• Journal of Korean Neurosurgical Society
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• v.43 no.6
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• pp.288-293
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• 2008

Objective : Bone cement leakage is a well-known potential complication of percutaneous vertebroplasty (PVP) in patients with osteoporotic compression fracture. Even though there has been a controversy in the efficacy of antecedent venography to prevent this complication, many authors have performed intra osseous venography before bone cement injection. The goal of this study was to classify the venous drainage patterns of spine before PVP, and compare their patterns at different vertebral levels. Methods : The authors retrospectively reviewed 1,042 intraosseous venographic patterns in 321 patients with 574 osteoporotic compression fractures during six-year period in one institution. To classify venogram patterns, we selected simple lateral X-ray of spine taken immediately after injection of the contrast dye. We classified the venography patterns according to contrast leakage pattern and leakage direction as follows; trabecular (TR), trabecular anterior (TA), trabecular posterior (TP), trabecular anterior-posterior (TAP), trabecular lateral (TL), venous anterior(VA), venous posterior (VP), venous anterior-posterior (VAP), soft tissue (ST). Also, we compared venogram patterns according to different spinal levels. Results : In overall, the most common pattern was TP type accounting for 37.4% (390/1042) of all intraosseous venograms. This is followed by TAP in 21.5%, TR 17.4%, TA 116%, TL 5.8%, ST 4.1%, VA 1.2%, VP 0.6%, and VAP 0.4% in descending order of frequency. According to the spinal level, TR and TAP types were most common in thoracic spine (T6-T10), TP type was most common in thoraco-Iumbar spine (T11-L2), and TP and TAP types were most common in lumbo-sacral spine (L3-S1). Contrast dye leakage to soft tissue such as psoas muscle or disc were detected in 43 (4.1%) venograms. Direct venous drainage without staining of vertebral body was found in 23 (2.2%) venograms. The 8.3% of thoracic venogram showed direct venous drainage. Thoracic level showed a more tendency of direct venous drainage than other spine levels (p<001). Conclusion : The authors propose a new classification system of intra osseous venography during PVP. The trabecular-posterior (TP) type is most common through all spine, and venous-filling (V) type was most frequent in thoracic spine. Further study would be necessary to elucidate the efficacy of this classification system to prevent bone cement leakage during PVP.

• Journal of Korean Neurosurgical Society
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• v.30 no.10
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• pp.1200-1209
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• 2001

Objective : A thorough understanding of the related venous structure is mandatory for successful removal of the petroclival meningiomas. This study was planned to investigate the guideline for safe ligation and incision of transverse or sigmoid sinuses and the importance of drainage pattern of vein of $Labb{\acute{e}}$ in surgical removal of petroclival meningiomas. Patients and Methods : The authors reviewed the venogram of the consecutive 37 cases of petroclival meningiomas and retrospectively analyzed their surgical findings. The drainage pattern of confluence of Herophili was classified as Type A(confluent & equal on both sides), Type B(confluent & non-dominant on tumor side), Type C(confluent & dominant on tumor side) and Type D(unilateral drainage only) as these findings gave the information on safe ligation and resection of the sinus. Usefulness of intraoperative test clamping of sinus for safe ligation was also reviewed. The vein of $Labb{\acute{e}}$ was analyzed with respect to its draining point and its collaterals to other superficial veins. Results : Contraindications of the sinus ligation and resection according to the drainage pattern at the confluence of Herophili were Type C(n=10, 27%)and Type D(n=4, 11%). Patients with Type A(n=12, 32%)and Type B(n=11, 30%) were tolerable to sinus ligation ipsilateral to tumor, if the test clamping proved to be safe. Identification of no brain swelling, after intraoperative test clamping of the sinus for more than 30 minutes performed in 7 out of 11 cases, was a reliable indicator of safe sinus ligation. The drainage pattern of the vein of $Labb{\acute{e}}$, especially low-lying type, could predict the possibility of postoperative hemorrhage and infarction. Its drainage into tentorium or superior petrosal sinus, however, made the transtentorial approach impossible, leading to restricted operative field. Conclusion : For a successful removal of the petroclival meningiomas preoperative venogram should be examined carefully. The extent of exposure in a planned approach can be estimated by analyzing the variation of sinuses and the drainage pattern of vein of $Labb{\acute{e}}$.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.337-341
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• 1989

A 40-year-old male developed the swelling of the right leg one month after trauma on cycling. Conservative measures to relieve the swelling of the right leg for three months were failed. Venogram showed complete obstruction of the right common iliac vein. Crossover bypass [Palmas operation] with great saphenous vein graft for relief of venous stasis of the right leg was performed. Postoperatively, the swelling of the right leg was subsided and able to walk without edema of the right leg.

• Journal of Korean Neurosurgical Society
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• v.40 no.5
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• pp.377-380
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• 2006

Intradiploic epidermoid cysts of the cranium are rare, benign and slow growing lesion. However, these cysts may cause neurologic deficits due to mass effect. Intradiploic epidermoid cysts are thought to be derived from persistent ectodermal remnants present in the cranial bones during embryogenic development. Here, we report a case of an occipital intradiploic epidermoid cyst with posterior fossa extension. The patient developed intracranial hypertension associated with hydrocephalus due to aqueductal stenosis, and venous congestion secondary to compression of the torcular and the transverse sinus. The imaging studies included a computerized tomography[CT] venogram, which is essential for determining the pathophysiological mechanism of the clinical spectrum and for surgical planning. Near total removal was accomplished and the postoperative course was uneventful. Postoperative imaging studies demonstrated a reversal of the neural structures, but no patency of the sinus, which was presumably indicative of prolonged sinus stenosis. The patient gradually improved and was discharged free of symptoms.

