• Journal of Korean Neurosurgical Society
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• v.37 no.3
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• pp.223-227
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• 2005

Systemic multiple aneurysms are rare, and an association between intracranial and visceral arterial or abdominal aortic aneurysm in the same patient is a very rare occurrence. We report herein three such cases. In one case, aneurysms of the right internal carotid artery(ICA) and the right middle cerebral arterial bifurcation(MCAB) coexisted with the inferior pancreaticoduodenal arterial pseudoaneurysm and two ileal arterial aneurysms. In another case, the patient had the A-com arterial aneurysm and the right renal arterial aneurysm. And in the other patient, he had the right vertebral artery dissecting aneurysm with the abdominal aortic aneurym. Initially, all patients were referred to our hospital with subarachnoid hemorrhage(SAH), and thereafter first two patients developed visceral arterial aneurysm rupture in the course of hospital stay and in the last patient, the abdominal aortic aneurysm was detected incidentally during carotid angiogram for Guglielmi detachable coil(GDC) embolization of vertebral dissecting aneurym. After thorough review of our cases together with pertinent literatures, we emphasize the possibility of underlying extracranial aneurysms in ruptured intracranial arterial aneurysm patient and it's uncommon but fatal complication.

• Journal of Chest Surgery
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• v.47 no.6
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• pp.548-551
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• 2014

Type II chronic dissecting thoracoabdominal aortic aneurysms are a surgically challenging disease. The conventional thoracoabdominal aortic aneurysm repair technique using cardiopulmonary bypass is a high-risk procedure. However, a recently developed endovascular technique may be an alternative treatment for the disease, but faces the obstacle of lesional restriction. This new technique uses a hybrid strategy to overcome the limits of endovascular thoracoabdominal aortic aneurysm repair. Herein, we report on a successful outcome after performing the hybrid visceral debranching procedure.

• Journal of Chest Surgery
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• v.27 no.11
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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.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.747-752
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• 2010

Surgical repair of thoracoabdominal aortic aneurysm (TAAA) remains a formidable challenge associated with significant rates of mortality and morbidity, especially in patients with high risk. Use of endovascular stent graff in aortic aneurysm disease is now accepted as an alternative treatment to surgery. But the saving of visceral arteries is the chief obstacle to endovascular repair of TAAA. We successfully treated two patients of TAAA with high risk by hybrid procedure including open visceral debranching and concomitant endovascular aneurysm exclusion.

• Journal of Chest Surgery
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• v.36 no.9
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• pp.695-698
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• 2003

Celiac artery aneurysms are rare, their incidence being reported as only 4％ of all visceral artery aneurysms. Atherosclerosis and medial degenerative changes are recognized main pathogenesis. They are usually asymptomatic and diagnosed incidentally, but the mortality rate of ruptured celiac artery aneurysm is approximately 80％. So one should give an aggressive surgical aid to the patients. We report 2 cases of celiac artery aneurysm which were successfully treated by elective aneurysmorrhaphy and anerysmectomy with aortoceliac bypass graft.

• Journal of Chest Surgery
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• v.46 no.1
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• pp.76-79
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• 2013

Venous aneurysms are uncommon in the lower limb and are more frequently found in the neck and thoracic and visceral veins. However, they have been reported to cause thrombosis, pulmonary thromboembolism, and other related complications. Popliteal venous aneurysms are often undetected because they are usually asymptomatic, but they may cause pulmonary thromboembolic events. We experienced a case of a 44-year-old man who was referred for recurrent pulmonary thromboembolism. He showed no other symptoms or signs except shortness of breath. A popliteal venous aneurysm was diagnosed incidentally because the examinations were performed to detect a deep vein thrombosis in relationship to the patient's history of pulmonary thromboembolism. We report a case of surgical treatment for a popliteal venous aneurysm that was complicated by pulmonary thromboembolism.

