneal inflammation and extraanatomic revascularization did not performed due to adequate distal blood supply through rich collateral circulation. After operation, he complained numbness on left foot on moderate exertion and felt coldness on left leg compared with right leg but not showed skin color change. 43 days after operation, he discharged without gait disturbance except numbness on left foot on moderate exertion.

• Journal of Chest Surgery
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• 제34권8호
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• pp.648-650
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• 2001

흉부 대동맥류나 대동맥 박리의 근치술시 문합부의 출혈은 수술 성적과 술후 합병증 발생에 큰 영향을 끼치므로 지혈이 중요하다. 이에 저자들은 문합부 지혈을 도모하기 위해 대동맥 치환시 사용하고 남은 인조혈관을 이용하여 문합부를 감싸줌으로써 양호한 결과를 얻어 소개하고자 한다.

• Knee surgery & related research
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• 제30권4호
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• pp.364-368
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• 2018

We report a case of 53-year-old woman with an injured popliteal artery due to excessive drilling with a drill bit during medial opening wedge high tibial osteotomy (MOWHTO). Pseudoaneurysm was diagnosed three days after surgery and confirmed by urgent computed tomography (CT) angiography. Open vascular surgery with resection of the perivascular hematoma and end-to-end anastomosis using ipsilateral saphenous vein interposition graft was performed. CT angiography at 8 months postoperatively showed that blood flow was maintained without obstruction of the graft site and active dorsiflexion of the foot was possible. To reduce neurovascular injury during MOWHTO, it is important not to drill the far cortex at the proximal part of the osteotomy site when using a drill bit, and the metal should be positioned posteromedially as much as possible.

• Journal of Chest Surgery
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• 제27권9호
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• pp.764-769
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• 1994

From november, 1985 to May, 1993, 222 arteriovenous fistulae were made in 201 patients with chronic renal failure. Among them, a total of 183 arteriovenous fistulae in 173 patients were reviewed to evaluate the factors influencing patency rate of the vascular access. The results were revealed as follows: There were 102 men and 71 women,aged 10 to 76 years [mean = 45.7 years]. Sixteen patients of them had previous shunts. The procedures included establishment of 214 radiocephalic or brachioocephalic fistulae, 203 side to end, 9 side to side, 2 end to end, 2 autologous saphenous vein grafts, 6 Gore-Tex grafts. There were 28 early shunt failures[12%] due to use of 23 inadequate veins and 5 thrombosis.There were 32 late complications[14%]; 19 thrombosis, 4 aneurysm, 4 venous hypertension, 3 steal syndrome, 2 infections. There were 32 diabetic patients [17 %]. No significant differences in graft patency were noted between diabetic and nondiabetic individuals. There were no significant difference in graft patency between male and female. Overall shunt patency in 183 cases with chronic renal failure was 96% at I month, 95% at 3 months, 93% at I year, 91% at 2 years, 84% at 3 years, 56% at 5years.This Study showed that early postoperative thrombosis and diabetic vasculopathy were most causes of the vascular access failure and suggested that prevention of thrombi and well control of diabetes mellitus were most important to enhance patency rates of the vascular access.

• Journal of Chest Surgery
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• 제28권10호
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• pp.900-905
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• 1995

Between Jan.1990 and Mar.1994, twenty-three patients[Male:20, Female:3 with aortoilac occlusive disease had underwent reconstruction [bypass garft . Two main causes of occlusion were atherosclerosis [21 patients and chronic thromboembolism[2 patients . Indications for operation were disabling claudication in 20 patients and critical limb ischemia in 12 patients. The procedures of operation included femorofemoral[8 , axillobifemoral[6 , aorto-bifemoral[6 , axillounifemoral[2 , aortoiliac[1 bypass graft. Postoperatively one patient died for sepsis and the operative mortality was 4.3%. Various anticoagulant therapy were maintained for at least six months. The 1year, 2year, 3year and 4year patency rates of bypass graft after operation were 91.3%, 80.8%, 71.4% and 58.4% respectively.

• Journal of Chest Surgery
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• 제31권6호
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• pp.619-623
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• 1998

우측 팔의 부종과 압통을 주소로 내원한 51세 만성 신부전증 환자에서 정맥 촬영술의 결과 반복된 쇄골하정맥 도관삽관술후에 생긴 중심정맥(우쇄골하정맥, 우내경정맥, 우상완두정맥과 좌무명정맥)의 폐쇄증을 Goretex 인조혈관을 이용하여 우쇄골하정맥-상공정맥에 10 mm Goretex 인조혈관 우회로 조성술과 좌쇄골하정맥-10 mm Goretex 인조혈관사이에 8 mm Goretex 인조혈관 우회로 조성술을 실시하여 좋은 결과를 얻었다.