• Archives of Plastic Surgery
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• v.36 no.3
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• pp.336-340
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• 2009

Purpose: The wound of a patient who has chronic venous insufficiency is easy to recur. Also they develop a complication even after the conservative therapy or skin graft. We have to diagnose the venous stasis ulcer correctly and remove the cause to improve the effectiveness of treatment. We operated endoscopic perforating vein ligation and splitt thickness skin graft on a patient with venous stasis ulceration on right leg. Methods: A 26 year old male patient who had a scalding burn on his right leg in July 2005 checked into our hospital in March 2008. Even though he got three operations - the split thickness skin graft - at different clinics, the wound did not heal. The size of the wound was 12 by $8cm^2$ and granulation with edema and fibrosis had been formed. We kept observation on many collateral vessels and perforating vein through venogram and doppler sonography and firmly get to know that the wound came with chronic venous insufficiency. After a debridement and an application of VAC$^{(R)}$ for two weeks, the condition of granulation got better. So we proceeded with the operation using subfascial endoscopic perforating surgery and split thickness skin graft. Results: Through the venogram after the operation, we found out that the collateral vessels had been reduced compared to the previous condition and the widened perforating vein disappeared. During a follow up of 6 months, the patient did not develop recurrent stasis ulcer and postoperative complications. Conclusion: Subfascial endoscopic perforator ligation is relatively simple technique with a low complication rate and recurrence rate. Split thickness skin graft with subfascial endoscopic perforator surgery can be valuable method for treating severe venous stasis ulcers.

• Journal of Yeungnam Medical Science
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• v.29 no.1
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• pp.38-41
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• 2012

Behcet's disease is a rare multisystemic disorder whose main pathological defectis vasculitis, and superior vena cava (SVC) syndrome without thrombosis is a very rare manifestation of the disease. These authors encountered a case of SVC syndrome without thrombosis caused by Behcet's disease. A 33-year-old man visited the hospital for aggravated dyspnea without any related medical and familial history. He had a threeday history of abrupt swelling of the face, neck, and right arm. He suffered from recurrent oral ulcer, and there were acneiform nodules on his face as well as redness and swelling at the site of the intravenous injection. On the multi-detected computed tomography (CT) chest angiograms (chest angio MDCT), the SVC narrowed without thrombosis. Venogram was carried out, and percutaneous transluminal balloon angioplasty of the SVC stenotic site was performed. The following day, the swelling was found to have subsided. The details of the case are reported herein.

• Vascular Specialist International
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• v.34 no.4
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• pp.117-120
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• 2018

The endovascular recanalization of the iliocaval system has replaced venous surgical reconstructions as the primary treatment option in severe post-thrombotic syndrome (PTS). We herein present a 51-year-old female with previous deep venous thrombosis, complicated with PTS with a large and complex circumferential calf ulcer measuring 25 cm of length in the left lower extremity. Venogram revealed a complete and extensive occlusion in the left iliofemoral system. A surgical bypass from the left common femoral vein to the right common iliac vein was performed. Patient recovered well and after 12 months postoperation her large wound is healing favorably with a clean and well granulated bed. Iliofemoral venous bypass is a feasible treatment for non-healing ulcer of lower extremity.

• Tuberculosis and Respiratory Diseases
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• v.47 no.3
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• pp.394-399
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• 1999

We report a case of congenital and familial antithrombin III deficiency developing massive pulmonary thromboembolism. A 44-year-old man was admitted to our hospital because of sudden chest pain and severe dyspnea. Five years ago, he was operated due to a mesenteric vein thrombosis of unknown cause. On admission, radioisotopic venogram showed deep vein thrombosis and lung scintigram showed multiple segmental perfusion defects. His plasma antithrombin III level was 10.5 mg/dL which was less than 50% of normal and those of a son and two daughters were also decreased. After treatment with tissue plasminogen activator, heparin and coumadin, his symptom and lung scintigram were significantly improved. As far as we reviewed, there were very rare reports with congenital antithrombin III deficiency presenting as pulmonary thromboembolism in Korea.

• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1594-1599
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• 2021

A 64-year-old male visited our emergency department due to severe right flank pain after falling from a 2-meter height. Contrast-enhanced CT revealed a right hemothorax with multiple fractures in the right ribs and iliac bone. A small hematoma in the right perihepatic space was noted, but there was no hepatic laceration on CT. Initial surgical management led to continuous uncontrolled bleeding around the porta hepatis, and subsequent arterial angiography could not demonstrate a bleeding focus. However, immediate follow-up CT showed contrast extravasation on the left side of abdomen, and a percutaneous transhepatic portal venogram revealed active bleeding from the left portal vein. Although the wound was embolized with a glue, the patient suffered from a cardiac arrest and finally expired. In conclusion, during evaluation of abdominal trauma patients, portal vein bleeding and contrecoup injuries should be considered when hepatic arteriography findings are unremarkable.