• Journal of Chest Surgery
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• v.22 no.2
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• pp.325-329
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• 1989

A rare case of aneurysm of the celiac artery due to arteriosclerosis was presented. The patient was 56-year-old female and had suffered from hypertension for 4 years, and recently, from dyspepsia prior to admission for 2 months. The operation was operated upon by interposition of an autogenous tubular saphenous vein graft between the proximal celiac artery and the common opening of the hepatic and the splenic arteries in the opened aneurysmal sac with inclusion technique. The postoperative course was uneventful.

• Journal of the Korean Society of Radiology
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• v.81 no.4
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• pp.933-938
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• 2020

Brachiocephalic venous aneurysm (BVA) development is an extremely rare, particularly as a primary vascular disorder. BVAs may be misinterpreted as lymphadenopathies owing to the variable degrees of enhancement seen in imaging studies, especially among patients with underlying malignancy. We report a BVA that mimicked lymph node metastasis on CT in a 60-year-old female who had undergone subtotal gastrectomy for stomach cancer. After follow-up chest CT with different bolus times and Doppler ultrasonography, a venous aneurysm originating from the brachiocephalic vein was diagnosed. We emphasize that, to make an accurate diagnosis, physicians should be aware of the potential diagnostic pitfalls and have a high index of suspicion for BVA when encountering certain lesions in the cervical area.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.3
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• pp.307-312
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• 2023

Hepatic arterioportal fistulae are abnormal communications between the hepatic artery and portal vein. They are reported to be congenital or acquired secondary to trauma, iatrogenic procedures, hepatic cirrhosis, and hepatocellular carcinoma, but less likely to occur spontaneously. Extrahepatic portal venous obstruction (EHPVO) can lead to pre-hepatic portal hypertension. A spontaneous superimposed hepatic arterioportal fistula can lead to pre-sinusoidal portal hypertension, further exacerbating its physiology. This report describes a young woman with long-standing EHPVO presenting with repeated upper gastrointestinal variceal bleeding and symptomatic hypersplenism. Computed tomography scan demonstrated a cavernous transformation of the portal vein and a macroscopic hepatic arterioportal fistula between the left hepatic artery and portal vein collateral in the central liver. The hepatic arterioportal fistula was associated with a flow-related left hepatic artery aneurysm and a portal venous collateral aneurysm proximal and distal to the fistula, respectively. Endovascular coiling was performed for the hepatic arterioportal fistula, followed by proximal splenorenal shunt procedure. This case illustrates an uncommon association of a spontaneous hepatic arterioportal fistula with EHPVO and the utility of a combined endovascular and surgical approach for managing multifactorial non-cirrhotic portal hypertension in such patients.

• Journal of Korean Neurosurgical Society
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• v.44 no.3
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• pp.170-173
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• 2008

Ventriculoperitoneal (VP) shunt is commonly and effectively used to treat hydrocephalus. Intracardiac migration of the shunt catheter is a rare complication. A 68-year-old woman underwent ventriculoperitoneal shunting for hydrocephalus secondary to subarachnoid hemorrhage due to anterior communicating artery aneurysm rupture. Two weeks after the shunt surgery, she had suffered from the abdominal pain. Plain chest x-rays, computed tomography, and echocardiography revealed the distal catheter which was in the right ventricle of the heart. We tried to remove the catheter through the internal jugular vein by fluoroscopic guidance. But, the distal catheter was kinked and knotted; therefore, we failed to withdraw the catheter. After then, we punctured the right femoral vein and pulled down the multi-knotted shunt catheter to the femoral vein using the snare catheter. Finally, we removed the knotted distal catheter via the femoral vein and a new distal catheter was placed into the peritoneal cavity. We report a case in which the distal catheter of the VP shunt migrated into the heart via the internal jugular vein. We emphasize the importance of careful and proper placement of the distal catheter during the tunneling procedure to prevent life-threatening complications.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.4
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• pp.440-446
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• 2023

Craniotomy is known as a cause of iatrogenic dural cerebral arteriovenous fistula (AVF). However, mixed pial and dural AVFs after craniotomy are extremely rare and require accurate diagnosis and prompt treatment due to their aggressiveness. We present a case of an iatrogenic mixed pial and dural AVF diagnosed 2 years after pterional craniotomy for surgical clipping of a ruptured anterior choroidal aneurysm. The lesion was successfully treated using single endovascular procedure of transvenous coil embolization through the engorged vein of Labbe and the superficial middle cerebral vein. The possibility of the AVF formation after the pterional approach should always be kept in mind because it usually occurs at the middle cranial fossa, which frequently has an aggressive nature owing to direct cortical venous or leptomeningeal drainage patterns. This complication is believed to be caused by angiogenetic conditions due to coagulation, retraction, and microinjuries of the perisylvian vessels, and can be prevented by performing careful sylvian dissection according to patient-specific perisylvian venous anatomy.

