• Title/Summary/Keyword: arteriovenous fistula

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A Clinical Study of Vascular Surgery: 108 cases (혈관수술 108례에 관한 임상적 고찰)

  • 김근호
    • Journal of Chest Surgery
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    • v.12 no.4
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    • pp.371-378
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    • 1979
  • The authors have performed operations on vascular system of 108 cases from 1972 through 1979, and analyzed the diseases, surgical procedures and results. They were 1. Arterial system; 45 cases P.D.A. : 20 Occlusive diseases : 13 Coarctation of aorta : 4 Aneurysm : 4 A-V fistula : 2 Trauma : 2 2. Venous system; 6 cases Esophageal varix : 4 S.V.C. syndrome : 1 Varicose vein : 1 3. Arteriovenous shunt for hemodialysis; 57 cases Of the arterial diseases, the worst results came from Burger`s disease. For the bleeding esophageal varices, we have performed ligations of varices or collateral circulations rather than emergency splenorenal shunt with good results. External A-V shunt for hemodialysis had much more complications than the A-V fistula.

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Changes of the Renal Arteries According to Various Embolic Materials (다양한 색전물질에 의한 신동맥의 변화)

  • Cho, Jae-Ho;Cho, Kil-Ho;Chang, Jae-Chun;Park, Bok-Hwan;Kim, Dong-Sug
    • Journal of Yeungnam Medical Science
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    • v.12 no.1
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    • pp.96-104
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    • 1995
  • The transarterial embolization has been widely used to control bleeding. It has a variety of clinical utility; to reduce bleeding on the surgical field, to reduce the size of malignant tumor as a preopearative treatment, to treat arteriovenous malformation or arterial aneurysm as a curative method and to promote life quality of patient with diffuse or multiple hepatocellular carcinoma as a palliative treatment, etc. With the advance of modem technology, various embolic materials have been also developed. However, it has not been fully investigated of histopathologic changes of the embolized organs according to the embolic materials used. This study was undertaken to investigate the histopathologic changes of embolized renal artery in rabbit by various embolic materials, according to each embolic material and to time passed by after embolization. Of the 5 arteries embolized by ethylene vinyl alcohol copolymer(EVAL), one showed abscess formation in embolized kidney. The other 4 allowed to perform further pathologic study: within a week after embolization there was no any specific change in vessels, however, minimal endothelial hypertrophy was observed following 2 weeks of embolization. Of the 8 renal arteries embolized by N-buthyl-2-cyanoacrylate(Histoacryl), 4 showed total occlusion of the main renal arteries as well as renal infarction, which reflects the strong adhesiveness of Histoacryl to vascular wall. The other 4 showed fibrinoid degeneration in vascular wall within a week. However, further change was not observed thereafter. In all the 5 renal arteries embolized by polyvinyl alcohol(Ivalon), there were infiltration of inflammatory cells along the vessel walls, within one week, which represents vasculitis. They showed some fibrosis with appearance of giant cells in the vessel wall two weeks after embolization and also showed marked fibrosis of connective tissues surrounding vessels two months after embolization, respectively. The results suggest that EVAL is useful for the embolization of hypervascular lesion with limited arteriovenous fistula, Histoacryl for the curative treatment of the lesion with high blood flow or severe arteriovenous fistula, and Ivalan for palliative treatment of malignant tumor or arteriovenous malformation, respectively.

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Surgical Repair of Aortocaval Fistula Presenting with Cardiogenic Shock

  • Kim, In Ha;Min, Ho-Ki;Kim, Ji Yong;Kim, Dong-Kie;Kang, Do Kyun;Jun, Hee Jae;Hwang, Youn-Ho
    • Journal of Chest Surgery
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    • v.51 no.6
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    • pp.406-409
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    • 2018
  • Aortocaval fistula (ACF) occurs in <1% of all abdominal aortic aneurysms (AAAs), and in 3% to 7% of all ruptured AAAs. The triad of clinical findings of AAA with ACF are abdominal pain, abdominal machinery bruit, and a pulsating abdominal mass. Other findings include pelvic venous hypertension (hematuria, oliguria, scrotal edema), lower-limb edema with or without arterial insufficiency or venous thrombus, shock, congestive heart failure, and cardiac arrest. Surgery is the main treatment modality. We report successful surgical treatment in a patient with a ruptured AAA with ACF who presented with cardiogenic shock.