• Journal of Chest Surgery
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• 제27권11호
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• pp.948-952
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• 1994

Superior mesenteric artery aneurysm is the third most common lesion and comprises approximately 5.5 % of all visceral artery aneurysms. The first successful repair was performed by DeBakey and Cooley in 1949. Since then, more than 100 cases have been reported. Fifty to sixty percent of these aneurysms are mycotic in origin. Other less frequent causes include arteriosclerosis, trauma, and medial degeneration. The operations are bypass with autologous tissue or with artificial vascular graft and aneurysmorrhaphy. We have experienced a case of superior mesenteric artery aneurysm which had undergone aneurysmectomy and artificial graft interposition. This is the first domestic case which was successful surgical repaired.

• International Journal of Vascular Biomedical Engineering
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• 제3권1호
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• pp.1-5
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• 2005

Background: Coronary atherosclerosis artery disease is the leading cause of morbidity and mortality. Coronary artery bypass grafting (CABG) which utilizes the saphenous vein graft, has helped in alleviating the suffering of these patients. Newer techniques are being developed to improve upon the techniques. Still there is significant number of failures, leading to re-grafting or re-vascularization. Some studies have helped in identifying the high and low shear stress regions. Further studies based on their realistic models are required. Material, methods and results: we developed the realistic model of fully blocked right coronary with bypass graft placed at angle of $5^0$ with curvature similar to that of artery. Pulsatile flow of birefringent solution through this model by polarized light was visualized. The images of complete flow field in the model were recorded and analyzed. Regions of high flow disturbances which are prone to further changes are identified. Existence of recirculation in the blocked coronary may initiate new blood-tissue interactions deleterious to bypass graft. Conclusion: Our study shows that by selecting the procedure to place bypass graft at minimum angle with curvature similar to that of artery and smooth sutures may improve the life span of the graft. This study also identified that coronary blocked regions contributing by recirculation flow at the proximal and distal regions of bypass which may require further studies.

• Archives of Reconstructive Microsurgery
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• 제14권1호
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• pp.42-49
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• 2005

Between June 1989 and may 2004 Ipsilateral vascularized fibular transposition was performed on nine patients with segmental tibial defects combined with infection following trauma. Ipsilateral vascularized fibular graft was performed on two or three stage according to the degree of infection. Initially free vascular pedicled graft was done followed by ipsilateral vascularized fibular graft. Type of free flap used is scapular free flap 3 cases, latissimus dorsi free flap 5 cases and dorsalis pedis flap 1 cases. The patients were followed for an average of 3.4 years. the average time to union was 6.7 months, and in all patients the graft healed in spite of complication. Complication was free flap venous thrombosis in 1 cases, persistent infection in 1 cases, delayed bony union at the distal end of fibular graft in 2 cases. The results showed that more faster bony union was seen in which cases firmly internally fixated and more faster hypertrophy of graft in which cases was permitted to ambulate on early weight bearing and more faster healing in which cases debrided more meticulously. Reconstruction of tibia defect with free flap followed by Ipsilateral fibular transposition is a useful and safe method to avoid the potential risk of infection for patients with tibial large bone defect and soft tissue defect associated with infection.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권3호
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• pp.227-232
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• 2007

The radial forearm fasciocutaneous flap(RFFF) is a well-known flap for the reconstruction of oral and maxillofacial defects. It was first described by Yang et al. in 1981 and Soutar et al. developed it for the reconstruction of intraoral defect. RFFF provides a reliable, thin, and pliable soft tissue/skin paddle that is amenable to sensate reconstruction. It also has a long vascular pedicle that can be anastomosed to any vessel in either the ipsilateral or contralateral neck. However, split thickness skin graft(STSG) is most commonly used to cover the donor site, and a variety of donor site complications have been reported, including delayed healing, swelling of the hand, persistent wrist stiffness, reduced hand strength, and partial loss of the graft with exposure of the forearm flexor tendon. Various methods for donor site repair in addition to STSG have been developed and practiced to minimize both functional and esthetic morbidity, such as direct closure, V-Y closure, full thickness skin graft, tissue expansion, acellular dermal graft. We got a good result of using artificial dermis($Terudermis^{(R)}$) and secondary STSG for the repair of RFFF donor site defect esthetically and report with a review of literature.