• Title/Summary/Keyword: Vascular grafting

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Subclavian artery pseudoaneurysm of 10 days after a traffic accident: A Case Report (교통 사고 10일 후 발생한 쇄골하 동맥 가성동맥류 1례)

  • Hwang, Yong;Shin, Sangyol;Choi, Jeong Woo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.7
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    • pp.4651-4655
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    • 2015
  • The subclavian artery pseudoaneurysm in blunt trauma is uncommon and rarely occurs secondary to penetrating injury. Subclavian artery injuries represent an uncommon complication of blunt chest trauma, this structure being protected by subclavius muscle, the clavicle, the first rib, and the deep cervical fascia as well as the costo-coracoid ligament, a clavi-coraco-axillary fascia portion. Subclavian artery injury appears early after trauma, and arterial rupture may cause life-threatening hemorrhages, pseudoaneurysm formation and compression of brachial plexus. Most injuries were related to clavicle fracture, gunshot, other penetrating trauma, and complication of central line insertion. The presence of large hematomas and pulsatile palpable mass in supraclavicular region should raise the suspicion of serious vascular injury and these clinical evidences must be carefully worked out by physical examination of the upper limb. Since the first reports of endovascular treatment for traumatic vascular injuries in the 1993, an increasing number of vascular lesions have been treated this way. We report a case of subclavian artery pseudoaneurysm 10 days after blunt chest trauma due to traffic accident, treated by endovascular stent grafting.

Myocardial Perfusion SPECT as a Screening Test before Planned Vascular Surgery for Predicting Perioperative Cardiac Complications (혈관 수술 후 심장 합병증 발생을 예측하기 위한 선별 검사로서 심근 관류 단일 광자 단층촬영의 유용성에 대한 연구)

  • Lee, Hyung-Chae;Hwang, Youn-Ho;Wi, Jin-Hong;Jun, Hee Jae;Lee, Yang-Haeng;Cho, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.25-32
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    • 2010
  • Background: Patients with vascular diseases commonly have coronary artery disease and associated cardiac problems. Therefore, their underlying heart diseases may be induced or exacerbated after vascular surgery. The effectiveness of SPECT imaging, which is a relatively simple and non-invasive imaging modality, for assessing these underlying heart diseases is still controversial. This study was performed to evaluate the clinical effect of tests and treatment based on SPECT imaging prior to vascular surgery on the development of post-operation cardiac complications. Material and Method: Sixty three patients who were treated at Inje University Pusan Paik Hospital between April 2004 and September 2007 and who underwent adenosine infusion technetium-99m (Tc-99m) tetrofosmin SPECT imaging prior to vascular surgery were selected for this study and we retrospectively reviewed their records. Result: The sensitivity and specificity of detecting a perfusion defect on SPECT to predict the development of cardiac complications was relatively low at 41.2% and 52.2%, respectively. However when coronary angiographies were done on the patients with abnormal SPECT and this was followed by aggressive treatment such as coronary artery intervention and coronary artery bypass grafting based on the angiography results, there was a tendency for lower cardiac complication rates. Conclusion: SPECT imaging shows low effectiveness as a screening test for predicting cardiac complications after vascular surgery.

The Effect of Platelet Derived Growth Factor on the Myocardial Revascularization in Implantation of Rabbit Internal Mammary Artery (토끼 내유동맥의 심근이식에서 혈관재형성 촉진에 대한 혈소판 유래 성장인자의 효과)