Flow Visualization of Arteriovenous Grafting Using PIV Technique (PIV 기법을 이용한 동정맥루 문합에 대한 유동가시화)

  • Jeon, Min-Gyu;Kim, Hyoung-Ho;Suh, Sang-Ho;Choi, Young Ho;Lee, Hyun-Jin;Doh, Deog-Hee
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.37 no.11
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    • pp.985-990
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    • 2013
  • An arteriovenous fistula is artificially produced using a graft for hemodialysis in patients. In an arteriovenous graft (AVG), the angle of its arterial or venous anastomosis play an important role in producing flows inside blood vessels, through which a stenosis may occur. Most studies thus far have focused on CFD results. In this study, a PIV technique is used to analyze the hemodynamic characteristics at the arterial or venous anastomosis of an AVG having an angle of $30^{\circ}C$. For flow dynamic similarity, the Reynolds number is set to be the same for real and simulated flows. A PIV experiment is performed with a control valve in the arterial part. In conclusion, the recirculation flow appeared in the bifurcation area and the total blood velocity changed according to the extent of valve opening.

Transit Time Flowmetry and Vein Size Are Predictive of Arteriovenous Fistula Maturation

  • Kwon, Yelee;Cho, Young Jong;Kang, Pil Je;Cho, Won Chul
    • Journal of Chest Surgery
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    • v.53 no.5
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    • pp.297-300
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    • 2020
  • Background: This study aimed to assess the effect of vessel size and flow characteristics on the maturation of autogenous radiocephalic arteriovenous fistulae (RCAVFs). Methods: We retrospectively reviewed records of patients undergoing RCAVF creation at a single medical center from January 2013 to December 2019. Operative variables were compared between patients whose fistulae matured and those whose fistulae failed to mature. Results: Overall, 152 patients (33 of whom were women) with a mean age of 62.6±13.6 years underwent RCAVF creation; functional maturation was achieved in 123. No statistically significant differences were observed between patients in whom maturation was or was not achieved in terms of the following variables: female sex (20.3% vs. 25.0%), radial artery size (2.5 vs. 2.4 mm), and pulsatility index (0.69 vs. 0.62). Low intraoperative transit time flowmetry (TTF; 150.4 vs. 98.1 mL/min) and small vein size (2.4 vs. 2.0 mm) were associated with failure of maturation. The best cutoff diameter for RCAVF TTF and cephalic vein size were 105 mL/min and 2.45 mm, respectively. Conclusion: In patients who undergo RCAVF creation, vein diameter on preoperative ultrasonography and intraoperative TTF are predictors of functional maturation. We identified an intraoperative TTF cutoff value that can be used for intraoperative decision-making.

The Effect of Far Infrared Heat Therapy on Vascular Access Function of Patients receiving Hemodialysis (원적외선 온열요법이 혈액투석 환자의 혈관통로 기능에 미치는 효과)

  • Choi, Hyang Mi;Choi, Eun Duck;Jang, So Hyeong;Kim, Eun Hee;Choi, Mi Jung;Back, Song Yi;Han, Bok Hee
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.2
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    • pp.215-222
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    • 2015
  • Purpose: For hemodialysis, a vascular access which can maintain a certain speed for a long time is required. The prevention of the vascular access dysfunction is very important to decrease morbidity and to improvethe quality of life of patients receiving hemodialysis It is reported that far infrared heat increases the blood flow by expanding capillaries and micro-arteriovenouses. This study aimed to evaluate the effect of far infrared heat therapy as a new nursing intervention for maintaining vascular access function and improving the blood flow of patients receiving hemodialysis. Methods: The quasi-experimental research of nonequivalent control group pre-post test design was carried out for 59 patients receiving hemodialysis 3 times per week at K medical center. A far infrared heat was applied to the experimental group for 3 months. Results: The arteriovenous fistula blood flow of the experimental group (far infrared heat therapy group) increased significantly when compared to the control group (p=.047). However, static intra-access pressure ratio(SIAPR)was not different statistically (p=.101). Conclusion: The far infrared therapy could be considered as nursing intervention of choice as it demonstrated increase in the arteriovenous fistula blood flow in the patients receiving hemodialysis.