• Journal of Chest Surgery
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• v.26 no.6
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• pp.492-495
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• 1993

We experienced one case of surgical treatment of abdominal aortic aneurysm using retroperitoneal approach. The transperitoneal route has been the standard surgical approach for elective and emergency treatment of aneurysmal or occlusive disease. Among its cited advantages for aortic reconstruction are familarity with the exposure, easy access to the infrarenal aorta and iliac vessels, possibility of simultaneous inspection of the intra-abdominal viscera, and speed of opening and closure.Despite the proved versatility of the transperitoneal approach, it is commonly associated with prolonged ileus, increased third space fluid loss, and significant pulmonary complications. The retroperitoneal approach, on the other hand, has many advantages; excellent exposure for the repair of juxtarenal or suprarenal abdominal aortic aneurysms and visceral vessel occlusive disease, fewer postoperative complications, decreased postoperative third-space fluid losses from intraoperative evaporation and ileus, and improved postoperative pulmonary function. Atherosclerosis was most common cause of abdominal aortic aneurysm. Dacron graft[18mm] was replaced successfully.Postoperative course was uneventful and he was discharged in good condition.

• Journal of Chest Surgery
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• v.43 no.2
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• pp.199-203
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• 2010

Infected aortic aneurysms are rare, but the mortality of patients with infected aortic aneurysms remains high. Open surgical procedures are the standard of care for infected aneurysms of aorta, but the surgical results are often disappointing. The risk factors related to the high mortality include aneurysm rupture and a suprarenal aneurysm location. The classic method for treating infected aneurysms has been aneurysm resection, soft tissue debridement, remote arterial reconstruction out of the field of infection and antibiotics. Infected anuerysms located in the suprarenal aorta are highly lethal because of the need to reimplant the visceral or renal arteries and the graft related complications. We reported here on a case of suprarenal infected aortic aneurysm in a 55-years-old man. We also include a review of the relevant medical literature.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.774-777
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• 2010

A 70-year old male with dilated cardiomyopathy was admitted to our hospital because of a renal stone, and a supra-renal abdominal aortic aneurysm was detected during work-up. We performed a hybrid surgery using an endovascular stent because of his co-morbidities. The operation consisted of removal of the renal stone, de-branching of the visceral artery and both renal arteries from the abdominal aorta, reperfusion of the de-branched arteries with retrograde bypass surgery using two Y-graft from the left external iliac artery, and deployment of stent graft in the abdominal aorta. Therefore, we report a case of hybrid surgery for supra-renal abdominal aortic aneurysm.

• Journal of Chest Surgery
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• v.50 no.1
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• pp.1-7
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• 2017

Complex lesions of the thoracic aorta are traditionally treated in 2 surgical steps with the elephant trunk technique. A relatively new approach is the frozen elephant trunk (FET) technique, which potentially allows combined lesions of the thoracic aorta to be treated in a 1-stage procedure combining endovascular treatment with conventional surgery using a hybrid prosthesis. These are very complex and time-consuming operations, and good results can be obtained only if appropriate strategies for myocardial, cerebral, and visceral protection are adopted. However, the FET technique is associated with a non-negligible incidence of spinal cord injury, due to the extensive coverage of the descending aorta with the excessive sacrifice of intercostal arteries. The indications for the FET technique include chronic thoracic aortic dissection, acute or chronic type B dissection when endovascular treatment is contraindicated, chronic aneurysm of the thoracic aorta, and chronic aneurysm of the distal arch. The F ET technique is also indicated in acute type A aortic dissection, especially when the tear is localized in the aortic arch; in cases of distal malperfusion; and in young patients. In light of the great interest in the FET technique, the Vascular Domain of the European Association for cardio-thoracic Surgery published a position paper reporting the current knowledge and the state of the art of the FET technique. Herein, we describe the surgical techniques involved in the FET technique and we report our experience with the F ET technique for the treatment of complex aortic disease of the thoracic aorta.