• Journal of Chest Surgery
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• v.19 no.2
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• pp.288-294
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• 1986

During the period from Mar. 1983 to Feb. 1986, 22 patients with vascular trauma were treated at Capital Armed General Hospital. 1] 11 patients had arterial injury alone, 6 patients had venous injury alone, and 5 patients had both arterial and venous injuries. 2] The mechanism of injury in these 22 patients was 7 penetrating non-gun shot wounds, 5 blast fragments injuries, 4 iatrogenic injuries, 4 blunt injuries, 2 gun shot wounds. 3] The method of 16 arterial repair was 5 autogenous saphenous vein graft, 8 synthetic vascular graft, 1 end to end anastomosis, 2 lateral suture. Midterm patency of 16 repairs was 100% within 1 months. 4] The method of 11 venous repair was 1 autogenous saphenous vein graft, 2 onlay vein patch, 2 ligation, 1 lateral suture. The thrombotic obstructions occurred in 4 repairs [36.4%], but they were resolved somewhat with heparinization. 5] Uncommon cases of false aneurysm of internal carotid artery and laceration of retrohepatic inferior vena cava were summarized.

• Journal of Chest Surgery
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• v.53 no.6
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• pp.417-419
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• 2020

Surgeons avoid creating arteriovenous fistulae in obese patients owing to deep vessels, cannulation complications, and inconsistent outcomes. We describe placing an arteriovenous polytetrafluoroethylene (PTFE) graft between the brachial artery and axillary vein to avoid these complications. A 39-year-old super-obese woman with end-stage renal disease had undergone several hemodialysis access procedures on both arms. We traced the course of the arteriovenous graft course with the patient sitting and lying down. The ideal course was more accurate with the patient sitting; thus, the patient sat when the course was drawn, before lying on the operating bed. The PTFE graft was placed between the right brachial artery and axillary vein, according to the course in the opposite arm. No anastomotic dehiscence or pseudoaneurysm has taken place during 2 years of follow-up. In super-obese patients, the ideal course for arteriovenous grafts should be drawn while they are sitting, avoiding skin folds. This tip could avoid anastomotic dehiscence and pseudoaneurysm between the axillary vein and a PTFE graft.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.128-132
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• 2001

Aneurysm of the basilar artery trunk are rare and the surgical approach is very difficult because of the complexity of surgical anatomy around the basilar trunk and the vulnerable adjacent neurovascular structures. The development of brain CT and MRI makes the accurate diagnosis and produces the improvement of surgical approaches at the lesion of the skull base. One of the surgical approaches of basilar trunk aneurysms, the retrolabyrinthine presigmoid transtentorial transpetrosal approach to the aneurysm of the basilar trunk has some advantages of minimal retraction of cerebellum and temporal lobe, intact auditory and facial nerve function by the preservation of the vestibulocochlear and facial nerves, a preservation of sigmoid sinus and vein of Labbe and a relatively good operation field. We had a good result with this approach for the patient of basilar trunk aneurysm and reported the case with the review of literatures.

• Archives of Plastic Surgery
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• v.49 no.6
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• pp.755-759
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• 2022

Brachial artery aneurysms are rare diseases that may be caused by infection or trauma. We report a case of a 71-year-old man who presented with a mass in his right antecubital fossa that increased in size slowly over time. Three years ago, the patient underwent ascending and total-arch replacement with artificial vessel graft to treat aortic root and ascending aorta aneurysm. Preoperative physical examination of right upper extremity showed a nonpulsatile mass with normal pulse of axillary, brachial, and radial arteries. The mass was removed and brachial artery reconstruction was done initially using saphenous vein graft. Two months later, the patient revisited with recurrent pseudoaneurysm, involving the bifurcation point of brachial artery. Aneurysm was totally resected and the brachial artery was reconstructed by interposition graft using a bifurcated GORE-TEX artificial vessel graft. The patient healed without complication and no recurrence was observed. Artificial vessel graft is an available option for reconstruction, and revascularization of vessel defect after excision of brachial artery aneurysm may involve bifurcation point.

• The Korean Journal of Nuclear Medicine
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• v.23 no.1
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• pp.89-93
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• 1989

Single pass radionuclide cardiac angiography was performed in 67-year old woman due to dyspnea and chest discomfort. The study showed markedly dilated ascending aorta and collateral ciculations from left sudclavian vein, and confirmed aortic aneurysm with partial obstruction of superior vena cava.