Vein Crossover Bypass Surgery for a Chronic Femoral Vein Ligation -A case report- (만성 대퇴정맥 결찰술 후 정맥 Crossover 우회로 조성술 -1예 보고-)

  • Hong, Joon-Hwa;Cho, Dai-Yun;Choe, Ju-Won;Sohn, Dong-Suep
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.534-537
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    • 2010
  • A twenty six year old man was admitted to our clinic for bleeding from a venous ulcer of the left leg. His left femoral vein had been ligated for bleeding control after a traffic accident that happened when he was 5 years old. He had a varicose vein, stasis dermatitis, and a venous ulcer on his left leg. To shunt left femoral venous return to the right femoral vein, we did a crossover bypass with arteriovenous fistula using the right greater saphenous vein. To get good patency of the arteriovenous fistula, the bypass graft was closed 6 weeks after the initial operation. He maintained his left leg circumference relatively well for 6 months after the operation. We report the case of a patient who had a vein crossover bypass for a chronic femoral vein ligation.

Clinical Analysis of Expanded Polytetrafluoroethylene Graft Fistula for Angioaccess in Hemodialysis (혈액투석을 위한 Exparlded Polytetrafluoroethylene 인조혈관을 이용한 동정맥루조성술의 임상적 관찰)

  • 유재현;김재학
    • Journal of Chest Surgery
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    • v.29 no.8
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    • pp.883-888
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    • 1996
  • Expanded polytertrafluoroethylene (expanded PTFE) graft fistulas are widely used as secondary vascu- lar access for patients receiving long-term hemodialysis treatment. We implanted 48 grafts in )5 patients during the period from August 1990 to August 1995. Forty-three grafts in 32 patients were followed for 1 to 46 months. We performed forearm straight grafts in 36 grafts and upperarm straight grafts in 7 grafts. We experienced 3 operative failures, 22 early and late complications(15 graft thrombosis). Cumulative patency for all grafts at 12 months was 63%, at 24 months 32%, at 36 months 32% Forearm graft survival at 12 months was 55%, at 24 months 30%, at )6 months 30%. Upperarm graft survival at 12 months was 8)oyo and 24 months 41%. After reviewing our experience, we think that expanded-PTFE grart as secondary vascular access still have many complications and low survival than autogenous a teriovenous fistula. And so utilization of the expanded PTFE fistula requires better techniques, close observation and maintenance to keep it functional.

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Transcatheter Embolization of Giant Pulmonary Arteriovenous Malformation with an Amplatzer Vascular Plug II

  • Kong, Joon Hyuk;Oh, Tae Yun;Kim, Jung Tae;Baek, Kang Seok;Chang, Woon-Ha
    • Journal of Chest Surgery
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    • v.45 no.5
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    • pp.326-329
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    • 2012
  • Pulmonary arteriovenous malformation (PAVM) is a rare anomalous direct communication between the pulmonary artery and vein with a considerable risk of serious complications such as cerebral thromboembolism or abscess and pulmonary hemorrhage. Although the past, surgical resection such as lobectomy was mostly used to treat PAVM, the recent development of endovascular treatment has made it a primary consideration to perform transcatheter embolization using coils or detachable balloons. We report a case of successful transcatheter embolization of giant PAVM with the second generation Amplatzer vascular plug II as a new self-expanding device.