  • 김용환;나석주;정상훈;문석환;조건현;왕영필;김세화;곽문섭
    • Journal of Chest Surgery
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    • v.33 no.4
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    • pp.277-284
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    • 2000
  • Background: Coronary artery bypases grafting in the old aged is associated with high mortality and morbidity, and it is difficult to perform if the coronary artery is diffusely disease. Recently it has been known that platelet derived growth factor(PDGF), especially PDGF-BB, stimulates angiogenesis. Material and Method: New Zealand white rabbit were used. In an attempt to achieve effevtive cardiac revasculatrization without vascular anastmosis, we divided into three groups(group I : Left anterior descending artery(LAD) was occluded by ligature, group II : Bilateral internal mammary vascular pedicles were dissected and implanted into myocardium, group III : The vascular pedicles were implanted into myocardium and PDGF-BB was injected into the myocardial tissue). Two weeks after IMA implantation, the proximal region of implanted LAD was ligated. Four days after LAD ligation angiogram, triphenyl tetrazolium chloride(TTD) staining and hematoxylin eosin staining were performed. Result: 1. Survival rate in group II was significantly higher than that in group I (P<0.05), and survival rate in group III was signficantly higher than that in group II(53% vs 93%, P<0.01). 2. There were significant differences in the ratio of area of necrosis to area at risk between group I and group II, and between group II and group III (P<0.01). 3. Microangiogram for angiogenic response revealed wide area of extensive revascularization with patent vessels in group III. 4. Histologic findings of three groups showed that polymorphonuclear leukocyte infiltration was minimal in group II and none in group III. Conclusion: PDGF-BB can establish functinal cardiac revasculatization through systemic vessels implanted directly into the myocardium.

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Morphological and Anatomical Evaluation of Grafted Pinus merkusii

  • Susilowati, Arida;Iswanto, Apri Heri;Wahyudi, Imam;Supriyanto, Supriyanto;Siregar, Iskandar Z
    • Journal of the Korean Wood Science and Technology
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    • v.44 no.6
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    • pp.903-912
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    • 2016
  • Morphological and anatomical evaluation of grafted P. merkusii have been undertaken to obtain the information about compatible and incompatible symptoms of 18 years old grafts based on morphological observation and microscopic analysis. Samples of compatible and incompatible grafts were obtained from previous research conducted by the Silviculture Departement Team in 1994. Result showed that compatible grafts have normal stem form and secondary growth (diameter growth), but some abnormality symptoms like undulated pattern of annual growth rings, phloem thickening and abnormality resin ducts in inner and middle parts of the union area occurred. Incompatible ones showed abnormality of the stem form, cortex-bark necrosis and swelling in the union area. Microscopic observation showed abnormality of all parts of the union, undulated pattern of annual growth rings, phloem thickening, abnormal resin ducts, low numbers and discontinuity of vascular elements in the union area.

Bypass Surgery in Arterial Thoracic Outlet Syndrome

  • Bae, Miju;Lee, Chung Won;Chung, Sung Woon;Choi, Jinseok;Kim, Min Su
    • Journal of Chest Surgery
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    • v.48 no.2
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    • pp.146-150
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    • 2015
  • Arterial thoracic outlet syndrome (TOS) causes ischemic symptoms; it is the rarest type, occurring in 5% of all TOS cases. This paper is a case report of a 38-year-old male patient diagnosed with arterial TOS, displaying symptoms of acute critical limb ischemia caused by thromboembolism. Brachial artery of the patient has been diffusely damaged by repeated occurrence of thromboembolism. It was thought to be not enough only decompression of subclavian artery to relieve the symptoms of hand ischemia; therefore, bypass surgery using reversed great saphenous vein was performed.

A Case of Aneurysmal Bone Cyst on the Thoracic Spine - A Case Report - (흉추에 발생한 동맥류성 골낭종 - 증례보고 -)

  • Hong, Chang Ki;Hyun, Dong Keun;Park, Chong Oon;Ha, Young Soo
    • Journal of Korean Neurosurgical Society
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    • v.29 no.5
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    • pp.675-679
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    • 2000
  • Aneurysmal bone cyst is a benign, highly vascular bony lesion of unknown origin that may present difficult diagnostic and therapeutic problems. It is usually located on long bones, but rarely on the spine. The lesion is usually treated successfully by curettage and bone grafting when it involves bones of the extremities, but there are special considerations in the management of the lesion when located on the spine. We report a case of aneurysmal bone cyst in on the 8th thoracic spine treated with surgical treatment.

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Treatment of Systemic Inflammatory Response Syndrome (SIRS) Following Open Heart Surgery Developed into Shock - A case report- (쇼크로 이행한 체외순환 후의 전신성 염증반응 증후군 치험 -1예 보고-)

  • 이동석;신윤철;김응중;지현근
    • Journal of Chest Surgery
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    • v.37 no.11
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    • pp.922-924
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    • 2004
  • A 55 year old male was admitted for dyspnea. The patient was diagnosed as acute myocardiac infarction, and coronary artery bypass grafting was performed with cardiopulmonary bypass. At postoperative day #1, Systemic Inflammatory Response Syndrome was developed with fever, leukocytosis, tachycardia, tachypnea and low systemic vascular resistance. The patient was recovered after being treated with high dose of (36 $\mug/min)$ norepinephrine, and was discharged.

