• Journal of Korean Neurosurgical Society
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• v.59 no.4
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• pp.400-404
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• 2016

We report a case of acute ischemic stroke involving both the anterior and posterior circulation associated with a persistent primitive trigeminal artery (PPTA), treated by endovascular revascularization for acute basilar artery (BA) occlusion via the PPTA. An otherwise healthy 67-year-old man experienced sudden loss of consciousness and quadriplegia. Magnetic resonance imaging showed an extensive acute infarction in the right cerebral hemisphere, and magnetic resonance angiography showed occlusion of the right middle cerebral artery (MCA) and BA. Because the volume of infarction in the territory of the right MCA was extensive, we judged the use of intravenous tissue plasminogen activator to be contraindicated. Cerebral angiography revealed hypoplasia of both vertebral arteries and the presence of a PPTA from the right internal carotid artery. A microcatheter was introduced into the BA via the PPTA and revascularization was successfully performed using a Merci Retriever with adjuvant low-dose intraarterial urokinase. After treatment, his consciousness level and right motor weakness improved. Although persistent carotid-vertebrobasilar anastomoses such as a PPTA are relatively rare vascular anomalies, if the persistent primitive artery is present, it can be an access route for mechanical thrombectomy for acute ischemic stroke.

• Journal of Chest Surgery
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• v.26 no.12
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• pp.926-933
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• 1993

We experienced 20 patients with Takayasu`s disease who required 22 surgical procedures for critical arterial stenoses, aneurym of descending thoracic aorta, and aortic regurgitation from 1986 to 1993.Five patients had type I arteritis, seven patients had type II , seven patients had type III, and one patients had type IV.15 patients were female and 5 patients were male.Patients` ages ranged from 17 to 47 years and mean age was 29.1 years. The surgical procedures were as follows;autotransplantations of kidney[3], aortic valve replacements[2], ascending aorta-bilateral internal carotid artery bypasses[2], unilateral renal artery bypasses[2], bilateral renal artery bypasses[3], replacement of descending thoracic aorta[1], ascending aorta-abdominal aorta bypass[1], ascending aorta-right internal carotid artery bypass[1], ascending aorta-right internal carotid artery and left subclavian artery bypass[1], left common carotid artery-left-subclavian artery bypass[1], pulmonary artery angioplasty[1], left femoro-bilateral axillary bypass[1] and others[2]. There was no hospital death.Mean duration of follow-up was 42.7 months[ranged from 3 to 96 months].There was one late death and late mortality rate is 5.9%.Two patients was underwent second vascular procedures, one after 5 years and the other after 5 months.The other patients have done well after surgery.

• Archives of Reconstructive Microsurgery
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• v.11 no.2
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• pp.135-140
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• 2002

It has been known that latissimus dorsi(LD) myocutaneous flap based on thoracodorsal artery is one of most useful method for microreconstructive surgery and the thoracodorsal artery of this flap has constant vascular anatomy. The retrospective study for anatomy of the thoracodorsal arterial system was performed at operative cases. The aim of this study was to document the anatomical variation of this pedicle clinically. 167 LD flaps were carried out from 1983 to 2002 in our clinic. We found unusual 7(4.2%) cases compared to standard textbooks of anatomy. One case was no vascular supply to LD muscle. In 2(1.2%) cases thoracodorsal artery was a typical branch of the subscapular artery but didn't branch to LD muscle, passed to lower serratus anterior muscle, and at this point, supplied vessel to LD muscle and it's vascular diameter was about 1mm diameter. The thoracodorsal artery arose from the axillary artery in 1.8% of cases(3 cases). One case had less than 1mm vascular diameter but a branch of subscapluar artery. It should be emphasized that we must elevate the latissimus dorsi flap after accurate cognition for the anatomy of thoracodorsal artery because the thoracodorsal arterial system is almost reliable but not uniform in rare cases.