Florida Sleeve Repair for Aortic Root Aneurysm

  • Kim, Dong Hee;Kim, Kwan Sic;Kim, Joon Bum;Lee, Jae Won
    • Journal of Chest Surgery
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    • v.46 no.5
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    • pp.353-356
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    • 2013
  • A 74-year-old man was diagnosed with aortic root aneurysm and two-vessel coronary disease. Echocardiographic assessment revealed an enlarged sinus of Valsalva 60 mm in diameter with mild aortic regurgitation. Florida sleeve repair was performed using a vascular graft combined with coronary artery bypass grafting. The postoperative course was uncomplicated and follow-up echocardiographic evaluations showed an aortic root diameter of 38 mm without aortic insufficiency up to 1 year after surgery.

Initial Experience with Epicardial Ultrasound Scanning in Coronary Artery Bypass Grafting

  • Kim, Dae Hyeon;Sohn, Suk Ho;Hwang, Ho Young
    • Journal of Chest Surgery
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    • v.53 no.5
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    • pp.263-269
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    • 2020
  • Background: The benefits of epicardial ultrasound scanning (EUS) in coronary artery bypass grafting (CABG) have not yet been established. The aim of this study was to evaluate the usefulness of EUS in CABG, including in the assessment of the quality of distal anastomoses, the identification of epicardial target vessels, and the evaluation of any graft issues other than the distal anastomoses. Methods: Fifty-three patients undergoing CABG were enrolled between March 2018 and February 2019. Intraoperative EUS was performed along with transit-time flow measurement (TTFM). Graft evaluations were performed early (shortly after surgery) and 1 year after surgery for 53 (100%) and 47 (88.7%) patients, respectively. Results: EUS was applied to assess the quality of all distal anastomoses, 32 target vessels, and 2 conduit trunks. Insufficient TTFM findings were obtained for 18 grafts. However, graft revision was performed for only 3 distal anastomoses; based on the EUS findings, the remaining 15 sites were not revised. The early and 1-year overall graft patency rates were 100% (141 anastomoses) and 96.1% (122 of 127 anastomoses), respectively. All 15 of the distal anastomoses that were not revised despite insufficient TTFM results were patent at the 1-year mark. Conclusion: The routine application of EUS in CABG could be beneficial by confirming the quality of surgery and reducing unnecessary procedures.

Peripheral Arterial Bypass using Interpositional Vein Graft in the Hypothenar Hammer Syndrome: A Case Report (소지구 망치증후군에서 정맥이식을 이용한 동맥우회술: 증례 보고)

  • Kim, Jeong Hong;Eun, Seok Chan;Heo, Chan Yeong;Baek, Rong Min;Minn, Kyung Won
    • Archives of Plastic Surgery
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    • v.36 no.1
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    • pp.89-92
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    • 2009
  • Purpose: The clinical syndrome of unilateral finger ischemia, caused by digital artery occlusions from embolization from the palmar ulnar artery associated with repetitive striking of the palm, has been called the hypothenar hammer syndrome (HHS). We report the case of a man with this unique disease probably caused by manual work. Methods: A 52 - year - old male left - hand dominant manual worker complained of pain and coldness in the left 4,5th finger. On physical examination, there was a tip necrosis and the result of Allen's test was mildly positive(sluggish filling of hand from the ulnar artery). Arteriograms confirmed occlusion of the distal ulnar artery without direct perfusion of the superficial palmar arch and distal digital artery. Surgical bypass with reverse autologous vein grafting was performed between ulnar artery and superficial palmar arch, common digital artery. Results: He had an uneventful postoperative course and has remained asymptomatic for 18 months since discharge. Patency has been confirmed by color doppler with resolution of cold intolerance and successful digital preservation. Conclusion: We introduce very unique pattern of vascular ischemic disease and recommend the arterial bypass with vein interpositional grafting.