• Journal of Chest Surgery
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• v.32 no.10
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• pp.891-896
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• 1999

Increasing interest in the use of arterial conduites is based on the better patency of the internal thoracic artery(ITA) than the saphenous vein graft and the hope that other arterial conuits will perform similarly over the long term. Material and Method: Between May 1997 and July 1998, 43 patients underwent coronary artery bypass grafting with ITA and the radial artery(RA). There were 28 men and 15 women with a mean age of 61.5 years(range, 35 to 78). In 43 patents, 30 bilateral ITA(including 7 diabetes mellitus, 5 more older 70 years), 8 bilateral ITA only, 2 left ITA and both RA, 11 left ITA and left RA and 22 both ITA and left RA were used. Result: There was 1 hospital mortality. Of the 42 patients alive, 39 patients are asymptomatic. Postoperative complications were postoperative bleeding in 1 patients, and low cardiac output syndrome in 3. Follow-up angiography was performed in 5 patients after the operation(mean 3 months), and all ITA & RA grafts showed excellent results. Conclusion: We conclude that complete arterial revascularization with internal thoracic artery and radial artery is technically feasiale with low mortality and morbidity, and but long term follow-up is needed.

• Journal of Chest Surgery
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• v.49 no.5
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• pp.383-386
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• 2016

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is an extremely rare, potentially fatal, congenital anomaly with a high mortality rate in the first year of life. It occurs rarely in adulthood and may appear with malignant ventricular arrhythmia or sudden death. We report a case of a 49-year-old woman with ALCAPA who presented with dyspnea on exertion. Management was coronary artery bypass grafting to the left anterior descending artery and obtuse marginal arteries, closure of the left main coronary artery ostium, and reestablishment of the dual coronary artery system.

• Archives of Plastic Surgery
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• v.49 no.1
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• pp.80-85
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• 2022

The instep flap and medialis pedis flap are both originate based on the medial plantar artery. The medialis pedis flap is based from the deep branch and the instep flap is based from the superficial branch. To increase the axial rotation, it is acceptable to ligate the lateral plantar artery. However, this can partially affect the blood supply of the plantar metatarsal arch. We restored the blood flow with a vein graft between the posterior tibial artery and the ligated stump. From 2012 to 2020, 12 cases of heel reconstruction, including seven instep flaps and five medialis pedis flaps, were performed with ligation of the lateral plantar artery. The stump of the lateral plantar artery was restored with a vein graft and between the posterior tibial artery and the ligated stump. Patients were followed for 18 months. Long-term results showed the vascular restoration of the lateral plantar artery remained patent demonstrated by doppler ultrasonography. Restoring blood flow to the lateral plantar artery maintains good blood supply to the toes. If the patient in the future develops a chronic degenerative disease, with microvascular complications, bypass surgery can still be performed because of the patency of both branches.

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.283-288
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• 2008

Purpose: The purpose of this study is to evaluate the transverse cervical artery of those who received preoperative radiotherapy or radical neck dissection and those who are unable to utilize the branch of external carotid artery system, which are most commonly used as recipient artery in head and neck reconstruction. Methods: 10 patients were selected as head and neck cancer candidates for study. 8 patients received radical neck dissection or modified radical neck dissection and 3 patients underwent preoperative radiotheraphy. In call cases, reconstruction using free flap was performed with transverse cervical artery as recipient artery and posterolateral cervical vein or transverse cervical vein as recipient vein. Results: Partial necrosis of flap due to wound infection was noted in one case and successful microsurgery was achieved in all other cases. The average pedicle length was 9.3 cm and all arteries underwent end to-end anastomosis. In 7 patients, posterolateral cervical vein was used as recipient artery and transverse cervical vein was utilized in 3 patients. Conclusion: In cases where recipient artery from external carotid system cannot be utilized due to preoperative radiotherapy or radical neck dissection, the transverse cervical artery can be an alternative option of choice. Due to diverse variations of transverse cervical vein as a recipient vein, the posterolateral cervical vein may be considered in such cases.

• Journal of Veterinary Clinics
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• v.17 no.1
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• pp.194-204
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• 2000

Echocardiography was performed to obtain the optimal planes for diagnosis of canine heartworm disease in 11 dogs. Imaging planes were taken the left ventricular outflow tract long-axis view, 4-chamber long-axis view, chordae tendineae level short-axis view and modified pulmonary arteries level short-axis view in the right parasternal window, and aptical 4-chamber long-axis view in hte left parasternal window. After echocaridography, the pulmonary artery valve pat was ligated with double 1-0 silk under the general anesthesia to prevent heartworm moving from pulmonary artery to right ventricle. The dogs were euthanized and examained for heartworms in heart and great vessels. Many adult heartworms were identified ultrasonographically within main pulmonary artery, bifurcation of pulmonary artery and right pulmonary artery, but not identified within right ventricle and atrium. At necropsy, adult heartworms were mainly found in pulmonary artery in 11 days, and also found in right ventricular outflow tract and right ventricle in 2 of 11 dogs. The modified pulmonary arteries level short-axis view was the best imaging plane for identifiying heartworms because the main pulmonary artery, branches of pulmonary artery and right pulmonary artery could be showed. The aortic root internal dimension (AOID) and right pulmonary atery internal dimension (RPAID) were measured from the modified pulmonary ateries level short-axis view and left ventricular outflow tract long-axis view. The RPAID and RPAID/AOID was higher in heartworm infected dogs than normal Korea Jin-do dogs in modified pulmonary arteries level short-axis view, and the AOID, RPAID and RPIAID/AOID was higher than in left ventricular outflow tract long-axis view, respectively. These results indicate that the pulmonary arteries were the major habitat of adult heartworm in canine heartworm disease and the modified pulmonary arteries level short-axis view was the best imaging planes for identifying heartworms because the main pulmonary arteries could be showed. Therefore the modified pulmonary arteries level short-axis view can be used for diagnosing heartworm disease and for monitoring dilation of pulmonary artery.

• Korean Journal of Psychosomatic Medicine
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• v.6 no.2
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• pp.126-135
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• 1998

The object of this study was to investigate the relationship between stress and the extent of coronary artery stenosis in 101 patients with coronary artery diseases. Global assessment of recent stress(GARS) scale and perceived stress response inventory were used to measure perception for stressors and stress responses. Biological variables such as the extent of coronary artery stenosis, the number of the affected lesions on coronary angiography, serum Low Density Lipoprotein(LDL)-cholesterol, High Density Lipoprotein(HDL)-cholesterol, and total cholesterol were measured in all the subjects. Scores of perceived stress related to changes in relationship and overall global scores on GARS scale had significantly positive correlation with the extent of coronary artery stenosis. On the other hand, scores of percieved stress related to changes in relationship and changes or no changes in routine had significantly positive correlation with the number of the lesions. Scores of perceived stress related to change or no change in routine also positively correlated with serum level of LDL-cholesterol and total cholesterol. In contrast, general somatic symptoms negatively correlated with the extent of coronary artery stenosis. Impulsive-aggressive behavior negatively correlated with the number of the lesions. However, impulsive-aggressive thinking positively correlated with LDL-cholesterol. The above results suggest that perception for stressors may negatively affect the extent of coronary artery stenosis, the number of the lesions, serum LDL-cholesterol and total cholesterol. However, some stress responses showed inconsistent effect on the above biological variables. Thus, strategies designed to modify perception for stressors and some stress responses are likely to help the patients minimize the extent of coronary artery stenosis and prevent the diseases.

• Journal of Chest Surgery
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• v.43 no.3
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• pp.296-299
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• 2010

A right coronary artery to left ventricular fistula with a giant right coronary artery aneurysm is a very rare condition. This requires surgical treatment because of the possibility of rupture of aneurysm, heart failure and infective endocarditis. A 47 years old male patient with dyspnea on exertion for 3 months was diagnosed as having a right coronary artery to left ventricular fistula with a giant right coronary artery aneurysm according to the CT and coronary artery angiography. We resected the aneurysm and performed a coronary artery bypass graft.